#045: A Crash Course in an Alternative Service Delivery Model for Articulation

Marisha: Hello there and welcome to the SLP Now podcast. I am so incredibly excited to have Kayla Redden with us today. She is my SLP bestie, but she's also an amazing school-based speech-language pathologist currently working as her sixth year in a rural preschool and elementary setting. She also serves as the secretary of the Kentucky Speech and Language Hearing Association and has participated in KSHA's ICANN Advocacy Network where she learned how to advocate for herself, her students and other SLPs. This is definitely a topic that I'd love to chat with Kayla about, all things advocacy, but today we are focusing on some articulation strategies, and if you're wanting to find out more about Kayla, we'll talk about this more at the end, but she also is ... She creates materials for elementary-age students on her Teachers Pay Teachers store, which is called Kayla SLP and she also blogs about therapy tips at kaylaslp.com. So without further ado, let's jump into today's conversation. But before we get into all of the practical tips and tricks, Kayla, first of all, welcome.

Kayla: Thank you. I'm so excited to be on here.

Marisha: Then, I also would love to hear a little bit about your experience as an SLP, in general, and how you started or how you got started with the service delivery model for articulation.

Kayla: I started working as a preschool and elementary SLP about six years ago. I've worked with preschool through high school, but the last few years I really zoned into the younger students. Something that has always bothered me about articulation therapy is that we so often gravitate towards the two times a week, 30 minutes a session, and it just kind of fits into our schedule and that's what we're so used to doing. But I wasn't seeing the progress that I really wanted to see with my students, and especially some of these younger students with such short attention spans. I was hearing some other students, I'm sorry, some other SLPs talk about five minute speech and I wasn't entirely sure what that was. So I did some Googling, I talked to some other speech therapists and I found out that it's a top of service delivery model.
Now, you can buy a specific product, they have Speedy Speech in Five Minute Kids that lay out the whole program for you, but you not really have to have that necessarily to implement this program. I started thinking about my own students and some of the difficulties I was facing like my students getting bored, or distracted, or me not feeling like I was spending enough time on each individual student in large groups and so I thought I'd try it out to see if it would work for me and my students.

Marisha: That is amazing. I love it. Just solving some problems in your SLP world and now you get to share about it with us. Awesome. So it sounds like you already told us a little bit about what convinced you to give it a try, but were there some aspects that you weren't sure about when you started looking into it and where you found those answers or was it a pretty easy decision? I'd love to hear a little bit more about how that process went.

Kayla: Honestly, I struggled a little bit whenever I started to implement this because I hated to switch all my students over to this model and then find out that it didn't work. And also with it being sort of non-traditional, it made me nervous that maybe my administration wouldn't want me to be doing this specific model or maybe the parents would be cautious about me pulling their students only for five minutes at a time working on them with their speech. But once I figured out a way to make it work with my schedule and talked to my administration and parents about it, I realized that it wasn't too much different than what I was already doing. Just shorter sessions basically.

Marisha: Yeah, and I bet you tried this with a couple of students before making it part of your inventory of strategies to use across your caseload.

Kayla: Yeah. That first year I picked three students, I believe, who only had a few sound errors, maybe one or two just as a test run. And when I saw how it was working for them, I started moving more and more over. But I would definitely recommend starting small with this just to see if it's going to work for you, and your students, and your schedule and just your school as a whole.

Marisha: Yeah, and I think that really helps guide that discussion with administration and parents and teachers, because if you're selling this approach and trying to implement it with everyone on your caseload, but you haven't gotten to use it yet, then it's harder to answer some of those questions and speak from a place of authority or experience maybe would be better. So I love that approach and I think that can apply to any type of change we're wanting to make with our caseload or our service delivery models or anything that. So super helpful.

Kayla: Absolutely.

Marisha: Then I'd love to hear a little bit more about the pros and cons of using this approach. So you talked a little bit about potentially having to modify your schedule, which could be a con initially. What else was on your pros and cons list when you were getting set up and implementing too?

Kayla: I would say some of my cons or initial inconveniences to getting started with this approach was, like you said, changing my schedule to make this model work. I will say that starting small help with that because I could see how much time I would need to block off just for three students. But just changing my schedule little at a time, changing over the IEP service minutes, trial and error with students who are starting out, trying to figure out who you want to use this approach with and who it might not work with and then just educating the parents and staff on what this service delivery method is.
As far as pros, I definitely have more pros. I see more increased attention and engagement within the tasks because there's no time for these students to lose interest. It's very quick and they're engaged the entire time. I've seen a increased ability to recall sounds they're working on whereas previously seeing students once or twice a week, they would sometimes seem to forget the sounds in between sessions. You know, "What sound are we working on?" "Oh, I don't know." And these kind of pick a sound, but when they're working on it almost every day it's really hard for them to forget what they're working on. I see more productions per session, decreased frustration because even if something is hard, I feel a student can do just about anything for five minutes and they're missing less class and they're sooner to be dismissed, honestly.

