Service Delivery Models in Speech Pathology

Therapeutic Methods: Service Delivery Models

Overview

These notes cover service delivery models in speech pathology, focusing on the roles of providers, formats, dosage (frequency, intensity, and episode of care), and settings.

Course Objectives

• Demonstrate knowledge of service delivery models in the field of speech pathology.

• Demonstrate understanding of dosage and associated terms.

Service Delivery Models

• Provider: The person administering the treatment.

  • SLP (Speech-Language Pathologist).

  • SLPA (Speech-Language Pathology Assistant).

  • Trained support personnel.

  • Intern

  • Caregiver

  • Others?

• Format: Type of session.

  • Individual (1-1).

  • Group.

  • Concurrent Group

  • Consultation

  • Coaching/Training

  • Others?

• Dosage: Frequency, intensity, and episode of care.

  • Frequency: Number of treatment sessions.

  • Intensity: Length of each treatment session.

  • Episode of Care: Length of treatment period.

• Setting: Location of treatment.

  • Home.

  • Outpatient Clinic.

  • Classroom vs. Separate Room.

  • Hospital.

  • Community-Based.

  • Others?

Service delivery is a dynamic process where changes are made to the above components.

Format and Service Delivery Models

• Direct Service

• Indirect Service

Dosage and Service Delivery Models

Dosage: The amount of services described as the combination of frequency, the length of a therapy session, and the length of an episode of care.

• Episode of Care: The length of time needed to address a specific problem.

• Frequency: The total number of sessions of intervention that occur over the course of a specified time period.

• Intensity: Time each session

Example Dosage in Educational Setting:

• Episode of Care: The length of the annual IEP (individualized education plan), semester/trimester.

• Frequency: Times per week, month, or year. Ex. 1x/week; 4x/month; 30x/year

• Intensity: Written in minutes (15, 30, 45)

  • Example: Services are recommended for 30-minute sessions, 3 times monthly (30 x 3/month) from 9/11/2025 - 9/10/2026, totaling 810 minutes annually.

Example Dosage in Biola Clinic Setting:

• Episode of Care: The length of the semester.

• Frequency: Times per week. Ex. 1x / week

• Intensity: Written in minutes (45 minutes)

  • Example: Amelia is recommended to attend speech therapy for one 45-minute session per week from 9/9/2024 - 12/16/2024.

Dosage Terminology

• Intensive: A highly concentrated dosage of therapy intervention provided over an episode of care.

  • Example: weekly sessions lasting 45 minutes or more in length or a frequency of 2x or more/week.

• Frequent: A moderate dosage of therapy intervention provided at consistent intervals over an episode of care.

  • Example: weekly or bimonthly sessions lasting less than 45 minutes in length.

• Periodic: A lower dosage of therapy intervention provided at regularly scheduled intervals for a specified number of minutes over an episode of care.

  • Example: 2 to 5x/year for a total of 60 minutes

• Intermittent: A low dosage of therapy intervention provided irregularly or when needed over an episode of care. Length of therapy session may vary.

  • Example: 1 to 2x/quarter for 20 minutes per session.

Setting and Service Delivery Model: The role of the Speech-Language Pathologist (SLP)

• Schools: SLPs diagnose and treat children through special education and consult with administrators and educational staff.

• Skilled Nursing Facilities: SLPs diagnose and treat adult and geriatric populations to ensure quality of life, including patients with progressive diseases like ALS, Parkinson's, and Dementia.

• Private Practices: SLPs work directly with clients and families to treat adults and children with chronic disorders or developmental delays, often in familiar environments (home or school) or a clinic space.

• Hospitals: SLPs diagnose and treat children and adults following an acquired or congenital neurological disruption, in both inpatient and outpatient settings.

• NICU (Neonatal Intensive Care Unit): SLPs diagnose and treat dysphagia in premature babies to ensure swallow safety in the first few days of life.

• Acute Care: SLPs facilitate functional communication and ensure safe swallow while patients are still in the acute phases of injury.

Speech Therapy Inclusion

Working in the Classroom

Assignment: Service Delivery Model Advertisement

1. Determine the service delivery model your group will recommend for your client.

2. Make an advertisement for this model highlighting the main strengths and how this will meet your client’s needs.

3. Submit on Canvas: Due next week