Going Rural Health’s Primary School Speech Pathology Program

initial findings

Claire Salter, Speech Pathologist & Going Rural Health Community Placements Co-ordinator, Shepparton

Claire Quilliam, Rural Nursing and Allied Health Research Fellow, Department of Rural Health Shepparton

As part of Going Rural Health’s focus on developing rural clinical placements in community settings, a school-based speech pathology placement program was developed.

Ethics approval was obtained to evaluate the program.

The Study

A pilot program seeking to address the speech, language and literacy needs of students within a Victorian Primary School was established in January 2019. The program involved the employment of a full-time speech pathologist and the rotation of final year university students studying speech pathology throughout the school year (approximately 8 weeks for each placement). As a partner involved in the speech pathology program, The University of Melbourne Department of Rural Health was interested in conducting an evaluation of the first year of the pilot program to determine the impact it was having on both staff and students.

How was the study conducted?

Information for the study was collected via semi structured interviews with school staff (school leaders, teachers and the speech pathologist) and university students completing a placement at the school. Ethics approval was obtained from The University of Melbourne and the Victorian Department of Education.

Of the 14 people invited to participate, a total of 11 people were interviewed, which is a participation rate of 79%.

Interview data was analysed using a process called framework analysis, where key themes were identified and grouped. Themes within the framework related to the program context, program activities, overall perspectives on the program, program successes and limitations, and strategies to improve the program.

What did we find?

Broadly there was consensus that the speech pathology program was beneficial for both the staff and the students. Participants observed the speech pathology program providing support and services in a variety of ways including planning lessons with teachers, delivering whole-class language sessions, conducting small group activities focusing on pre-literacy and oral language, providing training to teaching staff and working with school students one-on-one to conduct speech pathology assessment and therapy.

 

The school needs ongoing speech and language support

Participants mentioned that many school students come from disadvantaged backgrounds, with the Student Family Occupation measure placing the school as one of the most disadvantaged in Victoria. This disadvantage, alongside the potential limited capacity and resources of families to support their children’s speech and language development, meant that many children were starting school with delayed developmental skills, including communication and social skills. For example, the speech pathologist identified 20 of 23 Foundation level students needing speech pathology support in 2019. Previous efforts to address this high level of need was unable to be fully met by the visiting speech pathology service provided by the Department of Education, although it did assist in helping with funding applications for some students. Having a speech pathologist employed within the school was viewed as “an essential luxury”, where participants were grateful for the program, but felt it was more than justified, given the support needs.

Just having someone there every day, you know, that staff can talk to, that kids get to see every day—[the speech pathologist] is able to follow up with certain kids weekly, rather than…twice a term.

Additionally, participants identified that delays in speech and language were also impacting on school students’ learning, behaviour and social skills, and they could see that this would not lead to a positive life trajectory for these students. 

A further reason for the school needing the embedded speech pathology program was that school staff identified that their training and knowledge in speech and language development was not as in-depth as the speech pathologist’s. They commented how this specialist knowledge was helpful for teachers developing their skills, as well as for the school students.

I think that’s why [we need] someone who is highly skilled in it, highly trained, [is] more talented at picking up their [school students’] needs …

 
Positive impacts

There were a number of positive impacts reported by participants, who could see the potential for more significant outcomes in the future. Participants identified key stakeholders who had been positively impacted by the speech pathology program including:

  • School students:
    • Students are enjoying the whole-class sessions delivered by the speech pathologist and small group activities run by the university students and are happy to go for individual therapy with them
    • Changes have been noticed in students’ language and literacy skills in regard to sounding out words more confidently and linking speech pathology sessions to other parts of the curriculum
    • Students are receiving an increased level of support, aligned to the curriculum

I have noticed that a lot of kids are sounding out (words) and I think anecdotally that’s as a result of the [university] students this year and their activities, so I think that’s success.

  • Teaching staff:
    • Staff are learning new things from the whole-class sessions, the lesson planning, training sessions and through opportunistic discussions with the speech pathologist and university students, which is benefiting their teaching
    • Pressure has been alleviated from teachers in meeting the varied needs of their students through the small group activities and individual sessions, as well as the strategies suggested by the speech pathology team
    • The speech pathologist has been linking all planning and sessions to the curriculum, which supports teachers in meeting the students’ learning objectives

[The speech pathologist] would join in on the [teacher] planning once a week…[they] didn’t just come and say “this is what we’re doing”. [It] really meshed all [the] lessons together.

