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Speech in the Schools

Co-Treatment with an OT: Part 1

Published August 4, 2010 10:59 AM by Valerie Lill

In my last post, I started a discussion about alternate service delivery models than traditional small-group or 1:1 pull-out for speech-language intervention.  The first of these I'm going to discuss is co-treating with the OT.

At my elementary school, I work in a primary Life Skills classroom.  These students all have cognitive impairments, speech-language impairments, and motor difficulties due to varying diagnoses.  These students are probably the busiest kids in the building! Within a course of a week  depending on need, students could have up to 60 minutes of pull-out speech therapy (plus additional push-in time which I'll discuss in another blog), 30-60 minutes of OT, 30-60 minutes of PT, vision therapy, and/or up to 60 minutes of music therapy. Many of these therapies are provided as 1:1 pull-out.  In addition to the therapies, the students also attend lunch, recess, and specials with their grade-level, regular education peers.  Oh, and now and then they are supposed to get some sort of academic and life skills instruction to meet their IEP goals. 

The OT who works with the primary life skills classroom works only part-time and is only there on certain days of the week.  The PT is only there on one day a week, as is the case with music and vision. Needless to say, since I'm on a six-day cycle (and therefore don't see the kids on a days-of-the-week basis), fitting these kids in for speech instruction can involve a ridiculous amount of juggling. If I have an IEP meeting and need to miss a student to make up at a later time, forget it!  The OT and I were finding that often times we were scheduled to see kids at the same time are consecutively (meaning they'd be out of their classrooms for an hour chunk of time).   After some discussion and problem solving, we decided at least for some cases, co-treatment  with the students would best meet their needs.

I had asked the OT previously about how each of the students communicated with her (as many are unintelligible, minimally verbal, or non-verbal). When I found out that sometimes the answer was "not at all" I knew that I needed to get these students to work on using their communication skills with her.   The OT and I tried to co-treat at least once per month for a handful of our students.  It was very successful for students using AAC, whether it was a no-tech board/book, a low-tech device, or while trialing a high-tech device.   At first, the OT and I met prior to sessions so I could find out what her targeted objectives and activities were for the students. However, after awhile, we just planned our sessions via email. That's the great thing about communication — no matter what she was working on with the students, it was easy for me to embed the students' speech-language targets within the sessions. We found it didn't work well for all students for various reasons. As with all therapy, some trial-and-error is necessary, and you need to know your students to know what works best.

Co-treating with the OT for primary life skills students is something I plan on continuing next year.  We've already mentioned it to the parent of one of our incoming kindergarteners, and she was completely in favor of it.  Just from my experience last school year, I found it served two great purposes: 

  1. The OT had the opportunity to see what the students were capable of doing and how to get the students to use their communication systems when working with her, and; 
  2. The students had the opportunity to practice carryover/generalization of skills to a different environment.  

If you are looking for a way to fit over-scheduled kids into your therapy schedule, consider co-treating with your OT. I've also done co-treatment in a different way with my  middle school autism support students that I'll discuss in an upcoming blog.


PingBack from

August 20, 2010 1:16 PM

We have an OT and ST "Mouse and Tracy" in our Fragile X community who work together to teach, evaluate and make recommendations to therapies.  They also speak at conferences and hold workshops.  I think the combination not only helps with the time crunch but also results in better collaboration and results for the therapies.

Karen August 18, 2010 12:30 PM
Hartford WI

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About this Blog

    Speech in the Schools
    Occupation: School-based speech-language pathologists
    Setting: Traditional and specialized K-12 classrooms
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