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Long-time readers of this blog may remember waaaaaaaay back in 2012 I started a pilot program in my district doing what we called FIT therapy. A group of SLPs in the district wanted to try to implement the new model of short, frequent, intense therapy sessions to see how it would work for our articulation students.

The pilot year went very well, and the following year we kept data on our rate of students graduating from speech therapy. The data was impressive, and I’ve been doing FIT therapy with my articulation students ever since. I have also expanded to use it with students working on vocabulary as well.

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This past October I presented the method, along with our district’s pilot program and data, at the Washington Speech Language Hearing Association’s annual convention in Tacoma. My presentation was well-received, which was a relief to me because I was very nervous about it! Several other SLPs have since asked for my slides, in order to present the method to their colleagues and spread the information further.

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Me, nervously waiting to present!

I am thrilled that others are interested in implementing FIT therapy (also known as QuickDrill, 5-minute therapy, or 5-minute kids) with their clients. I have put my presentation on Google Slides, which is available for viewing for anyone who is interested. The handout is also on Google Drive, free to download (see below).

I would love to know if anyone else uses this service delivery model, or if you are inspired to try it!

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One of the greatest challenges for a school-based speech therapist is figuring out how to maximize the short time I have with students each week. I love my kids, and love seeing them make progress… but I am always hoping for MORE progress!

I spent a good chunk of last year collaborating with a group of other SLPs in my district, working on “service delivery” – how can we provide the most efficient services to our students? We came up with several options, and committed to pilot one of them this year. That is how I got myself involved in F.I.T. therapy.

What is it?

  • F.I.T. stands for Frequent Intense Treatment. It is a way of providing therapy that uses short (5-10 minute) individual therapy sessions, 2-5x/week.
  • It is different than traditional group therapy, which typically serves groups of students 1x/week for 20-40 minutes.
  • Therapy happens in pod areas, just like small group academic interventions for other students.
  • It is modeled after the “5 Minute Kids” program. (More info here)

Why do it?

  • Research is showing that short, frequent speech therapy sessions are more effective than longer, less frequent sessions.
  • Therapy is more individualized, because I see all students 1/1.
  • Students spend less time out of class, which means more time for LEARNING. 🙂
  • Students get short, repetitive PRACTICE, which is the greatest predictor of PROGRESS.

Research supporting F.I.T. Therapy:

  • A research study at Hudsonville Public Schools in Michigan evaluated the effectiveness of individual therapy for speech sound disorders. Students in this project were enrolled in a program called Accelerated Personal Therapy (APT) and received intervention services two to four times weekly for 10 minute sessions. The results indicated that the discharge rate after one school year of therapy for the APT program was 6% higher than the discharge rate of students receiving traditional services. This study also concluded that the reduced time for therapy (16 hours per year for the APT program as compared to 32 hours of traditional small group therapy) did not negatively affect the outcome of intervention. (McCann, et al. 2008)
  • Research at North Branch Area Schools (MI) in 2002 using the 5 minute kids program showed decreased time in therapy:

    Speech program

    Total number of months in therapy

    Minutes per month

    Total number of minutes in therapy

    Equivalent number of hours in therapy

    Traditional therapy

    18

    210

    3780

    63

    5-minute program

    9.6

    45

    432

    7

    Difference between programs

    8.4 months

    165 minutes

    3348 minutes

    56 hours

How much can you really do in 5 minutes?
Is it really possible to do very much in such short sessions? YES! You can:

Who is it for?

  • F.I.T. therapy focuses on drilling specific skills. It is a great fit for students who need frequent, intense drill sessions in order to progress on their goals.
  • Articulation therapy is an excellent fit for this style of therapy.
  • Some language and fluency skills can also be drilled in this way.
  • Skills which require more context, like social language skills or listening comprehension skills, may not be a good fit for this style of therapy.

Right now I am reviewing my caseload and identifying students who would be a good fit for this kind of therapy. I am focusing on students who are working on speech sounds, though in the future I may expand to include students working on language concepts also. I am VERY excited to see the results of using this model!

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Edit: I changed the name of this kind of therapy from “5 minute therapy” to “F.I.T. therapy” to prevent confusion with the copyrighted “5 Minute Kids” program. F.I.T. is a service delivery model, not a particular program.

Here in the Edmonds School District we use what we call the 3:1 model for speech therapy students. I am in the middle of that week right now, so let’s talk about it!

What is 3:1?

The ‘3’ stands for three weeks of every month. During those weeks I provide traditional speech therapy (“pull-out” therapy) where students come to my office for their weekly speech therapy sessions.

The ‘1’ is for the fourth week of each month, the indirect week. During this week students do not leave their classrooms. Instead I go visit them! I spend the week observing in classrooms, consulting with teachers, responding to referrals, calling parents, evaluating students, meeting with other speech therapists… the list is never ending!

Why do I get to take a ‘week off’?

This is the most common question I am asked about this way of doing speech therapy. Sometimes people ask this outright, and more often they think it without saying it out loud. 😛

The answer? I’m NOT taking a week off! I work just as hard during this week as I do every other week! The list of things I do during this week is loooong, and many of them would be impossible without the flexibility of the indirect service week.

What about the kids? Isn’t it bad to miss a week of therapy?

There are positives and negatives about not having therapy for one week out of the month. I wish I could see my kids more often, even two or three times a week! But the reality of 60+ kids on my caseload (along with all of their teachers and parents!) means that is not possible.

One of the biggest things I do during the indirect week is plan special activities to do in speech therapy during the following month. It makes the rest of the month so much better! This week I was able to create an interactive powerpoint game about idioms to use with the intermediate intensive support students. I would never have had time to do it otherwise, and the kids are going to love it!

Another thing to consider is how kids learn to “generalize” their speech skills. Generalizing is when a student can take something they learned in speech and use it in their conversation somewhere else, like in the classroom. It is very common for students to have great speech skills in my office, walk out my door, and revert back to their old habits as soon as they are back in class. Seeing me in classrooms and around the school is a big way to combat this.

Observing in classrooms is also a huge benefit to a student’s speech therapy program. Today I observed in six different classrooms, and picked up things to work on in therapy for half of the students I observed. One student was reading aloud and left off the final sounds of the words she was reading. Another student was using a phonics chart, but didn’t realize he needed to pronounce all of the sounds every time. A girl doing a science experiment noticed for the first time that the word “ready” had the /r/ sound at the beginning, and then used her new /r/ when talking with her table-mate.

Yesterday I observed circle time in an intensive support classroom, and heard one of my barely-verbal students lead calendar time and speak intelligibly. I also heard the teacher discussing how to greet someone in the morning, because none of her kids say “hello” or “good morning” when a teacher greets them. We’ll work on that next week during our speech time! I was also able to arrange a last-minute meeting with a parent to review her daughter’s progress in speech therapy, because I didn’t have speech therapy sessions that afternoon.

None of those things would have been possible without the indirect service week, and every one of those things will make therapy BETTER for my students.