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Shifting speech language pathology service delivery in schools

By Pam Waterhouse (she/her), speech language pathologist, Abbotsford

The role of a speech language pathologist (SLP) is to support students in accessing the curriculum by supporting their development of communication, thinking, and social skills. As a school SLP my method of service delivery has evolved along with our provincial curriculum. When I was first employed in BC schools in the 1980s, the medical service delivery model was the standard. SLPs were trained to pull students from class one at a time, often two or three times per week.

Now, as we move toward more inclusive and accepting models of education that value belonging, celebrate differences, and integrate First Peoples Principles of Learning, we are all obligated to make changes to the way we deliver services and supports to students. For SLPs, this means shifting our practice to be more collaborative with our colleagues and focused on student empowerment. While there are still a percentage of students that need one-on-one support from an SLP, there are many benefits to shifting our service delivery to be less isolated and more integrated in the school community.

Thus, you may have noticed your school SLP offering service to schools, families, and students in a different way. Using a consultative model, service delivery may look like meeting with families to learn more about students’ communication difficulties and offering home-based strategies, coming into classrooms to collaborate with teachers, and listening to teachers’ concerns and working together to address them. SLPs can also model strategies and co-plan lessons with teachers, attend school-based team meetings, or offer professional development in groups or one-on-one to teachers.

A benefit of teacher-SLP collaboration is that it ultimately has positive effects on more children than if the SLP is working in isolation with just one or a few children.

In my experience, SLP and teacher expertise typically complement each other well, with SLPs trained in a medical model of learning and teachers trained in an educational model. I realize I have as much to learn from teachers as they have from me.

Research is telling us that many communication difficulties are rooted in neurology, and as such, are not always “fixable.” An example of this is developmental language disorder (DLD). This is a lifelong disorder of unknown origins that affects approximately seven percent of the population. Thus, any teacher may have several students in their classroom that have difficulty with comprehension and/or verbal communication.

Pulling a student from their classroom for therapy sends a non-verbal message that this child will be “fixed” and catch up, a precept that can discourage the teacher, the family, and, most of all, the student. Rather than being pulled out of the classroom to work with the SLP (and missing classroom lessons), a preferred method may be for the SLP to work alongside the teacher to recognize students’ moments of communication breakdown and to explore strategies the students find helpful. Ultimately, we want to support students to have intact self-esteem, feel empowered to self-advocate, and be able to achieve success in the classroom and throughout their lives. Adequate supports for students reduce their chances of dropping out of school.

A benefit of teacher-SLP collaboration is that it ultimately has positive effects on more children than if the SLP is working in isolation with just one or a few children. For example, my teacher colleague Laura Carroll has a Kindergarten class each year that is composed of predominantly English language learners. She recognized the importance of teaching her students how to pronounce the sounds of the English language in conjunction with teaching the alphabet. This is especially important for the English sounds that don’t occur in the language of the home, as the inability to hear sounds can affect the acquisition of literacy skills. Laura and I developed exercises for the class, and one November I asked her if I could come to video her practising the “th” sound with her students for a presentation I was making. Laura replied “No, we’re finished practising. They all pronounce it now.” This astonished me just two months into the school year; without this classroom practice, students often take years to acquire English sound pronunciation.

Another example of how SLP collaboration can lead to positive outcomes for all students is when I did an hour-long, school-wide presentation on the development of narrative language. Narrative language is the ability to tell a story in a logical, sequential order with four parts: a setting, a problem or event, a solution, and a consequence. This skill is associated with social skills and is a perfect way to introduce complex sentence structures and new vocabulary and grammar in context while practising oral language skills. A week later the principal emailed me to inform me that the visual support I shared in a bookmark format for writers (pictured above), was laminated and added to the lanyards worn on playground duty. The school was having great success using the visual to help dysregulated students communicate problems or conflicts experienced on the playground and comprehend consequences.

When teachers and SLPs collaborate to integrate supports into regular classroom and school activities, and make these supports available for all students, the results can exceed our expectations and hopes. While I acknowledge that there are instances where one-on-one support is essential, I encourage my SLP colleagues to focus on shifting their service delivery to experience the many school-wide benefits of working in a collaborative model. This shift can also help us decolonize our practice, as we focus on supporting all students and families and creating classroom communities that foster belonging and value differences.

For more information about developmental language disorder see and chat with your school SLP.


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