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Speech Buddies Blog: Speech, Language & Pronunciation Guides

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Your child is starting speech therapy in school. But what exactly does this mean? The type of services your child will receive in school will depend on many factors. These include your child's age, the type of speech disorder that has been diagnosed, other learning delays or disabilities, the structure of your child's school, and more. The two basic forms of speech therapy in schools include in-class (sometimes referred to as push-in services) and separate services (sometimes also known as pull-out services). There are also other forms of assistance that speech-language pathologists can offer to your child.

The First Step for Speech Therapy in School: Assessment

Speech-language pathologists are trained to assess communication abilities of patients. SLPs can work with recommendations by physicians and listen to the concerns of teachers and parents to determine the needs of the child. Assessments take on many forms (even electronic) based on severity of symptoms, age, and other factors. Once these assessments are complete a plan, which often includes an Individualized Education Program (IEP), can be implemented for your child.

Speech Therapy in School: Push-In Services

There are services that can be provided to children in the classroom by an SLP or a speech/language classroom aide or paraprofessional under guidance of an SLP. This allows your child to continue to benefit from the whole-classroom experience while still improving communication skills. Depending on the reasons for the services, push-in therapies can include:

Working with your child to use appropriate volume control during classroom discussions

Working with your child to interact and communicate appropriately during question/answer sessions in class

Observing your child communicating in classroom setting

Helping your child develop graphic organizers to keep track of classroom expectations/homework

Paraphrasing and reviewing information for your child if he or she is struggling with communication intake

Observing your child's vocabulary comprehension in the classroom and assisting with various tools for building vocabulary

Working with your child to minimize stress during classroom speaking situation (i.e. when stuttering is an issue using calming techniques before giving a book report)

There are many other ways that an SLP can support your child in the classroom, but one of the biggest benefits (besides maintaining classroom connections for your child), is that your child's teacher also becomes more aware of the tools the SLP is using with your child to target specific communication needs. A side benefit is that other students in the classroom also learn from these strategies and tools provided by the SLP.

Speech Therapy in School: Pull-Out Services

There are circumstances when a child's speech disorder is either perhaps so severe or is accompanied by other disorders or multiple symptoms that it makes pull-out services more appropriate. If this is determined to be best for your child, he or she will receive therapy in individual or small group settings during the school day in a separate classroom setting. There will be more intensive techniques and tools taught and provided to your child. Sometimes pull-out services are utilized for kids who:

Sometimes a combination of approaches will be used that will maximize the therapy environment for your child. You can work with your child's teachers, SLPs, and school administration to assess homework needs and challenges and put together an IEP that will work for your child's speech therapy in school.

Individualized Education Program (IEP) School Speech Therapist Speech Therapy Techniques State Resources

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What Can We Expect from Speech Therapy in School?: SLPs in the Classroom

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Your child is starting speech therapy in school. But what exactly does this mean? The type of services your child will receive in school will depend on many factors. These include your child's age, the type of speech disorder that has been diagnosed, other learning delays or disabilities, the structure of your child's school, and more.

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School-based physical therapists (PT) are part of a team of related service providers who support a student's ability to access his/her educational environment. As specialists in movement, they assist a student's physical participation in a variety of settings throughout the school day. The primary role of the school PT is to help students benefit from their educational program within the educational environment.

School-based physical therapy is different from medical based physical therapy and determining the need for each of these services is different. Medical based physical therapy is typically provided in an outpatient therapy clinic or hospital. These services address quality of movement as well as function. Its primary objective is to maximize the child's skill level and quality of movement. Medically-based services are typically focused on a student's physical impairments and clinical deficits.

Physical therapy is provided at schools when it is related to educational needs. Intervention and goals in the school setting address the child's functional needs in accessing all areas of the school curriculum. Physical therapy interventions are designed to enable the student to travel throughout the school environment; participate in classroom activities; maintain and change positions in the classroom; as well as manage stairs, restrooms, and the cafeteria. School-based therapy is not intended to meet all of the therapeutic needs of a student; rather it is intended to ensure that a child can have physical access to his or her education.

