The INCLUDE project and collaboration between teachers and SLPs

Please note: This is an English translation of the Swedish blogpost: Projektet INCLUDE och lärar-logopedsamarbete. For information about the author Anna Eva (in English) see this portfolio page.

Hello!

November is coming to an end. And what a November it has been! Whirlwind is probably the best way to describe it - I have had many fun and important external engagements, made progress in several different research projects and spent two wonderful days in Gothenburg at the National Conference for Speech Language Pathology where I was involved in four presentations and had the opportunity to network with both researchers and clinics from all over Sweden (thank you Sahlgrenska Academy at Gothenburg University for arranging it so well!).

October 31st I also found out that I received funding from the Swedish Research Council for my dream research project INCLUDE: Interprofessional Coaching to Enhance Language, Learning and Participation in Secondary Classrooms Using Digital Education for Teachers. HURRAY!!!

This project will be carried out in 2025-2029 and means that I get to continue developing the evidence-based teacher professional development (TPD) program LINK-S by Starling et al. (2012). Ever since I first read about this TPD, I have wanted to take it to Sweden, develop it further, and evaluate it in Swedish schools - and now I will get to do precisely that!

Here is our description of the project:

INCLUDE aims to enhance learning and participation in secondary classrooms through a digital teacher professional development program called LINK-D, where teachers get techniques to modify their oral and written instructional language and increase direct vocabulary instruction. We build on an Australian manualized intervention with documented positive effects on student language/literacy scores and teacher behavior, and high teacher satisfaction. INCLUDE will advance current knowledge by 1) determining program effectiveness for various student groups, including L2-learners and students with/without language difficulties, and measure effects on subject-matter knowledge and participation in addition to language/literacy skills, 2) explore associations between teacher use and student perception of specific program techniques and outcomes, and 3) compare student and teacher effects with/without interprofessional coaching by a speech language pathologist. After program development and a proof-of concept study (year 1-2), LINK-D will be evaluated in a clustered randomized controlled trial including 48 teachers and their 8th grade students (year 2-4). We will use a mixed-method approach where qualitative analyses of survey responses and video-recorded learning activities will complement quantitative analyses. INCLUDE will expand our knowledge about effective and scalable TPD that help mainstream teachers meet the needs of secondary students with language and literacy difficulties.

In the first half of 2025 I will create a project website and of course I will also update here on my blog on project progress!

I hope I will continue to be this happy as the work with INCLUDE progresses! :)
Image by *Manfred Steger* *from* *Pixabay*

INCLUDE will mean a LOT of work (and that my duties within my position at Karolinska Institutet will change quite significantly), but it will be very exciting to get started! The project will start "properly" with my family and I moving to Sydney/Australia in July 2025, 18 months of collaboration with professor Natalie Munro (Southern Cross University) and Dr. Julia Starling to develop and evaluate a pilot version of the digital teacher training LINK-D. In January 2027 I will return home and continue the Swedish part of the project. My co-researchers in Sweden are Nils Kirsten, senior lecturer in pedagogy at Uppsala University, and Christina Samuelsson, professor of speech and language pathology at Karolinska Institutet. Stay tuned! :)

Interprofessional collaboration - a current issue

Interprofessional collaboration between teachers and SLPs and psychologists and SLPs is something I've written about a lot here on my blog - and something I myself try to practice in both my research projects, in my teaching, and in my supervision of students. To continue highlighting this today as I share the good news about INCLUDE, I wanted to write about a recently published article on teacher-SLP collaboration and found an article by Brady and Kim (2024). They investigated the ways in which teachers collaborate with SLPs and how they experience this collaboration in two Australian states: New South Wales/NSW (where I will live) and Queensland/QLD (where the researcher I collaborate with works). It felt fitting! :)

METHOD

The study was a survey study with 117 teacher participants. The survey and questions were designed based on previous studies and a framework for teacher-SLP collaboration by Suleman et al. (2014). The framework describes collaboration models from least to most integrated in the classroom, where the least integrated model means that the student practices individually/in a group with the SLP outside the classroom and the most integrated model means that the teacher and SLP teach together in the classroom. For a compilation of evidence on teacher-SLP collaboration, I recommend Archibald (2017).

