Preparing Speech Language Pathology Students to Work in Early Childhood

Abstract

The shortage of highly qualified speech language pathologists (SLPs) with specialized training in early intervention and early childhood special education (EI/ECSE) is a pressing issue facing the field and dramatically impacts young children’s social and academic success. SLP personnel preparation programs focused on training specialists in EI/ECSE are crucial to building a highly qualified workforce to meet the needs of young children with disabilities and their families. The purpose of this manuscript is to describe the design and implementation of one such program. The guiding principles, competencies, and practica experiences of this federally funded program are illustrated. Outcomes are delineated in terms of student competencies, feasibility of implementing an early childhood specialization within an SLP graduate program, and the impact on the local community and EI/ECSE workforce.

Keywords

interdisciplinary personnel preparation blended training early intervention

The lack of speech language pathologists (SLPs) trained to provide effective interventions to young children with special needs is a pressing need in elementary and preschools. Young children with communication delays need early identification and focused, effective research-based interventions to prevent, to the greatest extent possible, future problems. In addition to being knowledgeable about early risk factors and developmental disparities, SLPs must be trained to work collaboratively in settings with early interventionists, early childhood special educators, and other specialists to offer family-guided, culturally competent, empirically based, interdisciplinary, and comprehensive services (Crais et al., 2004; Hemmeter et al., 2005).

According to the American Speech-Language-Hearing Association’s (ASHA) Ad Hoc Committee on the role of the speech language pathologist in early intervention, SLPs working with young children should participate in

(a) prevention; (b) screening, evaluation, and assessment; (c) planning, implementing, and monitoring intervention; (d) consultation with and education for team members, including families and other professionals; (e) service coordination; (f) transition planning; (g) advocacy; and (h) advancing the knowledge base in early intervention. (ASHA, 2008, p. 9)

These activities should be implemented in collaboration with families, caregivers, and other professionals. Thus, course content and field experiences should include multiple and varied opportunities to gain knowledge and master skills related to providing interdisciplinary supports to young children and their families. However, to efficiently meet national standards as outlined by ASHA’s Standards for Certification in Speech-Language Pathology, most SLP training programs are designed to produce generalists who work across disabilities, ages (i.e., birth to geriatric), and environments (i.e., clinics, schools, hospitals), and often have little to no content related to young children with special needs and their families (Campbell, Chiarello, Wilcox, & Milbourne, 2009). The majority of SLPs are not prepared to work in early intervention and preschool settings, and frequently self-report low levels of competency related to working in these settings (Campbell et al., 2009; Roberts, Crais, Layton, Watson, & Reinhartsen, 1995). Furthermore, few SLP personnel preparation programs provide an interdisciplinary focus, the cornerstone to effective services for young children with special needs and their families (Chen, Klein, & Lavada, 2009).

The shortage of SLPs trained to work with young children is a serious nationwide problem requiring incentive programs and other innovative personnel preparation and recruitment efforts (LRP Publications, 1999). The purpose of this article is to describe a federally funded SLP personnel preparation project: Teaching Early Advanced Master’s Specialists (TEAMS). TEAMS is a collaborative project between the Early Intervention (EI) and Communication Disorders and Sciences (CDS) master’s degree programs at the University of Oregon. The goal of TEAMS was to produce highly qualified SLPs who are prepared to provide empirically based, effective services to young children with special needs and their families. TEAMS graduates have filled and continue to fill critical SLP positions in early intervention/early childhood special education (EI/ECSE) settings.

