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ASHA’s Workload Model: Making it Work for You

ASHA’s Workload Model: Making it Work for You. Deborah Adamczyk Dixon, M.A.,C.C.C.-SLP Director of School Services SLP Practices, ASHA . Our Goals. Understand the difference between caseload and workload Identify principles of the workload model

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ASHA’s Workload Model: Making it Work for You

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  1. ASHA’s Workload Model:Making it Work for You Deborah Adamczyk Dixon, M.A.,C.C.C.-SLP Director of School Services SLP Practices, ASHA

  2. Our Goals • Understand the difference between caseload and workload • Identify principles of the workload model • Understand steps to conduct a workload analysis • Understand strategies for implementation • Recognize the importance of advocacy for the model at the state and local level

  3. Caseload This term typically refers to the number of students with Individualized Education Programs (IEPs) or Individualized Family Service Plans (IFSPs) who are receiving services. 3

  4. Workload This term refers to all activities required and performed by professionals including direct and indirect activities necessary to: • support student education programs • ensure compliance with IDEA, NCLB and other state or local mandates • fulfill the role of professionals working in the school setting 4

  5. ASHA’s Position Statement It is the position of ASHA that the total workload activities required and performed by school-based speech-language pathologists (SLPs) must be taken into account to set caseload standards. A workload analysis approach to setting caseload standards is necessary to ensure that students receive the services they need, instead of the services SLPs have time to offer or services based on administrative convenience. American Speech-Language Hearing Association (2002). A workload analysis approach for establishing speech-language caseload standards in schools. Position statement. Rockville, MD: Author. 5

  6. ASHA’s 1993 position • Caseloads should not exceed 40 • Special populations and preschool caseloads should not exceed 25

  7. A shift in thinking… ASHA no longer recommends a maximum caseload number because it: • May be misconstrued as a minimum • Doesn’t encompass the full range of roles and responsibilities • Doesn’t reflect factors influencing workload • The standards of what constituted a reasonable caseload 18 years ago is very different today

  8. Principles of Workload Each student added to the caseload increases time needed not only for direct and indirect services and evaluations, but also for mandated paperwork, multidisciplinary team conferences, parent and teacher contacts and related responsibilities.

  9. Principles Caseloads must be of a size to allow for: • appropriate and effective intervention • conducting evaluations • collaboration with teachers and parents • implementing best practices • carrying out related activities • completing paperwork and compliance tasks within work hours

  10. Principles Education agencies must implement a workload analysis approach to setting caseload standards that allow professionals to engage in the broad range of activities needed to meet individual needs.

  11. Principles Make the shift from caseload to workload • Total workload activities must be considered to set appropriate and reasonable caseloads • A balance across workload activities will drive decision making toward the basis of student needs.

  12. Factors that Impact Workload 12

  13. Roles and ResponsibilitiesWhat’s on your list? • Prevention • Identification • Diagnosis • Assessment • Data collection • IEP/IFSP development • Case management • Intervention • Consultation • Equipment • Supervision • Documentation • Material prep • Parent/staff training • Planning teams • Travel • Advocacy • Policy-making • Transition planning • Professional development 13

  14. Survey says… According to the 2010 Schools Survey, the median SLP caseload in the U.S. is 50. THIS NUMBER HAS REMAINED THE SAME FOR MORE THAN 15 YEARS! • Median SLP caseload in New Hampshire (31) • State with highest caseload? Indiana (80) • State with lowest caseload? (Maine 30)

  15. Effects of large caseloads • Impacts negatively on student outcomes (speech-language & academic) • Leads to burn-out • May impact retention and recruitment of SLPs

  16. Effects of Large Caseloads • Interferes with time for other mandated activities & responsibilities. • May prevent provision of FAPE • Interferes with the intent of IDEA & NCLB 16

  17. Did you know… Job satisfaction among education personnel is related to a manageable workload. Language, Speech and Hearing Services in Schools, Vol.33, 282-290, October 2002.

  18. Effects of Large Caseload • Limits service delivery options • Roadblock to important professional activities necessary to meet the individual needs of students • Impacts ethical delivery of services to students with disabilities and to students at risk for communication disorders.

  19. Considerations • Research indicates that large speech-language caseloads are related to poorer student outcomesand to the availability of fewer service options for students with disabilities. This suggests that large caseloads impede the intent of IDEAfrom being fully implemented, given that federal legislation mandates the use of a continuum of services tailored to students' individual needs, and collaboration between special education and regular education teachers.

