The Workload Model: An Introduction SEPAC Meeting Presentation February 12, 2018 Brian Mistretta, Director of Special Services Leslie Fishbein, LDT-C
Background and Design • Conceptualized and implemented in the Portland Public School (2001-2002 SY) by SLP, Sharon Soliday • Utilizes flexible scheduling options • Utilizes a Workload Approach • Integrates collaborative solutions with staff and parents
Caseload vs. Workload Approach CASELOAD APPROACH WORKLOAD APPROACH • All activities related to school • The number of students compliance are the identified with needs that responsibility of the therapist. are served through direct Includes case management for and/or indirect service SLP’s. delivery options. • Not quantified by the number of sessions. • Quantified by the number • Can include students not yet of students and sessions. identified, but who receive pre-referral or early intervening services.
Workload Activity Cluster workload/caseload calculator-weighted services http://www.speechandlanguage.com/caseload-calculator
Caseload/Workload: Research Jackson, Polichino, and Potter (AOTA-2006) …“large caseloads limit school based therapists’ capacity to choose appropriate service options based on students' individual needs, as well as to collaborate with special education and general education teachers.”
Caseload/Workload: Research Chiang and Rylance - (2000) concluded in a special education report: “…caseload size symbiotically affects some of the very conditions that give rise to it. …caseload size….influences the roles and responsibilities of special educators. It exerts an impact on the extent of direct service time provided to students. ….caseload bears a direct relationship on the quality of education provided to students with disabilities.”
Service Delivery Model: Direct Services - 3 weeks ● Three consecutive weeks of direct intervention services: ➢ Pullout ➢ Integrated ➢ Individual or small group ● IEPS written to reflect minutes per month as opposed to minutes per week ● Month refers to a four week period of time as opposed to a calendar month (i.e. December, January, February, etc.)
Service Delivery Model: Indirect Services-1 week Flexible schedule options provided the 4 th week of the month include: ● Consultation/meetings with teachers, parents, and other specialists; ● Student and classroom observations ● Developing treatment materials; ● Providing make-up therapy sessions; ● Providing more intensive services ● Conducting assessments ● Participating in classroom observations ● Documentation ● Team Meetings
Service Delivery Model: Intervention services - IEP/504 Plans IEPs written as follows: “Therapy will be provided using a service delivery model/workload approach” Direct Therapy written with new service delivery model as: Student will receive 29 sessions per year (old model - 1x/week) Student will receive 58 sessions per year (old model - 2x/week) Type of session (push in, pull out, individual, and group) and duration of session (e.g. 20 minute, 30 minutes) remain the same using the traditional model of service.
Service Delivery Model: Research Outcomes •Provides more consistent services to students •Increased collaboration time with teachers and parents •Provides a higher quality of service to students and teaching staff •Generalization of skills in the classroom •Increase in therapist moral •School districts reported that reasonable workloads increased retention and recruitment of therapists •Fewer services were cancelled
Service Delivery Model: Summary • Therapists able to engage in the broad range of professional activities necessary to implement appropriate and effective service options • Intervention is individualized to meet student needs • Student success maximized by integrating collaborative solutions with staff • Mind shift for all stakeholders
Pros vs. Cons PROS CONS ● Allows for more collaboration ● Unintended problems that may arise ● Potential for staffing issues down the between provider and teacher(s) road ● Opportunity for parent meetings and ● Will Region V really give us “access” direct communication with related to OT, PT for the 4th week “flex service providers schedule”? ● Increase in generalization of skills in ● Will OT, PT, speech be able to actually multiple environments accommodate all students for the 4th ● Opportunity for new groups and week? sessions for the 4th week ● Will model continue at River Dell MS? ● 4th week allows for goal writing ● Should we pilot this in grades, specific collaboration between different students, etc.? related service providers ● Co-treating opportunities
Service Delivery Model: Resources American Occupational Therapy Association. (2017). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy , 68. doi: 10.5014/ajot.61.6.613 American Speech-Language-Hearing Association. (2002). A workload analysis approach for establishing speech-language caseload standards in the schools: guidelines [Guidelines]. Retrieved from Http://www.asha.org/policy/GL2002-00066/#sec1.2.1 Annett, M. (2004, March 2). Service delivery success: SLP’s in Oregon schools tackle workload, enhance recruitment. The ASHA Leader, pp. 1, 12-13. Retrieved from www.asha.org/publications/leader/archives/2004/040302/040302a.htm Cahill, Susan M. Exploring New Territories in the Schools. Early Intervention & School SIS Quarterly volume 10, Number 3 September 2012. Chiang, B., & Rylance, B. (2000). Wisconsin speech-language pathologists' caseloads: Reality and repercussions . University of Wisconsin-Oshkosh
Service Delivery Model: Resources Clark, G., Polichino, J., Schoonover, J. lecture on Response To Intervention lecture at AOTA Conference 4/27/12 Indianapolis, IN. Davis, Nancy (2012, June) Early Intervention & School Special Interest Section AOTA vol. 19, Number 2. School-Based Practice: Collaborative Partnerships in a Complex System Epstein, C. (2006). School Satisfaction surveys; An example for continuing competence. OT Practice 11 (1), pp. 9,22. Epstein, C.F., & Jaffe, E. (2003) Consultation: Collaborative interventions for change . In G. McCormack, E. Jaffe, & M. Goodman-Lavey (Eds.), The occupational therapy manager (4 th ed., pp 259-283). Bethedsa, MD: American Occupational Therapy Association. Gardner, C. & Lisbona, B. (2012) Enhancing related services in schools: The 3:1 model. Retrived fromc.ymcdn.com/sites/ www.njota.org/resource/resmgr/.../SC%2010%203in1model.ppt
Service Delivery Model: Resources Jackson, L., Polichino, J. & Potter (2006). Transforming Caseload to Workload in School-Based and Early Intervention Occupational Therapy Services. AOTA-Practice Tips Jacobs, K. (2012). PromOTing Occupational Therapy: Words, Images and Actions . Slagle lecture AOTA annual Conference April 27, 2012 Indianapolis, IN. Keller, L. (2007). 3:1 Model: From Research to Implementation, ASHA Conference. Retrieved from: http://www.asha.org/Events/convention/handouts/2007/0509_Keller_Li sa/ Mount, M. (2017). Promoting the 3:1 Caseload Model Effectively. Retrieved from https://www.speechpathology.com/slp-ceus/course/promoting-3-1-cas eload-model-8004 Occupational Therapy Consultants, Inc. (2017). [Satisfaction survey results for 2016-2017 school year in West New York Schools] Unpublished raw data. Strange, V. (2012). A Response to Intervention Approach to Handwriting . Advance for Occupational Therapy Practitioners, (8, October, pp. 16-17).
Service Delivery Model: Resources Streeter, A. (2010). Speech in Schools-Service Delivery: RtI and 3:1 Models. The Advance POV. Retrieved from: Http://community.advanceweb.com/blogs/sp_2/archive/2010/ 09/07/service-delivery-rti-and-3-1-models.aspx Thorne, D. (2011). Using Client-Centered Assessments and Practice in School Settings. Early Intervention & School Special Interest Section AOTA 18 (4). The 3:1 Workload Model- Cincinnati, Ohio SLHA- Retrieved from: http://www.ohioslha.org/pdf/Convention/2008%20Handouts/ MS27-ProfIssues-Candace%20Rapking.pdf
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