Marisha: Yeah, I love that. So many pros and it is definitely challenging to switch and try something new, but I think if we can remind ourselves of the impact that it can have on students, we can give it a try too, especially using that approach where we start small. So let in terms of helping SLPs get this set up with our caseloads, I'd love to dive into some of the cons or challenges that you mentioned. So the biggest one I think is getting administration onboard. So how did you go about this and what did that look for you?

Kayla: My best advice is to bring the research to the table when you're talking with your administration. Obviously, it's going to depend on who your administration is and I'm very lucky to have a director who trusts my decisions and what I say I would to try with my students, she's very flexible. But bring their research because they may say, this is something I've heard others say to me, "Well my administration says five minutes isn't going to do anything for these students because they're so used to seeing speech therapists use the traditional 30 minutes at a time approach." I do know that the Speedy Speech and the Five Minute Kids websites have research available that you can print off and bring to your administration, but just be upfront with them so they know exactly what this top of therapy looks. And really the research is just talking about how short, frequent, intensive therapy can lead to greater outcomes. So you don't have to have the program in front of you to bring to your administration. Just talking about how those short sessions with lots and lots of repetitions can make a change with students.

Marisha: Yeah. And especially for something articulation. There's some really cool research out there and I love that we can find we get easy access to summaries and handouts from those sites as well. That makes it even easier.

Kayla: Yes. I love it.

Marisha: So what about communicating with parents and teachers? What has that looked like for you?

Kayla: I feel I've had a very positive response from parents and teachers alike. The teachers really it because the students are missing less class and really they're with me no longer than they would be at a bathroom break, for the most part. So they're not missing all of science or all of social studies when they come with me, they're just missing five minutes. So they've been very on board with that. They to see that these students are really engaged with what I'm working on, because sometimes I'll do this in the classroom and they see what I'm doing and they're like, "Oh my goodness, I can't believe you get so much in just five minutes." And parents like that their kids are getting one-on-one therapy, and that's something that we don't always offer a lot of in schools. We see most of our students in groups, but even if it's just for a short period of time, parents knowing that their students getting all of your attention a few days a week for a short period of time means a lot.

Marisha: Yeah, and did you have any parents or teachers who were resistant to it at first?

Kayla: I personally have not had any. I came fully prepared that I might have some that were upset or worried about just a change in approach and I get it because it seems like five minutes, what can you do in five minutes? But I think if you're just upfront with them, especially after you've tried it a few times with other students and you can say, "Listen, I've seen really great results with this. Your student is missing less class and they're getting dismissed faster." Then that's enough to convince most parents and teachers that we're on the right track.

Marisha: Yeah. It's just a matter of bringing that information to the table and not just saying, "We're switching to five minute sessions." And instead, setting up the conversation and sharing the research and what it would look and just like we would with any other approach. So I love it.

Kayla: Yes, So whenever I had that initial meeting where I switch over, I do go over that with the parents and the teacher as to why I want to switch, what I've seen in the past and I just go over the reasoning. I think it puts everybody at ease.

Marisha: Yeah. Then also just before we dive into the logistics of actually getting it set up with your caseload, I'm wondering too if you can break down from what you've read in the research or what you've seen in your experience, who is a good candidate for this approach and maybe who wouldn't be as good of a fit?

Kayla: So like I said, when I first started out, I wanted to test it with my more mildly impaired articulation students. So I picked some single error or two error students and it worked really well. So over time I've learned that it does not have to be just those students. You can work with R students, and I say R is not a single sound error because there are so many different versions of R and it can take so long to fix an R, but those are great students to work on this with. Multiple sound error students. Phonology, you can use it with your kids who are using cycles because it doesn't have to be five minutes. You can do five, seven, 10 minutes for a child depending on what they need. So you could do three 10 minute days and use a cycles approach with these students. I've used it with kindergarten through elementary. I believe my other SLP at my school has used it with high school and I've used it with isolation through conversation levels. But the one group that I might not use this with will be preschool just because preschool doesn't always respond the best to drill, drill, drill, especially these new three year olds and four year olds. I use more of a play-based therapy approach with those students, but I feel most anybody else you can make five minutes for each work.

Marisha: That is super helpful, and then it's also case by case too. Maybe if we're in the very beginning stages of establishing a sound and it's really tricky, maybe the student would benefit from a longer session but I feel like from my experience that's pretty consistent with what I've seen too. I'm just trying to think if there's any other exceptions, but I think you got it. So I think we're ready to dive into some more of the logistics. What do you think, Kayla?

