Speech

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Speech LanguageProfessional Pay Skill Set

• Pre-Referral Interventions
• Response-to-Intervention (RTI)

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Planning Committee

• Sandy Drvota (Bancroft)
• Melissa Grossman (Lind Anwatin)
• Sharon Penner (Andersen)
• Catherine Trapskin (Pillsbury ELL)
• Pam Telleen (ELL)
• Frank Cirrin
• With special assistance from
• Amy Murphy (Bancroft)

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Agenda - Aug. 26, 2008

• 900 - 1130 AM
• Introduction
• Skill set overview
• Case studies and videos
• 1130 - 100 - Lunch on your own
• 100 - 330 PM
• Issues and implementation
• Small group discussion
• Next steps Portfolios and peer coaching in peer
  groups

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Introduction

• AM
• Focus on content of interventions and skills of
  SLP
• Parking lot for logistic barriers and
  implementation issues that come up
• Dont get hung up
• PM
• Address logistic barriers and implementation
  issues
• Small groups will have opportunity to discuss

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Brainstorm Idea

• Looking for a PDP topic?
• Why not use this skill set?

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Why do we need to know this?

• MN Statute 125A.56 Alternate instruction
  required before assessment referral
• Before a pupil is referred for a special
  education assessment, the district must conduct
  and document at least two instructional
  strategies, alternatives, or interventions while
  the pupil is in the regular classroom. The
  pupils teacher must provide the documentation. A
  special education assessment team may waive this
  requirement when they determine the pupils need
  for the assessment is urgent. This section may
  not be used to deny a pupils right to a special
  education assessment.

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Why do we need to know this?

• Current emphasis on Response-to-Intervention or
  RTI
• ASHA and other professional organizations
• Federal No Child Left Behind IDEA
• State MN Dept of Education
• RTI language will be added in 2008 for LD
• District OCR and MPS Problem-Solving Model for
  academic and behavior concerns

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Why do we need to know this?

• SLP Self-preservation
• Highest caseloads for special ed providers
• SLPs 134 (increase from last year)
• SERTS 123
• Special Programs 16 to 112 (ASD, DCD, CLASS,
  ECSE)
• No increase in S/L FTE for 08-09
• Fewer school resources to meet needs of at-risk
  students (e.g., generational poverty, ELL)
• Limited school experience, low background
  knowledge, low vocabulary, etc.
• Time-consuming S/L evaluations
• SLPs caseloads are full

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Pre-referral intervention vs. Response to
Intervention (RTI) in MPS

• Similarities
• Both emphasize reallocating school resources to
  prevent failure
• Both have early identification of learning
  problems, increasing intensity of interventions,
  regular/frequent student progress monitoring
• Both have 3 (or 4) intervention tiers
• Both focus primarily on learning disabilities
• Both should be regular education responsibility

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Overview of SLP skills for Pre-referral
consultation

• Selected points will be addressed in case
  studies others will be addressed in the
  afternoon discussion of issues
• How to consult with teachers who will be
  implementing interventions
• Involving teachers in the design and selection of
  interventions
• Helping teachers understand why/how the
  intervention will help their student

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Overview of SLP skills for Pre-referral
consultation

• How to document stages of the pre-referral
  consultation process
• Suggestions for teachers for collecting data on
  student response to interventions
• Pre/post data vs. daily data
• Suggestions for how teachers can integrate
  interventions into classroom routines (e.g.,
  small reading group)
• Interpretation - Making decisions on basis of
  student response to intervention

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Overview of SLP skills for Pre-referral
consultation

• When to share or turn-over responsibility for
  pre-referral consultation to other educators
• E.g. Comprehension
• ELL students - Special considerations

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Case Studies

• Language (Wh-Questions) (S. Drvota)
• Articulation (S. Penner)
• ELL Articulation with parent
• (A. Murphy)
• ELL Language (Wh-Questions) with ESL teacher and
  bi-lingual education assistant
• (C. Trapskin)

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Pre-Referral Issues and Implementation

• Individual consultation with teacher vs. at
  pre-referral meeting (e.g., CTARS, Problem
  Solving)
• Advantages
• Disadvantages - time!
• Workload solutions
• E.g., SLPs schedule one 2-hour block per month
  (Fri. PM)
• What would an ideal school pre-referral system
  (or CTARS meeting) look like?

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Pre-Referral Issues and Implementation

• Teacher data-keeping
• Issues
• Baseline and pre/post testing vs. daily or
  bi-weekly data
• Tally sheets ( correct) and/or functional rating
  scales (e.g., ASHA FCM)
• Data on how often teacher implements intervention
  (e.g., treatment fidelity)
• Recommendations
• Calendar with tallies and/or rating scales, and
  treatment fidelity
• Give teacher choices
• Use untrained stimuli for pre- and post-data
• Forms (examples)

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Pre-Referral Issues and Implementation

• When might SLPs need to share responsibility for
  interventions with other educators?
• When might S/L interventions not be a high
  priority?

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Pre-Referral Issues and ImplementationWhen might
SLPs need to share responsibility for
interventions with other educators?

• Teacher concerns
• Student cant follow directions
• Student cant answer questions
• Student has limited academic vocabulary
• Student has limited background knowledge
• Student must have language processing problem
• Student just doesnt get it
• ELL students - It must be a language problem
• SLPs think twice before taking on these concerns

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When might SLPs need to share responsibility for
interventions with other educators?

• Comprehension is complex
• Affected by students attention
• Affected by students behavior
• Affected by students background knowledge and
  experience
• Affected by students vocabulary
• Affected by students familiarity with task
• Affected by students teacher language
• Affected by students visual supports, etc.
• These factors affect the students application of
  the underlying language skill in classroom
• These factors relate to the students performance
  (vs. underlying linguistic competence)
• Lower priority for specific S/L pre-referral (?)

