Adolescent Treatment Approaches: A Comparison of Models

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Adolescent Treatment Approaches A Comparison of
Models

• Shannon Godsey, MA, CCC-SLP
• Lindsay Addy, BAS
• Tristan Kerfeld, BAS

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Agenda

• Design of study
• Background information
• student experience
• setting
• caseload
• Two treatment models
• Comprehensive delivery model
• Classroom-based treatment model
• Compare contrast the models
• Suggestions for the future
• Discussion

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The Program

• University of Minnesota Duluth Communication
  Sciences and Disorders
• First year graduate students
• Assigned to off-campus 4-8 hour internship
• Supervised by a certified speech-language
  pathologist

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The Study

• Functional approach
• Comprehensive model in the fall
• Classroom model in the spring
• Observational retrospective study

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The Setting

• Welcome to Harbor City International School

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The Setting

• Harbor City International School
• Open since 2002
• 200 Students
• Special education population between 20-40
  students
• Staff 3 special education teachers and three
  aides
• Four day week with Friday electives
• Schedule two semesters and two symposia
• 5-10 students with direct speech services listed
  on IEPs
• Total caseload approximately 10

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The Caseload

• Communication diagnoses including Autism Spectrum
  Disorder (ASD), Fetal Alcohol Spectrum Disorder
  (FASD), and general learning disability.
• IEP Goals included goals for receptive and
  expressive language, pragmatics, executive
  functioning, and articulation goals.

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Holly

• Autism spectrum disorder
• 10th grade
• Goals include
• Understanding conversational POV of others
• Controlling emotions during conversation
• Topic maintenance
• Social/pragmatic skills

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Rob

• Autism spectrum disorder
• 11th grade
• Goals
• Organizing information
• Pragmatics
• Expressive language

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Amy

• Autism spectrum disorder
• 9th grade
• Goals
• Auditory comprehension
• Dismissed at the end of fall semester

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Nate

• Learning disability
• 10th grade
• Goals
• Pragmatics
• Organization
• Receptive and expressive language

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Lucy

• Fetal Alcohol Syndrome
• 11th grade
• Goals
• Speech production
• Pragmatics
• Executive functioning skills

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The Models Comprehensive Delivery Model

• Based on Communication Solutions for Older
  Students Assessment and Intervention Strategies
  (Larson and McKinley, 2003)

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Prerequisites

• Administrative support
• Special education support
• Space
• Identification of students who would benefit from
  this model
• Program planning

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Structure of the class Communications Lab

• Class meeting
• Group activity
• Individual activity
• Homework time
• Grading

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Goals

• Speaking
• Listening
• Reading
• Writing
• Thinking

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Class Meeting

• Self reports
• Three communication examples outside of
  Communication Lab
• Issues or problems
• Addressed through discussion re communication
  breakdowns
• Problem solving chart
• Opportunity for determining appropriate topics
• Compliments
• Modeled and focused on actions instead of
  attributes
• Encouraged positivism and group cohesiveness

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Group Activity

• Addressed functional communication skills
• Used terms like thinking, listening, speaking,
  reading, and writing
• Individual goals were interlaced in between
  activities

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Homework Time

• Students were given time to complete homework
  assignments from our class other classes
• Assistance was given as needed
• Activities were provided if they had no homework

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Grades

• Attendance and participation
• Scale was determined for overall grade
• 90 A
• 80 B
• 70 C

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The Models Classroom-Based

• A traditional model
• 30 minute direct treatment
• Occurred during Friday electives
• Focused on individual goals
• Required more collaboration with teachers
• Pull-out if necessary
• Material was curriculum-based
• Activities were adjusted based on the students
  needs

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The Models Classroom-Based

• Traditional model
• Individual services
• Pull out if necessary

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Prerequisites

• General and special education support
• Flexible schedule
• Consistent channels of communication

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Structure of services

• One on one
• Time determined by IEP
• Usually 30 minutes
• Services provided during Friday electives
• Students choice
• Goals were focused on individual and tailored to
  address classroom content

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Goals Holly

• Peace in Action
• Remain in class and engaged
• Control emotions during conversation
• Maintain topic
• Social interactions

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Goals Nate

• Stained Glass
• Organization
• Following multiple step directions
• Appropriate conversational language

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Goals Lucy

• Literature in Film
• Speech production addressed in one on one
  situations
• Organizing assignment
• Research
• Note taking

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Goals Rob and Amy

• Amy discharged
• Rob scheduling conflict

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Collaboration (in theory)

• Purpose efficient service delivery
• Contacted ahead of time
• Received materials for review

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The Models Benefits

• Comprehensive Delivery Model
• Amount of direct attention
• Directly addressing transition goals
• Students were give opportunities to communicate
  in a safe, respectful environment
• Activities were easily created to address the
  needs of all involved students

• Classroom-based model
• One on one with students
• Activities directly addressed individual
  communication needs
• Functional therapy

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The Models Challenges

• Comprehensive Delivery Model
• 2 ½ hours long
• Motivation
• Behavior management
• Varying cognitive levels
• Coverage of class

• Classroom-based Model
• Scheduling
• Ensuring effective amount of time with each
  student Definition of role
• Appropriateness of activities
• Location of classes

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So Now What?

• Base camp shorter class, more appropriate group
• Pull-out with students when appropriate
• Push-in with students when appropriate

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Conclusion

• One model does not apply to all students
• Flexibility
• There is a place for all models

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Recommendations

• Comprehensive Delivery Model
• Shorter class
• More specific groups
• Pre- and post- assessment

• Classroom-based Model
• Process for communication with teachers
• Back-up activities
• Less flexibility
• Pre- and post- assessment

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The Future

• Research
• Quantitative data
• ???

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Questions and Comments