Kayla: Yeah, let's do it.

Marisha: Okay. So I'd love to dive into how you set this up with your caseload. So do you have any general setup tips or should we dive into the specifics of the IEPs? What do you think makes the most sense here?

Kayla: Just as a general rule, like we already said earlier, I would just start small. That's my best tip because you're going to be so overwhelmed if you start trying to change your entire schedule and all of your IEPs at one time for this. I would say wait until a student's annual rolls around before you change their IEP instead of trying to amend everyone's at one time, but yeah.

Marisha: Yeah, that makes a lot of sense. Then speaking of IEPs, what did that look when you ... So you said to wait until the annual, so you're not amending them, but then what did you write in the IEP or do you have any tips there in terms of how the Five Minute Kids approach, or the Speedy Speech, or just any variation of that would look in the IEP?

Kayla: I know that every IEP program allows you to write different things as far as service delivery times go. For Kentucky, where I work, we have to write how many times we're going to see the student either per day, week, or month and then for how many minutes. So when as soon as annual comes around, I typically write five minutes, 12 times a month and that allows me to see these students three days a week and that can be pretty flexible. You could write maybe nine times a month or 10 times a month if you want to allow some flexibility but I feel like five minutes, 12 times a month has worked well for me.
But let's say that you want to do cycles with a child you may choose the 10 minutes, three times a week or if a student is working on placement still and you still want to try shorter sessions maybe 15 minutes twice a week. Or if you can write ranges, which I think would be great, five to seven minutes, nine to 12 times a month or however you want to write it. It doesn't have to be that five minutes, three times a week. You can be flexible depending on your student and I know the manual, a Five Minute Kids kind of goes over that too, but again, five minutes is not the magic number. It's whatever works for your student. It's really just short, intensive sessions.

Marisha: Yeah, and I think that's a really important point to drive home. I think we get into our templates of once or twice a week for 30 minutes and this could become another template of, "Yeah, I do five minutes three times a week." But it's really like we're expanding into these different service delivery models and exploring them because we want to find the optimal service delivery time for that individual student. So you're absolutely right, it's not a template and we get to consider each student's individual factors as we're setting this up. So that's perfect.

Kayla: Yeah.

Marisha: Okay. Then what about Medicaid billing? I feel like there's a lot of questions about billing with this approach.

Kayla: Yes, lots of questions. Again, I'm very lucky to work in a school who does not force me to write my IEPs based off of Medicaid. I do know that if you want Medicaid to reimburse you can't write five minutes and some administration may want you to write your minutes more than five minutes just so that you can get that reimbursement. And I understand that and that's where I say the eight minutes, the 10 minutes may be just as beneficial for your student. They're getting a few extra minutes with you and it will meet your Medicaid requirements. So that's the discussion that I would suggest having with your administration before getting started just so everybody's on the same page and they know that five minutes will not get you reimbursed, 10 minutes will but still do what's best for your students. So if your students truly need the five minutes, that's a point that you need to really emphasize when you're talking about this approach with your administration.

Marisha: Yeah, and that absolutely makes sense. Putting students first and then advocating for them in that way, and then yeah, just kind of making it work and being a problem solver. We get to be really good at that.

Kayla: Absolutely.

Marisha: Then, what about scheduling? How did you get this set up in your therapy schedule?

Kayla: I set up a block of time for three days a week to see my students. I do allow some time for movement because I am going from classroom to classroom working my way down the halls seeing these students. So for example, if you have four students who are getting five minutes speech and you're seeing them five to seven minutes each, you may want to schedule 30 minutes just so you have enough time to transition between classrooms, make your way down the hall and see everybody. Because if you really only allow yourself five minutes, you will get behind and I have learned that the hard way because at first I set up my schedule five minutes, five minutes, five minutes and there was no way I could see three Five Minute Kids in 15 minutes even if they were in the same classroom together basically.
So always allow a few minutes of movement time. But I do suggest scheduling a block just so you can leave your room, work your way down the halls, and then come back to your room for whatever you have to do for the rest of the day. But there will always be some students who don't fit into that block. So the good thing about five minute speech is you could always say, "Okay. Well, third grade does not fit in this block. I will see them the first 10 minutes of school and I will see everybody in these 40 minutes in the afternoon." There's a way to make it work because it's such a short period of time.

Marisha: Yeah. And I'm curious, what does that block of time look like and how many students are you seeing in that amount of time?

