Speech in the Schools ADVANCE for Speech-Language Pathologists

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Speech in the Schools

Co-Treatment with an OT: Part 1

ADVANCE for Speech-Language Pathologists and Audiologists

In my last post, I started a discussion about alternate service delivery models

than traditional small-group or 1:1 pull-out for speech-language intervention.

The first of these I'm going to discuss is co-treating with the OT.

At my elementary school, I work in a primary Life Skills classroom. These

students all have cognitive impairments, speech-language impairments, and motor

difficulties due to varying diagnoses. These students are probably the busiest

kids in the building! Within a course of a week depending on need, students

could have up to 60 minutes of pull-out speech therapy (plus additional push-in

time which I'll discuss in another blog), 30-60 minutes of OT, 30-60 minutes of

PT, vision therapy, and/or up to 60 minutes of music therapy. Many of these

therapies are provided as 1:1 pull-out. In addition to the therapies, the

students also attend lunch, recess, and specials with their grade-level, regular

education peers. Oh, and now and then they are supposed to get some sort of

academic and life skills instruction to meet their IEP goals.

The OT who works with the primary life skills classroom works only part-time and

is only there on certain days of the week. The PT is only there on one day a

week, as is the case with music and vision. Needless to say, since I'm on a

six-day cycle (and therefore don't see the kids on a days-of-the-week basis),

fitting these kids in for speech instruction can involve a ridiculous amount of

juggling. If I have an IEP meeting and need to miss a student to make up at a

later time, forget it! The OT and I were finding that often times we were

scheduled to see kids at the same time are consecutively (meaning they'd be out

of their classrooms for an hour chunk of time). After some discussion and

problem solving, we decided at least for some cases, co-treatment with the

students would best meet their needs.

I had asked the OT previously about how each of the students communicated with

her (as many are unintelligible, minimally verbal, or non-verbal). When I found

out that sometimes the answer was " not at all " I knew that I needed to get these

students to work on using their communication skills with her. The OT and I

tried to co-treat at least once per month for a handful of our students. It was

very successful for students using AAC, whether it was a no-tech board/book, a

low-tech device, or while trialing a high-tech device. At first, the OT and I

met prior to sessions so I could find out what her targeted objectives and

activities were for the students. However, after awhile, we just planned our

sessions via email. That's the great thing about communication — no matter what

she was working on with the students, it was easy for me to embed the students'

speech-language targets within the sessions. We found it didn't work well for

all students for various reasons. As with all therapy, some trial-and-error is

necessary, and you need to know your students to know what works best.

Co-treating with the OT for primary life skills students is something I plan on

continuing next year. We've already mentioned it to the parent of one of our

incoming kindergarteners, and she was completely in favor of it. Just from my

experience last school year, I found it served two great purposes:

1. The OT had the opportunity to see what the students were capable of doing

and how to get the students to use their communication systems when working with

her, and;

2. The students had the opportunity to practice carryover/generalization of

skills to a different environment.

If you are looking for a way to fit over-scheduled kids into your therapy

schedule, consider co-treating with your OT. I've also done co-treatment in a

different way with my middle school autism support students that I'll discuss

in an upcoming blog.