**** American School Speech Pathology 2014 **

notes on image

The Girl with a Pearl Earring , Johannes Vermeer. Oil on canvas, 1665, Mauritshuis Museum.

Construction

Construction

ASHA Board Shifts Mission for Improving Accreditation

We are happy to see the Board of Directors has shifted the ASHA mission to include accreditation and educational preparation. The CAA (Council on Academic Accreditation) should be drawn out of its silo to address school speech-language pathology curriculum development.

The new mission includes “setting standards” and “fostering excellence in professional practice, and advocating for members and those they serve.”

ASHA Studies Mission in 2012 Update

In 2012 we began to examine how the ASHA Board of Directors views the mission of the American Speech-Language-Hearing Association with reference to curriculum development for school speech-language pathology students and employees. Here was the first post:

2012

The Board of Directors of the American Speech-Language-Hearing Association has announced for its August 2012 meeting interest in soliciting input on the Mission of the Association:

The current mission:

“Empowering and supporting speech-language pathologists, audiologists, speech, language and hearing scientists by:

Advocating on behalf of persons with communication and related disorders;

Advocating communication science;

Promoting effective human communication.”

Purpose

“A mission statement is a statement of the purpose of a company or organization. The mission statement should guide the actions of the organization, spell out its overall goal, provide a path, and guide decision-making. It provides “the framework or context within which the company’s strategies are formulated.”[1]  Wikipedia”

http://en.wikipedia.org/wiki/Mission_statement

Kids stuff for school.

Swallowing

In May of 2012 the Board considered a proposal adding a medical component to the mission statement:

“A group of members, who are board-recognized swallowing specialists, asked the Board to consider changing ASHA’s mission statement to include swallowing…. Following discussion, it was decided that ASHA should consider adding the words swallowing and balance to ASHA’s mission statement, while maintaining the original sense of the mission….”

2013 Update

The ASHA Board of Directors approved the following mission statement:

“Empowering and supporting audiologists, speech-language pathologists, and speech, language, and hearing scientists through:

advancing science,

setting standards,

fostering excellence in professional practice, and
advocating for members and those they serve.”

http://www.asha.org/ResolutionMotion.aspx?status=considered&year=2013

ASHA Accreditation CAA Calls for Input

Kids stuff for school.

Kids stuff for school.

In June of 2014 ASHA released a call for CAA input:

Call for Comment: Standards for Accreditation

The Council on Academic Accreditation (CAA) is seeking comment on its current Standards for Accreditation. Input received from the community will be reviewed carefully as the CAA considers changes to the standards for entry-level graduate education programs.”

Comment

A call for member ideas is a welcome turn of events. Let’s see how this information is processed? We hope it does not disappear into a black hole of poor feedback communication.

The CAA has a policy of “autonomy” and private decision-making insulated it from the membership. In fact it claims to have no influence from “ASHA”:

“CAA is completely autonomous in accreditation decision-making, standards-setting, and policy issues – distinctly separate and without influence of ASHA or staff in these areas “

http://www.capcsd.org/conference/2014Handouts/CAPCSD%202014%20CAA%20Update%20FINAL_OK.pdf

Teacher Referral a Cause of Special Education Over-identification

We are reposting this important feature to further draw attention to this component of special education over-identification. Teachability regardless of disability status is critical.

Girl Scouts Marching on Main Street.

Girl Scouts Marching on Main Street.

Teacher Referrals

How regular classroom teachers understand at risk children and then decide what special help they need is a critical factor as to the number of children who end up in special education. For example, there are more boys than girls in special education. We learn: “e.g., evidence that female teachers are more likely than male teachers to refer boys for special education coupled with the predominance of female teachers in the teaching force, especially in the elementary grades” (Policy Archive).

Although some special education referrals come from child find activities and parents, most come from the teaching faculty. Indications are teachers refer too many children to special education.

One hypothesis is that teachers view special education as a remedial support service rather than a disability-only service. Modern classrooms are full of “difficult-to-teach” (DTT) children, whatever the problems the children have. They do not easily follow the standard lessons teachers are prepared to conduct. When 20% or more of the children in a teacher’s classroom are difficult-to-teach, it is hard to achieve instructional goals.

“Children who are ‘difficult to teach’ (DTT) are those who experience considerably greater difficulty learning new educational material and mastering academic concepts than do their typical peers of the same age. Difficult-to-teach students may also display significant behavior problems (e.g., chronic inattention, a tendency to act impulsively, verbal defiance, or physical aggression). This group can be thought of as falling along a continuum, ranging from less severe to more-severe learning problems. In some cases, DTT children are classified as having a special education disability and receive special services. Many of these students, however, have no identified disability and are enrolled in general-education classrooms without additional support” (Jim Wright).

