SpeechLanguage Services in the Schools: Tennessee 2002

1
Speech/Language Services in the Schools
Tennessee 2002

• Sponsored by
• TSDOE and TAASLP
• June 2002

2
Major Changes

• Linking assessment, eligibility determination and
  IEP design and delivery to the general curriculum
• Requiring gt1.5 SD on standardized tests
• No longer using a language/cognition discrepancy
  formula
• Requiring and documenting adverse effects on
  educational performance or participation in
  appropriate activities
• Implementing the early intervention process
• Developing a collaborative relationship between
  the SLT and the school psychologist

3
Defining the Role of the School-Based
Speech-Language Therapist

• Am I approaching assessment from an educationally
  relevant perspective?
• Am I promoting school success within the context
  of interventions?
• Am I providing speech/language services in the
  least restrictive environment?

4
Guidelines for ReferralTerminology

• Prereferral implies that a referral will be made
  to special education.
• The early intervention process emphasizes
  assisting students within the general curriculum.
  

5
Guidelines for Referralcontinued

• Many of the speech/language concerns identified
  by teachers and parents can be resolved or
  sufficiently alleviated without a referral to
  special education.
• Early intervention is designed to
• Provide prompt support to the student,
• Avoid inappropriate referrals for comprehensive
  evaluations, and
• Gather assessment information when a referral to
  special education is appropriate.

6
Student Support Teams

• Are building-level problem-solving teams that
  address the needs of students with academic
  and/or behavioral difficulties.
• Suggest interventions and provide resources for
  the general education teacher.

7
Student Support Teams

• Benefit from collaboration with the SLT when
  developing and implementing general education
  intervention strategies.
• Identify, monitor and document the effectiveness
  of early intervention strategies. The Early
  Interventions Worksheet for Speech/Language is
  found in Appendix C.

8
Student Support Teams

• Help the teacher clarify the nature of concerns
  about the students communication abilities and
  the impact of these in the classroom.
• Review and evaluate efforts to adapt the
  curriculum, instruction or activities for the
  child.

9
Student Support TeamsDuties

• Seek information from the parents.
• Gather information about the students
  communication skills in a variety of settings
  with a variety of communication partners.
• Review educational, attendance and health
  records.
• Select, implement and monitor early intervention
  strategies.
• Compare the students progress to that of other
  students of same age, language and background.

10
Student Support Teams..

• Discontinue the early intervention process if the
  students communication difficulties resolve.
• or
• Initiate a referral to special education if the
  student continues to exhibit speech/language
  difficulties that are adversely affecting
  educational performance.

11
Prior to referral

• The SLT has been contacted about the possibility
  of a referral and has had an opportunity to work
  with the Student Support Team.
• The Student Support Team has documented adverse
  effects on educational performance.
• The Early Interventions Worksheet for
  Speech/Language (Appendix C) has been completed
  and is included in the referral paperwork.

12
The Early Interventions Worksheet for
Speech/Language

• Becomes part of the students educational record
• and
• Should be completed prior to the initial referral
  for a speech/language assessment.

13
Eligibility Determination

• The SLT conducts an assessment to determine if
  the student meets the TN eligibility standards
  for a speech and/or language impairment.
• After a speech/language impairment has been
  diagnosed, the IEP team determines if the
  students needs can be met in the regular
  classroom with or without special education when
  completing the Eligibility Report.

14
Guidelines for Evaluation

• A speech/language impairment is more than the
  numerical values derived from norm-referenced
  tests.
• Cognitive scores are only one component for
  predicting the benefit of speech and/or language
  services.
• Assessments are to be administered in the
  students native language or other mode of
  communication.

15

• Assessments for ELL students should measure the
  extent to which they have a disability in the
  native language and need special education.
• Standardized instruments may be inappropriate for
  students who are difficult to assess.
• Consider curricular expectations when gathering
  relevant, functional, and developmental
  information.

16

• Parents assist the team in determining how to
  assess the student and what focus the assessment
  will take as well as providing information about
  the students strengths and weaknesses.
• Assessments must consider the present level of
  performance and how this impacts the students
  success in the general curriculum or the
  preschoolers participation in appropriate
  activities.

17

• All areas of communication (language,
  articulation, voice, fluency) are to be addressed
  in a speech and/or language evaluation.
• Data is to be collected using a variety of
  assessment tools.
• The goal of the evaluation is to provide
  information to the IEP team to determine the need
  for special education services and the content of
  the IEP, if appropriate.