  20. Considerations Greater involvement in literacy support • Catts, Fey, Tomblin, and Zhang’s (2002) study indicates that a child who has a speech language impairment is six times more likely to experience difficulty with reading and spelling than a typical language learner

  21. Ethical Considerations • SLPs have an ethical obligation to provide appropriate services. Considerations include : • amount of service required at various points of therapy • environment • evidenced based strategies • Supports for academic and social success • connected to curriculum • collaboration with teachers • collaboration with families • communication with teachers and families

  22. Less is more… Progress in SL treatment is • positively influenced by small group size • negatively influenced by large group size 22

  23. Caseload and Student Progress 23

  24. 3 Steps to Workload Analysis Step 1. Look at your current workload relative to the needs of students receiving services.

  25. Workload and IDEA Direct Service to Students 25

  26. Workload Time Survey

  27. Workload Survey

  28. Workload Analysis (cont’d) Step 2. Determine whether the workload is balanced. Is there a problem?

  29. Workload Analysis (cont’d) Step 3. Collaborate with SLPs, teachers, administrators, union representatives, parents, and others to address workload issues.

  30. IDEA Compliance and Workload • Identify students with disabilities • Develop appropriate IEPs/IFSPs tailored to individual needs • Provide specially designed instruction in the LRE • Evaluate progress across settings 31

  31. Workload and IDEA Indirect activities that support students’ educational program. 32

  32. Workload and IDEA Indirect services to support students in general ed programs 33

  33. Workload and IDEA Compliance activities 34

  34. Direct Services • Least Restrictive Environment (LRE) • Individual needs of each student • Student’s rate of progress in the curriculum • Combining models • Evidence-based practice 35

  35. Factors Impacting Service Delivery IDEA mandates • Alignment of general curriculum & IEP goals • Communication needs related to curriculum • Grade-level standards for language • Need for classroom consultation • Natural communication supports 36

  36. Factors Impacting Service Delivery Individual considerations • Nature & severity of communication disorder • Age, grade, developmental level • Strengths, needs, emerging abilities • Frequency and intensity of service needed • Need for peer modeling • Student’s attitude, motivation, social skills • Need for services in non-academic or extra curricular activities 37

  37. Flexible schedules Think outside of the box to provide varied schedules and service delivery to maximize outcomes for students. 38

  38. Solutions Telepractice ASHA's position is that "telepractice is an appropriate model of service delivery for the professions of speech-language pathology [and audiology]. Telepractice may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or subspecialists, and impaired mobility.“ American Speech-Language-Hearing Association. (2005). Speech-Language Pathologists Providing Clinical Services via Telepractice: Position Statement [Position Statement]. Available from www.asha.org/policy

  39. Telepractice in Schools The majority of SLPs using telepractice do so in a school setting. Clark and Scheiderman-Miller, (personal communication, 1999) described a successful speech-language pathology telepractice program in rural schools. ASHA 2002 Telepractice Survey Applications: • School to child’s home • School to school • Health care facility to school

  40. Considerations • personnel • equipment • ethics • professional licensing • candidacy criteria • client and provider satisfaction • reimbursement

  41. Solutions Weighted caseload formula Assigning priority or “weight” to • direct and indirect activities • severity of student need 42

  42. Solutions 3:1 model • three weeks out of each month are designated for direct intervention with students • one week is set aside for indirect services, such as meeting with teachers, parents, and other specialists; developing treatment materials; and completing paperwork. 43

  43. Solutions Drill Bursts • Short – 10 minute drill bursts to increase rate of progress in articulation therapy • Individual therapy • Reduced time away from classroom instruction 44

  44. Flexible Schedules and IDEA Allows for: • Altering the frequency of services provided each week and/or month • Writing amount of therapy is monthly, quarterly or annual amounts. • Providing opportunities for individual therapy • Combining service delivery models • Providing opportunities for indirect services • Providing RTI services and interventions • Completing comprehensive evaluations • Scheduling in compliance activities 45

  45. What’s needed… • A wider range of activities conducted inside and outside of special edsetting • Variety in frequency, location and session length • Stronger ties to curriculum and functional performance • Write IEPs differently 46

  46. How to adapt • Write IEPs in minutes per month /per quarter or per year vs. minutes per week.

  47. The IEP and Workload IEP must specify frequency, location, duration of speech services (§300.347a6) • Frequency : interval of services and how often sessions are provided • Location : where service is provided • Duration : anticipated length of time (term of IEP is typically one year) • Type : direct or indirect 48

  48. Solutions • Supportive teaching • Complimentary teaching • Consultation model 49

  49. Solutions • Team teaching • Diversified roles • Resource Room 50

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