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.