Teachers’ perspectives on the role and scope of practice of speech-language pathologists working to support literacy in the early years of school

Abstract

Purpose: The purpose of this study was to explore the views of teachers in early year levels about the role and scope for speech-language pathologists (SLPs) to work on literacy support in schools.

Method: Sixty-one teachers from mainstream government schools across Victoria, Australia, completed an anonymous, online survey.

Result: Although many respondents reported knowing that SLPs support the literacy learning of some students in their school, they had limited awareness of the scope of speech-language pathology practice in literacy instruction and intervention.

Conclusion: Limited awareness of SLPs’ expertise and scope of practice may be leading to missed opportunities for collaborative practices. In order to capitalise on SLPs’ skill set for the benefit of students, the speech-language pathology profession should better promote and raise awareness of the various ways in which SLPs can collaborate within interprofessional literacy teams in schools.

Keywords:

• teachers
• speech-language pathology
• education
• literacy
• reading
• writing

Introduction

Mastery of reading, writing, and spelling (literacy) is critical for students’ academic and psychosocial success at school and beyond (Snow, 2016). In recent decades, the deeper understanding of reading as a language-based task (Snow, 2016; Snowling & Hulme, 2021) is consistent with models that emphasise the role of a range of linguistic processes in early reading acquisition (e.g. Gough & Tunmer, 1986; Scarborough, 2001). Gough and Tunmer’s (1986) simple view of reading posits that the product of oral language and decoding¹ is reading comprehension. Reading comprehension is dependent upon a strong foundation of oral language, i.e. vocabulary, semantics, syntax, and higher-level language skills such as abstraction inferencing (Snow, 2016), as well as rich background knowledge (Smith et al., 2021). Further, three national inquiries into literacy instruction since 2000 have emphasised theoretical models that specifically refer to five core elements critical to reading instruction: (a) phonological and phonemic awareness, (b) phonics, (c) fluency, (d) vocabulary, and (e) language comprehension, and their explicit teaching (National Institute of Child Health & Human Development [NICHD], 2000; Rose, 2006; Rowe, 2005).

Teacher knowledge of language constructs

Teachers play a central role in initial literacy instruction. However, persistent challenges in ensuring success for all students have given rise to concerns regarding teachers’ preservice training in the theoretical concepts necessary to teach students about the English writing system (e.g. Moats, 1994; Stark et al., 2016). Limitations in teachers’ knowledge about the most effective and efficient methods for teaching novice students how to read have also been documented (McLean et al., 2021; Meeks & Stephenson, 2020). Moats (1994) first reported this phenomenon when she found that many teachers demonstrated difficulties in tasks such as identifying individual phonemes and morphemes within words, defining linguistic terminology (e.g. inflected verb, derivational suffix, phonology), and had limited knowledge about the logical and orthographic structure of the English writing system. This finding has been repeatedly demonstrated over the ensuing two decades, both in Australia (e.g. Stark et al., 2016) and internationally (e.g. Binks-Cantrell et al., 2012). Buckingham and Meeks (2019) audited all preservice curricula in Australian initial teacher education (ITE) programs and concluded that ITE courses fail to adequately prepare preservice teachers for the teaching of literacy. In a similar study, Meeks and Stephenson (2020) examined the ITE literacy units across Australian universities and found that there was limited tuition time devoted to literacy, and what was offered typically lacked critical evidence-based content. Content aside, preservice teaching education is heavily influenced by constructivist philosophies (Teacher Education Ministerial Advisory Group [TEMAG], 2014). Since the 1970s, whole language and balanced literacy ideologies, rooted in constructivist pedagogy, have dominated preservice education (Seidenberg, 2017). Participants in a study of dual-qualified teacher and speech-language pathology practitioners by McLean et al. (2021) described a number of barriers to high quality, evidence-based Tier 1² (classroom) teaching of literacy. Participants reported relying on their speech-language pathology training in the theoretical and practical aspects of teaching children how to read, write, and spell, and that this was lacking in their preservice teaching degree. Further, for teachers, professional development offerings on literacy-related topics were of variable quality with respect to rigour and alignment with contemporary evidence.

Theoretical underpinnings for mainstream reading instruction

In accordance with Gough and Tunmer’s (1986) well-validated simple view of reading, Tier 1 classroom instruction and Tiers 2 and 3 intervention in literacy require school systems to teach and monitor and, where necessary, redress students’ code-based and/or language comprehension gaps. Failure to effectively intervene early places substantial economic and human resource burdens on education systems, as well as being potentially catastrophic for students in terms of their educational trajectories (Snow, 2021). Therefore, while it is vital that teachers possess critical knowledge and skills in the five essential elements of comprehensive literacy instruction (NICHD, 2000) when teaching novice readers at Tier 1, success for all students calls for the implementation of robust early identification and intervention processes. In this way, education systems can more successfully meet the needs of those struggling to keep pace with their peers under typical classroom-level instruction conditions.

Linguistic subskills that support reading

The heightened awareness of the linguistic subskills required for reading and writing has coincided with many researchers demonstrating comorbidity between developmental language disorders and reading difficulties (e.g. Snowling et al., 2016). Speech-language pathologists (SLPs) are required to complete units in linguistics and language development and to understand how these two areas of study form foundational knowledge when teaching children to read (Wilson et al., 2016). Speech-language pathology programs also emphasise a diagnostic/clinical focus and train students in evidence-based practice (Oates et al., 2004). The deep theoretical grounding that SLPs have in linguistics, language development and disorders, and models of communication positions them well to work in the literacy domain (Snow, 2016). As such, the inclusion of SLPs as part of the interprofessional team concerned with ensuring early reading success for all students would seem vital.