Quality Features of a Related Services Personnel Preparation Program in EI/ECSE

Project TEAMS infused effective teacher education principles into its program components (Brownell, Ross, Colon, & McCallum, 2003). These included the following: (a) an interdisciplinary focus and collaboration of faculty across the EI and CDS programs, (b) an alignment and understanding of philosophies and perspectives to create a shared conceptual framework for the TEAMS program with core competencies, (c) a commitment to evidence-based practices, (d) a continuum of field experiences with multiple opportunities to master competencies, (e) effective supervision practices, and (f) ongoing evaluation of program outcomes. These features often are particularly difficult to achieve in personnel preparation programs due to the demands of state and national certification, the fragmentation and multidisciplinary nature of the system, the broad range of clients and settings, incongruent philosophies and approaches, and lack of a shared vision present challenges for personnel preparation programs (Winton & McCollum, 2008). The following section describes how these features were incorporated into the TEAMS program.

Interdisciplinary Approach and Collaboration of EI/ECSE and SLP Faculty

No single discipline can meet the needs of diverse groups of young children with disabilities and their families (Bricker & Widerstrom, 1996). In addition, children and families reside in communities that vary tremendously in size, constituencies (e.g., different cultural/ethnic groups), and economic resources. An interdisciplinary approach to personnel preparation is crucial to ensure that children and families receive effective, coordinated services. SLPs are an integral part of a coordinated service delivery team involved in identification, intervention planning, and implementation for children with communication delays and disorders.

The TEAMS program provided multiple opportunities for collaboration and interdisciplinary teaming with families, students, faculty, and service providers across coursework and practica (Whitehead, Jesien, & Ulanski, 1998). The philosophical perspectives, practices, and terminology of multiple disciplines were emphasized (e.g., SLP, EI/ECSE, psychology; McWilliam, 2010). An interdisciplinary team service delivery model was used (e.g., seminars with EI/SLPs; practicum activities in interdisciplinary, natural settings with early interventionists, occupational therapists [OTs]; visits to interdisciplinary medical clinics with developmental pediatricians, OTs, and physical therapists [PTs]) to prepare SLP graduates to confidently enter the EI/ECSE field and effectively deliver supports to families (Chen et al., 2009). In addition, TEAMS included an interdisciplinary collaboration between the EI and CDS faculty; the core TEAMS faculty included two faculty members from each program. As noted by Crais et al. (2004), faculty modeling, involvement, and supervision of interdisciplinary, collaborative teaming and practices might be the central component to training effective interdisciplinary practitioners. The faculty emphasized and modeled interdisciplinary collaboration, teaming, and ongoing programmatic evaluation.

Moreover, the EI and CDS faculty taught the TEAMS courses. Through this collaboration, faculty adapted existing EI/ECSE courses to embed identified competencies. The TEAMS courses, taken in addition to their CDS program requirements, are listed in Table 1. TEAMS students took four foundational courses in the summer prior to starting the CDS program and three methods courses throughout the 1st year, and completed the program within the same 2-year timeline as the CDS program. The methods courses were designed to (a) demonstrate and describe commonly used, empirically supported assessment and intervention practices with young children; (b) provide an overview of the role of the SLP in homes, classrooms, and other natural settings; and (c) describe effective teaming and collaboration strategies. This training was interdisciplinary beyond EI/ECSE. For example, TEAMS faculty adapted an EI methods course to specifically focus on interdisciplinary collaboration and consultation and paired students with an interdisciplinary mentor from the local early childhood community (e.g., EI/ECSE practitioners, OTs, PTs). Through this course, students observed interdisciplinary practices in a variety of settings (e.g., home visits, assessment, consulting in community settings) and had multiple opportunities to interact with and learn from OTs, PTs, and psychologists through coursework and practica experiences.

Table 1.

