Speech-Language Therapy Reimagined: Brooklyn School Lessons in Adaptation

When I first began working as a speech-language pathologist (SLP) in a municipal school setting in Brooklyn, New York, I approached each session with a rigid plan. I had spent years in graduate school learning about evidence-based interventions, the mechanics of speech and language development, and how to collect and analyze data. I was eager to apply these tools. But I quickly realized that clinical expertise alone wasn’t enough. I had expected students to adapt to my lessons. Instead, I needed to adapt to them. This lesson revealed a larger truth that still shapes my practice: progress is not linear, and success in speech-language pathology—especially in a city system as diverse as ours—requires flexibility, patience, and a deep understanding of municipal structures and student needs.

Understanding the Difference Between Classroom Teaching and Therapy

One of the most significant shifts in my thinking came when I began to understand the distinction between classroom teaching and speech-language therapy. In graduate school, we were always told teach, preteach, review curriculum-based and classroom level content with the students. So the idea that the primary focus was on the strategy, not the content, was never explicitly spelled out point blank; I entered the field thinking that my sessions should look like mini-classroom lessons to reinforce classroom units and content. But therapy, while does include explicit teaching, it's focus is on teaching strategies and speech-language skills, with content as an enforcer. While both classroom teacher and school-based SLP roles aim to support student growth, speech-language therapy is individualized and strategy-focused. Our work revolves around building skills that support communication, cognition, and social interaction.

Research supports this distinction. Studies show that therapy focused on metacognitive and metalinguistic strategies—rather than rote academic instruction—leads to more sustainable gains for students with language impairments, particularly those on the autism spectrum¹. As municipal employees working in schools, our job is to build these cognitive tools. This means sometimes a session is not about collecting data or hitting a benchmark. Sometimes, it is about modeling a strategy, practicing it in a safe space, and reinforcing the student’s effort—even if the outcome doesn’t fit neatly into a data chart.

Building Relationships: A Foundational Strategy

Effective municipal service delivery in schools begins with relationships. This is not a soft skill; it is a technical necessity. Students, especially those with communication challenges, thrive when they feel seen, heard, and understood. When I started out, I was so focused on task completion that I missed opportunities to build rapport. Now, I understand that trust and connection are prerequisites for therapeutic success. This is especially true in diverse urban settings like ours, where cultural, linguistic, and socioeconomic differences impact how students engage with therapy².

Building relationships also means working closely with teachers, paraprofessionals, and families. Municipal systems are interconnected, and collaboration is key. When we align our strategies with those used in the classroom or at home, we create consistency for the student. This does not mean abandoning our clinical judgment; it means using it to enhance the student’s entire support network.

Flexibility Within Structure

Structure is important. Students benefit from knowing what to expect, especially those with autism or other neurodevelopmental differences. But structure should not mean rigidity. I design flexible units that have continuity and interconnected lessons, but each session allows room for adaptation. For example, if I plan to use a book to target narrative skills, I will prepare multiple ways to engage with that book: visual supports, verbal prompts, movement-based activities, and drawing tasks. This allows students with different learning modalities to access the same core content in ways that work for them.

This approach is supported by research in differentiated instruction and Universal Design for Learning (UDL). These frameworks emphasize the importance of providing multiple entry points to content, especially for students with disabilities³. In practice, this might look like using the same storybook for a week but shifting the focus each day—retelling on Monday, sequencing on Tuesday, identifying emotions on Wednesday, and so on. Each day builds on the last, reinforcing skills through repetition and variation.

Real-Time Adaptation and Data-Informed Decision Making

While data collection is a cornerstone of municipal accountability systems, not every session should be a data-collection session. Some days are strategy days. These are the sessions where I introduce a new tool, model its use, and help the student try it out. The data from these sessions is often qualitative: Did the student engage? Did they attempt the strategy? Did they reflect on its usefulness?

This doesn’t mean abandoning measurement. Instead, it means using a broader lens. Formative assessment—observations, student self-ratings, and work samples—can be just as informative as quantitative data, especially in complex communication cases⁴. Municipal supervisors and administrators can support this approach by recognizing the value of qualitative data and ensuring that evaluation frameworks reflect the nuanced nature of therapeutic progress.

Micro and Macro Planning

Progress in speech-language therapy happens at both micro and macro levels. At the micro level, I plan individual sessions with specific targets and strategies. At the macro level, I design units that build upon each other across weeks or months. This helps students see connections between skills and apply them in new contexts. For example, a unit on social language might begin with identifying emotions, then progress to recognizing emotions in others, followed by practicing perspective-taking in structured role-plays.

This layered approach mirrors how municipal systems operate. Just as city agencies must think about both daily operations and long-term strategy, SLPs must plan for immediate needs and future growth. Research in developmental language interventions supports this model, showing that cumulative, scaffolded instruction leads to better generalization of skills⁵.

The Lessons I’ve Learned

Looking back, I see how much my practice has evolved. I no longer expect students to fit into my lessons. Instead, I design lessons to fit their needs. I use data, but I also trust my clinical observations. I build relationships first, knowing that trust is the foundation for growth. And I create flexible units that provide structure without being prescriptive.

For new practitioners entering municipal systems, especially in diverse urban communities, I offer this advice: progress takes time. Be patient—with yourself and your students. Use each session as a chance to learn, not just to teach. Collaborate with your colleagues. Adapt in real time. And remember that success is not always visible in the moment. Sometimes, progress is a student using a strategy independently weeks after you introduced it. That is the work we do. And it matters.

1. Cirrin, Frank M., and Ronald B. Gillam. "Language intervention practices for school-age children with spoken language disorders: A systematic review." *Language, Speech, and Hearing Services in Schools* 39, no. 1 (2008): S110–S137.

2. Hammer, Carol Scheffner, et al. "Parent–teacher communication for Latino children in bilingual Head Start and kindergarten classrooms." *Language, Speech, and Hearing Services in Schools* 36, no. 4 (2005): 312–324.

3. Hall, Tracey E., Anne Meyer, and David H. Rose. *Universal Design for Learning in the Classroom: Practical Applications*. New York: Guilford Press, 2012.

4. Nelson, Nickola Wolf, et al. "Academic and cognitive profiles of children with language impairment." *Journal of Speech, Language, and Hearing Research* 47, no. 4 (2004): 876–889.

5. Ukrainetz, Teresa A., ed. *School-Age Language Intervention: Evidence-Based Practices*. Austin, TX: PRO-ED, 2006.