Quantitative results

The results showed that a majority of the students that teachers and SLP collaborated on were in primary school, and had a diagnosed impairment in speech, language, fluency, or autism. Collaboration mainly happened to improve students' language, followed by speech, while collaborations to improve fluency and pragmatics were relatively uncommon.

When the teachers were asked about the last time they collaborated with a SLP, the results showed that collaborations outside the classroom were most common in NSW, while a combination of approaches was more common in QLD. A majority of teachers in both states agreed with the statements that the teacher-SLP collaboration was perceived as positive (≈85%) and that the SLP’s goals were relevant to the students (≈90%). A majority of teachers also believed that students would benefit more from SLP interventions if they were classroom-based (≈85%).

“A majority of teachers also believed that students would benefit more from SLP interventions if they were classroom-based”

When the teachers had to estimate what affected interprofessional collaboration the most, "school finances" and "schedule/time to collaborate" were major hurdles (≈70% of the responding teachers perceived them as obstacles), while fewer agreed that lack of knowledge about what SLPs can contribute with, and lack of knowledge about each other's professions constituted an obstacle (10-15% of the responding teachers).

It would be very interesting to see how Swedish teachers in different regions/municipalities would answer the same questions!

Qualitative results: how do teachers experience the collaboration with SLPs?

The results that I found most interesting and thought provoking were the qualitative analysis that analyzed free text responses from 77 of the teachers who had left a comment about their experiences and experiences of collaboration with SLPs. Brady and Kim (2024) identified four themes (see figure below) and my impression is that this agrees well with what I know about what it looks like in Sweden and also based on previous research.

*How is your experience and experience of speech therapy collaboration? Results of qualitative analysis from Brady and Kim (2024).*

The responding teachers saw many advantages of collaboration with SLPs and they highlighted that SLP services support students with speech, language and communication difficulties to develop important skills. They also highlighted that there are too few SLPs in the school system, which leads to very limited interventions. They also believed that SLP interventions need to be more diverse and occur in more settings (SLPs should, for example, work more interactively, more preventively, and also be involved in screening and in professional development for teachers).

Finally, the teachers also highlighted that a lack of interprofessional consensus can negatively affect the usefulness of SLPs in school. I have written about the differences (and similarities) between speech therapy and pedagogy based on Gallagher et al. (2019) previously. Based on the representative quotes reported by Brady & Kim (2024), the teachers in their study believed that SLPs must be more realistic in their expectations and not "run their own race", but instead connect interventions to the school context and the linguistic demands in the school. SLPs must also be aware of the recommendations they give and how they fit into the everyday life of the school because otherwise they can be difficult to implement. This is something I recognize from the Swedish context, which the SOU report took up already in 2016 and also relates to the bulleted "recommendation lists" to teachers from from SLPs and psychologists, which I have discussed in a previous post.

Why is this interesting?

The study by Brady and Kim (2024) is a relatively small study conducted in Australia. It is also a survey study where the researchers did not have much control over who chose to answer the survey. In other words, it is not a study I can or want to draw any big conclusions from. BUT I still think it points to a few things that I hope to achieve with the INCLUDE project and the digital teacher training program LINK-D:

SLPs and teachers collaborate less often in secondary school - and more evidence is needed for SLP interventions, the benefits of teacher-SLP collaboration and language-friendly classrooms for this age group!
Since the intervention and the interprofessional collaboration in INCLUDE takes place online through LINK-D, more schools will be able to access SLPs for a limited, evidence-based intervention, especially schools located further from metropolitan areas. This is important both in Australia and Sweden, where schools are spread over large areas with a relatively small population, and so far few school SLPs
Finally, as a part of INCLUDE we will try to enhance the interprofessional consensus around students with language challenges, and the recommendations and focus will be on individually adapted advice to each individual teacher's practice - it is central to connect recommendations to what happens in that particular teacher's classroom , and of course both student and teacher needs!

Despite the upcoming move to Australia and this large change in my focus, I plan to continue updating the research blog at least once a month also in the future. In February, the research blog celebrates 10 years(!) and I will see if it can be celebrated in some appropriate way :D.

I will be very happy if you want to join me on this INCLUDE trip too!

/Anna Eva

Relaterade inlägg: Interprofessionellt samarbete