Tuesday, November 25, 2014

Bridging the Gap between the Private and School Speech Worlds

Probably the most demanding, taxing job I had over the years in my speech world was working in the public school system.  Caseloads were always astronomically high and more kids were added to the roster with fewer discharges every year.  Then, you had to make time for report writing, evaluations, screenings, teacher collaboration, classroom lessons, therapy planning, documentation, decorating your closet space, and speech and language small group sessions. It makes my head spin all over again just writing about it!  Nowadays, there are these champion school speech pathologists that do all of the above and then go home and create products, write blogs, and somehow manage to eat and sleep before going back to work bright and early the next morning!  Even with all the challenges and stress, I wouldn't change a thing about my experiences and collaboration with so many heroes.  It made me the therapist that I am today and fueled my drive to pursue private practice.

When I set out on the private journey, I had three C's in mind:  Consult, Collaborate, and Connect.  I believe that these three actions help create a bridge between private and school speech pathologists working with the same client.

Before I can take one step forward, I need to get caregivers to obtain and sign school consents so I can begin connecting with school professionals.  Once the paperwork is complete, I typically send an email to the school SLP introducing myself.  From there, we work on scheduling my school observation which typically includes observing my client in action and setting aside some consult/discussion time with the school SLP.  In my private practice, I try to make this observation within the first few months of the school year so I can begin helping the team collaborate goals in all settings.  To date, I have found that all school speech pathologists have been very receptive to my visit and many appreciate the collaboration, especially when updating annual IEPs.  Caregivers are especially grateful of this networking because it gives them more information about specific activities targeted at school.  I have found that my presence at a client's school setting is far less intrusive and distracting than a caregiver's.  Most children hardly notice that I am there, which likely wouldn't be the case if mom or dad was visiting!

When I visit my client's school, I typically bring something that we have been working on in my practice.  While I do honor IEP goals, I also write some of my own based on my data collection, evaluations, and parent report.  In the past, I have asked parents to send a picture exchange communication book or highly motivating snack in preparation for my observation.  I have also brought pacing boards and oral motor tools like the Z-Grabber for demonstration purposes.  Sometimes, I don't bring anything.  Instead, I collect as much information as I can and follow-up via emails later with school staff.  Personally, I have found that I can obtain so much more valuable information during an hour observation as opposed to exchanging emails and phone calls with the school SLP.  It helps me to watch and listen to my colleagues because we all have our own unique styles and expertise.  Maybe it's because I am such a visual learner, but I make better connections when I see things happen in real time.

The final, most important step in my game plan is connecting my consult visit and collaboration with the school team to the client's family.  Sometimes, I write my SOAP note during the visit and leave a copy for families.  Most often,  I type out my chicken scratches at home and review the documentation with caregivers at the next clinical session.  I can honestly say that every visit that I have had to a school setting has been a worthwhile, successful trip.  I've seen changes made in a child's diet, increased use of picture exchange communication, and improved execution of voice output devices.

My hope in writing this post was to send a message to all the school speech pathologists out there that you are doing an AMAZING job with all your responsibilities.  As a private therapist, I want to help improve carryover and make the best impact that we can for the families that we are blessed to work with at school and home.  If you are reading this post and work in the schools or private sector, then I'd love for you to share your success stories in the comments section.  Regardless of your placement, what do you look for when collaborating with colleagues?  What would help you improve your service delivery model?

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