Kayla: I probably see 10 students in about maybe an hour because that gives me about 10 minutes that way to ... Well, I don't know, I'll have my schedule in front of me. I think I see about 10 students maybe in 50 minutes and then that leaves some time for me to move down the hall, but I've fluctuated and I've actually dismissed so many students I'm not entirely sure how many I'm seeing that block of time. Because I've actually got to dismiss two of those students just recently and that helps a little bit. But I say, however many students you're seeing allow about 10 extra minutes of movement time just because you may be walking across the entire school building to see some of these kids or one may be in the bathroom and you have to wait a minute. So just allow some flexibility.

Marisha: Yeah, that makes sense. Then I'm curious too, if you have three students in a class, do you just tell the teacher, "Okay, I'll be here on Mondays, Wednesdays, and Fridays from 3 to 3:30."

Kayla: Yes.

Marisha: Or do you give each student a specific time?

Kayla: I just sort of give the teacher a block of time and then I make my way into their room and just call them over one at a time to see me, and a lot of times they'll even go get the next student. If we're all in the room together they're like, "Oh, do you need so-and-so? Let me go get them." So it flows very fast but the teacher knows within about a 15 minute period that I'll be in their classroom.

Marisha: Yeah, that's awesome. Then of course I bet that some days everything goes super smoothly and then other days it takes a little longer. So having that range I think is helpful.

Kayla: Yes.

Marisha: Awesome. So totally doable. Then that also reminded me of a question that comes up a lot in terms of student privacy because these sessions are typically happening in the hall or the classroom, right?

Kayla: Yes.

Marisha: Yeah.

Kayla: Just to make sure that your students are not ... You're not breaking FERPA because you do want to keep your students' privacy protected and the fact that they are receiving a special education service. Taking students into the hallway may not always work. Now, if you were in a school where you have a ... The end of the hallway where no one's coming down and it's a quiet end of the hall, that may be okay. Or if you have some fold-out barriers, I know that we have some fold-out cardboard barriers we can put up at the end of the hallway to use you can do that. But I also see students in the classroom. I try to go in during a busier time in the classroom, so when they're not doing silent work so that I can just pull them to the back or the side without disturbing the entire classroom for them to work with me.
So I see students at a back table in their classroom, on the rug, I've pulled them into the library before. Just anywhere where I'm not disturbing the rest of the class and the rest of the class isn't disturbing us necessarily. But you don't have to go in the hall, it doesn't work for everybody. I know that you don't want to parade your speech students around. So definitely, if you can find a little corner somewhere to go, just go there.

Marisha: Yeah, that's perfect. Then also I'm curious what the sessions typically look in terms of the structure, the materials, all of the good tips you've got.

Kayla: So this may be my favorite part of five minute speech, besides the fact that so many kids get dismissed. You don't have to plan much for it. You don't have to print off worksheets, or bring a ton to flash cards, or set up a game. Usually, when I go to five minute speech it is me, my clipboard and my iPad and that's about it. So my iPad has all of the apps that I would use for my articulation students for flashcards or reading passages, conversation starters. Most of the apps that I use allow me to track my data on them so I don't really have to bring a data sheet with me most of the time, but I usually keep something just so I can jot notes down for my next session with that student.
I use Articulation Station Pro and it goes from word-level two reading passage level. So that covers most of my caseload. I use Little Stories Pro, which has reading level and conversation level and super-duper story starters, which may be free, I believe and it's conversation level. Just fun little topics for your students to work on conversation carryover. But I love that I don't have to bring a cart full of stuff down the hallway. It's just my iPad and my clipboard and me and I time it on my watch, or you can use a digital timer, but if you have an Apple Watch you can just say, "Five minute timer." And it'll start vibrating whenever time's up.

Marisha: Ooh, that is a fun little hack too. I love that.

Kayla: Yeah, and my students think it's super cool that I talk to my watch so you earned some cool points doing that too.

Marisha: I love it. And it keeps you on track, so win-win-win.

Kayla: Yes. Yeah, It kind of keeps you from going over too much on time because it is easy when you get in that session just to keep going and going. So I do suggest setting a timer so that you and the student know when time's up, next student, but I'll see you tomorrow.

Marisha: Yeah, no that's great. So you grab the student, they sit down with you, you pull up whatever activity they're doing on the iPad, then you drill, drill, drill, drill, drill. Do you have anything that you do when they first sit down or with the wrap-up? Obviously, you say hi and check-in, but do you frequently share their progress or is there any other little elements that you think are helpful that you add in?

