September 22, 2009 Features

Leading Change With the Workload Approach

The 2009 ASHA Schools Conference became an incubator for systems change through an inaugural workload implementation practicum. The day-long workshop held during the conference was the first of its kind and brought together 28 speech-language pathologists who drafted plans to implement this model in school districts across the nation.

Participants represented diverse experiences: urban and rural districts, supervisors and new clinicians, those implementing the approach and those planning to teach the approach. All participants realized that the traditional caseload service delivery model was not working. They were committed to using scheduling options and service delivery models that recognize the full range of services that SLPs provide—both direct services to students and indirect services that support individualized education programs (IEPs).

For some participants, economic pressures and increasing caseloads make workload an idea whose time has come. "SLPs in our district provide support for 85 schools," said Lisa Keane, of Ft. Lauderdale, Fla. "Caseloads are high, time is short, and money is tight."

Participant Mandi Leigh Watson of Winston-Salem, N.C., sought to increase the effectiveness of services. "I was delivering services to students on my caseload twice a week for 30 minutes and that was not efficient," she said.

Other participants understood that workload implementation is crucial to response-to-intervention (RTI). Barbara Slingerland in Rockwell, N.C., said, "There's no way to do a caseload approach with RTI."

Workload also is a tool to manage complex caseloads, said SLP Carol Cooney from the Boston area, who stressed that administrators must be on board with the effort. A former teacher, Cooney said that it is difficult to meet students' needs with a traditional caseload model. "Administrators don't always understand the SLP's role. They think that if you're not with a student, you're not working," she said.

Making a Plan

Presenters Barbara Ehren, Judy Rudebusch, and Ellen Estomin took on the roles of leaders, facilitators, and guides to help participants implement workload through a year-long dynamic learning group. Kimberly McCallister, an SLP in Hanover County, Va., and Susan Trumbo, an SLP in Botetourt County, Va., highlighted their success in implementing the workload model.

Participants began by drafting an action plan to discuss with stakeholders in their district, beginning with a concept familiar to educators—backwards design. This approach begins by envisioning the five-year outcome of the plan. The presenters emphasized that change involves small, sequential, and strategic steps toward yearly outcomes. Every plan will be different, reflecting the circumstances and culture of each school or district and the unique factors that facilitate or inhibit the change process, said Ehren, director of the doctoral program in communication sciences and disorders at the University of Central Florida.

She introduced five key leverage points for workload change: workload advocacy, caseload selection, varied service delivery, schedule flexibility, and IEP development.

For each leverage point, participants used an Innovation Configuration Map, a planning and monitoring tool for school and district reform initiatives. Participants examined several desired outcomes for each leverage point and rated their school or district on a scale from "unacceptable" to "ideal."

A Leadership Role

"Many clinicians across the country know about workload, but two things stall the change process: lack of clarity about change, and lack of leadership that supports change," Ehren said.

Change is difficult for many reasons, Ehren reminded participants. It is a process—not an event—and takes more time than anticipated. "It's important to understand the human side of change, which is difficult and occurs at different rates." Implementing workload should begin with cultivating the support of a particular individual or group.

Participants were encouraged to assume leadership roles as change facilitators—regardless of position or job title—and to change organizational culture by encouraging the people within that organization to change. "Change facilitators influence others to move forward," she said.

Administrator support is essential to success, said Rudebusch, division director for special services in the Irving (Texas) Independent School District. "A supportive principal is an effective agent in mandating change," she said. Gaining this support requires a workload advocacy agenda and background knowledge of federal laws, state regulations, policies and procedures, and evidence-based practice. State funding systems may affect workload implementation and policies might need to be re-interpreted.

State your goals in terms of student outcomes and state and school district priorities, said Estomin, recently retired executive director of the Program for Students with Exceptionalities in the Pittsburgh school district. "Identify arguments that will resonate with others. Identify how you will play a role in raising adequate yearly progress," she said.

Data-Driven Results

Participants were encouraged to have a well-developed plan for pilot implementation of workload, to document outcomes, and to market results. "You must be data-driven," Rudebusch said. "Administrators will look at outcomes, numbers, and budget. With workload, you work with a greater number of students per year, but you are not working with them the whole year."

Throughout the next year, participants will have several one-hour discussions on specific implementation plan topics and connect through a Web-based project collaboration site.

Becky Panganiban, who works in a school district near Cincinnati, Ohio, said that the workshop allowed her to network with colleagues who share the same goals and challenges. "I was confused as how to even begin the process of making a change in my services and even though this workshop didn't have ‘the' answer, it did help me understand how the process begins. We are now equipped to be the ones who bring about changes and who advocate both for the children we serve and for ourselves."

For more information about implementing the workload model or about future practicum workshops at the Schools conference, contact Deb Adamcyzk, MA, CCC-SLP,director of school services, at dadamcyzk@asha.org.

Susan Boswell, assistant managing editor of The ASHA Leader, can be reached at sboswell@asha.org.

cite as: Boswell, S. (2009, September 22). Leading Change With the Workload Approach. The ASHA Leader.

Virginia SLPs Transform Workload

by Kimberly McCallister and Susan Trumbo

On opposite sides of Virginia, speech-language pathologists in Hanover and Botetourt counties have implemented a workload approach to service delivery over the last four years as part of response-to-intervention (RTI). For students, the approach resulted in fewer special education referrals, improved scores on high-stakes testing, and greater participation in general education. For the SLPs, the approach changed the frequency and type of services provided and allowed more time for collaboration with colleagues.