18
Components of Speech/Language Assessments

• Determination of adverse effects
• Educational performance
• Appropriate activities
• Hearing screening
• Vision screening
• Information from parents/guardians
• Information from the general education teacher(s)

19
Determining Adverse Effects

• Presence of a communication disorder does not
  automatically constitute an impairment that
  adversely affects educational performance.
• Document adverse effects
• Parent/teacher input
• Student work samples
• Classroom observations
• Social/emotional and vocational factors must be
  linked to an adverse effect on educational
  performance.

20
Eligibility Standards Language Impairment

• Significant deficiency which is not consistent
  with the students chronological age in one or
  more of the following
• Receptive language
• Expressive language
• Processing (auditory perception)
• Deficiency causes an adverse effect on
  educational performance in general curriculum or
  learning environment
• Not attributable to dialectical differences or
  characteristics of second language acquisition

21
Assessment for Language

• Both formal (standardized) and informal
  (descriptive) assessment tools shall be used.
  Tests with a mean of 100 and SD of 15 are
  preferred.
• A minimum of 2 of the following shall be used
• Criterion- and/or norm-referenced instruments
• Functional communication analyses
• Language/communication samples

22
At least one standardized, comprehensive measure
of language ability shall be included.

• Standardized - The tool is administered in a
  prescribed way for a specific population.
• Comprehensive - The measure yields a receptive,
  expressive, and total language score.
• Examples CELF-3, PLS-4, TOLD-I3, CELF-PS, OWLS,
  CASL
• Vocabulary tests do not meet this requirement
  (e.g., PPVT-3, EVT, ROWVT, CREVT).

23
Descriptive Measures

• Language sample
• Communication sample
• Observations
• Interviews
• Play-based assessment

• Curriculum-based assessment
• Criterion-referenced tests
• Checklists
• Narrative analysis

24
Language Evaluation
25
Analyzing Assessment Results

• Are the receptive, expressive or total language
  scores gt1.5 SD below the mean ( 7th percentile
  or a score of 77 or below)?
• Additional assessment is required when the
  obtained score is lt1.5 SD below the mean but
  significant weaknesses are demonstrated in any
  skill area (i.e., receptive, expressive, auditory
  perception, pragmatic language).

26
Analyzing Assessment Results

• Does descriptive information support or
  contradict the results of standardized testing?
• Eligibility decisions shall not be made solely on
  the basis of standardized test scores.
• Functional communication skills and curriculum
  standards must be considered.

27

• Have dialectical differences and/or
  characteristics of learning a second language
  been considered?
• Information is available in Appendix H describing
  characteristics of dialect and English Language
  Learners (ELL).

28

• What evidence is there that the perceived
  communication difficulties are having an adverse
  effect on educational performance or
  participation in appropriate activities?
• Can the documented communication difficulties be
  interpreted as a part of another disability, such
  as autism, mental retardation, developmental
  delay, learning disability in listening
  comprehension and oral expression?

29
Language Assessment Considerations

• Norm-referenced tests are not appropriate for
  some students with severe disabilities.
• Functional Communication Rating Scale and Teacher
  Input - Functional Communication forms (Appendix
  D)
• Functional Communication Profile, Every Move
  Counts assessment procedures, checklists,
  communication samples
• When standardized measures are used for students
  not included in the normative sample, document
  the rationale for doing so and report
  age-equivalent scores.

30
Consideration of IQ

• Cognitive measures may be used to support the
  findings of the speech/language evaluation, but
  the discrepancy formula comparing an IQ score
  with a total language score may not be used.
• It is appropriate to consult with the school
  psychologist to determine if the documented
  language difficulties can be considered part of
  another disability instead of existing as a
  separate language impairment, such as
• LD listening comprehension and oral expression
• Health Impaired ADD/ADHD
• Multiply Disabled
• Mentally Retarded
• Developmentally Delayed
• Autistic

31
Language Severity Rating Scale

• Use assessment data to complete the severity
  rating scale.
• Adverse effects must be documented to meet the
  eligibility standards for a language impairment.
  
• Educational performance
• Participation in appropriate activities

32

• Insert language severity rating scale here.

33
Evaluation Report

• Assessment information is to be reported in the
  Speech and Language Evaluation Report and
  submitted to the IEP team.
• This report is to be written in such a way so as
  to be understood by the IEP team.
• Avoid using technical terminology that parents
  may not understand. Use standard scores and
  describe them with terms such as, average, below
  average, etc. Avoid using age-equivalent scores.

34
Augmentative/Alternative Communication

• Any device, system or method that improves the
  ability of a child with a communication
  impairment to communicate effectively
• Ideally includes more than one mode of
  communication

35
Purpose of AAC

• Increase the ability to achieve the following
  communicative functions
• Control the environment
• Regulate social interactions
• Receive and convey information and ideas

36
Types of AAC

• Unaided gesturing, vocalizations, sign language,
  finger spelling
• Aided paper/pencil, computers, pointing devices,
  letter or picture boards, electronic devices
• Low-tech or manual devices do not require a power
  supply.
• High-tech or electronic devices are computers and
  dedicated voice output devices.

