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I feel like this post has been a long time coming. I’ve actually thought about what I would write many times over and never put pen to paper or in the case, texting thumbs to my blog app. Many titles for this post as well as emotions have entered my mind trying to create the perfect reflection to share my experience with push-in speech therapy. What I’ve decided is to blog about tips from my experience with room for prequel and sequel posts in an effort to break this writer’s block.

Here’s the cliff note history of my push-in journey. I was interested as well as challenged years ago to begin pushing therapy services into classrooms. Last year, the push for this service delivery was greater and I found myself fully included in K-5 classrooms about 75% of my direct therapy time. The first quarter did not go well. I dreaded most of the experience and wanted out. I was completely uncomfortable and unsure I was going to be able to adapt to this change.

Fast forward to now, with five additional school year  quarters under my belt, I’m genuinely settled and might even tell you I’m not ever leaving the classrooms. I’m also beginning to witness the benefits that I was blind to before.

Since this post isn’t designed to share all my feelings, a pro and con list, specific logistics for caseload factors, or even how to start, I’ll rather move into sharing some tips from my experience providing speech therapy services in classrooms.

  • Be true to yourself. Know your strengths and weaknesses. 
I am VERY anxious in new situations. I freeze in front of groups and become disfunctional, losing all my confidence. Going into classrooms was completely out of my comfort zone.

I am, however, flexible and as a colleague once told me, I’m good at seeing the positive in others...so I used that to build relationships with teachers, slowly. Don’t get me wrong, I was awkward, often. As my comfort level rose, so did my confidence in interacting.
  • Watch, listen and process what is happening in classrooms.
This takes time and is different for each grade, teacher, subject area, etc. Find how you can best integrate yourself into their routine, at first. In my experience, small group time is ideal! Logistics inhibit a perfect schedule, just as with pull-out therapy. Be open to large group, at times. Also be open to subject areas you might not have initially entertained. Our focus was on the ELA time block. Enter that schedule problem of being in all ELA blocks while having a large caseload. Math, science, and social studies can be excellent times for push-in. Don’t forget about morning meetings, if your teachers incorporate this activity. Additionally, having a good understanding of the curriculum aids your ability to determine what students need to be successful.
  • Don’t be afraid to abort the plan! 
You know the saying...best-laid plans. This doesn’t mean stop pushing in, this may mean trying something different. Pick a different subject or time. Reevaluate your students’ needs. Refer back to your observation notes! My schedule changes no more or less than it did with pull-out therapy. 
  • Communicate! 
It’s what we do best, but I found it hard due to my comfort level. Tell teachers what you need, offer tips,  ask questions and for suggestions. Ask for their plans or get their weekly newsletter sent to you, so you know the skills and strategies they are focusing on each week. 
  • Change your perspective. 
This might be the most difficult and most important. Yes, you have far more control in your small group pull-out sessions. You can control the content, materials, prompts, the environment, the data you are collecting and so much more. You feel confident with your perfectly tallied data, know you have chosen materials to meet each goal and your prompts and cues are spot on. Classroom therapy may be different. Very different. You have far less control, at times. You may be using materials that are less familiar. Distractions are present and frequent. Different is not always negative, in fact I’ve found many differences to be quite positive.
  • Keep your therapeutic focus.
Remember, you are using your speech-language pathologist lens and the angle you take makes the experience therapeutic. Language is everywhere and we can provide strategies and practice of target skills for our students anywhere using any material. Being familiar with the curriculum allows you to determine the language underpinnings necessary for student understanding of the content.
  • Do more with less. 
I cart around fewer materials with a bigger impact. I have streamlined the materials I use and try to use curriculum/classroom materials when I can.  I keep visuals with me, organized for quick accessiblility. Check out posts here and here about my visuals.
I spend less time and gain more focused therapy. I have the opportunity to do some 1-1 quick drill with students when necessary. I’m also getting more time on task because I’m not transitioning the students to another location and not needing a structured therapy routine that’s different from the classroom. Managing behavior takes far less time. My therapy is less mixed group and more focused on like goals.
  • Start somewhat small.
I’d like to tell you to start small, but since I did and continued to only do what was confortable for me, I never really immersed myself in the classrooms until I was pushed (silently kicking and screaming BTW). So, go ahead and push yourself. You can start small by keeping the way you provide the service in a similar fashion (just inside the classroom) until you have more comfort with how your services can evolve.

