Push in - Pull out
Service Delivery
Service Delivery
"Pull out service delivery is used when a therapist removes a child from the classroom to work on direct interventions focused on specific skill development. Push in models are used in the classroom, when a therapist works side by side directly with a student on either the classroom activity at that time, or another therapeutic activity the therapist has brought in." (Case Smith, J., & O’Brien, J.C., 2020)
(Lvl 3) (Watt, 2018)
Participants prefer providing push-in services, even though they do not meet the needs of all children.
Frequent barriers for push-in include lack of practitioner training, limited school support, high caseloads, and variable classroom and practitioner schedules.
Common themes from the study include; a sense of practitioner positivity, students’ needs, education and training, school environment, relationships and attitudes, and workload.
(Lvl 5) (Layne, 2024)
Pull out programs can be beneficial for students who need targeted support while simultaneously having drawbacks.
The pros of pull-out programs include; enhanced specialized instruction, targeted intervention, smaller class sizes, peer interaction and support, flexibility in curriculum, opportunity for differentiated instruction, reduced disruption in regular classroom, increased parent involvement, specialized resources and materials, tailored transitions and reintegration.
The cons of pull-out programs include; disruption of regular classroom routine, limited interaction with peers, logistical challenges, increased stigma or labeling, missed instructional time, limited exposure to heterogeneous classroom environment, teacher workload and coordination, possible loss of continuity in instruction, limited generalization of skills, resource allocation.
If pull-out programs are not a method that will work there are other alternatives that can be chosen, present and future benefits need to be considered.
This article contains helpful frequently asked questions to discuss areas of concern from parents/guardians.
(Lvl 4) (Barton, 2016)
Barton interviewed teachers (special education, general education, and music), parents, and students to discover the best place for educating students with special needs.
According to Barton, the least restrictive environment (LRE) is dependent on where the student learns best.
Students do best when the lesson is co taught by the general and special education teacher
(Lvl 4) (Howe & Mercer, 2007)
Howe and Mercer completed a survey study that interviewed children (varied ages) during completing various activities.
This study considered the perspectives of Piaget and Vygotsky, and the results were consistent.
Children learn important communication skills with peers that cannot be replicated with adults.
Children’s social histories affect engagement in collaborative learning activities.
Children may not understand full potential unless provided with structured guidance.
Summary:
Selecting the option of push-in or pull-out requires a number of factors to consider.
Students each have unique experiences that may make one choice better than another.
How the student is currently doing in class and where their goals are for the future can lead to which option is best for them.
References
Barton, K. (2016, April 25). Pull-out or push in? Impact on students with special needs social, emotional, and academic success. St.
John Fisher University Fisher Digital Publications. https://fisherpub.sjf.edu/cgi/viewcontent.cgi?article=1336&context=education_ETD_masters
Howe, C., & Mercer, N. (2007, October). Children’s social development, peer interaction and classroom learning. Supporting
productive interaction. http://girlsschools.org/wp-content/uploads/2017/11/Children%E2%80%99s-Social-Development-Peer-Interaction-and-Classroom-Learning.pdf
Layne, J. (2024, November 1). 20 pros and cons of pull out programs. Ablison.
https://www.ablison.com/pros-and-cons-of-pull-out-programs/
Watt, H. (2018, November). Push in or pull out? Factors influencing occupational therapy practitioners’ use of service delivery models
in school systems in two western states. Am J Occup Ther November 2018, Vol. 72(4_Supplement_1), 7211510188p1. doi: https://doi.org/10.5014/ajot.2018.72S1-PO5015