PT in a school setting can vary based on a student's individual needs, and can include:

Modifying the environment to maximize participation (i.e. adaptive seating).

Altering expectations to maximize success and independence.

Educating staff to enhance physical participation.

WHO MAKES THE REFERRAL FOR PHYSICAL THERAPY SERVICES?
*A signed parent consent is required to initiate an evaluation or screening.

A teacher, another service provider, or a parent can refer a student for a PT observation or screening. Therapists will use a variety of tools to identify deficits that can impact a student's learning in the school environment. These can include interviews with teachers; observing the student in the classroom, PE, and playground; and administering standardized testing.

Before referring a student to the physical therapist consider how your concern affects the child's access to the curriculum. If the student is benefitting from the education program without the service, consider what the benefit of the referral will be. For example, if a student appears "clumsy", but is safe in the playground and participates in PE class, think about what part of the education he/she lacks access to. Remember that school-based PT must be related to educational needs.
WHO IS ELIGIBLE FOR SCHOOL-BASED PHYSICAL THERAPY?
First and foremost, the proposed service must be educationally relevant. Secondly, the child's needs must be able to be addressed only by the skilled service of a physical therapist. Some common physical concerns can be addressed by the classroom staff, with the support and consultations of a physical therapist.

Some examples of students who do not qualify for PT are:

1. A child presents with mild motor delays (for example, they have difficulty skipping or hopping), but their participation in all areas of the school curriculum is not impacted. He/she can participate in gym class with exception of a few activities. Direct physical therapy services are not indicated for this student. Instead, the therapist may send home exercises for the parents to address the specific motor skills, and monitor the progress on a monthly basis.

2. A child walks on tiptoes. However, the student is safe in navigating the school both indoors and outdoors. Additionally, the student's gait pattern does not affect the school curriculum. The therapist may send home exercises for the parent and refer the student to the pediatrician. Parents may seek medical based PT services.

Some examples of students who do qualify for PT are:

1. A student cannot safely and independently navigate the school environment. They may trip in the hallways and bump into objects in the classroom. Transitions throughout the school day are educationally relevant to the student's education.

2. A student may have difficulty maintaining sitting posture either in a classroom chair or on the floor. This may be due to low muscle tone or muscle weakness. This directly affects his/her education.

HOW ARE SCHOOL-BASED PHYSICAL THERAPY SERVICES PROVIDED?
*A physician prescription is required to initiate PT services

Physical therapy services may be direct or indirect.

For direct intervention, the therapist works with the student on a consistent basis either individually or in a group setting. This can be provided in the therapy room, classroom, physical education gym, playground, or any other location where the student needs to practice motor skills.

For indirect intervention, the therapist will consult with classroom staff and other interventionists to make recommendations and suggest strategies to enhance to student's independence and participation in school.

Michele Fox, PT, DPT, C/NDT
Doctor of Physical Therapy

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School-based physical therapists (PT) are part of a team of related service providers who support a student's ability to access his/her educational environment. As specialists in movement, they assist a student's physical participation in a variety of settings throughout the school day.

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What's Required

Counseling as a Related Service and Psychological Services may be provided to students with disabilities who have chronic severe behavioral, emotional, or social difficulties and additional school supports are required to help the student achieve annual goals.

Counseling services, according to IDEA, means services provided by qualified mental healthy professionals. In Katy ISD, these services may be provided by qualified social workers, Licensed Specialists in School Psychology (LSSPs), professional school counselors, or other qualified personnel such as interns supervised by licensed or certified professionals. Counseling as a related service assists students in accessing and benefiting from specialized instruction provided in special education.