The interprofessional expertise that should be brought to bear on early reading success is magnified in importance by the fact that in industrialised nations, reading levels have been consistently falling well below expected benchmarks in recent years. For example, in the USA, National Assessment of Educational Progress (NAEP) data revealed reading scores at fourth and eighth grade levels had flatlined, and 37% of fourth graders and 30% of eighth graders were achieving below the “NAEP basic” level in reading (The Nations’ Report Card, 2022). For Australian students, the Program for International Student Assessment (PISA) 2018 data indicated that less than 60% of 15-year-olds achieved the national proficiency standard in reading (Australian Council for Educational Research [ACER], 2021). Furthermore, since PISA’s inception in 2000, the reading performance of Australian students has been on a downward trajectory (ACER, 2021). Results from the Progress in International Reading Literacy Study (PIRLS) 2016 indicated that 19% of Australian Year 4 students did not achieve the proficiency standard expected, and approximately 7% failed to reach the lowest standard measured (low benchmark; Thomson et al., 2017).

Speech-language pathology scope of practice

In 2001, the American Speech-Language-Hearing Association (ASHA) released a position statement describing the scope of practice of SLPs with respect to school-aged students with literacy difficulties. This statement asserted that SLPs’ responsibilities include: (a) having a direct role addressing the prevention, assessment, and intervention of literacy problems; (b) advocating for evidence-based instructional and intervention practices; and (c) working collaboratively with all stakeholders in the literacy domain (ASHA, 2001). As with all areas of speech-language pathology practice, SLPs are expected to undertake assessments, provide intervention, adhere to principles of evidence-based practice, and actively engage in interprofessional collaboration. In the years since 2001, numerous researchers (e.g. Blood et al., 2010; Snow, 2016; Staskowski & Zagaiski, 2003), together with national and international speech-language pathology peak bodies (ASHA, 2016; New Zealand Speech Language Therapists’ Association, 2012; Speech Pathology Australia, 2021; Speech-Language & Audiology Canada, 2016) have continued to advocate for an established speech-language pathology role within school-based literacy teams.

In spite of the international consensus described above, a lack of clarity remains regarding how SLPs should negotiate their role to contribute most effectively to literacy support teams both in Australia (Serry & Levickis, 2021) and internationally (e.g. Staskowski & Zagaiski, 2003). This uncertainty is likely to compromise teachers’ understanding of the contribution that SLPs can make as members of literacy teams in schools.

The power and influence of the teacher in the classroom cannot be overstated. Hattie (2003) noted that approximately 30% of variance in student achievement is attributable to teachers. Teachers have direct contact with students at a time fraction that far exceeds what could ever be offered via intervention (speech-language pathology support or otherwise). Teachers should be recognised for their expertise in curriculum, pedagogy, and their ability to teach to large groups of students (Bauer et al., 2010). The expertise of SLPs, however, lies in knowledge of oral language development, complex developmental disorders, and tailoring intervention to the needs of individual students (Bauer et al., 2010). However, for all the knowledge and expertise the SLP can bring to intervention, without adhering to the dosage intensity and frequency required to meet the fidelity of evidence-based approaches (i.e. a minimum of 30 minutes, three times a week; Justice, 2006) the impact of such intervention will be attenuated.

Interdisciplinary collaborations among professionals working in literacy are critical to students who are the beneficiaries of education (Roth & Troia, 2009). Staskowski and Zagaiski (2003) identified three critical factors for such teams to be successful: interprofessional practice, understanding team member expertise, and a sense of group belonging. Unfortunately, barriers to collaboration exist. In a survey by Watson et al. (2020), reading teachers (employed specifically to work with students with reading difficulties) expressed “highly favourable” views of SLPs’ knowledge and skills important for reading. However, reading teachers reported little support from administration for SLPs to work in reading instruction. Almost half of their sample noted that SLPs did not understand the curriculum sufficiently. Additionally, reading teachers reported that, due to caseload sizes and the itinerant nature of service provision, SLPs do not have time to work on reading. Some reluctance to enter the literacy space on the part of SLPs exists. For example, in their survey of 271 teachers, Loveall et al. (2022) found that SLPs supported the notion that assessment, prevention, and intervention for reading disabilities are within SLPs’ scope of practice. Despite this, over half of their respondents believed the teachers bore a greater responsibility than SLPs for the prevention, assessment, identification, diagnosis, and intervention of reading disabilities. Strengthened school-based collaborations between SLPs and teachers may assist in ensuring the relevance and alignment of speech-language pathology therapy goals to curriculum (Tambyraja et al., 2014). Through collaboration and an improved reciprocal understanding of roles, it has been suggested that SLPs can act as consultants for classroom-level instruction and as interventionists for students requiring targeted Tier 2 or 3 literacy support (Ukrainetz, 2006).

The current study

Previous research has explored the perspectives of SLPs regarding their practice in literacy. SLPs have reported sometimes experiencing resistance from teachers to their contributions for students struggling with literacy; this results in difficulties clarifying the boundaries of professional roles and responsibilities between teachers and SLPs (Justice & Kaderavek, 2004; Serry, 2013). In a recent survey of Australian SLPs, Serry and Levickis (2021) found that approximately one-third of respondents felt that recognition of the SLP’s role in literacy was not understood and that collaboration with their interdisciplinary colleagues was not easy. Additionally, in some studies, SLPs have indicated reluctance to take up literacy as part of their professional practice (e.g. Serry, 2013). In a survey of 219 Australian SLPs (Serry & Levickis, 2021), two-thirds expressed confidence providing intervention for literacy, with confidence varying depending on specific literacy subskills (e.g. phonological awareness versus morphological awareness). To date, the perspective of mainstream/classroom teachers has not been explored and, as such, it is not known what teachers think about SLPs’ role and work in literacy. As an initial step towards building more effective, productive, and transparent collaborations between teachers and SLPs, we therefore sought to explore how teachers perceive the role of SLPs’ work in literacy with school-aged students. We chose to recruit those teaching in any of the first 3 years of schooling, where the focus is on early reading instruction. In Victoria, Australia, the first 3 years of formal schooling are called Foundation³, Year 1, and Year 2. We use the term Early Years’ Teachers (EYT) to refer to teachers in these year levels. We focused on EYTs (a) because this is an initial exploration of Australian teachers’ perspectives and (b) to align with a preventative model of instruction and service.