37
Types of Messages

• Initiate interactions - What did you do last
  night?
• Greet/farewell - Good morning See you later.
• Protest - Stop that!
• Request - Open the door, please.
• Exchange information - My favorite color is
  green. Let me tell you about my vacation.
• Comment - Yuk!
• Repair conversations - Thats not what I meant.

38
AAC Assessment

• Use a student-specific, multidisciplinary team to
  consider
• needs/interests of the AAC user and behaviors of
  communication partners
• multiple modes of communication (e.g., eye gaze,
  vocalizations, pointing)
• motor skills and methods of access
• appropriate messages
• appropriate symbols to represent messages (e.g.,
  miniature objects, line drawings, words)
• expectations of communicative independence

39
AAC Considerations

• Best practice understands that everyone
  communicates.
• Persons with severe and multiple disabilities can
  benefit from AAC that is appropriate and
  individualized.
• AAC is assistive technology and, as such, is to
  be considered by the IEP team under IDEA.
• AAC assessment is an on-going process.

40
Eligibility Requirements

• Speech/Language Evaluation Report documents that
  the student meets the eligibility standards for a
  speech and/or language impairment.
• The Eligibility Report documents that the student
  requires special education services to progress
  in the general curriculum.
• Disabilities are listed on the Eligibility Report
  as
• Language Impaired
• Speech Impaired Articulation
• Speech Impaired Fluency
• Speech Impaired Voice

41
Reevaluation Guidelines

• A Reevaluation Review is required
• at least every three years to determine
  eligibility for special education services,
• when considering dismissal from special
  education, and
• when the student is not making progress on
  his/her IEP.

42
Purpose of the Reevaluation Review

• focus on progress in or access to the general
  education curriculum
• focus on progress in special education
• address how the IEP is meeting the students
  needs
• investigate the need for further evaluation
• If the IEP team determines that there is
  sufficient information available to determine
  eligibility, a comprehensive assessment is NOT
  required.

43
Consider a comprehensive reevaluation when

• validity and reliability of previous testing are
  questioned.
• child was tested before the age of 8 years.
• significant discrepant results were obtained on
  two previous evaluations.
• the IEP team determines a need for additional
  information to plan the IEP.
• requested by the parent or other member of the
  IEP team.
• Informed consent from the parent/guardian is
  required for all comprehensive evaluations.

44
Service Delivery

• The disability category does NOT determine the
  services available to a student who is eligible
  for special education.
• The IEP team determines the services, whereas the
  SLT determines if the student meets the
  eligibility standards for a speech/language
  impairment.
• The IEP team decides on services based on IEP
  goals and objectives.

45
Determining Services

• Determining that a student is eligible as speech
  or language impaired, does not automatically
  determine that the SLT will be the sole, or even
  primary, provider of direct services to the
  student.
• Likewise, a student does not have to be speech or
  language impaired to receive speech/language
  services.
• The disability does NOT determine the services.

46
The SLT may

• assist the IEP team in drafting communication
  goals and objectives to be implemented by the
  classroom staff,
• provide consultation speech/language services
  (Option 1) or
• provide direct speech/language services using a
  collaborative model with the classroom teacher or
  a pull-out model.

47
Guidelines for Dismissal

• Discuss exit criteria from speech/language
  services with the IEP team when intervention
  begins.
• The SLT is expected to assess the students
  progress periodically as stated on the IEP.
• The SLT can recommend dismissal, but the IEP team
  makes the decision to dismiss based on input from
  all IEP team members.
• Lack of progress requires the attention of the
  IEP team to consider changes to goals and
  objectives and/or modifications and
  accommodations and possible dismissal.

48
Dismissal should be considered when

• the student is making progress in the general
  education curriculum or the special education
  program and speech/language IEP goals and
  objectives have been met
• the student is making progress in the general
  education curriculum or the special education
  program and speech/language services are no
  longer warranted
• speech/language services may not greatly improve
  education-based communication goals or
• communication skills no longer adversely affect
  the students educational performance or cause
  social, personal, or emotional difficulties as
  determined by the IEP team.

49
Remember

• A reevaluation is necessary if the student will
  no longer be receiving special education services
  in speech or language.
• Follow the Reevaluation Review process in order
  to determine IF a comprehensive assessment is
  required.
• Obtain informed parental consent IF a
  comprehensive evaluation is requested.