Parent counseling and training emphasize the importance of parents as active participants in their child's education. According to IDEA, parent counseling and training means: (a) assisting parents in understanding the special needs of the student, (b) providing parents with information about child development, and (c) helping parents to acquire the necessary skills that will allow them to support the implementation of their child's IEP or Individual Family Service Plan (IFSP). Parent counseling and training is identified by the Texas Education Agency (TEA) as one of the eleven strategies or options an ARD/IEP Committee may choose for a student with autism in order to facilitate carry-over of communication skills or behavior strategies in the home.

Psychological services as a related service, according to IDEA, includes:

administering psychological and educational tests, and other assessment procedures

interpreting assessment results

obtaining, integrating, and interpreting information about student behavior and conditions relating to learning

consulting with other staff members in planning school programs to meet the special educational needs of students as indicated by psychological tests, interviews, direct observation, and behavioral evaluations

planning and managing a program of psychological services, including psychological counseling for student and parents

assisting in developing positive behavioral intervention strategies

Psychological services as defined by IDEA include some services not defined strictly as psychological in nature and therefore can be appropriately provided by other trained personnel including behavior specialists, school social workers, diagnostic specialists, interns and counselors. These would include gathering information about student behavior, behavioral program planning, educational testing, and developing behavioral intervention strategies.

In Texas, certain services are defined by the Texas State Board of Examiners of Psychologists (TSBEP) as 'psychological services' in the schools and therefore can only be provided by those individuals licensed as an LSSP by the TSBEP. Specialist in School Psychology Interns supervised by an LSSP may also provide psychological services.

An ARD/IEP committee is responsible for determining the appropriateness of psychological services as a related service based on the individual educational needs of a student, regardless of the disability categories, and with the recommendations and expertise provided by the professionals involved in assessing these services. Parents are invited to participate in the ARD/IEP committee decision-making process. Related services are provided to an eligible student with a disability at no cost to the parent or guardian.

What We Do

The referral for counseling or psychological services evaluation is initiated by the ARD/IEP Committee.

The need for counseling or psychological services is examined in an evaluation. While this is often addressed in psychological evaluation once a student is already receiving special education services, an evaluation for counseling may be necessary to examine difficulties as they arise.

If eligible for services, an IEP is developed to specify the goals/objectives, projected begin and end date, amount, frequency, duration, and location of the services.

Progress reports explaining the student's progress toward the annual IEP goals will be provided to parents, teachers, and relevant school personnel on a regular basis.

Any changes in the amount of services listed in the IEP must be made at an ARD/IEP meeting.

Counseling or psychological services providers should be present at an ARD/IEP meeting when the need for the services is discussed or when the progress of the services is reviewed. Service providers may submit their findings in writing if the IEP Committee agrees to excuse them from the meeting.

While a formal evaluation can be performed, it is not required to dismiss a student from counseling or psychological services as a related service however data for dismissal should be reviewed.

Dismissal from counseling or psychological services should be based on data from a variety of sources, including teacher observations, parent input, mastery of IEP goals and objectives, performance on statewide assessments, disciplinary referrals, and any other relevant data.

The decision to dismiss from a related service is determined by the ARD Committee and supporting documentation is included in the student's IEP document.

Counseling and Psychological Services as a Related Service in the IEP

When an ARD/IEP Committee determines the need for counseling or psychological services to support the student's special education program, a specially designed counseling or psychological services program is included as part of the student's IEP. The supports and services provided are documented on IEPs and indicated as part of the progress reporting system to parents and adult students. The goals for services:

focus on school-related issues

are behavior and/or learning based

are minimally intrusive

emphasize practical and immediate application rather than development of insight

are necessary in order to make educational and/or behavioral progress and access the student's IEP.

Counseling Services may be provided by:

Licensed Specialists in School Psychology (LSSPs)

Professional School Counselors

Social Workers

Other qualified professionals such as interns under the supervision of a certified or licensed professional.