Kayla: Usually, when we first sit down, I will ask them, "What did we work on yesterday?" And I mean 95% of the time, even my kindergartners can tell me exactly what we did the day before, which is a huge win in my opinion because with the traditional models, they didn't always remember that we worked on T last time or Ks last time. So just a quick refresh, "What do we work on yesterday?" Then sometimes we'll pull up their scores and we'll say, "Okay, here's how we did yesterday. Let's try to beat that score today." Then we'll do our drills for five minutes and then at the end I'll let them see their data. And the good thing with Articulation Station is that it gives a little checkmark if they've hit 80% or 90% whichever one you set it to. So if they see that checkmark, they know that they're reaching that goal, but even if they don't reach the goal, they can see if their progress went up or stayed the same or went down from the day before and they enjoy that.

Marisha: Yeah, that's super fun. And it's so easy to see progress using this approach because it's super fresh, they're practicing it regularly, all that good stuff. That's awesome. Then do you ever send home homework or anything like that with this approach when you're implementing it?

Kayla: I usually will send home something. Some of these students, if they're having particular difficulty with a certain set of words I will email that word list to their parents, and Articulation Station allows you to do that. You can pick the sounds they're working on and send the email, I believe with the flashcards on it to the parents. And I'll also send home a monthly little checklist thing of, "Okay, if you practice your sounds 15 days out of this month then you get something." Or, "If you practice every day this month you get something." So I do send home a little bit of homework because I feel like if I'm working on it every day, then it should be pretty easy to carry over at home because the students can tell their parents exactly what they're working on and that's one of the biggest barriers I see to homework is that the parents don't understand how to help their child. But when I've seen them almost every single day the student can say, "Well, here's what we're doing and here's how I say that sound." And it just helps with the carryover.

Marisha: Yeah. And I love that tip that because I don't think I've used that feature. I love Articulation Station. I don't think I've used the email feature other than to email myself the report in the evaluation app, but that's so helpful. So cool. Awesome. That's so easy then and you definitely ... It's super relevant and you don't need to do any printing and that's probably easier for parents too because that way if they're waiting, I don't know, if their sibling is in soccer practice and they're just sitting in the car waiting they can just pull that up and run through some words, and it can just very easily become a routine, which is amazing. I love it.

Kayla: And you can also screenshot it, I believe. And if you, if your school uses Remind or ClassDojo, you can send it that way too. So if a parent doesn't have email or doesn't check their email often, most of them will check a text or Remind. So I send it that way too. I just take a screenshot and send it through Remind and it's just they're on their phone at anytime. They can practice anytime.

Marisha: Yeah, I loved using that with my caseload. Then in case listeners aren't familiar, what is Remind and ClassDojo and all those kinds of things?

Kayla: Those are apps for parent communication, and I know that most schools adopt some system of parent communication as a whole. It's basically another way to text parents without giving out your phone number to parents. And we personally use Remind at our school and you can send text messages and photos. You can't send videos, I wish you could. I would love to share my students doing their five minute speech with their parents, but you can share the photos of whatever you're working on or take screenshots and send it to parents that way.

Marisha: Yeah, that's perfect. And I had loved using that with my caseload. It was something that the school was already using and I would just have them ... I did send out emails just in terms of getting it set up, and I'd love to hear how you did this, but I ... Because I was new to this school so I sent out handouts asking the parents to join. I set up a class for my speech students and I set it up so that the other parents couldn't see other students. So they only could see their student. But I sent that invite out and then some parents responded to that. Not everyone did though, but at every IEP meeting I would bring that up and I was at ... What do you call it? A title one school.

Kayla: Yes, right.

Marisha: I think they traditionally get a rap for not having as much communication or less just involvement, but every parent that I talked to about it ended up signing up for it and we were able to communicate. It just makes, this is a little bit of a digression, but it just makes a really huge impact on student progress because we're able to just send super quick notes back and forth. I don't know what it is, but answering the phone or listening to a voicemail or reading an email even sounds like a big chore, but this just feels a super easy little text message and they just respond really quickly. And I've seen it help tremendously with generalization and I love the tips that you shared of sending screenshots and with this approach, it's super easy to implement that because it is one-on-one.

Kayla: Right, and you can even say just a quick text to the parent that says, "Hey, we worked on K this week. Here are some words to practice at home." And like you said, you're way more likely to get this parent engagement I feel like when you send a text style message to the parents because it is, it's so quick for you to send it and it's so quick for them to respond. So if anyone is not using one of these programs I really suggest you look into it, because I think you'll be surprised at what the open lines of communication will do for you and your students.

Marisha: Yeah, I absolutely agree. Then also just a couple other tips. Some school districts or some schools might not be using an app Remind or ClassDojo. I've heard of some SLPs using Google Voice and just setting up a number and then they can ... Because then that way they don't have to share their personal number, but there's a way to communicate and just check with your administration and check with your confidentiality and all of that, but those are things that I've heard of other SLPs doing just as a way to navigate that.

Kayla: I've heard that too and I've actually had that before. So I also recommend Google Voice if no one's used that. Give it a try.