Teachers may have difficulty adapting their standard classroom methods for special needs children. They may lack training in “differential teaching.” Therefore, they are inclined to fall back on the special education services.

ASHA Continuing Education Program Successful!

A July 2014 press release indicates the continuing education program has reached a milestone:

“ASHA CE celebrates its 35th anniversary!

Thirty-five years ago, ASHA first started approving organizations as ASHA CE Providers. At that time, Jimmy Carter was President, the Steelers beat the Cowboys in Super Bowl XIII, and “YMCA” was the top song of the year! Find out more about our “35th” and the ASHA Approved CE Providers who have been part of our continuing education journey.”

A clown on main street.

A clown on main street.

Integrative Phonology for SLP Clinical Applications

Over the years I have noticed scholars picking up on early work we did at Kent State University in the 1970s addressing trading relationships in phonological and grammatical production as factors in clinical intervention. It is a robust factor and appears in normal language development. A primary aim of this line of investigation was to demonstrate sound-by-sound treatment is invalid for the most part. I believed we could change intervention to make it more efficient, significant and enjoyable for clinicians and children. However, when I returned to school practice for four years in Arizona schools I found that the treatment of “articulation disorders” lagged far behind. I wondered why the American Speech-Language-Hearing Association had allowed this to happen. This lead me to questions how ASHA keeps practice up-to-date through management of curriculum trends.

Definition

Integrative phonology means teaching sound structures in relation to grammar, meaning, prosody and information processing constraints. Because of integration one can expect broad generalizations across all components of expression. For example, treating articulation should improve morpho-syntactic development as well as sounds. Teaching isolated language structures out of context should be avoided and the motivation of the child should be considered. Phonology is essential to generalization of learning and academic performance.

Generalization

Integrative phonology can reduce the fragmentation of the scope of practice by mapping relationships among the different types of treatment:

“speech sound production
articulation apraxia of speech
dysarthria a
taxia
dyskinesia
phonology
morphology
syntax
semantics
pragmatics (language use, social aspects of communication)
literacy (reading, writing, spelling)”

In the area of literacy, what’s more, integrative phonology addresses methods of teaching phonological awareness within a linguistic hierarchy fostering articulation improvement charted in IEPs.

Best Practice

From the very beginning we sought to combat the teaching of isolated linguistic structures outside of the communication context. We observed some indications that children treated this way developed side effects, such as faulty generalization, disfluency and rule misapplication.

During my four years as a practicing school SLP I studied articulation / phonology practice and concluded it was out-of-date in American schools. I submitted a paper on the topic to The ASHA Leader and withdrew it after the editor said, “This wouldn’t do any good.” My impression was that this candid point of view was a public relations problem for ASHA. The paper was published elsewhere and was received favorably. I began to suspect ASHA was more concerned about image-making than improving graduate education.

I have always envisioned the simplification of developmental intervention by integrated treatment plans aimed at generalization across communication components. I imagined SLPs using their energies wisely to maximize improvement by letting generalization do the work. In school settings I saw 20 to 40 percent improvement of untreated sounds of the high functioning children.

At one of my practice sites I took on a boy with cleft palate impairment. He had been in treatment for several years for sound-by-sound treatment of affected sounds. His frustration level peaked and there was no evidence sound practice was the answer. In papers I have written I have pointed out that typical articulation treatment can be too aggressive, obliging clients to say sounds when their motor-speech systems cannot respond to the pressure. For 50 years articulation treatment have been production oriented. We know speech development is impaired but we continue to push the limits for “correct production.” I believe there are side effects if one notices.

I noticed with this boy that sound production was not the significant problem. He made sound errors because he could not produce rapid antagonistic syllable sequences using a faulty speech mechanism. The palate had been repaired but was scared and movements across syllable boundaries in words were slow and inaccurate. Of course when long words and phrases were targets, there was no chance of sustaining grammatical prosody to hit the embedded sounds accurately. Articulation errors were a symptom of syllable/morpheme production issues. I rewrote the IEP goals so rhythmic syllable production was a higher-level aim. He would have to hit sound targets in creative ways to suggest correct execution. (Many years ago a paper was published in JSHD about a client who had no tongue but intelligible speech. The acoustic effect is what is important.)

