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Outcomes management practices in tiered school-based speech-language therapy: A Canadian example.

Peter T Cahill¹, Stella Ng^2,3, Leah Dix⁴

¹School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

International Journal of Language & Communication Disorders

|November 25, 2022

Summary

School speech-language therapists face challenges managing outcomes in tiered service models. Developing context-specific tools is crucial for effective outcomes management in educational settings.

Keywords:

decision making evidence-based practice (EBP)outcome outcomes management school-age children speech-language therapy

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Area of Science:

Speech-language pathology
Educational psychology
Healthcare management

Background:

Outcomes management in schools is complex due to community dynamics and tiered service delivery.
Existing research on outcomes measurement primarily focuses on medical settings, creating a gap for school-based practices.
Tiered service models require tailored outcomes and management strategies for diverse student needs.

Purpose of the Study:

To explore how school-based speech-language therapists manage outcomes during the transition to tiered service delivery models.
To identify the successes and challenges encountered by clinicians in outcomes management within school environments.

Main Methods:

A secondary deductive-inductive content analysis was conducted.
Qualitative interviews were held with 24 clinical managers and senior therapists in Ontario, Canada.
Trustworthiness was ensured through iterative peer debriefing and reflexive journaling.

Main Results:

Clinicians identified seven key outcomes: student progress, participation, stakeholder perspectives, buy-in, capacity building, responsiveness, and accountability.
More challenges than successes were reported during the transition to tiered services.
Challenges stemmed from organizational barriers, the shift to tiered models, and educational system philosophies.

Conclusions:

School-based speech-language therapists manage diverse outcomes within tiered models, but significant challenges persist.
Effective outcomes management requires tools that address tiered models, the educational context, and organizational specifics.
Enhanced clinical-research collaboration and knowledge exchange are recommended to support practice.