Marisha: Yeah. And I think it's especially helpful for EI or if you're traveling or whatnot because then it's easy, then you don't have to give out your personal number and you can call parents and send them updates just as you're communicating scheduling and all that.

Kayla: Completely agree.

Marisha: So awesome. So thanks for humoring that little digression, but I think that's super important. If we're seeing a student for three times a week for five minutes, and if we can get the parents to help us we could essentially be doubling or tripling the student's practice time, which would result in much more progress. So this is a very important element of it and I'm glad we got to dive in.

Kayla: Me too.

Marisha: Okay, so another question. Do your students get bored? Because it sounds like it's ... Like it's not any fluff. You didn't mention a bunch of reinforcers or gains, you're just running through the articulation apps. Do they get bored?

Kayla: That was a fear of on when I switched over to this method, just because these students that I was using this with were used to getting to leave class, coming in my room, playing a game, getting a reward, and then going back to class. So I was nervous that I might have some pushback from the students themselves because they were no longer getting to come to my room, or get these fun games that we've been playing in my classroom. But I learned that maybe the first couple of times they may say, "Well, why don't I go to your room anymore? I want to go in your room and play a game." But I just tell them, "You're doing so well. This is how we're going to start working on your speech and I want you to be able to get back to your friends as fast as possible." My students really don't get bored. And I think it's just because the sessions are so quick there's no time to get bored. Whereas even in the classroom, when you're doing something super engaging you're going around the table and everybody takes a turn. Student one may be bored by the time you get to student three. Well, in five minutes speech is just you and that student, and there is no time for boredom because they're the only ones doing all the work.
So we still joke around and we still have fun and they love using the iPad. So bringing that, it's just a reinforcer in of itself even if you are practicing flashcards on there, or playing a matching game, or reading a sound loaded story. It's sort of rewarding in and of itself versus having to get a reward in the classroom.

Marisha: Absolutely. And I think if we are having that discussion with our students and they're really clear on what they're working on and if we're seeing them that frequently they're making that progress. So I think being able to see that progress is really rewarding. I know that would get me super excited. It's like, "Last week I was at 60 and I got 80 this time. I'm getting better." So I think just emphasizing that progress and mastery can be a huge win and we need all the extra stuff.

Kayla: Honestly, and sometimes your students are just excited because they're seeing you more. They're seeing you for less time, but they're seeing you almost every day and they love that. They're like, "Oh, I get to see you three days this week, four days this week." Or however often you're seeing them. But that gets them excited too, just you say, "Well, you used to only see me once a week for 30 minutes, but now you get to see me three days a week and I'm bringing the iPad." And yeah, it's a good time.

Marisha: And they get your one-on-one attention. How often does that happen throughout the school day and maybe even at home? That's, pretty special.

Kayla: Yeah, it means a lot to them, I can tell.

Marisha: Yeah. Oh, that's amazing. Have you ever run into behavior issues or do you feel like the length of the session is just so short that it doesn't even come up?

Kayla: Knock on wood, I have yet to have a behavior issue and I have used this with maybe 20 plus students so far. Actually, I'm sure more than that, but I've never had an issue. It's just because the students look forward to working with me one-on-one. Like you said, they love that attention. They don't want to get in trouble. And I tell them, I'm like, "We only have five minutes." That's one thing I do tell them if they start to get off task. You know, "We only have five minutes together today. So let's make the most of it. Let's not be silly, goof around, roll on the floor and I'll see you again tomorrow but we have to work hard today." Then that pretty much nips it in the bud right there.

Marisha: Yeah. Then another thing too, because when I was using Remind to communicate with my parents, they knew that I would be sending a note to their parents at the end. That wasn't something that I said often. Like, "Oh, I'm going to text your mom." But I feel like they just know that I'm going to be having that communication and they know that their teacher is right there too. It is just so incredibly short that I think all of those factors just combined make it really easy to manage that behavior because it just ends up being a non-issue.

Kayla: I agree.

Marisha: Okay, awesome. Then do you reward students at the end of the session or what does that look like?

Kayla: I don't always give rewards during five minute speech just because it's such a short period of time. I feel like they're getting rewarded, I know this sounds ... This is going to be controversial because some people believe in stickers every time or candies every time, but I feel like if I'm seeing a student for five minutes, then maybe not a candy for hanging out with me for five minutes and working hard. I will sometimes bring a smelly, which is what I use for some of my younger kids, a scented chapstick, put it on the back of their hands but that's sort of a rare thing even. It's usually, "High five, great job, look at your progress, see you again tomorrow." And they don't ask for things. It could be partially because even when they were in traditional type therapy with me I didn't really give out a lot of rewards. I was more of a, "Here's a smelly." Or, "You can sit in the teacher's chair for the session." That kind of thing. But they don't really ask for rewards and when they do get one it's super exciting because they don't come around that often.

