Consultation Model of Service Delivery – is it worth it?

The consult-only model is considered by some a hassle-free way to keep tabs on students, allowing the TODHH to take on more students. It can also be seen as less important than direct service. This should not be the case.

One of the toughest questions teachers of the deaf and hard of hearing need to decide when completing an evaluation or annual review is the level of service. The law is designed to provide our students with a continuum of alternative placements and services – options – in order to meet specific needs. This coincides with deciding what model of service delivery is best given the student’s current academic and functional performance.

There are three common levels of service: 1) direct services; 2) indirect services; and 3) consult.  What these three levels of service entail are as follows: 

Direct – Involves regular and consistent contact with the student for the purpose of explicit instruction on goals and/or objectives written by the service provider. Instruction typically occurs in 1:1 or small group setting. TODHH also may have (depending on the point of service) direct and consistent contact with the student’s team of teachers and additional service providers such as speech, OT, PT, etc. Progress monitoring on specific goals is ongoing, and TODHH is responsible for documenting said progress.

Indirect – Some schools also call this level of service consult.  This may involve intermittent contact with student.  Goals are not usually written by DHH provider.  Contact with student does not include instruction, instead for purposes of (including but not specifically limited to)  assessment, check-in on grades, and/or hearing technology. The TODHH makes periodic contact with teachers and staff and is available for providing in-service, answering questions, and attending IEP meetings.

Consult only – TODHH typically has no scheduled contact with the student.  This model is for advising the staff and providing in-service, resources, strategies, and troubleshooting.  

The consult-only model should not be seen as less important than direct service. Fostering relationships, collaboration, in-service training, assisting with progress monitoring and/or performing assessments, contacting parents, overseeing equipment needs, ensuring access to curriculum is being provided takes time and commitment and, most importantly, should be seen as the ‘grease to the wheels that makes it possible for the student’s ongoing success’.

When the consult-only model can breakdown or fail:

1. When communication is not given or returned.

2. When negative personal viewpoints are allowed to dominate the relationship and create resistance between the TODHH and staff.

3. When questions and concerns are not followed up.

In an ideal world, the consult only model of service works, because the TODHH communicates regularly with staff, and the staff is receptive to this communication. In an environment that projects a negative view of students in special education the success of the consult-only service delivery model breaks down. Combine that outlook with teachers who are overwhelmed, understaffed, and/or undertrained, and the consult-only model ceases to be an effective way to provide services. The importance of establishing  good relationships with staff cannot be overstressed. This can avoid awkwardness and tension that might indirectly be projected onto the student. Negative attitudes and resistance may also require more work for the TODHH to ‘break through’ barriers and make sure the student is receiving adequate instruction. However, consultation services ought not be considered any less important than instructional services. Less time-consuming, maybe; less important, no.

What TODHHs can do to help make consult-only services effective:

1. Communicate, communicate, communicate. This cannot be emphasized enough. Regular and consistent communication is key.  Not only with the teacher of record for the student, but other staff members and parents directly involved in the education of the student.

2. Meet the teacher(s) in person if at all possible. Introduce yourself to any other staff working with the student. Include the office staff and campus administrators.

3. Include enough time in the IEP for observation, monitoring, assessing, collaborating, and reporting. Adding the ‘as needed’ phrase is too vague. Specifying a realistic amount of time needed, on average, will go far in allowing TODHH to capture the true caseload requirements and as a way to explain being overwhelmed to administrators.

4. Provide ongoing support by asking specific questions. Avoid using global questions such as, “How is Brian doing?” This question is too general, so the answer is likely to be just as general and unhelpful. Phrase your questions so that you provoke a more detailed answer. Examples: Does Brian have any missing assignments this week? Or, Is the FM/RM being used every day in class?  Where can I find his XXX scores on XXX test?

5. Be proactive. Introducing yourself one time and showing up a grading period or semester later will not ensure the teachers or staff (or student) will remember who you are or your role in the process. The more visible and communicative you are, whether it be in person, video, text, phone call, or email, the more likely those involved will remember and have confidence they can contact you when needed. This will also ensure that teachers remember who to contact.

6. Phrase your comments and questions to teachers so that they are about the student, or the situation. Avoid using accusatory language. Example:  Student focused: Is the student accessing the FM system every day? v. Accusatory: Are you using the FM system every day? Shifting your focus when asking questions is not easy or natural for many of us, but taking the time to phrase your questions in this way may create much more positive and productive communication between you and the staff.

Making the consult-only model an effective way to serve students will fall mainly on the service providers and not the teacher of record. The quality of the relationship between the TODHH and the other professionals is usually in direct correlation with the quality of the consult service. Be aware of the duties and responsibilities of consultation, communicate, and follow through. This will ensure the student receives the maximum benefit from the consult-only model.

See also:

Models of Service Delivery

One Size Does Not Fit All

By Brenda Wellen, Teacher of the Deaf and Hard of Hearing
© Supporting Success for Children with Hearing Loss, November 2023