question

15 Dec

Does anyone diligently use push-in therapy? And if so, why? Is your district mandating it? Is the state? Some other force to be reckoned with? Is push-in EBP? What resources do you have regarding push-in efficacy?

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3 Responses to “question”

  1. Margi Linder December 16, 2011 at 7:17 am #

    I would really love to have the answers to all those questions too!!!!

  2. Sean Sweeney December 17, 2011 at 12:43 pm #

    I do use push-in models, selectively when it will work for the kids involved. A couple of reasons why:
    -Our services in the schools exist because the students have a disability that affects their access to the curriculum, and our role is to facilitate that access in light of building deficient skills related to their diagnosis. For this reason, we should be using curriculum contexts and content wherever possible. This is partially helped by having a close relationship with the classroom. And the curriculum has TONS of language in it, so it becomes easier when you think about strategies that relate to the curriculum language (see below)
    -We are mandated to provide services in the Least Restrictive Environment (LRE), and pull-out is more restrictive. We can and do of course justify pull-out how we can, based on what we are doing in tx and the students’ profiles. But according to the law, we really should be doing as much push-in as possible.
    -Many students (and their parents) do not want to be pulled out of class. As far as EBP is concerned, I don’t know if there is a study re: efficacy of pull-out vs. push in (good question) but one aspect of EBP is client values according to ASHA’s paradigm.
    -Also, another aspect of EBP is our own data, and I can say from years of experience that implementing at least part of my tx in the classroom increases the teacher’s likelihood of implementing strategies (e.g. scaffolded language with the students, finding other ways to apply the programs I use, again, see below) from virtually zero if I am not in the class, to well, a lot more.
    -RTI is playing a role for a lot of people and that is becoming mandated of course.
    -Finally, there are a lot of great programs SLPs can use in classrooms that are more or less “ready to go” but have a lot of value in teaching strategies that can apply across the curriculum: Visualizing and Verbalizing, Story Grammar Marker/Thememaker, Social Thinking, Reading with TLC’s Lively Letters, to name just a few.

    Anyway, I wax way wordy and I appreciate your question, hope my viewpoint is helpful in some way- obviously it’s something I am passionate about. You should definitely check out the articles by this in LSHSS by Barbara Ehren. They are like Bible to me. Thanks!

    • weathersby December 17, 2011 at 3:50 pm #

      Thanks so much Sean! The SLPs at my externship site are being encouraged to do more push-in services but they don’t know why or says who. I’m trying to find some resources for them.

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