In Australia, school-based speech-language pathology services vary by state or territory, location (urban, rural, remote), and eligibility for disability funding (Speech Pathology Australia, 2022). Australia comprises six states and two territories. Both territories (the Northern Territory and the Australian Capital Territory) and two of the states (New South Wales and Western Australia) have no, or very limited, publicly funded speech-language pathology services in government schools (Commonwealth of Australia, 2014). Three education sectors are recognised in Australia: government, Catholic, and independent (the latter often cultural, religious, or oriented in a particular philosophical belief). In government settings, predetermined service models are described within departmental guideline documents, meaning government-employed SLPs’ practice must align with the strategic directions and goals of the education sector (Speech Pathology Australia, 2022). Independent settings have their own governance processes.

We focused on investigating only one sector in one state of Australia (the Victorian Department of Education [DE])⁴ because of the impact that different education legislative frameworks and policies between states and territories have on mainstream schooling and the provision of, and access to, specialist services such as speech-language pathology. Based on DE website contents, there is no statewide application of the response to intervention framework in Victorian DE schools. Within the Victorian DE, principals are given autonomy regarding the development of educational programs and the approaches to instruction in their school (State Government of Victoria, 2022a). Such DE resources include the Literacy Teaching Toolkit (State Government of Victoria, 2019), which comprises literacy practices best described as balanced literacy. The Victorian DE employs SLPs under the Student Support Services (SSS) framework to provide services to numerous schools within large geographic regions. SSS staff are located in area-based offices, not on-site in individual schools. A health and wellbeing key contact (either a social worker, psychologist, or speech-language pathologist) provides the initial contact point for schools to negotiate referrals, consultation, and services (State of Victoria, Department of Education and Training, 2018). The full operating model for SSS is detailed within the Student Support Services Handbook (State of Victoria, Department of Education and Training, 2018). The Victorian DE routinely employs SLPs as part of their SSS portfolio. Schools may make discretionary decisions to directly appoint an SLP on staff, separate and independent to their SSS service allocation. Schools may also employ SLP services as subcontractors. Access to students in DE schools by private SLPs funded by individual parents is at the discretion of each individual principal. School leaders have the right to refuse private practitioners from delivering their services on DE premises (State Government of Victoria, 2022b).

Research questions

Our research questions were:

1. What do EYTs understand about the role and scope of practice of SLPs who work in literacy?

2. How likely are teachers to initiate collaboration with SLPs to work on literacy goals?

Method

Approval for the study was granted by the La Trobe University Human Research Ethics Committee (HREC19047) and by the Department of Education and Training (DET) Research Ethics Committee (2019_003941).

Sampling

Our respondents were drawn from the Victorian DE, which accounts for just over two-thirds of primary student enrolments in the state (State Government of Victoria, 2021). To be eligible, respondents needed to be EYTs currently employed in the DE, Victoria⁵, Australia as a mainstream teacher, in the first 3 years of school (Foundation, Years 1 and 2).

Survey instrument and dissemination

A purpose-designed survey (Supplementary Material) was developed based on previous literature (e.g. Fallon & Katz, 2011; Serry, 2013; Shaughnessy & Sanger, 2005) and Speech Pathology Australia’s 2016 clinical guideline⁶ (Speech Pathology Australia, 2016) regarding the roles and responsibilities of SLPs working in literacy. In refining the tool, three experienced teachers and three SLPs currently working in schools trialled the survey and provided feedback; minor adjustments were made accordingly. For example, “early print concepts” was defined further based on feedback and became “early print concepts (letter recognition, letter naming, letter-sound knowledge, book and reading orientation).”

The final survey comprised 28 questions divided into two sections and included 21 multiple-option questions, and seven items requiring responses on rating scales. The two main sections of the survey were (I) background information and (II) speech-language pathology services, teaching, and school-based practices. Respondents were informed that for the purposes of the survey, literacy was defined as “reading, writing, and spelling.”

Section I comprised 10 questions asking about respondents’ work setting, qualifications, and years since graduation. Section II posed questions concerning their professional contact with SLPs and their knowledge about SLPs’ scope of practice in literacy. Five questions in Section II (Questions 17, 19, 21, 24, 25) allowed respondents to select more than one option from the selection provided. Of these, two questions (Questions 21, 25) allowed for additional comments. Three questions used 3-point scales (Questions 26, 27, 28). Item 28 (“How likely are you to pursue a speech pathology referral as an avenue for literacy support for students experiencing low progress learning to read in your classroom?”) also invited respondents to provide a text-based response.

Respondents were required to respond to all questions. As such, there was no option to skip individual questions. However, embedded skip logic was used to streamline the survey, which meant that respondents may not have been presented with all questions.

Convenience sampling was used to recruit respondents using the X (formerly Twitter) handles of the three authors, as well as four closed education-related Facebook groups. After reading an online participant information and consent form, teachers entered the anonymous online survey (hosted on the QualtricsXM platform) by clicking “I agree, start questionnaire”. The survey was open for 8 weeks across March to May, 2019. One reminder was posted 4 weeks after the initial advertisement. The median time respondents took to complete the survey was 9.47 minutes.