How has flexible scheduling facilitated these results? At Central Academy Middle School (CAMS) in Botetourt County, in the western part of the state, the SLP typically spends three days per week in the building and spends consistent time in content-area classes to collaborate, co-teach, station teach, parallel teach, and/or supplemental teach to address language underpinnings within the framework of the Content Literacy Continuum. During the 2009–2010 school year, the SLP will teach a literacy strategies class that includes students with and without Individual Educational Programs (IEPs) who have specific needs in reading, writing, listening, and speaking. Pullout time is limited, but provided regularly outside of the school day to meet students' needs.

At James River High School in Botetourt County, the schedule varies from that of the middle school. The SLP provides services two days of the week to students with speech/language IEPs. These services are directly related to the curriculum of the students' content-area classes, often within the classroom. Students without speech/language IEPs also realize the benefits of an SLP supplementing instruction in these classes. As at the middle school, pullout services occur outside of the school day.

At Liberty Middle School (LMS) in Hanover County, in the eastern part of the state, the SLP's schedule rotates with the nine-week grading period. Students with IEPs who require consistent pullout services for articulation and fluency receive services at scheduled times that change every nine weeks. This scheduling avoids pulling students from the same class and gives SLPs the flexibility to be available for varied co-teaching and collaboration opportunities. Every nine weeks, the SLP provides specific learning strategy instruction classes to address literacy needs; different groups of at-risk students are identified throughout the year and instructed using the strategy that best meets their needs. In addition, intensive instruction targeting the language underpinnings of reading and writing is provided to students in small groups. In the 2009–2010 school year, the SLP at LMS will co-teach a social/pragmatic skills resource class that will give students in special education the opportunity to interact with general education peers during non-academic activities.

In hopes of replicating this model in other districts, two years of data were analyzed to determine what services were being provided with what frequency. The most recent findings, based on repeated time studies conducted in April 2008 and April 2009, show that approximately 55% of SLP time has been spent in direct services with students, including screenings, evaluations, and therapeutic instruction. Interventions, provided for students both with and without IEPs, are delivered through one-on-one, small-group, and whole-group scenarios. Indirect services comprise 30% of SLP time and include activities such as teacher collaboration and consults, file reviews, documentation, and student-related meetings. An additional 15% of SLP time was spent in activities that were not focused on students, such as school meetings or clerical tasks. However, this time was invaluable in building relationships with colleagues.

The workload and flexible scheduling approach at these schools has evolved over the past four years. SLPs worked their way into classrooms, beginning collaboration with teachers with whom a strong rapport had been developed. However, there is fine line between presenting yourself as the "expert" and being viewed as a "partner." The attitude conveyed by the SLP when approaching teachers was the key to developing successful collaboration and/or co-teaching relationships. Administrator support was also an integral part of implementing a workload approach, and obtaining this support may require endorsement beyond the building level.

As ideal as flexible scheduling sounds, validation through consistent data collection was essential to sustaining a workload approach. The data needed to promote a workload approach may vary according to setting. At CAMS, for instance, data collection focused on the SLP's impact on test scores and referral trends for special education. In 2006–2007, there were 11 referrals for special education with six students found eligible under IDEA. In 2007–2008, seven students were referred with six found eligible; in 2008–2009, only two students were referred and both were determined eligible.

At James River High School data provided information on the correlation between the involvement of SLPs and the number of students with speech-language IEPs who obtained verified credits that affect diploma status as well as students' post-graduation plans. In 2008–2009, 14 students with speech-language IEPs graduated; six received standard diplomas, four received modified standard diplomas, and four received special diplomas. Seven plan to attend community college, four will enroll in additional technical training, and three will be employed in a sheltered environment.

At LMS in Hanover County, information was collected about how SLP involvement may have improved placement in less-restrictive general education settings and increased scores on standardized testing. Self-contained placements at LMS have decreased by 8%, with students divided equally into collaborative and regular-education placements. In a comparable middle school that was not using an RTI and workload approach, the data showed that although adequate yearly progress was achieved, there was a corresponding 10% increase in self-contained placements. In addition, referrals to Child Study at LMS have decreased by 50%.

Communication about successes and challenges as well as SLPs' evolving roles is critical to effective implementation of a workload approach that promotes access to the curriculum for all students. Disseminating this kind of information was a new responsibility, and one that was important in keeping all stakeholders informed about the role of SLP with literacy to promote workload implementation.

Both of the authors initially were skeptical and uncertain about to how this new role would evolve and about the impact of these changes. After having made the transition from a traditional service delivery model to the workload approach, neither of the authors would choose to return to the tradition model. The current approach is not necessarily a finished product, but a process that is a constantly evolving professional journey.

Kimberly McCallister, MS, CCC-SLP, is a speech-language pathologist at Liberty Middle School in Hanover County, Va., and has been a leader in a school-wide literacy initiative as part of the Virginia Content Literacy Continuum (CLC) with the University of Kansas Center for Research on Learning. Contact her at KMcCallister@hcps.us.

Susan Trumbo, MS, is a speech-language pathologist at Central Academy Middle/James River High Schools in Botetourt County, Va., and has participated in the redesign of speech and language services as part of the Virginia CLC with the University of Kansas Center for Research on Learning. Contact her at strumbo@bcps.k12.va.us.



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