Marisha: Yeah, I think that makes a lot of sense. And I mean the reward is in being able to spend with you and make progress towards their goals, and they get to do fun stuff during the session. It's not like you're making them pull their teeth out or anything.

Kayla: It is not just straight-faced flashcard drill, and I'm talking even kindergartners. So I'm not just talking older students. Even my kindergartners do not necessarily require a reward at the end. It's literally just, "You did so great today. Look at how much you went up." Maybe you could say, "I'm going to text mom and tell her how great you did today." High five and then we'll do it again the next day.

Marisha: Yeah, that's perfect. Then I loved what you mentioned because I think you ... From what I understand, you don't do a prize box or the stickers or the candy in general, right?

Kayla: Right. I've stayed away from that recently.

Marisha: Awesome. And you have a really great blog post that you wrote. So I'll link to that in the show notes as well as the different apps that you mentioned and any other resources that came up. Like the links to the programs and that'll be slpnow.com/44 but I really loved that blog post because they think if you are struggling with that and your students are always asking for more stuff, or you're not sure if you want to be spending money on that, Kayla has a lot of really great ideas so look for that in the show notes as well. That's a really helpful post.

Kayla: Thank you.

Marisha: And I just love the scented chapstick idea because it costs one or two dollars and it probably lasts you forever. So tell us a little bit about how you do that just in case it's not super clear.

Kayla: I have a box of about 20 different chapsticks that I've bought up throughout the different seasons and at Walmart and on Amazon, and at the end of a session if a student worked hard, was nice to others, did their job, then we get a smelly, that's what we call them. And I close my eyes and make a really big deal out of picking out a chapstick from the box and we talk about what smell it is and then they all get just a little smudge of it on the back of their hands, and they can smell that for the rest of the day or until they wash their hands. But they love it. It's a huge, huge, huge deal.

Marisha: Yeah. And that gets to be a language activity in and of itself because you're working on describing and all of that.

Kayla: Yes.

Marisha: Awesome. I love it. Awesome. And I love the experiential rewards, like getting to sit in a special chair or ...

Kayla: Right, and I tried the treasure box, but it was more of a, "You don't have what I want in there." So I just kind of got rid of that and now it's more of, "No shoes." Or, "Sit in the teacher's chair." Or, "Five minutes of iPad time." Just something that doesn't require physically buying something and stocking a treasure box that may not even suit all of your students' wants and needs.

Marisha: One of the rewards that I would give was to have lunch with me, which was a surprisingly exciting prize. And I think it's cool too, we can get creative with how we implement this. With articulation, we're working through the hierarchy, so we're from isolation to ... Or yeah, isolation to syllables and words, and phrases, and sentences, and maybe we can implement some rewards that way too. Like if you get to the word-level or if you master this level then we'll get to have this celebration thing. And maybe it could be just a scented chapstick depending on how long it takes, but there's fun little things that we can do.

Kayla: The great idea though, I didn't think about that. Yeah. As they master a level then the reward comes. That's a great idea. I love it.

Marisha: Yeah. I have a little ladder that I print out. It's just like ... And all of my students have a little articulation folder, but then we'll use that. We'll get to color in the levels of the ladder as we move through the steps, and I think it helps to educate the students so they know what they're working towards and we'll kind of say ... Not all students are going to go all the way to the top of the ladder right away. Some students take longer than others, but I feel like with this approach it could happen pretty quickly. So we just-

Kayla: Yeah, it moves fast.

Marisha: Yeah.

Kayla: And I love it, but definitely write your goals a little loftier than you normally would I feel like with this approach, because if you write just a word-level goal your students are going to surpass that it seems like in no time. So that's another thing to keep in mind when you're writing your IEPs. Think bigger than what you may be thinking now because the progress is going to come faster than what you think.

Marisha: That is so exciting. I love that. I wish we could ... We need tacs this for all of the different types of goals that we write because it's amazing.

Kayla: Yes.

Marisha: I love it. Okay. So let's just recap real quickly. So in terms of some of the pros to using this approach, so we've got ... Maybe we can round-robin it and see how many we can come up with. So we've got increased engagement because of their short sessions and all of that. Is there anything else?

Kayla: Increased ability to recall those sounds. They know what they're working on.

Marisha: Yeah, goal awareness. And then rapid progress.

Kayla: Yes. Less time missing class.

Marisha: Yes, and less of that educational impact, which is awesome. Then, let's see, what else can we think of?

Kayla: Sooner to be dismissed? That faster progress leads to sooner dismissal.

