Innovative Speech Therapy: The Push-In Approach

Traditionally, speech therapy has relied heavily upon what has come to be known as the ‘pull-out’ model.  Put simply; this is where the student was taken out of class, assessed and treated in isolation within a specialized room.

But researchers have discovered that practicing therapy solely in isolation means that students find it difficult to adapt their newly learned skills to the classroom where they’re truly needed.  In other words, what the kids have gained in their sessions lacks context. Without experiencing this “context,” they cannot efficiently replicate interactions and activities found in the classroom.

The “Push-In Approach” is gaining credibility. This approach is more focused on education and curriculum while de-emphasizing the clinical element. In this model, the speech therapy pathologist teams with the classroom teacher to implement strategies into ongoing classroom instruction.  The benefit is obvious- these strategies can be carried over after the SLP leaves.

Of course, this isn’t meant to replace the “pull out” model, but rather to enhance it.   In fact, the argument for the merging of pull-out and push-in approaches is reflected in the literature. The balance between the two methods should be tailored to each student. It can’t be only clinical or only contextual- it needs some of both.

Team-Based Intervention

Sports has what to teach us regarding what makes an excellent speech therapy pathologist.  And amongst the most important lessons is that of teamwork.  A well-coordinated team of interventionists, working in tandem with one another will focus on only the most critical things and strive for excellence. Teamwork results in the student improving in the areas that matter most.

But this teamwork can only succeed if the speech therapy pathologists develop a mutually respectful and productive working relationship with the children’s teachers.  Only this will ensure that the outcomes are maximized.  Research has shown that the clinical and academic needs of the children need to be integrated together if the child reaches his potential.

Continuous Assessment

For the speech therapy pathologist to continue to bring excellence to his/her profession, there must be constant reflection.  And as mentioned above, this reflection cannot be solely of a clinical nature but must be context-based reflection as well. The clinician must continually be asking, Is the child’s team on course?  Are the interventions working and making a difference?.

To answer these questions there need to be assessment tools that will provide relevant, practical information for the pathologists to utilize. Simply put, the speech therapy pathologists need to make themselves fluent in combining their actual observations with the most advanced tests and measurement skills that they can find.

The “Push-In Approach” needs to be combined with dynamic teamwork, and then subjected to continuous assessment. This powerful triad will assure that the clinicians know what they and the other members of the team are doing inside and out. Excellent speech therapy clinicians are of the greatest gifts the administrator can give to the children. The children are counting on you!