TEAMS Courses

Core EI/ECSE courses taught by EI faculty	Summary of content	Specialized EI/ECSE methods courses cotaught by CDS and EI faculty^a	Summary of content
Foundations in Early Intervention	Guiding principles of EI/ECSE; typical and atypical child development	Developmentally Appropriate Practices with Young Children	Implementing developmentally appropriate, child-focused practices with young children with special needs; Division for Early Childhood Recommended Practices
Assessment and Evaluation of Young Children	Best practices in assessment for screening, eligibility, programming, and evaluation with young children	Communication Interventions for Young Children	Identifying and implementing communication interventions with young children in clinics, classrooms, homes
Family-guided Early Intervention	Principles and practices for working with families in EI/ECSE; family systems theory, family assessment	Collaboration/Consultation in Early Intervention	Interdisciplinary teaming; consultation and collaboration in early childhood
Curriculum Approaches in Early Childhood	Curricular approaches for working with young children in early childhood settings; designing and implementing early childhood curricula	Evidence-based practices for Young Children with Autism	Implementing evidence-based practices with young children with autism; identifying and interpreting research
		Designing and Implementing a Parent Support Group	Interdisciplinary approaches to supporting parents; adult coaching strategies

Abbreviations: TEAMS, teaching early advanced master’s specialists; EI/ECSE, early intervention and early childhood special education; CDS, communication disorders and sciences.

All TEAMS students took any three of these Methods courses, depending on which ones were offered during their 1st year.

Shared Conceptual Framework and Competencies

Many therapists (including SLPs) are trained in predominantly medical models of service provision that focus on identifying and remediating disorders, and include brief and short-lived treatments (ASHA, 2008). Educational models, on the other hand, are focused on interventions that help children be independent, participating members of their families, classrooms, and communities, and are focused on long-term progress. The conceptual framework for an effective SLP personnel preparation program in EI/ECSE must integrate policies and practices common to SLP training and adapt them for the unique needs of young children and their families. The TEAMS program aligned core CDS and EI program philosophies to create one coherent vision for the project focused on family-centered services, cultural and linguistic responsivity, developmentally appropriate practices, participation in natural environments, interdisciplinary collaboration, and evidence-based practices. TEAMS competencies also were based on national recommendations and empirically determined best practices from the Division for Early Childhood (DEC; Sandall, Hemmeter, Smith, & McLean, 2005) and ASHA (2008). Faculty integrated competencies across DEC and ASHA to create a set of six core competencies: (a) foundations in EI/ECSE; (b) typical and atypical early development; (c) assessment; (d) family involvement; (e) design, implementation, and evaluation of culturally competent interventions; and (f) interdisciplinary and interagency collaboration (see Table 2). The students were required to master these competencies and all state and national licensing requirements.

Table 2.

Continuum of TEAMS Practica Experiences

	Type of TEAMS practica^a	Examples	Description of activities	TEAMS competency area
On-going, direct supervision and modeling, controlled setting	Faculty-supervised clinic experiences	UOSLHC	One-on-one experiences in a clinic setting	Typical and atypical development, assessment, intervention
	Faculty-designed and supervised practica in community and clinic settings	LAPE	Designing and implementing a classroom for toddlers with communication delays; coaching parents of children with speech sound disorder	Assessment, family involvement, intervention, interdisciplinary collaboration
		SELG
		BLAST
Community based, fewer hours of direct supervision^b	Community-based settings supervised by community SLPs	Early Interventionist	Participating in IFSP and IEP meetings; collaborating with families and practitioners; supporting parents; evaluating child progress	Assessment, family involvement, intervention, interdisciplinary and interagency collaboration
		Consultant with ECSE preschool classrooms
		SLP for elementary schools

Abbreviations: TEAMS, teaching early advanced master’s specialists; UOSLHC, University of Oregon Speech-Language-Hearing Center; LAPE, language and play every day; SELG, speech and early literacy group; BLAST, building language and speech together; SLP, speech language pathologists; ECSE, early childhood special education; IFSP, Individual Family Service Plan; IEP, Individual Education Program.

The level of supervision was related to the practica and to the individual student needs. The level of supervision depended on where they were in the program and their competency rating at their end of term evaluation. Students could not start their community-based field experience until they received a high competency level in clinic and faculty designed practica.

All Communication Disorders and Sciences (CDS) students must have 25% treatment and 50% assessment supervision during all practica. A CDS or community-based supervisor must be in the building where a student is working at all times.

