Support Services for diverse learners, such as SETSS (Special Education Teacher Support Service) Speech Therapy, Occupational Therapy, Physical Therapy and Counseling, are invaluable resources that can change the way a mainstream classroom accommodates students with disabilities.
Students who require this type of related services receive a legal document called an IEP (Individualized Education Plan) from their local education agencies, which dictates how often students should receive each therapy and for how long. Where the session takes place, however, can make a world of difference.
Related services should be provided at school, during school hours, rather than after school. Children have a busy schedule of afterschool activities and are exhausted after a long day of school. Additionally, since all therapists have their own styles, therapists who work within a school will be more aligned to the school’s culture and educational philosophy.
In school, there are two options for service providers, known as “Push in” or “Pull out.” The pull out model is common because it’s assumed that small group or 1:1 therapy without the distraction of class will be the most beneficial to the students. For example, if a student is mandated for speech therapy, the speech therapist pulls her out of her classroom at the same times each week. The student and therapist go to an office or resource room for the duration of therapy, after which the student returns to her class, and the therapist pulls out the next student on the schedule.
Though it seems simple and routine, the pull-out model generlaly has the least impact on the rest of the community, and is the least successful approach for holistically supporting the child receiving the services. The reality is that children are forced to leave their friends and learning communities to do something that their peers aren’t aware of, in a section of the school typically designated exclusively for students with disabilities, while missing out on social opportunities by being removed from the classroom. For therapists, it is difficult to simulate real life situations in an empty room. There are no opportunities to integrate the work children are doing with their therapists with the work happening in the classroom. Therefore, work done with therapists stays in the Special Education wings of schools.
The Push-in model is less common, because it takes more effort for the parties involved, but it is the most effective way to support the whole child: not just Jon who struggles with math, but Jon who loves Legos, riding his bike, and has memorized every state capital. This model involves therapists entering children’s learning environments and providing services in the classroom in real time. This underutilized model has extraordinary benefits including reducing stigma, increasing organic learning, reducing missed class material, continued progress with the classroom teacher and neurotypical modeling by other students.
When children are removed from the classroom, they sometimes present defiantly to therapists— and this behavior may be because the children prefer to stay in the classroom with their peers or are embarrassed to be pulled out. This turns into a power struggle between the student, not wanting to leave, and the therapist, just trying to do her job and ultimately results in wasted sessions.
When pushing in, the stigma is reduced or eliminated. Therapists pushing in can work with a group of students at a table, or go from student to student one-on-one, and they look and act like another teacher in the classroom. In fact, a sign of successful integration of a therapist in the classroom is when neurotypical students approach this adult and ask for next steps on the assignment or to go to the bathroom. In this way, students with a disability receive the same support, but in the comfort of their classrooms, making them more receptive to the support and also helping the classroom teachers by gaining another active adult’s assistance.
Additionally, with the Push-In model, teachers are able to observe the strategies that the therapist is working on with the child, and implement the strategies even without the therapist, giving the student infinitely more support than one 30-minute session. Ultimately, therapists aren’t pulling an essential piece out of the classroom, but are joining the classroom, and are treated as full members of the classroom community.
Another great benefit of pushing in is the organic nature of the therapy. If a child has weak fine motor skills, he can be pulled from the classroom to put pegs into a board and strengthen the muscles in his hand. Alternatively, the occupational therapist can push into the classroom during a writing lesson and help him with his grip, letter formation, and spacing, in congruence with his peers. The student is more motivated to do the work because it is in real time, and he benefits more from it because he sees the tangible benefits of the help he is receiving, which is completing the same work at the same time as the rest of his classmates. This is doubly important for therapy focusing on social skills such. The best way for a child to learn conflict resolution skills or how to initiate a conversation is by doing it in the natural environment with the support of the therapist preparing the student for the interaction, watching the scenario unfold, and helping the child debrief afterwards.
This reason ties into the important factor of neurotypical modeling. It is possible for students to work on their decoding skills in isolation. It is better for students to see their friends working on those tricky diphthongs and to learn from them in the context of the Language Arts lesson with the added benefit of their presence as motivation. This also holds true across other domains and an IEP goal quickly goes from a theoretical skill to work on, to a child thinking, “I want to do what my friends are doing so I will watch, learn and work harder on this, so I can do it too!"
Lastly, with push-in, the student isn’t missing class material. Students cannot be expected to catch-up, or stay on par with their peers if they are constantly removed from the classroom and missing essential lessons. Sometimes, pull out therapy is taking the student a step back, when its purpose is to move the student forward.
Ultimately, for inclusion to be successful, schools need the help of talented related service providers. The best use of these therapists is their influence and expertise permeating in the natural learning environment for students with disabilities to gain needed skills without the stigma.
Dana Keil is the Director of Room on the Bench: A Project of Luria Academy of Brooklyn, where she served as the Director of Support Services for three years. She is a certified Special Educator in New York and Massachusetts and has a B.S. in Severe Special Education from Boston University and an M.S. in Special Education with a focus on Behavior Disorders from Hunter College. Dana has experience in the New York City and Brookline, Massachusetts Public School systems, as a Special Educator in inclusive classrooms.