Data analysis

Descriptive statistics are used to report the survey responses for items exploring EYTs’ understanding about the role and scope of practice of SLPs in literacy. Frequency and percentage of responses are reported for all survey items. The denominator in all cases is 61 unless otherwise specified. No comments were entered by participants for any questions except for the final open-ended question of the survey, which was designed to examine the likelihood of teachers initiating collaboration with SLPs specifically related to literacy goals. Responses to the one open-ended question were imported to a spreadsheet for analysis, ordered by the respondents’ indication of likelihood of referral to speech-language pathology for literacy support (i.e. “high”, “moderate”, “low”). Responses were reviewed multiple times by the first author. Inductive content analysis (Elo & Kyngäs, 2008) was then used to code, sort, and organise the data into topic-based categories. To ensure the trustworthiness of the data (Liamputtong, 2013), after the first author undertook the coding, regular meetings were held with the second and third authors with an audit trail maintained (Carpenter & Suto, 2008). The final analysis was determined in collaboration with the second author, who cross-checked the category matrix used by the first author and differences of opinion were discussed (Chilisa, 2012). Authenticity of the data was established via the inclusion of direct quotations from different respondents.

Result

Respondents

Seventy-three respondents answered at least one question. Incomplete surveys (n = 12) were not analysed. Sixty-one EYTs completed the survey in full and these data were analysed. Respondents represented both metropolitan (n = 34; 55.7%) and non-metropolitan areas (n = 27; 44.3%) of Victoria. While almost half of the respondents (n = 29; 47.5%) reported teaching students in Foundation, representation across the first 3 years was achieved. Eighty percent (n = 49) had worked as a teacher for 10 years or less. Table I provides full details profiling the respondents.

Table I. Respondent characteristics (n = 61).

		n (%)			n (%)
Teacher type	Classroom	59 (96.7)	Years of experience	0–2	14 (23)
	Specialist	2 (3.3)	teaching F-2	3–5	16 (26.2)
Geographic location	Metropolitan	34 (55.7)		6–10	19 (31.1)
	Regional	27 (44.3)		11–15	4 (6.6)
Victorian DE region	North-eastern	10 (26.4)		16–20	7 (11.5)
	South-eastern	19 (31.1)		>20	1 (1.6)
	South-western	17 (27.9)
	North-western	9 (14.8)
	Don’t know	6 (9.8)
Year level taught	Foundation	29 (47.5)	Teaching Qualifications^a	Bachelor	43(59)
				Masters	11 (15)
	Year 1	10 (16.4)		Post-Bachelor^b	19 (26)
	Year 2	8 (13.1)
	Composite 1-2	14 (23)

^aRespondents held multiple qualifications. Total qualifications = 73.

^bPost-bachelor includes three different graduate education qualifications available in Australia not deemed Masters level .

Respondents’ self-rated confidence in teaching specific subskills of literacy

In order to examine possible factors that may influence the likelihood for teacher-initiated referrals to an SLP for literacy, we asked respondents about their confidence teaching specific subskills of literacy, and also about areas where they could share their knowledge to support SLPs working in literacy. Respondents were asked to rate their confidence teaching individual subcomponents of literacy spanning code-based reading skills, oral language skills, reading comprehension, and handwriting (see Figure 1). As a group, they reported high confidence for teaching early print knowledge (n = 52; 85.2%) and close to three-quarters felt highly confident to teach reading accuracy (n = 47; 73.7%) and sight word reading (n = 44; 72.1%). More than two-thirds of respondents reported high confidence in their knowledge of other areas related to literacy such as spelling, phonological awareness, reading fluency, reading comprehension, and handwriting. A smaller proportion of respondents (n = 22; 36%) felt highly confident teaching oral language.

Figure 1. Respondents’ self-rated confidence to teach specific areas related to literacy.

The top three literacy-specific areas in which teachers believed they could share their knowledge to support SLPs working in literacy were: early print knowledge, 86.9% (n = 53); reading fluency, 77% (n = 47); and phonological awareness and reading accuracy, both 73.8% (n = 45). See Table II for the full results.

Table II. Areas on which teachers report they can share their knowledge to support speech-language pathologists working in literacy (n = 61).

Area	n (%)
Knowledge of the student	55 (90.2)
Early print knowledge	53 (86.9)
Reading fluency	47 (77.0)
Behaviour management	47 (77.0)
Phonological awareness	45 (73.8)
Reading accuracy	45 (73.8)
Reading comprehension	44 (72.1)
Handwriting	43 (70.5)
Spelling	42 (68.9)
Sight word reading	40 (65.6)
Oral language skills	36 (59.0)
Other:
Teacher workload	1 (1.6)
Depends on the skills of the teacher	1 (1.6

Respondents’ knowledge of students receiving speech-language pathology services and service providers

All but one respondent (98.4%) reported that, across their career, at least one of their students had received speech-language pathology services. Nearly three-quarters of respondents (n = 44; 72%) were currently teaching a student who was seeing an SLP. They noted that two-thirds (n = 46; 66.6%) of speech-language pathology services were delivered by private SLPs⁷ (either on- or off-site), while one-quarter (n = 17; 24.6%) were accessed through government-funded school-based services.

Respondents’ knowledge of speech-language pathology services at their schools

Most respondents (n = 51; 84%) noted that their school had access to a government-funded SLP (see Table III). A smaller number (n = 10; 17%) of respondents indicated that an SLP had directly been appointed to the staff. Even so, few SLPs were reportedly included in whole-school meetings (n = 2; 3.3%) or literacy team meetings (n = 3; 4.9%). Respondents also indicated that SLP services were frequently provided on-site by privately contracted SLPs who had no specific connection to the school or its curriculum.

