The Speech Language Pathologist-Teacher Tango

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Because of my interest in the language-literacy nexus and school success, I was very interested to read the following in a recent post on the Speech Language Literacy Lab blog: 

Service delivery models have changed substantially over the last few years. While small pull-out groups are appropriate in many situations, keeping students in their classrooms is more of a priority than it has been in the past. As SLPs, we are often told by administrators that we should be "pushing-in" to general education, and providing services in the classroom. 

This post called to mind some thought-provoking conversations I had with various UK colleagues during my recent visit there. Professor Courtenay Norbury (Royal Holloway, London) was lamenting the fact that Speech Language Therapists in the UK are increasingly providing a secondary consultation service to teachers and classrooms, spending very little time working 1:1 with those children whose poor language skills pose serious and imminent threats to school success, both academically and socially. Courtenay and I discussed the fact that classrooms are educational, not therapeutic environments, and teachers (or indeed teaching assistants) cannot be expected to provide the kinds of specialised, individually-tailored intervention that children with significant language difficulties need, in order for them to engage with the curriculum and form social connections with peers. If SLTs (SLPs in Australia and the USA) are operating more at Tier 1 in a Response to Intervention (RTI) framework, with occasional Tier 2 work and virtually no Tier 3 interventions, this has serious implications for (a) the extent to which such children have their educational trajectories altered, and (b) the development and maintenance of professional SLP skills in ameliorating complex expressive and receptive language disorders in young children. Courtenay observed that a consultation-only model is a sure-fire route to redundancy of the specialist knowledge and skills that sit within the SLP profession.

Some commentators have referred to SLPs providing their 1:1 services to children in "homeopathic doses" -  a charge that most clinicians would recoil from, yet it is hard to argue the other corner if a sufficient intervention frequency and intensity cannot be demonstrated. It will also be difficult to establish the efficacy of SLP interventions if they are conducted in ways that promote classic Type II errors, if not statistically, then certainly in the minds of administrators and policy makers. Remember the dinosaurs?

The other conversation that stands out for me in relation to SLPs and teachers working together on the issue of early literacy instruction is the one I had with Professor Bill Wells at the University of Sheffield. When I commented during a presentation that teachers have, in recent years, received uneven pre-service preparation on the linguistic basis of the transition to literacy, Bill rightly asked me whether I thought SLPs learn enough about how reading should be taught during their pre-service education. While I can't call on any empirical data to answer this question, my guess is that an audit of SLP curricula would reveal similar gaps and unevenness to that which has been reported in teaching curricula concerning linguistic precursors to reading.

So - if we are wanting SLPs and teachers to meet in the middle, then it really will take two to tango.

Dancing Tango

Faculties of Education need to ramp up their curricula with respect to linguistic precursors to literacy (vocab., phonemic awareness, narratives, syntactic complexity and so on) and Speech Language Pathology curricula are going to need to cover historical, epistemological, and pedagogical approaches to reading instruction. If this isn't done, too much time will be lost in trying to deal with turf issues and find a common language between professions. If it is done, however, the children who really need them might have better chances of receiving those Tier 2 and 3 services that genuinely impact on their language, academic, and social struggles.

I am absolutely all for SLPs and teachers working collaboratively at Tier 1, sharing knowledge, both of theory and of individual children. At Tiers 2 and 3, however, SLPs need to be able to offer targetted services to children whose language needs will never be met in the context of the mainstream classroom. Advocacy for this needs to come both from the education sector and from SLP/SLT peak bodies. Failure to do so will "dumb down" the skill-base of the SLP profession and will entrench developmental disadvantage for those children whose language skills are not adequate to meet the rapidly changing academic and social demands of the classroom.

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