Family-Centered Practices

Although family-centered practices are a guiding principle for EI/ECSE services (Sandall et al., 2005), personnel preparation programs rarely provide opportunities to work on interdisciplinary teams to support families (Knight & Wadsworth, 1998). TEAMS courses emphasized that family plays a central role in the assessment, intervention, and evaluation of services for all young children, and the goal of early intervention is to enhance the family’s capacity to promote their child’s development. TEAMS students had multiple opportunities to provide both indirect and direct supports to young children and their families, participate on interdisciplinary teams with families, understand family perspectives, establish relationships, gather information, provide support, receive feedback from families, and practice self-reflection during course assignments and practica (Crais et al., 2004). For example, in the course Family Guided Early Intervention, students were paired with a family from the community that had a child with disability. The students worked with the families to establish relationships, determine their priorities and concerns, and support families in accessing community resources.

Culturally and Linguistically Responsive Supports

Today’s population is more diverse, with increased numbers of cultures, languages, and English Language Learners (ELLs) in our communities, preschools, and school environments. When practitioners demonstrate an acknowledgment of and value for the family’s culture (including language, parenting practices), the relationship is strengthened (Cheatham, Armstrong, & Santos, 2009). TEAMS provided multiple opportunities for self-reflection regarding values and dispositions toward development and caregiving and families’ strengths, priorities, and concerns. Cultural and linguistically relevant practices were embedded across the TEAMS courses through readings, assignments, and guest speakers. In addition, students practiced communicating with and supporting culturally and linguistically diverse families and children through practica, and received extensive feedback and support on their interaction style with children and families (Dunst, Trivette, & Hamby, 2006).

Interdisciplinary, Collaborative Services

As described earlier, research demonstrates that interdisciplinary, coordinated service delivery systems are related to better outcomes for children and families (Harbin, McWilliam, & Gallagher, 2000). The TEAMS program provided multiple opportunities for students to learn interdisciplinary teaming and collaboration strategies. TEAMS students participated in interdisciplinary teams with EI/ECSE students and faculty, families, and community practitioners (e.g., OTs, PTs) through coursework and practica.

Participation in Natural Environments

Federal policy mandates that EI services are provided in natural environments and ECSE services are provided in the least restrictive settings (Reauthorization of the Individuals With Disabilities Education Act, 2004, § 634(4)(G)), meaning the home, community, and settings in which children with typical development participate. The natural environment includes the experiences, routines, and preferred activities that the family participates in at home and outside of the home, at day care, preschool, playgroups, and so on (Dunst, Hamby, Trivette, Raab, & Bruder, 2000). Furthermore, the goal of EI/ECSE is to support the child’s participation within the family or classroom’s daily routines, activities, and community (Roggman, Boyce, & Innocenti, 2008). The TEAMS program emphasized services that supported the child’s participation within their daily routines and activities. Thus, the students conducted authentic assessments in natural environments and used evidence-based coaching strategies to support teachers’ or caregivers’ capacity to embed learning opportunities throughout the child’s day across natural settings (McWilliam, 2010). For example, students in the Language and Play Everyday (LAPE) practicum collaboratively identified learning opportunities within the family’s preferred activities and routines using the family’s toys and materials to enhance the caregivers’ responsivity and capacity to teach their children to communicate (Dunst & Kassow, 2008; Powell & Dunlap, 2010). These experiences supplemented, yet contrasted, the traditional, clinic-based or pull-out experiences typically available in the CDS program. The TEAMS students participated in both natural and clinic settings to fulfill their CDS program practica requirements.

