Big Groups, Mixed Goals, and ‘Winging It’: How to Run Effective Therapy When Time Is Tight

It is Tuesday morning. You're working with a group of four students across two grade levels. One student's working on R, others are regular past tense verbs, wh questions, social language, and you have zero minutes in between groups and you are thinking, we just have to make this work.
If that's you, you're not disorganized.
You are trying to make the most of a very full schedule, where you're trying to serve as many students as possible, keep up with your paperwork and billing and all of the other things that we have to do.
Today we're going to talk about how to make these sessions more effective, even if they're not ideal.
All school-based SLPs have mixed groups. Most groups are larger than we prefer, and most of us don't have 30 minutes to craft intricate lesson plans for each group. And we're doing the best that we can. And the goal is not perfect therapy. The goal is structured and efficient therapy.
Two episodes ago, we chatted about session structure, which I teach five different steps. So check in, assess, teach, practice, wrap up. I've taught this to thousands of SLPs at this point, and it's a game changer.
By having a repeatable, evidence backed structure that we can use in our sessions, it helps reduce our cognitive load. It helps us be more effective and efficient, and it also helps our students. They know what to expect and they're set up for success as well.
And mixed groups aren't the problem. It's unstructured mixed groups that are the problem. And when we're able to segment our caseload and choose strong language rich thematic units with a consistent session structure, mixed groups are actually incredibly effective.
Instead of having 63 random students on your caseload, you can segment your caseload. In the previous episode, I talked about a hypothetical preschool through fifth grade caseload. Let's pretend now that I am a secondary SLP and I'm seeing sixth through 12th grade, and I might segment by grade or based on the student's needs. So I might have a functional communication unit that I use with the students who would benefit from that type of support. I might have a nonfiction unit. And I might have a science experiment. Those three units will are designed to target different types of goals and support different types of students.
And so I can break up my groups and identify, okay, these groups would do best with the functional communication unit. This group would do best with the nonfiction unit. These groups would do best with the science experiment. And then I know that instead of planning 50 different therapy plans, I can just prep those three units and make my caseload planning much easier and more effective because now I'm not having to pick a different activity for every group or a different theme for every day. I can use these thematic units for a whole month of therapy. So I am only having to make three decisions once a month. Which unit am I using for segment one, two, and three?
And this is incredibly powerful because the units are made up of language rich activities that are a beautiful context for our students' goals. You may even be able to get away with less segments depending on what your caseload looks like.
That is a very effective strategy. And by doing that, we reduce our cognitive load. We simplify our planning. We also make it easier for our students to know what to expect. And that familiar context helps them to work on their skills more effectively. These are designed to help with generalization. There's so many benefits to having things set up in this way, and it allows us to be more systematic.
It's a great opportunity to make sure that we're getting adequate opportunities to target vocabulary and getting enough repetitions there. The evidence-based structure to the units also ensures that we're effectively scaffolding skills. A lot of these decisions that would take you hours and hours and hours to work through are automatically taken care of for you.
So that's the first step is just segmenting your caseload and picking those units for those different segments.
And then step two is kind of built into this, but this is when we use language rich activities to target numerous goals. We touched on this already, but we want to be intentional with the units that we're selecting to make sure that they're a rich context to target all of our students' goals.
For example, our K through two picture book, we're working on narrative retell, wh questions, describing, inferencing, vocabulary. These are language rich activities and we can target all of these types of skills. The same applies for older students. So if we're using the functional communication scenario, we have peer modeling videos inside SLP Now, and so you have the video and then you have a unit that goes with the video. And it gives students the opportunity to target their functional communication goals in the context of this activity. They get to see peer models and practice these skills in a really functional scenario.
Ordering a burger at a fast food restaurant. They're super fun and meaningful activities. When we are using these types of activities, we're able to target all of our students' goals.
And this third step is to let students build on each other. So instead of seeing mixed groups as a limitation, what if we looked at them as an asset?
We get to have mixed groups versus we have to. Mixed groups are a great opportunity to provide students with peer models, and students get to hear each other's responses. They build on each other, and language becomes collaborative. And we're thinking about generalization from the very start.
For example, if we are using a picture book unit, and we have four students in the group. The first student is working on wh questions. We can ask a question about something that happened in the book. So student A answers and they get to target their WH questions goal.
Let's say student B is working on past tense verbs. They can repeat the student's answer, but use the past tense. Then let's say student C is working on articulation. They can work on repeating the sentence using their target sound. And if student D is working on syntax, they can expand the sentence.
So we're using the same activity of answering a wh question, but we can target comprehension answering wh questions 'cause that's what the activity is. But we can also target grammar, vocabulary, syntax, all of these types of things. I know that mixed groups get a bad rap, but I think they can also be incredibly beneficial.