Even as I’m finishing this post, I can’t believe the transformation I’ve made to accepting and even promoting push-in therapy. I’m still learning everyday and by no means is the path smooth; however, it wasn’t before either:)! I’ve gained confidence, a new perspective, built stronger collaborative relationships and have witnessed positive student benefits.

Using leveled reading fluency passages is a great way to generalize speech sounds with a curriculum-based focus. For students working at the reading, structured speaking or carryover levels within the articulation continuum, this curriculum material is a sound choice!

Since I push into classrooms, I have the benefit of access to quick collaboration with teachers on a daily basis. Seeing students work on reading fluency passages weekly allowed me to easily realize how effective adding targeted speech sound practice would be for my students. While this post is not meant to offer specific reading passages or information/research on reading fluency, I will offer my experience as a school-based SLP and how I’ve used leveled reading passages in articulation/phonology therapy.

Ideas for Where to Start:
  • Ask your client/student’s teacher to provide you with the reading level of your student. If they have reading fluency passages that are appropriate already, by all means use what they provide. If not, search resources on Teachers Pay Teachers or other commercial materials to find short leveled reading passages. Our district purchased reading series has these leveled passages for easy download.
  • I have found that leveling down works best for my students. If my student is reading at a 2nd grade level, I may choose late 1st grade or wherever the child reads fluently with high accuracy. This is my tip as I want my students to be able to focus on their speech sounds, which takes more effort and slows down the reading. So, in essence, the task of the actual reading should be less challenging for the student. Again, this is my experience and has worked for me. Use your clinical judgment and collaborate with teachers.
  • Decide on weekly speech sound target(s) for your student. For students working on carryover of multiple sounds, I usually stick to one sound or class of sounds/patterns (ex: morphological endings, blends, fronting, etc.). You can also choose one sound in one position or all targets. Again, use clinical judgment and follow your therapy plan for that student.
  • For baseline or progress monitoring, I start with the student reading without any highlighting of sounds. I tell them what I’m listening for, but you could also take data on all targets. If you need a tip on accomplishing this task, I usually use a 100 word sample sheet and mark the targets I’m listening for and do a plus/minus system for occurrence. You could also just do a plus/minus for each word as correct or incorrect and then log sounds/patterns consistently in error. Check out my Workload product for a 100 word sample data sheet. You could also make a copy of the passage and mark targets right on the story.

  • I then use a highlighter to mark speech sound targets on the student copy and have the student read the passage again. You can again take your data on this sample, depending on how your goal is written.
  • Send the passage with the highlighting home for practice. I ask that students practice it twice each night.
  • I give another passage the following week and repeat the process. You can also take data on the previous week’s passage to note progress. My teachers refer to the initial “cold read” and the final “hot read” for fluency. With this articulation fluency, you are working on automaticity, so I think it goes well with this rehearsal factor of building fluency.
  • For work at the structured speaking and carryover levels, have the child retell the story or answer comprehension questions. Many reading passages have questions following the passage.
This therapy idea is very individualized as you are selecting the child’s reading level and specific sounds targets. It has a curriculum focus on reading fluency and it’s easy to incorporate into push-in classroom-based speech therapy. For select students, I’ve been able to work 1-1 with them for 5-10 minutes per week within their classroom. Maybe the best part is the built-in home practice that is manageable for families, aiding both speech sound development and reading!

Have you tried this technique to aid generalization?

Do you see mixed groups for speech therapy and need some fresh ideas to organize your sessions along with ways to progress monitor using consistent materials? 

My monthly themed packs just might be a resource you could use! I keep mine in a toolbox kit (there is a 
free download in my store for the labels). Each month has two drawers and I can easily pull the drawers to my therapy table or pop in my cart, if I’m traveling. (I keep the reinforcement games in the bottom drawers.)

I use the task cards during mixed group therapy by setting out the monthly reinforcement game activity in a container in the middle of the group with each student taking a turn practicing his/her target skill and then choosing a reinforcement card. One student may be working on verbs, while another works on vocabulary, and a third listening to details. These skills and many more goals are addressed in each monthly pack. If you don't have a mixed group, you can choose one set of cards and add the game cards.

There are also activities within each pack in addition to the task cards. I organize these in a binder. I can use the articulation open-ended worksheets and word lists for quick drill and home practice. The topic talk activity is perfect for social conversations or articulation carryover.

