How to Make the 3:1 Model Work in Speech Therapy



Hi!

About 2 years ago, my school district decided to adopt the 3:1 model of speech therapy. We adopted it slowly, with some pilot schools testing it out first. Now all therapy staff, OT, PT, and SLP, are using the 3:1 model. For those of you unfamiliar with this model, this is basically how it works: students receive 3 weeks of traditional direct services and 1 week of indirect services each month.

When I first heard about changing to this type of service delivery model, my first thoughts went something like this - "Are you crazy? A whole week with no direct therapy services? Parents will throw fits! Kids won't make progress! Who came up with this idea?!" And now, 2 and a half years later... I'm loving it! I am a fully-converted 3:1 model supporter. Here's why I like it:

  • Let's be real: Our caseloads are not getting any smaller! My week is jam packed with sessions all day long! These direct services are important (obviously), but there are also other types of "services" we provide for our students outside of of their direct therapy time, including observations, progress monitoring, consulting with teachers, programing devices, making visual aids for classroom use, and training para's and even parents! These indirect services are important for making sure our students are successful across environments, not just for 30 minutes at a time in the speech room. Having a designated period of time each month to accomplish these tasks makes it easier to get them done!
  • I get to be in the classroom:  Sometimes I am so busy, I just have no idea what is going on with my kids outside my door. Now, during my "week 4" (my indirect service week), I get to see what is going on in my kids' worlds. It can be very eye opening! Sometimes I think a student has nearly mastered a goal and when I go into the classroom, I see the student is not carrying over the skill at all! This lets me know we need to work more on that skill and on carryover. Sometimes it is the opposite! I can confirm that a student is indeed carrying over a skill and he or she has mastered that goal. For my students working on pragmatic skills, I love observing the real problems they are facing in class with their peers. I use the situations I observe during my week 4 as opportunities for discussion and analyzing during direct services for the next 3 weeks. I find it much more meaningful and effective than giving the student only hypothetical situations.
  • My teachers know I am available this week: SLPs are full of knowledge and strategies to help all students, not just the kids on our caseload. My teachers can sign up for a time to come consult with me about any concerns they are having with a student (IEP or not!) or even how to teach language related strategies to their classes, such as phonemic awareness or comprehension. Having this time to consult allows me to be a better asset to all of the students at my school, not just students with IEPs. 

Implementing the 3:1 model took some time and adjustment for everyone involved. It is not something you can decide you want to do tomorrow and jump right in. Here are some tips for successfully implementing this type of delivery model:

  • Get your administrators behind you: You need your special education administrators on your side to help explain to principals, other special educators, teachers, and parents why a change in service delivery is happening. Change can be scary! But if you have both therapy staff and administrators on the same page, it makes the change must easier. I suggest going to your special education administrators first, with plenty of documentation to back up why you might think this service delivery model could be a good change, including a history of caseload numbers for your district, typical speech therapy schedules that show a lack of time to accomplish indirect services, and support from ASHA (there are various presentations and articles about the 3:1 model if you search ASHA's website.)
  • Take a full year to roll-out the model: It would get a little crazy if you tried to hold every student's IEP meeting at once to change their services. Instead, switch over to the new model at students' regular IEP meetings. Make sure to document this change appropriately in the IEP! My district uses minutes per month instead of sessions per week and also puts a statement in the LRE specifically stating the child will participate in the 3:1 model of therapy. 
  • Avoid co-worker jealousy: I can understand why other teachers may think that SLPs just get a "week off" or a week to do paperwork with this model. Make yourself available and visible during this week! If teachers can see how this model also benefits them, they will be much more likely to support it. I send out a calendar that allows teachers to book time with me to either consult about students, strategies to teach their class, or co-teaching lessons! Check out youcanbookme.com to make your own calendar! It even connects to your google calendar to show when you are busy or available! 

Has your district tried the 3:1 model? Share your comments or questions below! I would love to hear from you!

~Erin


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5 comments

  1. My district has used the 3:1 model for a whole year now and it's great for me. The hardest part by far at my school is getting teachers on board, as well as my 'guilt' for not seeing students. Hopefully this will ease up as time goes on!

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  2. I still hold sessions for the students who I feel need that consistency or regress quickly without therapy. Getting teachers on board was tricky for me at first too, but now most of them appreciate it because I can be in the classrooms more often.

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  3. I tried to set this up at my district but was told the only way it'd be allowed is if I specifically documented in time/services in the IEP for that indirect week. Which meant I would need to crate and implement a schedule of actually seeing the kids in their classroom and follow it during the "off week". Do you do this? I was under the impression that most SLPs who do 3:1 use the indirect week at their discretion... Classroom visits, teacher meetings, plan/prep for high maintenance students, research, etc...?

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    1. I do not put in service times in the IEP for the "off week", but I do document my activities of what I do during that week. That way, if there are ever any questions, I can say exactly what I was doing. What I choose to do with that week is up to me and it varies each "off week."

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