Evidence-Based Practices

Evidence-based practices require an integration of rigorous empirical research, professional judgment, and family input to guarantee services are relevant, based on the family’s values and concerns, and produce socially important outcomes for the child and family (Dunst & Trivette, 2009). Evidence-based practices were a fundamental component and guiding principle of TEAMS. For example, students took research courses in which they learned to identify evidence-based practices and integrate research findings in their intervention practices. They implemented enhanced milieu teaching (EMT; Kaiser & Hancock, 2003), phonological awareness (Gillon, 2005), and focused stimulation (Ellis Weismer & Robertson, 2006) with young children and their families. Research methodology and interpretation were emphasized across courses and practica experiences. The TEAMS students completed a research project during the final year of their graduate program that involved (a) gathering family input and using professional judgment to identify an evidence-based intervention approach for young children, (b) conducting a comprehensive literature review of the intervention, (c) implementing the approach with young children and their families, (d) monitoring progress and adapting the intervention as necessary, and (e) preparing a written and oral report of the project with a focus on interpreting the evidence for practice. This applied research project provided the students with an important opportunity to understand the research to practice link and utilize analytic, data-based decision-making processes (Gast & Wolery, 1990).

Continuum of Field Experiences

TEAMS students were immersed in a variety of interdisciplinary field experiences intentionally structured to provide staged learning opportunities (Macy, Squires, & Barton, 2009). This continuum of field experiences in clinic, university-designed, and community-based settings provided students with multiple and varied opportunities to practice and generalize skills across children and settings, receive frequent and specific feedback from multiple experts across disciplines, and work across a variety of contexts, agencies, and professionals to address specific needs and consider career opportunities.

Clinic Experiences

The University of Oregon Speech- Language-Hearing Center (UOSLHC) provides a broad range of speech-language-hearing services, including diagnostic evaluations and individual therapy sessions. All SLP students were required to participate in closely supervised clinic practica at the UOSLHC. For example, during their 1st year, the TEAMS students typically worked with young children and their families and administered standardized language assessments, identified intervention approaches, implemented interventions in weekly or biweekly sessions, and used data to evaluate and refine interventions.

University-Designed Practica

TEAMS faculty designed five different field experiences specific to working with young children with special needs and their families. These practica were intentionally designed to provide opportunities to practice interdisciplinary teaming and collaboration in natural settings and were meant to supplement the traditional, clinic-based CDS practica. These field experiences are described in the following sections.

Community toddler group

TEAMS faculty contracted with the local EI/ECSE agency to operate a parent-toddler group, for toddlers with language delays. Students planned and implemented individual and group activities for the children and their parents and conducted monthly home visits with each family. EMT and responsivity education–prelinguistic milieu teaching (RE-PMT) were used depending on the needs of the children, and caregivers were coached to implement EMT or RE-PMT at home during daily routines (Kaiser & Hancock, 2003; Yoder & Warren, 2002). Students also prepared quarterly updates for the children’s Individual Family Service Plan (IFSPs) and, with supervision, led IFSP meetings.

Toddler and parent support groups

TEAMS faculty created a toddler group at the UOSLHC for toddlers with communication delays. The group was similar to the community-based group with the exception that caregivers participated in a concurrent support group and were not in the classroom. The students identified and implemented evidence-based practices with the toddlers (e.g., EMT, RE-PMT, conversational recasting; Camarata, Nelson, & Camarata, 1994), and led concurrent parent support groups to coach caregivers in implementing the practices during their daily routines and activities.

Language and Play Every Day

LAPE was designed in collaboration with EI and CDS faculty to teach caregivers of toddlers with expressive language delay to use language-enhancing strategies within play and daily routines. Students led parent group sessions, which were composed of brief presentations and open discussions on such themes as evidence-based language elicitation techniques (e.g., responsive interaction, EMT), establishing joint attention, and play and routine-based interactions. The students also planned and implemented toddler classroom sessions using developmentally appropriate, evidence-based practices. Students practiced evidence-based family coaching practices, using live and video modeling, providing follow-up practice activities, and embedded all strategies into the families’ daily routines and preferred activities (Powell & Dunlap, 2010). Students collected a variety of outcome measures (e.g., parent responsivity, child communication, and implementation fidelity).

