Service Delivery Models: Push-in
After taking a break from previous, on-going discussion of service delivery models to remind us all that we're Itinerant & Fabulous, I've decided to jump right back into things. "Push-in" services can meet a lot of different things to a lot of different SLPs. Even for me it means something different dependent upon the population of students I'm discussing. In today's blog I'm going to talk about "push-in" therapy as it relates to my work with my moderate to severely impaired students.
I do push-in therapy within functional school settings (special ed classroom, regular education, specials) with my students with moderate-severe disabilities once per six-day cycle. I have allotted nearly an entire school day exclusively to push-in services with these students so that it allows me flexibility about what time of day I go in the two classrooms. During push-in times, I go into the classroom and work with the students on whatever they happen to be doing in the classroom at the moment, all the while incorporating their IEP objectives. The students in these classes range from non-verbal to minimally-verbally, to verbal. Modes of communication these students use include speaking, sign, communication boards, communication books (including ones using PODD — pragmatically-organized dynamic displays), low-tech devices and switches, high-tech AAC devices, and in many cases, a combination of more than one of these modalities. Here are some real-life examples:
- working on a student's articulation targets during a math activity
- showing students new vocabulary added to high-tech devices, low-tech devices, or no-tech boards, how to navigate to the new words, and how to functionally use them in class
- practicing functional requesting using the students' modes of communication during snack time
- facilitating student communication while participating participate in circle time
- using a student's low-tech device to functionally request during lunch
- providing Aided Language Stimulation using the students' various communication modes during "free play"
- working on expanding length of utterances during "Language for Learner" lessons
These are just a few of countless examples I can offer. I've found numerous benefits to push-in which include:
- I can see and data collect on what the students are doing in functional, dynamic settings (rather than the more static, structured setting of the "speech room")
- I can model strategies and techniques for the teachers and paraprofessionals.
- I can offer suggestions for eliciting language and offer kudos for reinforcement of strategies for teachers and paraprofessionals.
- I find teachers and paraprofessionals ask me more questions and for more feedback when I'm in their "turf" (versus them having to seek me out).
- I can easily move amongst the students and work with one, some, or all of the students at the same time. Most of the students are seen individually or 2:1 in the "speech room."
At first I was a bit nervous/uncomfortable about it because I did not want the teachers to think I was just another adult in the room (without anyone seeing the value of my being there) or that I was "stepping on toes." This is my third year doing push-in with this population. I've found it gets easier to do with each passing year. It's important to discuss what push-in is going to look like with the classroom teacher (so they do not assume that you are there to teach a separate lesson) and explain how it will be of benefit to the students. Just go in there and do your thing, and you'll earn the respect and appreciation of the teachers and paraprofessional who work with these students on a daily basis.
If you are not currently using a push-in model with moderately to severely impaired students, I'd highly recommend it.
Are any of you using push-in models with this population? How has it worked for you? Comments regarding my blog can be made below or through the ADVANCE Facebook page.