What I did was to give the boy relief from his labors of producing sounds. A “top down” and perceptual approach was adopted. The first aim was to maximize fun and success. He had had very little pleasure from speaking for therapy purposes.

My first task was simply to see if he could count the number of syllables in words. “How many syllables are in school bus?” When he said two, I was excited and he realized he got it right. No hard work. He was able to move on to find word boundaries and stress in longer words, and grammatical stress in phrases. No problem. Eventually I dropped to the lowest level of the linguistic hierarchy to see if he could perceive some of the sounds he could not produce in syllable sequences. This was more difficult but he could with extra tries. Perceptual skills seemed to be intact and available for phonological learning.

I began to read about phonological awareness for literacy training as understood in education. This method is nothing more than phonological intervention in the perceptual domain except there is a print connection.

I switched my articulation clients over to phonological awareness training and began to believe this could help production problems improve while facilitating reading development. Using prosodic contours with embedded features is a general approach with great promise to facilitate language development. When particular children have impaired speech production mechanisms, prosody intervention integrates and nurtures linguistic processing, placing less demand on brain resources for language development.

Prosody exercises are easy to design for success and fun. Music can be brought in for ear training the melody of speech. The boy had limited vocal range for speech and song could have helped him.

Diagnosis

I began to realize, as well, that SLPs misdiagnosis young children with pervasive linguistic impairments, i.e. “learning disabilities” (developmental Broca’s aphasia). By calling these children SLI and treating articulation narrowly they prevent early diagnosis of learning disability.

A child with multiple articulation errors in speech can be dismissed too early, before the learning disability comes into focus as a result of classroom instruction. SLPs take themselves out of the treatment process too early, and LD identification happens too late.

Public Policy

On the public policy level I took the position that ASHA appears to have no central curriculum process to identify, clarify and implement critical changes in school practice. This “evidence-based” approach goes a long way toward improving ASHA accreditation “standards” as promulgated by The Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA). Certainly, phonology would be central to a credible accreditation system of standards.By linking communication development to learning as IDEA did one must change theory and method for graduate education. Years go by without changes in graduate education. Deflecting new and current practice into continuing education is wrong.

John M. Panagos

July 7, 2014

ASHA has used a FACEBOOK post to direct attention to the clinical summary of this new content:

http://www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology/

Reforming the ASHA Presidency for Progress

Tracing through the history of ASHA’s questionable curriculum leadership for school speech-language pathology, it becomes clear the Board of Directors has the final authority to make corrections when it wants to.

“Key to reform is to create a different role for the president of ASHA. Deep historical uncertainty over the roles of the director and the president lingers. We must have leadership accountability. Someone must be clearly in charge of all business on behalf of the membership. The notion of mutual cooperation masks the authority issue. Kenneth Johnson did much as the strong executive leader but that role turned out to be inappropriate for the Association. The president must have full authority and responsibility so we know where the buck stops. All this is clear and central to reform.”

Strong Leadership

The relationship with the Chief Executive Officer must continue to evolve leaving behind fully the era of authoritative leadership by Kenneth Johnson. The President must not accept the role of “chief coordinator:”

“The President works in partnership with the Chief Executive Officer to achieve the mission of the Association and to optimize the relationship between the Board and staff.”

http://www.asha.org/About/governance/BOD/President/

The president should function in the manner of the president of the National Education Association. The NEA president as described in its documents has strong authority to conduct business, including representing the Association in policy matters, preparing the agenda for governing bodies and appointing chairpersons and committee members.

Vision

The president must shed his or her agenda of idiosyncratic personal interests and address the concerns of all members. There must be a well articulated vision of how to move the Association forward philosophically, scientifically and operationally.

Who have we been and where are we going?

The president should deliver a yearly “state of the union” address at the national convention in a large ballroom where many members can come and ask questions. We should hear about the issues of the year, challenges and new directions the president has crystalized for us.

http://www.nea.org/assets/docs/2013-NEA-Handbook-Bylaws.pdf

Focus

The president should serve for one or two three-year terms and be paid very well. The silly rotation of three presidents for one year stints should be abandoned to combat leadership by committee and second-guessing. The Board of Directors must be streamlined to support the president’s authority and range of activities. There should be a vice president to serve when necessary and a secretary who furiously tracks Association business. The president should manage ongoing business, making sure THINGS GET DONE!

Mission creep must be addressed to focus on the most important business. Now ASHA sprawls in so m any directions accountability requires a fortune-teller.

Accountability

Members should be able to vote to recall the president.

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