  • University students:
    • University students are getting hands-on experience working with children from a variety of cultural and language backgrounds, enriching their learning experience
    • University students are providing services in a range of ways, giving them exposure to the full scope of practice of a speech pathologist in an education setting

The involvement of university students was viewed favourably, with the students providing “more hands on-deck” and running useful small group activities, seeing children individually and developing resources for students and teachers.

 

Limitations to the program

Participants attributed most of the perceived limitations to the program as being related to the fact that the program was in its first year and in a pilot phase. Critique included a lack of clarity and communication about the program purpose and objectives and limited ways to measure the progress and success of the program. This lack of clarity meant that some participants felt they had almost started working with the speech pathologist by accident and that their interactions with the university students were incidental, so better communication around roles and expectations was requested. Student behaviour was seen to impact negatively on the whole-class sessions in particular, although the speech pathologist was seen to be adapting the sessions to better keep the attention of students. One final element that was viewed with some hesitancy, was that the program model, where the speech pathologist is employed by the school with no other allied health team and is directly accountable to the principal, may create some professional isolation and pressure for the speech pathologist.

 

Ideas for program improvement

Acknowledging that the program was in a pilot phase and seeing the potential it could have, participants shared a range of ideas to improve program outcomes. These included:

  • Establishing a clear speech pathology annual plan, with measurable actions
  • Expanding the program into more school years
  • Increasing collaboration with school staff including more planning with teachers and more whole-class sessions
  • Supporting teacher’s knowledge through coaching and observation of speech pathology sessions
  • Working with individual students in the classroom some of the time so teachers can see strategies being applied
  • More discussion regarding program focus with teaching staff
  • Increased involvement of leadership, i.e. observing sessions
Conclusion

Overall, the primary school speech pathology program’s first year of implementation was viewed favourably by participants, who saw a number of benefits to school students, teaching staff and university students. Many participants saw the value and potential of the program and were keen to see the expansion of the program in 2020 and beyond to include more year levels and increased engagement between the speech pathology team and teaching staff. A number of ideas for improvement were suggested, which are worthy of consideration as the program progresses.

Recommendations

With so many ideas contributed by participants, there are few additional recommendations to be made:

  • Improved communication internally at the school regarding the speech pathology program: Participants provided many ideas for the how the program could be improved, but it seemed that few of these ideas had been discussed between school staff. There is an openness from many people at the school to the inclusion of the speech pathologist’s knowledge across various components of the curriculum, so ongoing meetings and discussions are encouraged.
  • Increased family and student engagement: inclusive education environments encourage the authentic engagement of families in the decision making around their child, as well as the child themselves (Connor & Cavendish, 2017[1]). The voice of both the school students and their families was somewhat absent from this study and it is recommended that efforts continue to find ways of effectively engaging families in the speech pathology program and finding ways to enable them supporting their children’s speech, language and literacy development in the home.
  • Close observance of the Response to Intervention (RtI) model: The RtI model is recognised as an evidence-based best practice approach to delivering allied health support within an education environment (Speech Pathology Australia, 2017[2]). Whilst the speech pathology program is following many of the principles of RtI, further consideration of the model and the need for ongoing data collection and monitoring is recommended to give more fidelity to the service model and hopefully improved outcomes for students.

[1] Connor, D. & Cavendish, W. (2017). Sharing power with parents: improving educational decision making for students with learning disabilities. Learning Disability Quarterly, 41(2), 79 –84.

[2] Speech Pathology Australia (2017). Speech pathology in schools: a resource to support engagement and participation of student with speech, language and communication needs in schools. The Speech Pathology Association of Australia.

 

Acknowledgements

The authors would like to thank the participants for their time in contributing their thoughts and ideas about the speech pathology program. They would also like to acknowledge the commitment by the participating school to trialling this new initiative for the benefit of their students.

The authors acknowledge the Australian Government Department of Health’s funding of the University Department of Rural Health and Going Rural Health through the Rural Health Multi-disciplinary Training Program (RHMT) program.

For more information about this study or a copy of the full report, please contact Claire Salter at claire.salter@unimelb.edu.au.

The full interim report is available below:

Interim report_19.03.20

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