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The Speech-Language Pathologist
āChanging from predominately pulling students out to inclusive service has been an exciting challenge of creativity. I have really enjoyed the process of discovering new ways to support students. . . . I think teaching students in the context of peers and rich communication has made my services more effective.ā
āErin (speech-language pathologist)
Like Erin, many speech-language pathologists (SLPs) are navigating new methods to deliver their related services within inclusive classrooms in order to ensure that students with disabilities have continued access to quality instruction and related services throughout the course of the school day without the disruption of pull-out sessions. SLPs across the country envision different service provision models aimed to support students with disabilities. Whether you are a preservice SLP or someone who has been practicing in the field for years, this book is designed to help you take on the role of providing inclusive services with ease. Some of the information in Chapters 1 and 2 may be a review for those who are seasoned SLPs; feel free to skim those sections if they are familiar to you already. Our goal is that this book provides you with useful ideas to create more inclusive service provision. This book is meant to provide essential knowledge and guidance about 1) what it means to be an SLP, 2) special education basics, 3) inclusive education, 4) how to work within a collaborative team, 5) new ways to think about the students to whom you provide services, 6) how to provide social supports, 7) implementing therapy provision that aligns with academic goals, 8) behavioral supports, and 9) how to take care of yourself while doing this important work.
In one inclusive second-grade classroom the SLP and teacher sit down with the specific communication goals of the two students who receive speech-language services in that classroom. They plan an upcoming English/language arts lesson that not only meets the needs of all the students but have embedded individualized education program (IEP) goals right within the lesson. So, as the lesson is carried out, the SLP teacher has a center, the general education teacher has a center, and the special educator has a center. All the students rotate through all of the centers and at each center the individual goals are embedded and practiced with each adult running the center. Data are collected on each of the goals, and they plan again next week.
The SLP was vital in embedding communication and speech skills not only for the two students who received speech services, but also for the entire class. Furthermore, the two students who need intensive speech support were able to receive these services without a disruption to their typical classroom routine and without missing general education content. This example highlights possible contributions a school-based SLP can make on an educational team to deliver instruction to all students. This chapter will familiarize you with the evolving job of the school-based SLP. We will outline the history of SLPs, the definition of speech and language therapy, the roles of the SLP, the benefits of SLPs, the different types of settings in which school-based SLPs work, the most common professional responsibilities for SLPs, and some commonly asked questions.
The History of Speech-Language Pathologists
The history of inclusive education has had a large impact on the role of school-based SLPs. It has only been since the passage of the Education for All Handicapped Children Act of 1975 (PL 94-142) that students with disabilities have had a legally protected right to attend public school. Prior to that, students with disabilities were educated mainly in the home, in segregated settings, or in institutions. In the 1950s and 1960s, children with disabilities were in segregated educational and rehabilitative programs. As a result, therapists primarily worked in these separate settings only for children who required their services. In the 1970s and 1980s, however, a strong, parent-driven push began for including children with disabilities in general education settings alongside students without disabilities. At this time, the inclusive education initiative began (Will, 1986), and parents began to learn about the idea of mainstreaming or inclusion. The role of SLPs shifted accordingly, as students with disabilities began participating in general education classrooms.
