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Speech in the Schools

Service Delivery Models: Push-in

Published September 15, 2010 12:09 PM by Valerie Lill

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.


If a child has an IEP that states "individual" and "Group" can a push-in model be used or does it need to state on the IEP that a push-in model will be used??

Cherie October 31, 2015 3:26 PM

I would like to know what push in therapy looks like as written on a script for services on the IEP? If you are in the classroom for a 30 minute session, can you bounce around or do you have to remain with the same child for 30 minutes?

Barbara, School age - Speech Therapist, Elementary school January 23, 2015 6:31 PM
Wappingers NY

I love the functionality of push-in therapy. I'm curious how you're able to provide this model of service - it seems like it would be difficult to arrange due to time constraints - I see almost all of my students in groups of 3-4. If you're going into classrooms to work with individual students, how are you able to structure your time?

Jessica March 12, 2013 11:22 PM

I never heard about "push-in therapy" prior to this.   I think it is good that more and more special educators are going into the classrooms to work with children.  I feel it is a lot more functional and beneficial depending on the child.  

Meghann Delaplaine, Student September 22, 2010 7:16 PM
Searcy AR

I agree with your recommendation to use the "push in" model with moderate to severly impaired students. I didn't know this was the name for what I do. I use this model in one of the classrooms and it is great seeing Teacher Assistants using the AAC devices and picture books! Also I went to a conference on PODD. I like how the book and pictures are organized into categories and has core vocabulary pictures. Thanks for your info!

Leanne September 18, 2010 10:30 AM

Yes, please share info from conference and how you are applying it.

Lisa September 17, 2010 1:54 PM

Re: PODD - it's a pragmatically-organized dynamic display.  Last spring I saw a two-day presentation with Linda Burkhart on the topic of using PODD.  The idea came from Gayle Porter, who works in Australia. It really opened my eyes to a lot - changed my philosophy a bit, gave me lots to think about.   Here's a link to Linda's webpage:

I certainly would be willing to blog about what I took from the conference, and how I'm applying what I've learned to my students!

Valerie Lill September 16, 2010 6:51 PM

I would be interested to know more about the PODD that was mentioned in the article. Thanks!

Anne Wagner, , Speech Therapist United Preschool Center September 16, 2010 1:34 PM
White Plains NY

The PODD communication book sounds interesting.  Can you explain more what it is?  I think it may work with some of the students I am working with.  Thanks.

Lisa Truitt September 16, 2010 9:17 AM

I am so glad that working with this population of students is being discussed.  I have been slowly attempting to do more push-in therapy.  Some teachers are more willing to have me in the room then others.  I have had more positive experiences when working with teachers and staff that understand why I am in the room.  I find it important to do push-in therapy with these students because they need functional language skills through out the day, not just in the speech room.  It helps the teachers now understand what I do with the students and we all become a team working on communication goals all day.  I not only see more progress with my students, but I can say I enjoy it so much more then pull-out therapy.

Jaime September 16, 2010 7:28 AM

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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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