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When might SLPs need to share responsibility for
interventions with other educators?

• Comprehension is also affected by students
  underlying linguistic competence
• E.g. TACL-R operationalizes comprehension
• Background knowledge is controlled
• Vocabulary is controlled
• Examiner focuses student attention and behavior
• Task is familiar (pointing to 1/3 pictures) and
  held constant
• TACL-R looks at how comprehension varies with
  length and grammatical complexity of sentences
• SLPs are concerned with the underlying language
  skill (understanding of linguistic structure)
• This is the students underlying linguistic
  competence (vs. performance or application in
  classroom)
• HIgher priority for specific S/L pre-referral (?)

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Pre-Referral Issues and ImplementationWhen might
SLPs need to share responsibility for
interventions with other educators?

• Teachers already have multiple strategies for
  helping students with performance problems
• Examples of research-based instruction designed
  to facilitate comprehension
• SIOP (Sheltered Instruction Observation Protocol)
  - for ELL students
• Reading First
• Houghton-Miffliin Soar to Success

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Pre-Referral Issues and ImplementationWhen might
SLPs need to share responsibility for
interventions with other educators?

• SIOP - Pam
• 5 min overview big picture
• Hx of prior MPS training for schools
• Use Lumens to show a few handouts from SIOP packet

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Pre-Referral Issues and ImplementationWhen might
SLPs need to share responsibility for
interventions with other educators?

• Reading First - Melissa
• 5 min overview big picture
• Hx of prior MPS training for schools
• Use Lumens to show a few handouts from Reading
  First packet

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Pre-Referral Issues and ImplementationWhen might
SLPs need to share responsibility for
interventions with other educators?

• SLP pre-referral priorities
• Suggestions for SLPs (re SIOP, Reading First,
  etc.)
• Remind teachers that they have been trained in
  strategies for facilitating comprehension
• Integrate these strategies into your consultation
• SLP may not have to design additional
  interventions
• Teachers can apply strategies more intensely for
  target student(s)
• Compile selected comprehension facilitation
  strategies into handout packet
• Other?

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Pre-Referral Issues and Implementation

• How to interpret data on student response to
  interventions?
• Issues
• What is enough progress?
• No absolute cut-off points
• Lots of day-to-day variability in student
  performance
• Underlying competence vs. performance in
  classroom

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Pre-Referral Issues and Implementation

• How to interpret data on student response to
  interventions?
• When student makes progress on specific tasks
  (underlying linguistic skills) - demonstrates
  competence, but still shows lack of performance
  in classroom
• An increase from 20 baseline to 40 post-test
  means something
• Student can learn with minimal intervention
  (e.g., 4-6 weeks twice per week intervention for
  5-10 minutes)
• Successful S/L pre-referral intervention
• Hold off on S/L evaluation
• Continue with classroom interventions designed to
  increase classroom performance generalization

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Pre-Referral Issues and Implementation

• How to interpret data on student response to
  interventions?
• When student does not makes progress on specific
  tasks (underlying linguistic skills) - does not
  demonstrates competence
• Verify that the intervention has integrity and
  high treatment fidelity
• Review big picture information previously
  gathered (e.g., ELL, competence vs. performance
  issues)
• Consider for S/L evaluation or
• Continue with other classroom interventions
  designed to increase classroom performance
  generalization
• The team can try something different!

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Pre-Referral Issues and Implementation

• Preschool populations
• Pre-referral not required?
• Is it desirable?
• Increase general background knowledge, positive
  response to language facilitation strategies
• Decrease time consuming evaluations, entry point
  for SLP caseloads, etc.
• Brainstorm ideas
• Discuss pre-referral options with parents and
  screeners (e.g., 348-TOTS)
• Enlist parents and other family members for
  in-home interventions
• High quality pre-school experiences prior to S/L
  evaluation (e.g., Headstart, High 5)
• In the families native language?
• Other?

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Pre-Referral Issues and Implementation

• Other Issues
• More formal consultation (with forms) vs. casual
  conversation with teacher in the hall or
  lunchroom
• Teachers should get input from parents
• Process is the same for students in special
  program classes (ECSE, CLASS, ASD, DCD, etc.)
• 2 bona fide interventions to try to solve problem
• Do not add S/L to eval plan without pre-referral
  Rx
• OCR Update
• Add Speech-Language box to OCR website

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Small Group Discussion

• Focus questions
• Feedback to planning committee

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Portfolios

• Design an intervention (following template)
• 2 intervention strategies
• Classroom - integrate into routine, small group
• 11 teacher/student task and materials
• List S/L concerns that intervention would address
• Describe and include specific task(s),
  activities, materials
• Suggestions for pre/post data (include form)
• Draft 1 portfolio due for Oct peer group
• Revised portfolio due for Nov peer group

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Peer Groups in Sept., Oct. and Nov.

• Sept 19 - Continue discussion of implementation
  issues focus questions and feedback forms
• Oct 10 - Peer coaching (1) on first draft
  portfolios
• Nov 14 - Peer coaching (2) on revised portfolios

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RTI Prof. Pay Skill Set Credit

• 6 hrs - Aug. 26 session
• 2 hrs - Sept Peer Group (Discussion)
• 2 hrs - Portfolio homework
• 2 hrs - Oct Peer Group (Coaching)
• 2 hrs - Portfolio homework - revision
• 2 hrs - Nov Peer Group (Coaching)
• 16 hours Total (or 1.6 PGCs for ATPPS)