Grandview Kids became the lead agency and started delivering School Based Rehabilitation (SBR)-SLP services in January of 2020, quickly impacted by the world-wide pandemic and the rapid growth of Durham Region. The wait time of four years, the Preschool Speech and Language Program no longer delivering Junior Kindergarten services and the new Ministry Guidelines for early intervention meant that change was required.
Caregivers of children waiting and accessing services participated in focus groups with a third-party consultancy to identify needs and expectations.
Families shared the need for flexibility, improved communication and easy to use home activities. They want to know how to carry over the practice with their child.
Grandview Kids therapists participated in discussions identifying successes and challenges in the current state and made recommendations for future state improvements.
Therapists shared a need to streamline services, prioritization of students with motor speech and fluency, and increased need for parent involvement at all ages.
Working groups were established, with representation from clinical staff, Family Engagement and leadership.
Three new pathways were developed. The key principles are early intervention, caregiver coaching, client-directed care for older students.
Kindergarten Pathway (JK-SK)
- In-centre, caregiver coaching pathway
- 2 cycles of 5 sessions delivered as group or individual
- Potential of up to 2 more cycles of 5 in year 2 of pathway
- Standardized materials and handouts for caregivers
- Scoring matrix to determine type and number of sessions
Elementary Pathway (G1-6)
- In-school pathway based on cycles
- 7-session cycle with an additional one caregiver coaching session
- Scoring matrix to determine the number of cycles up to a max of 4; each cycle includes additional caregiver coaching
- No re-referral
Collaboration Pathway (G7-12)
- Clients in G7-12
- Clients who have completed their elementary pathway or are fluency clients who have completed their JK/SK pathway for fluency
- In-centre, client/caregiver coaching pathway
- Client-directed – they call to book a session
- Recheck session, home program, potential of 2 coaching sessions
- Clients can book twice per year, once every 6 months
Number of Staff – 2.6 SLP, 3 CDA
Number of Assessments (Sept-Dec) – 245
Number of waiting Ax – 445 with DOB 2019 or 2020
Length of wait referral to Ax – 146 days
Challenges
- Caregivers unable to attend due to work or childcare
- Transitioning between multiple pathways resulting in a second wait time
Opportunities
- SLP/CDA ratio allows for high number of assessment and high number of group treatment slots for flexibility (25-30 per week plus 10 individual with CDA) (SLP 5 Ax, 5 reAx and 10 treatment)
Expected Benefits
- Tiered intervention model – good for all strategies prior to Ax targeted to reason for referral, response to intervention for tier 2 or 3 services
- Small group intervention in Kindergarten creates capacity for more students to be seen
- Early intervention with service in Kindergarten
- Increase parent coaching and engagement
- Students on Collaboration book when they are ready for next strategies, less tracking and calling by staff
Feedback
Great feedback from staff and families:
“His teacher approached me and asked how the speech program was going and shared she had noticed a big difference in class. She said if saying a word with a tricky sound he now stops/shows awareness that it’s tricky for him. She said she is not asking him to repeat himself and he is more confident when sharing in class.” – Parent
“She was able to immediately communicate his weakness and teach me how best to help him at home. As well as adjust to best help him as needed.” – Parent
“Kids are responding well, parents are open to learning the strategies, 30 min session is perfect, the last 15 min their attention is fading, 5 sessions are great, most are doing really great with 10! Parents have a better understanding of the bigger picture of speech. I’m enjoying it.” – CDA
I love how it’s working. I feel that getting a quick contact with families shortly after SBRS referral has been so valuable. Especially for students referred directly by the school boards, most of whom have not accessed any speech intervention prior to entering school. I’m able to get right in there with knowledge for families and indirect strategies that they can pass along to the school” – SLP
“I feel a bit better about the wait time for E pathway when parents have had a chance to experience direct therapy in K and have had conversations about why speech is hard to understand and have been coached to watch, listen, and model. Beyond that, understanding how and when to work on goals at home removes some of the well-meaning barriers to success and increases healthy communication behaviours at home, regardless of specific speech goals.” – SLP
Contact
Marika Beaumont – marika.beaumont@grandviewkids.ca
Corrie Dixon – corrie.dixon@grandviewkids.ca
Phone number: 905-728-1673