Psychological Services may be provided by:

In Texas, certain services are defined by the Texas State Board of Examiners of Psychologists (TSBEP) as 'psychological services' and therefore can only be provided by those individuals licensed as an LSSP by the TSBEP. Specialist in School Psychology Interns supervised by an LSSP may also provide psychological services.

Service Delivery

Counseling:

Counseling is a complex helping process in which a trusting and confidential working relationship is established.

Counselors interact with students individually or in small groups.

The focus is on problem-solving, decision-making, and discovering personal meaning related to learning and development.

Psychological Services:

Psychological services provided in KISD may include Ongoing Consultation

There are three levels: Monitoring, Generalization, Intervention

These are direct, indirect, or a combination;

Assigned according to assessment of intensity of need

Psychological services providers consult and collaborate with parents, school personnel, medical professionals, and other professional service providers to develop and implement strategies to help students succeed.

The focus is on assisting the school staff, students, and parents/family to solve problems related to learning and student behavior.

Resources

National Association of School Psychologists
Texas State Board of Examiners of Psychologists​

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Counseling as a Related Service and Psychological Services may be provided to students with disabilities who have chronic severe behavioral, emotional, or social difficulties and additional school supports are required to help the student achieve annual goals. Counseling services, according to IDEA, means services provided by qualified mental healthy professionals.

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Two types of in school services: Push in and pullout.
First step is to asses the student on communication abilities. After assessment the SLP creates a plan.

Push in services: Allows the student to benefit from whole class instruction while improving communication skills.
Can include: working on using appropriate volume, interactionsand communications appropriately, observing, helping child organize things to keep keep track of class expectations, reviewing information, building vocabulary, minimize stress in environemnt.

Pull out services: More intensive techniques and skills taught. Can includeL need help for swallowing disorders, multiple impairments, autism, assistive device learning, use technology.

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PT can recommend to: Modify the environment to maximize participation (i.e. adaptive seating). To alter expectations to maximize independence. Educate staff to enhance physical participation.

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1. A child presents with mild motor delays (for example, they have difficulty skipping)
2. A child walks on tiptoes.

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Counseling services, according to IDEA, means services provided by qualified mental health professionals.

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Counseling services, according to IDEA, means services provided by qualified mental health professionals.

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Counseling service is provided by Licensed Professionals

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Counseling service is provided by Licensed Professionals

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LSSP, Professional School Counselor, Social works and other qualified professional under supervision of certified professional.

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Teachers can take feedback and suggestions from PT on how to help student participate more comfortably in the classroom.

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Services are provided by qualified social workers, Licensed Specialists in School Psychology (LSSPs), professional school counselors, or other qualified personnel such as interns supervised by licensed or certified professionals. 

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Services are provided by qualified social workers, Licensed Specialists in School Psychology (LSSPs), professional school counselors, or other qualified personnel such as interns supervised by licensed or certified professionals. 

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students who qualify for pt cannot safely and independently navigate the the school environment based on teachers observations 

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students who qualify for pt cannot safely and independently navigate the the school environment based on teachers observations 

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Teachers, service provides, and paras can recommend PT, but the parent must provide consent. 

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Teachers, service provides, and paras can recommend PT, but the parent must provide consent. 

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SLP can benefit the entire classroom of students when they provide services for a student as a push in service.   The other students in the classroom can learn from the strategies and tools for communicating. Also the child’s teacher can becomes more aware of the tools the SLP is using with the student to target specific communication needs.

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The supports and services provided are documented on IEPs and indicated as part of the progress reporting system to parents and adult students.

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goals for services are included in IEP planning

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goals for services are included in IEP planning

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focus on school-related issues

are behavior and/or learning based

emphasize practical and immediate application rather than development of insight

are necessary in order to make educational and/or behavioral progress and access the student's IEP.

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The focus is on assisting the school staff, students, and parents/family to solve problems related to learning and student behavior.

# data[].attributes.subject
The focus is on assisting the school staff, students, and parents/family to solve problems related to learning and student behavior.