By the 1990s, a wider array of students with more significant disabilities was included in classrooms across all grade levels in school. From 2000 to the present, inclusive education has been a legal mandate. The No Child Left Behind Act (NCLB) of 2001 (PL 107-110) initially set accountability and educational standards for all children, including students with disabilities. The federal legislation that had particular impact on students with disabilities was the reauthorization of the Individuals with Disabilities Education Improvement Act (IDEA) of 2004 (PL 108-446), which established outcome expectations for students with disabilities receiving special education and related services. In the Findings section of IDEA 2004, Congress acknowledged that the purpose was to āensure that all children with disabilities have available . . . a free appropriate public education that emphasizes special education and related services designed to meet their unique needs . . .ā (20 U.S.C. 1400 [c]). Therefore, students with disabilities were entitled to receive related services. That is, under federal legislation, the role of SLPs is to āassist a child with a disability to benefit from special educationā (IDEA, 2004, 20 U.S.C. Ā§602 [26][A]) and to ensure these students have āaccess to the general education curriculum in the regular classroom, to the maximum extent possibleā (IDEA, 2004, 20 U.S.C. Ā§601[c][5][A]). As educational policy and practice have evolved and more students with significant disabilities are being included in general education settings, it is clear that SLPs who work primarily with children work under the provisions of IDEA, and their services now take place in schools (Swinth, Spencer, & Leslie, 2007). Presently, āmore than 57% of certified speech-language pathologists work in educational facilitiesā (American Speech-Language-Hearing Association [ASHA], 2013). Furthermore, āit is essential that speech-language pathologistsā roles and responsibilities be redefined in light of substantive changes that have taken place in schools, as well as in the discipline of speech-language pathologyā (ASHA, 2010). As mentioned, our intention is that this book be a practical resource for information and strategies for school-based SLPs who take on the role of providing services within inclusive contexts. Thus, we now consider what the job of SLP means in educational settings.
What Does Speech-Language Pathologist Mean?
You already have a vast understanding about school-based SLPs. Here we complement this knowledge by reviewing what federal legislation describes. SLPs within education settings are integral members of the educational team, providing students with disabilities access to communication and language supports. The job of the SLP is described in section 300.34 of IDEA 2004 as a related service. āRelated services means . . . supportive services as are required to assist a child with a disability to benefit from special educationā (20 U.S.C. Ā§ 300.34). Specifically, the definition of speech and language therapy is in section 15 of IDEA 2004:
Speech-language pathology services includes: (a) identification of children with speech or language impairments; (b) diagnosis and appraisal of specific speech or language impairments; (c) referral for medical or other professional attention necessary for the habilitation of speech and language impairments; provision of speech and language services for the habilitation or prevention of communicative impairments; and, (d) counseling and guidance of parents, children, and teachers regarding speech and language impairments. (20 U.S.C. Ā§ 300.34 [c][15])
In other words, SLPs are qualified professionals who identify and diagnose speech and language impairments as well as provide services to improve communicative functioning to allow a student with a disability to benefit from special education services.
NCLB 2001 considers SLPs as pupil services personnel in section 9101.36:
The term pupil services personnel means . . . other qualified professional personnel involved in providing assessment, diagnosis, counseling, educational, therapeutic, and other necessary services as part of a comprehensive program to meet student needs. (section 9101, paragraph 36)
We have provided the legal definition of SLP (IDEA, 2004) and pupil services (NCLB, 2001); now, we will discuss what this means in practical terms and what it actually looks like in the classroom.
Speech-Language Pathologist: From Pull-Out and Caseload to Inclusive, Collaborative Workloads
The role of SLP is essential in public schools today. SLPs are faced with growing caseloads, and we must be sure these are reasonable. ASHA (2010) argued, āFor SLPs to be productive in the many roles and responsibilities for which their expertise prepares them, they must have reasonable workloads . . . new or expanded roles cannot merely be additions to an already full workload.ā This increase in caseload is attributable to many factors. The number has increased primarily because many more students with significant disabilities (e.g., autism spectrum disorders, cognitive disabilities) are included in general education classrooms. In addition, there has been a slow increase in the number of students who are being identified as having disabilities. Many educators view the consultation and classroom-based support of an SLP as key for students with disabilities to benefit from special education in the context of general education classrooms.
Consequently, the role of SLP has become more complex as it moved from a direct, hands-on, pull-out only service model to classroom-based therapist. In the past, students with significant disabilities were routinely educated within segregated classrooms with a focus on functional and behavioral skills. Educational goals for these students were essentially limited to life skills and job-related tasks. As a result, the role of SLPs was mainly to support these life skills in relation to language and communication and was performed through segregated environments. ASHA (1996) stated,
Traditionally, service delivery was based on a medical model in which the clinical process was often separated into diagnostic and treatment functions that encouraged isolated, individualized assessment and treatment. Frequently, when clinical speech-language pathology services were rendered, there was insufficient communication between the speech-language pathologist and other instru...