Table III. Respondents’ knowledge of speech-language pathology services available in schools (n = 61).

		n (%)
School has access to government-funded SLP	Yes	51 (83.6)
	No	4 (6.6)
	Not sure	6 (9.8)
SLP directly employed by school	Yes	10 (16.4)
	No	45 (73.8)
	Not sure	6 (9.8)
Private SLPs permitted on-site	Yes	37 (60.7)
	No	13 (21.3)
	Not sure	11 (18)
SLP a member of school’s literacy team	Yes	3 (4.9)
	No	57 (93.4)
	Not sure	1 (1.6)
SLP regularly attends whole school staff meetings	Yes	2 (3.3)
	No	58 (95.1)
	Not sure	1 (1.6)

Respondents’ beliefs of why students are referred for speech-language pathology services

When asked for reasons why respondents believed their students were referred to an SLP, 60 of the 61 respondents were able to select multiple options from a list (see Figure 2). Most respondents (n = 55; 91.7%) selected more than one option, with a total of 173 selections made. The most common reason for referral was to help children improve their speech production (i.e. clarity of speech; n = 52; 86.7%). Support for literacy (i.e. reading, writing, spelling) along with stuttering therapy were the least frequently selected reasons for referral to an SLP (n = 24; 40% for both).

Figure 2. Reasons respondents believe that students have accessed speech-language pathology services. Note: Selections as presented in the survey: (a) speech production = difficult to understand, lack of speech clarity; (b) language = difficulty understanding others and/or expressing themselves verbally; (c) social communication = difficulties engaging with peers and others in socially appropriate ways; (d) stuttering/stammering = words or sounds getting repeated, stretched, or stuck; and (e) literacy = reading, writing, and/or spelling difficulties. Totals exceed 60 as participants could select multiple options.

Respondents’ referral patterns

Nearly 90% of respondents (n = 54) reported having referred one or more of their students for speech-language pathology services over the course of their career. When asked to select reasons for the referral, those 54 chose one or more reasons from 10 options. For analysis, these were collapsed to seven categories: (a) language, (b) assessment, (c) literacy, (d) speech production, (e) academic concerns, (f) English as an additional language learner, and (g) other. A total of 240 selections were made. Language (i.e. receptive and expressive) was the most frequently reported reason for referral (n = 65; 27%), followed by assessment (i.e. for diagnostic or funding purposes; n = 52; 21.7%), speech production (n = 49; 20.4%), and literacy (n = 35; 14.5%). Of note, nine of the 54 respondents selected dyslexia assessment as a reason to refer to an SLP. When asked about referrals made over only the last 3 years, the options offered to respondents were “spoken language”, “speech clarity,” and “literacy”. Fifty-three participants had made at least one referral in the last 3 years. As with patterns observed regarding referrals made over the course of their career, for recent referrals, speech clarity and spoken language (n = 48; 90.6% for both) were more common than referrals related to literacy (n = 38; 71.6%).

Respondents’ beliefs concerning the role SLPs have in supporting low-progress students in various language and literacy-related curriculum areas

We asked respondents to rate how they viewed the role of SLPs when supporting low-progress students in various oral language and literacy curriculum areas. As shown in Figure 3, more than 90% of respondents perceived that SLPs have a major role in speech sound correction and for working on students’ oral language skills, while more than three-quarters saw a major role for SLPs to work on phonological awareness. All other elements of literacy presented in the survey were not considered by respondents as major areas for SLPs to address, such as reading accuracy (30%), spelling (26%), and reading comprehension (25%). See Figure 3 for the full list of elements.

Figure 3. Respondents’ perceived role for speech-language pathologists working with children on various language and literacy-related curriculum areas.

Likelihood of referrals for speech-language pathology services in the future

We asked respondents about the future likelihood of referring a student to an SLP for literacy support. Twenty (32.8%) said it was highly likely, 26 (42.6%) said they were moderately likely to do so, and 14 (24.6%) indicated that the likelihood of this was low. Fifty-four respondents provided comments about their likelihood of a future referral to an SLP for literacy difficulties. These responses were categorised as: “reasons to refer” and “reasons for not referring.” Reasons to refer were identified in 26 of the comments made by respondents compared to 47 comments being categorised as reasons for not referring. Table IV outlines the coded analysis of short answer responses.

Table IV. Respondents’ views about referral of students to a speech-language pathologist (n = 54^a). 

Category subcategory	# responses in this category	Example comments
Reasons to refer to an SLP for literacy support
Collaboration	8	Can provide strategies for teachers (R29) To help think of other ways to help the student and cater to their needs (R13)
Knowledge of speech-language pathology scope of practice	8	These are the people with expertise when my avenues are exhausted (R51) Speech pathologists have more knowledge about the science of literacy (R6)
Positive interprofessional experiences	5	I have done so [referred for literacy] in the past and had good results. (R43) The speech paths in my region are amazing (R15)
Seeking a diagnosis	5	Children with specific learning difficulties and this requires a specialist to help diagnose (R58)
Reasons for not referring to an SLP for literacy support
Reduced knowledge of speech-language pathology scope of practice	12	Never really thought of it as an option (R14) Speech pathologists are not teachers. I believe their role to be oral language specialists, not reading and writing teachers (R39)
Service model constraints	10	A student with literacy would not get seen by our speech path (R15) We have been told it is virtually impossible to get anyone seen for speech through the dept (R5)
Challenges faced by referral process	9	[They’re] just going through the process of assessment and then nothing else (R22) The process is tedious (R17)
Using internal supports or alternative avenues first	7	We cater for low progress students through other intervention programs within our school (R33) I would access school based intervention (R53)
Teacher confidence in own capacity to address reading difficulties	6	I would aim to further diagnose literact [sic] skills such as letter knowledge, phonemic awareness, processing speeds etc before seeking a referral (R25) I guess I haven’t really thought of speech pathologists helping kids with some of the aspects of literacy mentioned in this survey (concepts of print, spelling, behaviour management, etc)… Each of these other areas I feel competent enough to work on (R38)
Negative interprofessional experiences	3	They’re [speech pathologists] not very friendly (R28) SSS are ‘pushing back’ when we refer (R35)

^a54 of 61 participants entered a text comment about their likelihood of future referral.