And let's figure out how to leverage the strengths of mixed groups instead of focusing on all the things that aren't ideal about them. And granted, there are some cons, and mixed groups aren't always the best scenario, but I do think more often than not, we can leverage some of the benefits of mixed groups and have them work for us a little bit better, given the circumstances, especially.
So now step four is to anchor everything in structure. So I chatted about the framework of check in, assess, teach, practice, wrap up. So the five steps for a session structure. The structure does the heavy lifting. Students know what goal they're targeting. We have supports ready to go, expectations are clear, and students know what to expect in terms of the activities and targets. When the structure is predictable for you and for your students, mixed groups and multiple goals feels a lot more manageable. The chaos disappears. We know the unit, we know the structure, and we know the students' targets. There's not a whole lot to like stress about anymore if we have all of those bases covered.
We often assume that smaller, perfectly matched groups are the gold standard. Small groups are great, and there's definitely some benefits, but mixed groups, we have more peer modeling. We get to target listening skills. We encourage flexible language use. We get to support generalization. We get to provide social language practice.
Big groups aren't always ideal, but mixed groups can still be effective, especially when they're designed intentionally.
So to wrap things up today, we talked about segmenting our caseload, choosing one language rich unit for each of the segments and using that for a month of therapy. When we add in a consistent session structure and give students the opportunity to build on each other's responses and take advantage of the benefits of having a mixed group. When those pieces are in place, you're no longer winging it and you're running structured, effective evidence backed therapy and. Winging it is when we don't have goal clarity and when we're just fine by the seat of our pants.
But with this framework, we have structured flexibility. We have clear goals and flexible materials, and we're able to reuse the same unit, the same story, the same activity across groups, and I argue run more effective and higher quality therapy than we would with our winging it strategy.
I know that many of us are worried that our students aren't getting enough repetition, that it's ineffective. Progress is too slow. But when we're using this five step framework of the check-in, assess, teach, practice, wrap up, we are intentionally progress monitoring. We have explicit goal focus. Students are getting really meaningful exposures and meaningful practice. In context, and we, so we are providing really high quality therapy and we're monitoring the data to make sure that things are working.
And progress isn't about perfection. It's about consistency, session after session after session. We will have that data to back us up. And if it's not working, we can reevaluate and reconsider. But more often than not, this strategy will do the trick.
So here are three practical tips that you can implement tomorrow.
They're just little tiny adjustments.
Option one is to pick your caseload segments and choose one unit for each of them. If you're feeling overwhelmed of like which segments are am I gonna choose and how am I gonna find these units?
If you go to slpnow.com/pod, sign up for the free trial. It'll ask you what grades you're working on, which goals you're targeting, and it'll recommend segments for you. And then if you click on those segments, you'll have a short list of recommended units. This could take you literally less than a minute to complete, and you would have a month of therapy planned out for you.
So you just sign up for a trial. Answer the question about your caseload. Go to the Therapy Plans tab, the segments will appear right there and just click through them. Pick one unit and you're done. That is the first strategy or tip that you can implement.
And then the second strategy is to do your planning in your session. So what worked in the session? What does a student need additional support with? What do you want to remember to do next time? So taking these few seconds at the end of the session is a huge favor to your future self. By taking this time within the session, it doesn't add any more to your workload.
You can wrap up with your students and come up with a game plan for the next session. This has been a game changer for me in revamping my planning. Having that end of session quick note to myself is a game changer.
The third thing that you can try is for your next group or whatever group feels like is giving you the most stress. Do you have progress monitoring tools for your students' goals in this group? And do you have visuals to teach their skills?
You more than likely have some materials ready to go, so just pull something that you can use for their progress monitoring and for their teaching visuals for each of their goals. It makes it easier to implement the five step framework that we talked about.
And if you need some support in finding the right progress monitoring tools and the right visuals, you're more than welcome to sign up for a free trial of SLP Now as well. Again, the link is slpnow.com/pod. We have a whole library of progress monitoring tools as well as teaching visuals.
You should be able to find whatever you need to support your students. You don't have to reinvent the wheel.
Those are three suggestions for things that you can do as an action step. Please feel free to choose the one that is most helpful for you.
You definitely don't have to do everything all at once. Just take one step at a time.
Our workload becomes dramatically easier when we're not creating probes and visuals from scratch and when we have goal aligned, supports ready to go. I highly encourage you to set that up, especially if you're feeling overwhelmed.
You don't need perfect groups to be an effective therapist. You just need structure, clarity, and consistency.
Even if you're feeling like you need more of that structure, the clarity, consistency, you're already doing meaningful work and I just want to help make it a little bit easier.