These packets can be stretched out over a month, depending on how many target goals your students have. You might use 4-5 sets of task cards per month to work on target skills within a group. Since this isn’t the only way I plan therapy, I tend to use them one week out of each month or may carry some task cards with me for the month for quick drill when needed.

I find these monthly packets are perfect for progress monitoring each month. While the vocabulary CHANGES with each theme/month to expand language, many of the target skills are CONSTANT. So, if your student is working on pronouns or following directions, for example, you will have the same format each month with varied content. It’s a great way to have consistent data collection on set skills to know what you are measuring.

Tackling mixed groups does not have to be intimidating. Any month is a great month to give these materials a try!

Let's talk about some ideas for targeting speech sounds with kindergarten students. In my experience, these young students require pictures and predictability when working on articulation and phonological targets. My materials prep often looks different for kindergarten students as compared to other elementary-aged students. While I don't use the same therapy materials every time, you can bet the plans recur. Here are a few tips & ideas for kindergarten speech sound sessions.

Tip 1:
Use recognizable, age-appropriate images with words paired on each target card. Young students need pictures AND words to aid in literacy development. 

Tip 2:
I pair those same target cards within varied activities and my students think they are games! Fun makes for cooperation and engagement! Try some of these activities with your target cards.
  • Tic Tac Toe-Draw a board large enough to put your target cards in each spot. Remove and say a card prior to adding your "X" or "O" mark.
  • Sort cards into BEGINNING, MIDDLE or END to work on sound placement within a word.
  • Add your cards to a bag or container and put an "X" on the back of one card (or any other letter you would like them to recall). Students can stay away from the “X” or try to be the first to find the target letter.
  • Roll a Card-Use a dry erase maker and board (or write on the table) to draw numbers 1-6 and place a target card under each number. Roll a die to see which card to practice. 
  • Spin a Card-Use a spinner to point to target cards or determine the number of times to practice each target.
  • Add Cards to a Craft-Print or copy cards (black & white) to add to any craft or open-ended articulation worksheets. I reduce the size when copying for mini speech sound cards. This is great for home practice too!
  • Feed Your Cards-Feed your cards to anything. I have a small flip-a-lid garbage can that I attach character "mouths" to for feeding cards. I also picked up some mini recycle bins at a dollar store for "recycling" cards to practice.
  • Hide Your Cards-Hide your cards in a sensory bin. Use cut up straws, gift bag paper filler, or garland to fill your container. Use toy plastic tongs to pick up cards to practice.
Tip 3: 
Don't forget to add in sight word targets and higher levels of speech sound practice as soon as possible for student success, expansion of utterances and literacy development. I pair target cards with carrier phrases/sentence starters.

Tip 4:
Remember the predictability above...using the same target cards fosters confidence and success in young learners, while also allowing for progress monitoring for the SLP. That doesn’t mean I don’t use other targets, as I do for generalization and variety, I just don’t always need to break the routine if students are engaged and meeting or exceeding goals!

If you need articulation picture cards in color or black & white, I would be honored if you took at look at my products. Some of the activities I discussed are included within the interactive sheets.

If you are a traveling SLP or would like your targets right at your fingertips, try organizing your cards in a container! Check out my free organization cover.

How do you prepare materials for your young speech sound students? I'm also eager to add to my SLP tricks!

Do you have students that are stumuable for all speech sounds, just require a model or cue? I’ve started using these bookmarks for quick drill classroom practice to aid automaticity and promote generalization. I’m in classrooms all day long and accustomed to the flow of most rooms. Taking 5 minutes to work with these students using Speech Sound Bookmarks is helping me fit this additional service delivery into my schedule. 

I print on card stock and cut multiple copies, then clip together individualized packs for these quick drill students. I throw them in my therapy bag so they are ready when I’m near that student. I pull out the bookmark or stack and drill with the student for 5 minutes and then leave the bookmark behind for their classroom book box or take home folder. The next week, I switch out the sound, if the student has more than one target, or keep practicing the same targets. A good tip is to make 2 copies of each in case the one you leave behind gets misplaced. In my experience though, the bookmarks have remained part of their classroom!

Will this work for you? Students can create their own speech sound bookmark with words from the curriculum or a favorite book. You can also download these FREE bookmarks for every sound.

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