Discussion

We investigated EYTs’ views about the scope of speech-language pathology services in education settings. We had a specific focus on the scope of practice for SLPs in literacy and teachers’ experiences and reasons for accessing these services. Results provide opportunities to examine possible facilitators and barriers to collaborations between EYTs and SLPs when supporting students with literacy difficulties.

In response to research question one, our respondents were in agreement that SLPs intervene in the areas of students’ speech sound correction, oral language, and phonological awareness. There was less consensus among respondents regarding the degree of involvement of SLPs’ in supporting students with early print knowledge, spelling, reading comprehension, and reading fluency. The contrast between respondents’ perception of the SLPs’ substantial role in helping children with oral language when compared to reading comprehension and reading fluency is notable, and may reflect the fact that EYTs and SLPs are operating under different theoretical paradigms concerning language and literacy. Such a conclusion is understandable in light of the documented limitations of Australian teachers’ training of the essential constructs of language and literacy needed for effective reading instruction (e.g. Stark et al., 2016). Further indications of the paradigmatic position of teaching can be found in the DE’s Literacy Teaching Toolkit⁸ (State Government of Victoria, 2019). The toolkit provides exemplar lessons steeped in balanced literacy strategies (e.g. advocating the use of the three cues: “visual,” “meaning,” and “structural”); the use of levelled, repetitive texts in instruction; and the use of running records for progress monitoring, with citations to the work of whole language/balanced literacy advocates such as Marie Clay (Clay, 2000) and Fountas and Pinnell (Fountas & Pinnell, 1996) supporting such lesson plans (State Government of Victoria, 2019). It may be that these different theoretical paradigms are operating as a barrier to teachers’ recognition of the potential for SLPs to work as interdisciplinary collaborators more broadly in literacy.

Given the undisputed evidence that reading is language-based (Snow, 2016, 2021), the role of SLPs to work on students’ literacy, particularly at Tiers 2 and 3, is clear. Our findings suggest that a substantial number of respondents (25–41%) tended not to make this connection. On the contrary, SLPs were perceived as being best equipped to support verbal communication (speech and oral language) and auditory-based tasks (phonological awareness) to a far greater extent than working in written language (e.g. word reading, reading fluency, reading comprehension). However, according to the simple view of reading (Gough & Tunmer, 1986), a model of early reading that informs the literacy work of SLPs in Australia (Speech Pathology Australia, 2021), the ability to read for meaning is seen as a product of word recognition and oral language comprehension. These paradigmatic differences between education and speech-language pathology may help to explain why interprofessional practice between these disciplines remains challenging in the areas of teaching and supporting novice and struggling readers (McLean et al., 2021).

The contrast between respondents’ ratings of self-confidence in teaching oral language (which was low) compared with reading comprehension (which was high), further draws attention to a potential lack of shared understanding about the theoretical links that form the language-to-literacy nexus. According to established theoretical models of reading (Gough & Tunmer, 1986; Tunmer & Hoover, 2019), reading comprehension is not a stand-alone or discrete skill. Instead, a multitude of mainly language-based subskills must align in order for reading comprehension to occur. Oral language skills (Snowling & Hulme, 2021) along with background knowledge are two significant contributors (Smith et al., 2021). Without making the critical connection of the importance of oral language, a likely consequence is missed opportunities for referral to and collaboration with SLPs to assess for and address language-based difficulties in students demonstrating poor reading comprehension.

Regarding the second research question, the data obtained indicated a number of barriers to teacher initiation of collaboration with SLPs regarding literacy goals. A barrier to likelihood of referral includes being unaware of the SLPs’ role and breadth of practice in literacy. Phonological awareness was the one area related to literacy where a large majority of respondents felt that SLPs could contribute. Respondents’ recognition of the potential for SLPs to have a major role in providing intervention and support for low-progress students in literacy beyond phonological awareness was limited. It is understandable in this context that respondents would be less inclined to refer for literacy-related intervention other than for phonological awareness. We suggest reasons for this perception are twofold. Firstly, this aligns with respondents’ general confidence in their teaching, which was higher than the recognition expressed for the SLP’s role for all domains except oral language. Very few EYTs reported low confidence in their abilities for any area of literacy instruction. As such, if one feels confident in an area and they do not perceive the SLP as having a major role in intervention for that same area, it makes sense that they would not refer to speech-language pathology for support. Secondly, EYTs’ limited knowledge of the SLP’s role in literacy suggests that SLPs may need to consider their responsibility for sharing information and promoting their role in literacy. It must be acknowledged that SLPs themselves may be limiting the promotion of their services to phonological awareness and oral language, as a recent Australian study suggested SLPs expressed variable professional confidence across the literacy continuum (Serry & Levickis, 2021). SLPs may need to evaluate the effectiveness and impact of their efforts in clearly communicating their complete range of practice in education settings.