Speech and Early Literacy Group

The Speech and Early Literacy Group (SELG) provided direct intervention and parent support for preschool children with speech sound disorders. Students administered developmental assessments in communication, motor, problem-solving, social-emotional, and adaptive functioning. The students embedded phonological awareness practices into storybook themes to improve early literacy skills (phoneme and print awareness) and speech sound production based on individual needs (Gillon, 2000, 2005). TEAMS students also taught caregivers to embed the strategies during daily routines and activities at home.

Building Language and Speech Together

Building Language and Speech Together (BLAST) was a group for young children with moderate-severe hearing impairment using either hearing aids or cochlear implants. TEAMS students led weekly group sessions using developmentally appropriate practices based on the needs of the children (e.g., EMT, phonological awareness, cycles approach [Prezas & Hodson, 2010] and literature-based language intervention with a focus on narrative development through story retells [Swanson, Fey, Mills, & Hood, 2005]). The students also transcribed and analyzed language samples via wordless books, wrote reports, and collaborated with other practitioners.

Community-Based Experiences

Finally, all TEAMS students participated in community practica and externships. These included working in local pediatric clinics, early childhood special education settings, or early intervention agencies. During their final two terms, students completed two externships, one in a school district and one in a medical setting. All TEAMS students completed a placement in an early childhood setting and had the option to complete the medical externship in pediatric hospitals.

Effective Supervision Practices

Although research on preservice personnel preparation is scarce (Stayton, Miller, & Dinnebeil, 2003), extensive studies indicate that professional development without follow-up coaching and feedback is largely ineffective at changing adult behaviors (Joyce & Showers, 1983; Fixsen, Naoom, Blasé, Friedman, & Wallace, 2005), and level of implementation is directly linked to child outcomes (Odom, Boyd, Hall, & Hume, 2010; Strain & Bovey, 2011). TEAMS used a clinical model of supervision and evidence-based coaching strategies to ensure students mastered all competencies. Faculty provided performance-based feedback regarding skills and practices through conferences and observations (Krajewski, 1993) and coached students by using modeling, performance-based feedback, role-play, and demonstration videos (e.g., Casey & McWilliam, 2008; Joyce & Showers, 1983). In addition, students wrote weekly reflections and supervisors provided suggestions and support based on their reflections. Supervisors (e.g., CDS supervisors, TEAMS faculty, community practitioners) delivered timely and frequent performance-based feedback in writing and delivered via email or in person (Brown & Woods, 2011). This interdisciplinary approach to feedback and coaching was a quality feature of TEAMS. Specific forms were developed for each practicum experience that clearly defined expected competencies and rated student’s performance on each of those competencies. For example, in the LAPE program, supervisors provided written feedback on the students’ ability to implement EMT, focused stimulation, and support families. Students and supervisors discussed strategies, planned upcoming sessions, and discussed family and child progress.

Evaluation of Program Outcomes

The TEAMS faculty evaluated the feasibility of the program, the extent to which the graduates mastered competencies during the program, the impact on the local community, and the impact on the EI/ECSE workforce. Course grades, student practica competencies, caregiver satisfaction, parent and child outcomes, and job placement after graduation were continually analyzed. All TEAMS graduates mastered both their TEAMS and ASHA competencies. For example, Table 3 provides student self-evaluation competency ratings after participation in LAPE. These data indicated all students felt they were competent in implementing responsive interaction and milieu teaching practices. Overall, the students felt less competent in working with families. This was not surprising given this was the first practicum experience for many of the students. This information was used to adapt subsequent LAPE experiences by providing more demonstration, modeling, supervision, opportunities, and feedback for effectively working with families. Caregiver satisfaction was measured using an anonymous survey during select university-designed practica experiences, and overwhelmingly indicated caregivers were satisfied with the TEAMS practica (Barton & Moore, 2011).

Table 3.

