Acronyms are usually one of two things: Confusing (e.g. teenage shortenings of phrases/words that never needed shortening in the first place) or frightening (e.g. diseases and the like). It seems like one of the most recent fear-inducing acronyms in the world of education has been RtI, or Response to Intervention. Used in general education for years, RtI looks to provide a multitiered approach to providing interventions to struggling students at differing levels of intensity.
Now we have combined two acronyms: SLP + RtI! (Sometimes I refer to this as “Caution, it’s Slipperti”… please excuse my ridiculous use of puns!) I was dumped straight into the deep end of this RtI pool when I moved back from Chicago, where I had been working with Early Childhood, to Kansas City in 2011. It may seem odd to say, but my new position in KC was the first time that I would be working with “regular education” students in my career. I spent most of my graduate studies, practicum, and employment working with students with severe disorders and primarily with nonverbal students. So, needless to say, RtI was a new concept to me. I also found out that it was also a new idea to so many others in our profession.
Much like districts across the country, my new district had been using RtI with regards to speech, voice, and fluency for a few years. However, there was not a district-wide approach and I was left asking questions that would largely be left unanswered. I learned that in previous years, typically a teacher would tell the SLP that they had a student with speech errors, the SLP would screen the student, and begin seeing them for twenty or thirty minute sessions. There were also grade-wide screenings in second grade. However, each school in our district had a different procedure. So, being the somewhat cliché type-A speechie that I am, I began researching RtI in districts around the country and learning what I could from massive amounts of internet searches and journal articles. I attempted to develop a process of tiered intervention that was similar to the RtI seen in regular education for other subject areas. So the other SLP in my building and I gathered our quick screeners, referral sheets, and Missouri State norms and got up in front of our amazing staff and showed them our fail proof system. Or so we thought.
I am not entirely sure what we thought would happen but we were about to learn a lot about teacher-SLP relationships and the ups and downs of throwing another new process/intervention at teachers. I will say, that many of our staff members took our new plan and ran with it. They screened students they were concerned about, looked at the normative data to see if it was an age-appropriate error, and then worked with us to see which tier the student would best benefit from. My best example would be a First Grade teacher at our school who was concerned about the intelligibility of a student. She took time to sit down with him and work through our Quick Screener. She consulted with me afterwards and we looked at the data she had gathered together. She then spent a few weeks seeing if he would make progress with Tier 2 interventions in the classroom. She kept amazing data of his productions. When this student failed to make progress, and due to other academic concerns, we moved into full evaluation mode. The best part was that we were able to use her data to justify speech testing and eventual qualification for speech services. However, this was not the norm. We were left wondering where we went wrong.
In the year since our introduction of the new RtI process began, we have learned so much about a more successful recipe for Speech RtI in our building. It is still far from perfect but has improved quite a bit. The secret was getting out of my room and into the hallways and classrooms in my school. It also meant taking another look at how RtI services were carried out. Here is how it has changed:
Before: Teachers approached us with students they were concerned about.
Now: I try to check in with staff members on a regular basis. When I see them in the lounge, when I pick up other RtI students, and through e-mails.
Before: Teachers did not utilize the screening tool we provided. Speech was put on the back burner. I received 3 completed screeners for 2011-2012.
Now: I offer to walk teachers through the screener before they work with any students. We have also added a “referral form” to increase communication and clarity in our process. I have received 10 completed screeners during the fall of 2012 alone! Teachers have also begun to place the screeners in the child’s soft file to notify the next grade’s teacher that they noticed an error that may not be age-appropriate in the following year(s).
Before:Students were not identified until second grade for sounds that are commonly in error such as /s/, /r/, and /th/.
Now:Screenings are done in every grade when a concern is noted. Students are identified as soon as Kindergarten if the sounds are not age-appropriate. We also do not begin working on sounds until it is no longer an age-appropriate error (/r/ and /th/ typically).
Before: No Tier 2 interventions were utilized. Students went from Tier 1 to Tier 3 immediately.
Now: Students are typically in Tier 2 with classroom teachers for 2-4 weeks. These interventions included modeling correct production (of visible speech sounds) and drills provided to them by me. Teachers speak with me about how to work with a student. Tier 2 has been successful for most visible sounds including /th/ and /l/. The /r/, /s/, and other sounds are more difficult. We move /r/ and /s/ to Tier 3 pretty quickly as they are the most difficult sounds for teachers to target.
Before:Students were typically seen in my room in groups twice a week for 20-30 minutes. They typically missed 50-70 minutes of classroom instruction per week to attend sessions.
Now: Students are seen individually 3-4 times per week for 5-7 minutes in the hallways near their classrooms. These sessions are drill-based and yield many more opportunities for productions and direct intervention. This also increases the effectiveness of therapy and decreases the amount of time students are out of the classroom. They typically only miss 20-30 minutes of classroom instruction per week. (For more information on 5-minute therapy, head over to http://www.5minutekids.com/ResearchArticle.pdf)
Before: Slow growth was seen in students. Only 2 RtI dismissals in 2011-2012.
Now: Quick growth has been seen in students. I have dismissed 4 students in the fall of 2012! I also dismissed 2 students that began services in September/October, caught on quickly and now correctly produce the sounds they had errors with! Exactly what RtI is meant to do!
Before:I dreaded RtI services, screenings, and conversations with teachers who did not agree with our new procedures.
Now: I enjoy my RtI kiddos and activities. Because I provided the majority of these services in the hallways, my communication and relationship with teachers has greatly increased. I’m more aware of their comfort levels and who may need more assistance to be successful in tiers 1 and 2 of intervention.
It has not been an easy road. It is honestly a road that I thought I would never have traveled. At times I wish I had paid a little more attention in my phonology courses or had taken more interest in my articulation clients. But this SLP who swore she would only work with severe needs students has learned to enjoy and be an effective elementary SLP. I encourage each of you to find what works best for you, your staff, and, most importantly, your students. RtI is tricky but when done correctly, can greatly increase the effectiveness of your treatment and aid in decreasing your overall caseload/paperwork load. Oh, and yes… it is contagious, but in a good way!
Recipe for Response to Intervention – Speech Style
Your state’s normative data
Easy to use intervention materials for the classroom teachers
1) Preheat your relationships with teachers to at least a friendly first name basis. Spend time getting to know them, their comfort level and knowledge of speech errors, and letting them know that you are more than just a pretty/handsome face.
2) Utilize the above free materials to find what will work best for your staff and students. Provide trainings, professional development and constant handholding if necessary. Realize that some teachers may never bite into your new recipe but others will gobble it down and ask for seconds.
3) Bake for about a year. Don’t expect miracles in the first few months, you will most likely only be disappointed. Check in often on your recipe to ensure that the ingredients are working well together. Make sure that teachers know you are always available to assist them and walk them through how to complete screeners. Once they learn, they will feel more confident in providing you this information.
4) While it is baking, be okay with changing the typical “30 minutes twice per week” mentality to a “5-10 minutes three or four times a week” mentality. The more frequent your interventions, the more effective they will be.
5) After baking is completed, make sure to enjoy the little victories. Teachers who bring you completed Quick Screeners, students who only need RtI for a few months, and teachers who attempt speech interventions in the classroom. I like to constantly build up my staff. A lot of “great job” and “you’re awesome” e-mails and notes.
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