Our findings may reflect that EYTs experience other barriers to making referrals to speech-language pathology, such as service model constraints (as outlined in the SSS handbook; State of Victoria, Department of Education & Training, 2018) and/or prioritisation of different facets of speech-language pathology practice within the supports offered (for example, speech-language pathology resources directed to addressing motor speech disorders rather than literacy; McGill et al., 2021). Some respondents indicated that service model constraints were seen to limit the ability of SLPs to accept literacy-based referrals. It may be that some EYTs recognise that SLPs are not afforded the time to provide intervention for early print knowledge and/or spelling, with referrals going to other school-based literacy specialists variously described as learning specialists, literacy coaches, and reading specialists. As such, responses may indicate that although respondents do recognise that SLPs have a role in these areas, they understand that SLPs are unable to provide such services. Further research is needed to gain a thorough exploration of these issues.

Open-ended comments by our respondents reflected more reasons not to refer than to refer to an SLP. Although there was some support for the role of collaboration between SLPs and EYTs, the major barriers for referring children to an SLP appeared to relate mainly to a limited awareness of what clinical services SLPs could offer in literacy instruction or intervention, along with constraints to accessing SLP services. In the four priorities for service listed in the DE handbook (State of Victoria, Department of Education & Training, 2018, p. 11), direct work with students, “short to medium term intervention” (i.e. “learning difficulties—assessments/reports/strategies” and “speech pathology intervention”), is listed last. A higher priority is, “prevention/capability building” including “professional learning for teachers”. This suggests a prioritisation for a consultative service model. Respondent 14 summed up such barriers in the comment, “never really thought of it as an option”.

When examining respondents’ rationales for referring children to an SLP for literacy support, comments tended to be non-specific regarding targets or goals that the SLP could address. Statements such as the students, “need as much support as we can get them” or that “the speech pathologist at my school is excellent” may be indicative of EYTs needing another perspective, or knowing that additional support is needed but not being sure of exactly what the SLP can offer. When asked where teachers could share their knowledge and expertise to support SLPs working in literacy, respondents indicated that teachers felt confident to share their knowledge in a number of domains suggesting a willingness of teachers to work collaboratively with their interdisciplinary colleagues.

Direct appointment of SLPs by schools was reported infrequently among our respondents, mirroring findings of the Commonwealth of Australia’s (2014) report on speech-language pathology services in Australia. Unfortunately, a limitation of our survey was not including items regarding the time fraction of SLPs directly appointed by schools. While we do not know enough about the work practices of part-time SLPs in schools, part-time employment may explain why, when respondents’ schools did employ an SLP, only 10% of these participated in whole-school meetings. Part-time employment may also explain why, according to current respondents, only 7.4% of service demand in the schools of respondents is met by school-based practitioners despite 16% of respondents’ schools having direct and immediate access to an SLP they had directly employed. Alternatively, it may be that the school’s prioritisation for the appointed SLP has been directed elsewhere, addressing school-specific and school-identified needs specific to their student population.

Visual inspection of our data suggest that the demand met by private practitioners was more than double that provided by the state-funded service available within schools. Respondents noted that the bulk of speech-language pathology services in schools are provided by practitioners acting as visiting SLPs (i.e. the combined workforce of the DE’s itinerant service and private practitioners).

The overrepresentation of service provision by visiting SLPs presents logistical barriers to speech-language pathology and teacher interprofessional relationship-building and face-to-face contact (planning, problem solving, communication, and feedback). Furthermore, this may present barriers specific to SLPs, such as familiarity with broader school-wide contexts, duration of time on-site, confidentiality (if privately employed by individual families), role clarity, professional responsibility, and professional accountability. The net effect of the barriers is a likely further constraint on meaningful opportunities for collaborations between teachers and SLPs. This may create a self-perpetuating cycle, as reduced knowledge of scope of practice may result in missed opportunities for referrals, further reducing potential opportunities for contact and collaboration between teachers and SLPs.

Implications

The sector focused on for this study (the Victorian DE) routinely employs SLPs as part of their SSS portfolio. Given that the core business of education centres on language and literacy, the DE should examine avenues for more effectively capitalising on and utilising the specialised skills, knowledge, and expertise of SLPs regarding language and literacy learning.

Suggestions for improving interdisciplinary awareness and collaboration include professional development, resourcing evaluation, and examining the sustainability of the government-funded service-delivery model. As a first step to building collaboration, both professions, teaching and speech-language pathology, must have a shared understanding of the expertise each brings to the team (Hartas, 2004). To promote the desire to collaborate, teachers need to be supported more to be aware that SLPs have a vital role in literacy. Professional development targeting both teachers and SLPs to promote shared knowledge could serve to clarify professional roles, improve interprofessional communication, and improve the knowledge and awareness of the capacity and limitations of the SSS service. The DE could examine the resourcing required for the SSS service model to be feasible and sustainable (e.g. caseload size and prioritisation, number of schools serviced, travel times between allocated schools and base). The Victorian DE may need to explore options to increase the feasibility of the service model. For example, if direct therapeutic services are to be offered, the DE might consider stipulating that SLP services must directly align with the core business of education: the curriculum. This is not an unreasonable suggestion given that government-funded National Disability Insurance Scheme (NDIS) speech-language pathology services cannot align to education, and that private services are available to address therapeutic goals not directly within the remit of the education sector. By ensuring appropriate human resourcing, which in turn would result in reduced caseload sizes and reduce the number of schools serviced by a single SLP, greater duration of contact time between SLPs and teachers could occur. It may be that limitations on resourcing (e.g. SLP positions remaining vacant despite recruitment attempts) are such that the only feasible model is one of consultancy/capacity building with the removal of direct intervention. Currently, it is unclear from the Victorian DE’s handbook what capacity there is for SLPs in the SSS service to provide modelling or coaching at the classroom level. This is an area that could be more clearly articulated. Resourcing must be such that modelling and coaching is delivered in-line with best practice guidelines (Hartas, 2004). However, distinction and clarity should be maintained between classroom instruction and therapeutic intervention. It cannot be expected that teachers are coached to deliver individual therapy while simultaneously teaching a class of students.