Student Self-Rating of Competency After the LAPE Practicum Experience

Practicum competency category	Number of competencies	Average self-rating^a (n = 12)
Family coaching	3	3.8
Responsive interaction	6	4.6
Enhanced milieu teaching	2	4.4
Focused stimulation	2	4.3
Progress monitoring	2	4.3

Abbreviations: LAPE, language and play every day.

The self-rating scale was as follows: 0 = strongly incompetent, 1 = incompetent, 2 = somewhat incompetent, 3 = somewhat competent, 4 = competent, and 5 = highly competent.

Parent and child outcomes also were measured during clinical and practica experiences. For example, in LAPE, toddlers with communication delays increased their spoken words, and parents demonstrated increased use of responsive interaction strategies (Barton & Moore, 2011). Likewise, in SELG, all children increased their accuracy on letter sounds, and children with speech sound disorder demonstrated improvements with minimal clinician-therapy when parents were given explicit suggestions for implementing interventions at home (Kirk, Moore, Capri, & Feusahrens, 2010). Finally, the impact on the EI/ECSE workforce was measured. Many, yet not all, TEAMS students were employed in EI/ECSE-related positions after graduation (see Table 4).

Table 4.

Job Placement After Graduation for the 26 TEAMS Graduates

Category	N = 26 (total number of TEAMS graduates)^a
Total number working with children with disabilities	17
Working in EI/ECSE	7
Working in an elementary school with children (ages 5–8) with disabilities	10
Total number working with adults	5
No response^b	4

Abbreviations: TEAMS, teaching early advanced master’s specialists; EI/ECSE, early intervention and early childhood special education.

These numbers are based on self-report.

Four TEAMS graduates did not report their current employment.

Implications and Recommendations for Effective SLP Personnel Preparation Programs in EI/ECSE

The TEAMS faculty concluded the following based on program evaluation data, insights, and experiences with the TEAMS project.

After the 1st year, the faculty recognized that although many of the CDS students applied for the TEAMS program (which included paying for the 1st year of tuition and a stipend), few were truly interested in working with young children and their families in natural settings. Many primarily were interested in the program due to the financial assistance provided. Moreover, TEAMS was characterized by increased time and rigor because students had to complete all CDS and TEAMS coursework. Thus, students needed excellent time management and organizational skills. Over the next 3 years of the project, the faculty used a more intentional, rigorous application process and only accepted students who expressed a clear interest and had experience working with young children with disabilities and their families. In addition, TEAMS faculty continually coached students in time management and organizational skills. Thus, specialized personnel preparation projects should develop an application process than ensures students have an interest in EI/ECSE and the aptitude to handle the demanding course load and practica.

The partial tuition and stipend provided an incentive to attract qualified students. However, many of the TEAMS students still had to take federal student loans to cover the remainder of their tuition. Some of the most talented students reported that they wanted to take positions in EI/ECSE, but felt that they could not afford it. Most positions in EI/ECSE in Oregon pay significantly less than jobs in public schools and far less than jobs in hospitals or skilled nursing facilities. This is reflected in the large percentage of graduates who are not working in EI/ECSE (Table 4), despite having a service obligation (i.e., TEAMS students had to work in EI/ECSE for 2 years for each year of tuition). Some of the TEAMS graduates stated they could not afford to work in early childhood settings and pay back their federal student loans. However, they could take higher paying jobs elsewhere and pay back the funds provided by the TEAMS grant. This has important implications for policy and emphasizes the need for examining multiple sources of financial support and innovative recruitment efforts by employers.

During the 1st year of Project TEAMS, students were somewhat dissatisfied with the EI courses, which were primarily focused on classroom interventions and the role of the teacher. Over subsequent years, the TEAMS faculty continually adapted the courses to explicitly and intentionally address the role of the SLP, and the students reported higher levels of satisfaction. Personnel preparation programs for related services should intentionally adapt courses to address their specific professional roles.

