For 100 years school speech-language pathologists have relied on the “pull out” direct service model, and educators have gotten used to it.
“Speech therapists” take children from their classrooms and work in the “therapy room” on lessons designed to directly teach basic speech skills. Most educators believe speech therapists work on articulation. Bright colorful materials are used to engage children in practice routines, either one-on-one or in small groups.
Shifting to a case management model, as we suggest, where a variety of things are done to promote learning, is confusing to teachers. Teachers identify with therapists who are “teaching.” The idea of “collaboration” is less supported unless it is started by the school. The same with “consultation.” The idea of problem-solving with a family over the phone is not a work expectation.
Yet we argue here that past expectations have to be overcome to prepare clients for dismissal. The desire to move them along an LRE continuum rather than having them spend their entire program in direct service is consistent with current IDEA trends.
If SLPs are to participate in prevention — pre-service, RTI, early intervention — they must free up time to work with non-disabled children.
SLPs can self advocate for a changing role in special education, and many do successfully. However, without administrative support it is difficult to create sufficient flex time to transition to the broader approach. The long-term practical solution for most SLPs is slow and steady efforts to reduce eligibility errors.
Collaboration should reach the point, ideally, where an SLP using science can recommend dismissing an SLD pupil from special education.
To really do the work of IDEA 2004, with respect to reducing misidentification, supporting progress in the general curriculum, and engaging in prevention programs, SLPs and other related service personnel must work around teachers and administrators who are less attuned to changing times. But the rewards can be great and the effort is necessary to avoid trying to straddle the competing demands of direct service and case management.
Linda Taylor gives this stark assessment of the problems of moving children towards exits: “So, do not underestimate the strength of this black hole, and the power of federal monies – education and Medicaid – to create and sustain the energy force that entraps and holds these children. Do notice how few honest steps are taken to bring about real reform – ones that would actually, and effectively, educate American children in general, and special education students, in particular. The most shocking and inexcusable aspect of the pretense, the mouth-service, given to “accountability,” is the dearth of professionals who actively attempt to get students OUT of Special Education. Few see any value in specifically structuring special education programs towards ‘repairing’ and releasing children; few feel any urge to commend an exiting child; few see the importance of choosing curriculum and methods that would prevent the need for such programs in the first place” (Linda Schrock Taylor).
School Speech Pathology Blog 