Speech-language pathology as a profession should consider the role it plays in contributing to the current status quo. One factor for the profession to address is the need to more actively promote SLPs’ expertise in assessment and intervention for literacy, and SLPs’ willingness and capacity to work collaboratively with teachers. The profession should continue to provide advocacy for evidence-based literacy practices, as well as evidence of impact.

Limitations and future directions

This study represents an initial investigation into Australian EYTs’ perspectives regarding the role of speech-language pathology services in education, with a particular focus on school-aged literacy. There are key limitations that need to be acknowledged. First, our respondents came from only one state and one education sector in Australia, albeit Victoria is the second-most populous state in Australia and DE it its largest education sector. Furthermore, while it was not possible to report the total number of EYTs in Victoria, as this information is not publicly available, the sample of respondents was small relative to the number of EYTs in Victoria. Teachers from rural areas that may be less well served by SLPs may have been over-represented relative to the population. Therefore, generalisations cannot be extended to broader populations of teachers. Secondly, the validity and reliability of the survey tool is yet to be established. However, initial efforts to establish content validity were made via reference to the literature, the first author’s clinical experiences, via piloting with teachers, and by seeking speech-language pathology experts’ feedback on the tool. Another limitation is that it is difficult to know whether there is a systematic bias in the respondent sample (e.g. towards teachers who have experience of referring to SLPs and/or to those with particularly positive and/or negative experiences). The respondents were primarily teachers with experience of their students receiving SLP services. As such, it seems they have self-selected into the study. Recruitment via X and Facebook may have introduced an element of bias as not all teachers use these social media platforms professionally. Finally, this survey was limited to the perspectives of EYTs. The opinions and experiences of upper primary or secondary education teachers is not known and was not addressed in this study.

While we have been able to gain preliminary insights into teachers’ perspectives about the role and scope of practice of SLPs working in literacy, further research to address these limitations is needed. Our recruitment method (social media) may have also introduced a bias into the sample, towards those who engage more with current debates on language and literacy instruction and support. In designing the survey, all components of oral language were condensed in a single category. The subcomponents of oral language could have been presented as multiple options in survey questions and although this may have resulted in more nuanced data, it would also have significantly lengthened the survey. This is a survey-design dimension that future researchers could consider. A suggestion for future research is to extend the sample population to include other Australian states and territories, multiple education sectors, and settings with differing service models. Future research could also extend upon this study by exploring teachers’ perceptions of students who demonstrate low progress in literacy, in conjunction with an assessment of teacher knowledge and classroom observations and/or recordings so that perspectives, knowledge, practices, and student data can be properly considered in relation to each other. Additional research could also examine factors that influence teacher-SLP collaboration and interdisciplinary relationships in schools that identify as using a response to intervention (Justice, 2006) framework.

Conclusions

Our findings provide preliminary insights into the understanding of the SLP role in literacy alongside teachers from perspectives outside the speech-language pathology profession itself. This broadens the knowledge base, which to date has been built largely on the perspectives of SLPs. Concerns are raised about the extent to which EYTs are informed about the scope of practice of SLPs in their capacity to contribute to school-based literacy instruction and support. In order for students to benefit maximally from educational services available, improved interprofessional functioning and resource utilisation is required. Our results suggest that the dominant mode of operation for SLPs providing services to government schools in Victoria is perceived by EYTs as one of working within a disciplinary silo. This limits opportunities to work collaboratively with teachers to prevent or identify literacy difficulties and support students identified as needing additional supports in a timely manner.

Acknowledgments

The authors wish to thank the teachers and SLPs who provided initial feedback regarding survey content. The authors wish to express their gratitude to all respondents for their contribution to this research, and to the DE for ethical approval to proceed with this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated and/or analysed during the current study are not publicly available, as participants were not informed data might be shared and did not consent to this use of their data.

Notes

1 In more recent discussions, decoding is referred to as word recognition—see Tunmer & Hoover, 2019.

2 Tiers 1, 2, 3 reflect increasing levels of support within the response to intervention (RTI) framework (see Buckingham and Meeks, 2019). RTI is a school-wide framework of three tiers providing early, data-driven identification and intervention for “at risk” students in an effort to avert ongoing and long-term poor academic performance (Fuchs et al., 2003).

3 In Victoria, Australia, Foundation refers to the first year of formal schooling. In other Australian states and territories, this is variously termed Prep(aration), Reception, or Kinder(garten). In Victoria, students can be enrolled in Foundation if they have their fifth birthday by 30 April in the calendar year in which they commence school.

4 At the time the study was conducted, the Department of Education was known as the Department of Education and Training (DET). It is now known as the Department of Education (DE).

5 Victoria is located in the south-eastern part of Australia. Its capital city is Melbourne, which has an estimated population of 5.06 million; the remaining 25% of the population of Victoria live in rural and regional parts of the state (World Population Review, 2021). There are three education sectors in Victoria: government (68% of primary enrolments), Catholic (20% of primary enrolments), and independent (11% of primary enrolments; State Government of Victoria, 2021).

6 At the time of developing the survey, Speech Pathology Australia’s 2021 guidelines had not been published.

7 It was not possible to determine the context around private service provision (i.e. how it was delivered, nor by whom).

8 The Literacy Teaching Toolkit is an online resource for DE teachers, designed to guide their practice in instruction and assessment of literacy (State Government of Victoria, 2019).