Before the TEAMS project, few of the clinic practica or school-based externships provided models of effective teaming or interdisciplinary collaboration. The faculty created practica (e.g., LAPE) and redesigned courses to explicitly teach interdisciplinary collaboration and consultation strategies. Many courses were cotaught and intentionally designed to meet competencies for both programs. Thus, faculty made minor adaptations to existing EI courses to emphasize collaboration and teaming, rather than create new courses. In fact, many of the courses were cotaught by EI and CDS faculty, and these were the most successful, based on student satisfaction (measured by course satisfaction surveys) and achievement (measured by student competencies). SLP personnel preparation programs should consider collaborating with EI/ECSE faculty to create interdisciplinary courses and practica that meet state and national standards for both professions, rather than have students take separate courses.

The project may not have been as feasible or successful without federal funding to partially support faculty time and efforts. In the future, programs might consider innovative ways to create and sustain programs with minimal extra funding. This likely will involve adapting existing courses and practica and identifying innovative practica that address community needs.

Home visiting and family coaching are critical competencies for attracting students to work in EI. The TEAMS students who took these jobs after graduation were those who had the most experience in EI prior to or during their TEAMS program. These strategies are rarely taught in traditional SLP programs and there are limited, if any, practica opportunities in EI settings. Personnel preparation programs should be creative in designing practica and field experiences to ensure students have multiple opportunities to work with families of infants and toddlers with disabilities in their homes.

TEAMS faculty engaged in ongoing program evaluation and revision. This ongoing process was essential for ensuring the project met students needs. Faculty gathered information from students, other faculty, practitioners, families, and children. Program evaluation data included a range of measures (e.g., student competencies and satisfaction, caregiver satisfaction, child progress, fidelity of implementation). Thus, multiple forms of information from consumers were used to make program refinements. This was important for ensuring the program continued to meet and respond to student and community needs.

TEAMS practica included explicit strategies and experiences for working with families and on interdisciplinary teams. All TEAMS students mastered these competencies across practica. However, performance during practica does not guarantee the use of practices after graduation when working in the field. Thus, more and varied evaluation measures are needed to examine postgraduation use of interdisciplinary practices. For example, Crais et al. (2004) found students in SLP programs with a specialized interdisciplinary focus used most of the targeted practices after graduation based on self-report. More research examining use of targeted strategies post graduation is necessary and imperative for policy development. Programs might evaluate their graduates’ use of targeted strategies through multiple measures, including self-report, employer ratings, child outcomes, and observational measures. In addition, programs could examine their graduates’ differential use of targeted strategies based on the extent of their experiences in parent training and coaching, working with young children with disabilities, and interdisciplinary collaboration and consultation.

From the start, the TEAMS faculty were invested in evaluating the impact on local EI/ECSE practices and related policy. To this extent, faculty followed TEAMS graduates after graduation and collected information on their job placement. Moderate increases in SLP graduates taking jobs in EI/ECSE were noted over the first few years of the program. Additional research documenting the impact on the local community and the field is imperative for changing policy and influencing practices. Rigorous evaluation data of personnel preparation programs is critical to having a long-term impact on policy.

The TEAMS project was embedded within two existing graduate programs, which ensured all TEAMS students graduated within the same number of years and with the same licensure and certification as their peers in the traditional CDS program. Thus, personnel preparation programs can and should be designed to meet the needs of the field rather than just state and national requirements.

The TEAMS faculty intentionally designed the program with minimal extra faculty time or resources to ensure sustainability over time. The community partnerships were an essential component to ensuring the TEAMS students had high-quality interdisciplinary experiences and opportunities to master competencies. Sustainability over time will require both a commitment from a diverse group of faculty and strong community partnerships.

Footnotes

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Preparation of this manuscript was supported, in part, by the United States Department of Education, Office of Special Education Programs (Grant: H325K070314, Teaching Early Advanced Master’s Specialists). The opinions expressed do not necessarily reflect the policy of the United States Department of Education or the Office of Special Education Programs, and no official endorsement should be inferred.

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