Therapy Services in Prekindergarten (PreK) Adapted from presentation by Elizabeth Powell and Heather Gonzalez, Seminole County Schools

Learning Objectives Participants will: Define integrated therapy and identify flexible service delivery models for integrating the therapist into the PreK classroom. Describe the importance of collaborating to write Individual Educational Plan (IEP) goals and targeting communication goals and objectives within the PreK classroom. Identify a variety of materials and strategies that can be used to target communication goals and objectives within the PreK classroom.

What is Integrated Therapy? In integrated therapy, a student's related service needs are planned, provided, and assessed during classroom activities and routines. Skills are identified and addressed as part of a student's real life. The teacher, therapist, and paraprofessional work and learn together, sharing their knowledge and expertise.

Addressing Preschool Indicators Indicator 6: Early Childhood Settings - % of children ages 3-5 with IEPs receiving majority of special education and related services in regular early childhood program Provide training and technical assistance for therapists to serve children in the least restrictive environment (LRE). Indicator 7: Preschool Skills - % of preschool children ages 3-5 with IEPs with improved skills Provide training and technical assistance to districts to improve children’s early communication and literacy skills.

Why Provide Speech-Language Services in the PreK classroom? Federal law requires a full continuum of services in the LRE for all students, including those with speech and language impairment. For many students, services in the classroom constitute the LRE. When speech-language pathologists (SLPs) model techniques in classroom routines and activities, teachers and paraprofessionals develop the ability to embed speech- language supports into their daily instruction.

Why Provide Speech-Language Services in the PreK classroom? Provides more natural language opportunities for students to interact with peers and adults in a classroom setting Promotes generalization of speech and language skills Allows greater opportunities for PreK teachers, paraprofessionals and SLPs to collaborate

Goals of Therapy in the LRE: Children receive functional communication interventions during classroom activities and routines – all day, every day. Teachers and paraprofessionals have the knowledge and skills to facilitate speech and language skills during daily routines and activities.

Flexible Service Delivery & Scheduling Options for the PreK Classroom

Integrated Therapy Models Direct (therapist works with a student) Indirect (therapist works with a class or group including a student) Consultation (therapist meets with teacher(s) of a student)

Whole Group Teaching Approach: Team Teaching One teaches group while others assist Possible times for whole group instruction: Circle time, story time, morning meeting When introducing/ teaching new concepts or vocabulary

Whole Group Activity

Small Group Teaching Approach: Station Teaching What it might look like: Assign students to small groups based on abilities, goals, peer modeling Pair SLP with teacher or paraprofessional to model and coach them on facilitating communication goals in the activity Rotate groups

Small Group Activity

Incorporate SLP into a Classroom Routine Teaching Approach: Direct or indirect What it might look like: model ways to facilitate communication during daily routines such as: snack time lunch time transitions hand washing toileting playground

Working Together During Snack Time

Collaboration Type of Service Consultation What it might look like: Teacher and SLP collaborate to make modifications/accommodations to the curriculum, instruction, and assessment to help student achieve IEP goals and objectives during classroom activities and routines. Amount of consultation varies by therapy needs, program implementation, teacher skills and prior training Must be provided “on behalf of the child” and must be in accordance with the IEP.

Flexible Scheduling Combined Direct Service and Consultation A. 3:1 Model - Three weeks out of each month are designated for direct service with students and one week for consultation services, such as class observations, progress monitoring, consultations with staff, and conferences with parents. B. Block Scheduling - related services are scheduled so they can support children in a variety of ways during blocks of time in the classroom rather than scheduling by student.

“SLPs provide services to support the instructional program at a school.” Functional IEP Goals Optimally, IEPs should be written collaboratively, with functional skills that are relevant to daily activities, routines, and transitions. Whenever possible, services should be provided in the LRE and result in the least amount of disruption to the student’s classroom activities. All take ownership and participate in monitoring progress.

IEP Services Page If student has met criteria for language impairment, language services could look like: Language Therapy - Direct Services 120 minutes/month 240 minutes/month Best to write services that permit flexibility in setting or session length Consultation 60 minutes/month monitoring 60 minutes/month consultation Don’t forget to keep a log of consultation and data

Medicaid Certified School Match Program Billing School districts can bill for services provided by SLPs and speech-language assistants (SLPa) to students in any school setting with speech or language services on their IEPs or individualized family support plans (IFSPs), if they meet Medicaid provider requirements Reimbursable services include: -evaluations -individual therapy -group therapy (group no larger than 8) Detailed requirements found in Chapters 1, 4 and 7 of the Medicaid Certified School Match Coverage and Limitations Handbook at http://www.fdhc.state.fl.us/medicaid/review/ Specific/Certified_School_MatchHB.pdf Anne Glass anne.glass@fldoe.org

Suggestions for Getting Started SLPs observe at the beginning of the school year and determine a good time to embed language goals into classroom routines/activities. PreK teachers and SLPs look for opportunities for a mutual planning time to collaborate. SLPs set up blocks of time or days of the week to go into the PreK classroom (possibly multiple times a week).

Resources Materials that may be available in your district, school, or FDLRS program: Autism and PDD Picture Stories and Language Activities (Matt and Molly) Read It Again - Pre-K! entire program online: https://earlychildhood.ehe.osu.edu/research/practice/read-it- again-prek/ Tell Me Program – AAC in the Preschool Classroom (Year Round Literature for Language and Articulation) Books are for Talking Too! Expanding Expression Tool - EET https://www.expandingexpression.com/ Visual Supports and props to encourage engagement & participation Interactive shared book reading Picture Exchange Communication System (PECS) materials

Next Steps… To get additional training and support for integrated therapy, contact your TATS Facilitator: North West– Liza Smith tats-uwf@ucf.edu North Central – Kim Galant tats-fsu@ucf.edu North East – Bettianne Ford tats-unf@ucf.edu West Central – Sandra Erickson tats-fgcu@ucf.edu Central/Springs – Chris Bond tats-ucf@ucf.edu South West – Debbi Nicolosi tats-fiu@ucf.edu South East – Suzanne Ekelund tats-fau@ucf.edu