Marisha: Yeah, and then more impact in the therapy time too.

Kayla: Yes. And the one on one therapy, which a lot of students, like you said, they're not getting that most of the times, that one on one.

Marisha: Yeah. Anything else? Or do you think that covers the essentials?

Kayla: I think that's the biggest part of it.

Marisha: Oh, and then last prep time too.

Kayla: Oh, yeah.
My favorite. I already forgot my favorite. I just love that I don't have to prep for those 10, 12 students or however many you have on it. It cuts your planning time greatly. Greatly, you'll love it.

Marisha: Yeah. And I love when those worlds collide where there's less planning and more impact. It's the like thee ...

Kayla: Could it get any better?

Marisha: Yes. So that's amazing. Then for some of the challenges, we talked about just like getting it ... The setup seems the biggest challenge and we talked about how to communicate with administrators, how to communicate with parents, teachers and then-

Kayla: Just starting small.

Marisha: Yeah.

Kayla: Don't overwhelm yourself, just start small and go from there with your schedule and service minutes and all of that. Because that is the hardest part, is getting everything moved over but give yourself the year. Give yourself that school year to start moving students over and then the next year it'll already be set up for you.

Marisha: Yeah. Perfect. Then I love that tip that you gave too, as you're updating student's IEPs to decide if it would be a good fit for them and then making that change there and then, yeah. We can get creative there if we feel like, "Oh my goodness, this student is not making any progress. We need to make a change ASAP." We can problem solve in those situations, but I think that's a good strategy to make it feasible because rolling it out over the course of a year is better than never rolling it out because it feels too much of a hurdle.
So we can let go of a little bit of our perfectionism because it can be hard to think about, "Oh my goodness, I want to do this and if I'm going to do it, I have to do it all the way." But I think that's something that was helpful for me. At least I'm implementing it with these students and then the rest will come. But that's really the most feasible way to make a change in any area of our practice.

Kayla: Absolutely.

Marisha: So awesome. I love that. Okay, and then I think we are ... I think that covered ... That was a good recap of what we covered. Did you have any other tips for success or strategies that you found to be particularly helpful or just anything else you want to share?

Kayla: Just my biggest tip besides not stressing yourself out trying to get this started is to, when you start to roll it out, like I said, have the research, have those open conversations with the parents, and with the teachers, with your administration. Maybe even talk to the teachers before the meeting and just say, "Hey, there's this service delivery model that I'm really wanting to try out with some students. I think your student would be a great fit." And that way explain it to them first so when you go into the meeting, nobody's caught by surprise and when you talk to the parent about it, the teacher's already on your side. They understand your rationale behind it instead of just saying, " inaudible understand what you can do in five minutes." Talk to the teacher beforehand, talk to administration beforehand, and the parents, I think they will be in agreement with what you want to do for their child because you are doing what's in the best interest for their child.

Marisha: Yeah, and I think that automatically shines through when that's the case. So that is super helpful and I love the tip, particularly if you think it might be a challenge if you let the teacher know upfront. I think that could make a really big difference because the parent will, especially if they have a good relationship with the teacher, they might look towards him or her to kind of see, "Okay, what's her reaction or what's his reaction?" So if she or he is nodding along and they're positive about it then I think that can help, especially for parents who you think might be a little more resistant to change or whatnot.

Kayla: Absolutely.

Marisha: Awesome. Okay, so that was super helpful. I feel like this was jam-packed with practical tips and strategies to get this started. I love all of the suggestions for really easy things that we can do to work through this. So thank you so much for sharing all of this, and I was wondering if you could share where ... If SLPs listening to this want to find out more about you, where can they connect with you and what's a good place to learn more about your therapy strategies, and materials, and all that good stuff?

Kayla: You can find out more information about how I run my therapy and some of the activities that we do in my therapy room on my blog, which is www.kaylaslp.com. You can also find me on Facebook and Instagram, Kayla SLP. And I also sell on Teachers Pay Teachers. Again, Kayla SLP. So you can find me pretty much anywhere just by Googling Kayla SLP. But I talk about a lot of this stuff, the five minute speech, the reward systems, lots of good stuff everywhere. So just find me on social media.

Marisha: Awesome. I just remembered that you wrote that post, so I will link to your ... If SLPs or listeners prefer to get a readout of some of the points that we talked about, Kayla did write a super helpful blog post. So that will also be in the show notes at slpnow.com/44.

Kayla: Sounds great. Thank you for having me.

Marisha: Yeah, thank you so much, Kayla. This was so incredibly helpful and thank you to all of you who made it to the end of this podcast for listening in. I hope you're walking away with tons of practical tips and strategies and that's a wrap. Thank you.

Kayla: Thank you.