Monthly Archives: April 2010

1. RTI and Speech-Language Pathology

Girl Scouts Marching on Main Street.

In our posts we have considered the importance of competence for collaborative education. We say current trends push hard on the traditional model of isolated small-room pull-out intervention. The skills required for collaboration rapidly must become best practice, at least in university speech and hearing clinics where first skills are developed. Otherwise they must be acquired through continuing education and school in-service. Competence includes knowledge of the history of special education, IDEA 2004, evidence-based programs, national implementation trends, team models and eligibility procedures.

In recent years motivated SLPs have struck up relationships with others to run meritorious cooperative programs. We call this Inspirational Collaboration. Now the trend is toward Mandated Collaboration, under IDEA 2004; schools impose programs on special education and general education personnel from the top down. The SLP role changes on the basis of perceived skill, availability and cooperation. Role modifications can come under “other duties as assigned” as stated in employment contracts.

There are no set guidelines as to who organizes collaborative school programs such as RTI and early intervention. School administrators, curriculum directors, psychologists and special education directors are vying for leadership roles, helter-skelter. In some instances district superintendents play a central organizational role and they should. Related service personnel are largely left out in the cold because they are thought to be clinical specialists rather than program-design specialists.

Reading or “literacy” is the key content battleground, as it were, when mandated collaboration is mounted. There is the widespread view in 2010 that reading is the essential skill for struggling students to avoid academic delay and special education placement. Regular classroom teachers historically have “owned” reading but it is now an ownerless interdisciplinary domain. Reading specialists surprisingly play lesser roles. SLPs are identified oral language specialists and not print specialists. There is a large body of research saying pre-print cognition is crucial to reading achievement but educators do not teach to cognitive precursors.

Response To Intervention is the strongest national movement justifying cooperative programs. Spectrum k12 survey data suggest some two-thirds of America school districts are engaged in setting up RTI programs. There are commercial packages available. School mandates for evidence-based programs place pressure on SLPs to collaborate according to the protocols purchased. It is costly for schools to buy commercial systems so expectations for willing participation run high.

SLPs should understand the significant congressional and research origins of RTI under IDEA 2004 regulations:

“The reports of both the House and Senate Committees accompanying the IDEA reauthorization bills reflect the Committees’ concerns with models of identification of SLD that use IQ tests, and their recognition that a growing body of scientific research supports methods, such as RTI, that more accurately distinguish between children who truly have SLD from those whose learning difficulties could be resolved with more specific, scientifically based, general education interventions. Similarly, the President’s Commission on Excellence in Special Education recommended that the identification process for SLD incorporate an RTI approach” (IDEA Legacy).

The momentum of RTI nationwide means SLPs are in the path of an avalanche without much warning. However, SLPs are competent school employees who have the ready talent to make RTI work. It depends on the flexibility of special education directors and individual SLPS. In many cases SLPs will be pushed to the side regardless of their willingness to collaborate.

The regulations give emphasis to reducing the number of children misidentified as learning disabled pupils. This aim is being dropped. SLPs should advocate for reduction of over-identification as a means of ethically reducing caseload size.

It is unfortunate SLPs nationwide are tied down to moderately heavy caseloads at a time when they need flexibility to follow mandated educational trends. What happens to the traditional practice areas of voice, fluency and articulation?

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10. “Struggling Students”

The Department of Education on behalf of President Obama has issued it’s plan for “The Reauthorization of the Elementary and Secondary Education Act” (March, 2010). It is called “A Blueprint for Reform.” In it, reference is made to “diverse learners.” There are many names in use for what we call “struggling students.” The list does not include special education categories for IDEA 2004.

diverse learners
struggling students
at risk
special needs
special education
disabled
disadvantaged
hard-to-teach
impaired
culturally and linguistically different
handicapped (historic)
slow learners (historic)
migrant
neglected
English language learners
minority
poor

PEJORATIVE

disruptive
problem
difficult
lazy (historic)

9. “Struggling Students”

The Department of Education on behalf of President Obama has issued the plan for “The Reauthorization of the Elementary and Secondary Education Act” (March, 2010). It is called “A Blueprint for Reform.” Reauthorization will bump up against IDEA 2004, meaning that “struggling students” will be important to both laws.

HIGHLIGHTS

Support for raising achievement in low-performing schools.

Support for “Evidence-based instructional models.”

Support of access to improved instruction for students in high-poevery and high-minority schools.

Support for closing achievement gaps.

Support to meet the needs of diverse learners (English language learners, disabled students, Native Americans, homeless students, migrant students, rural students, neglected students) to prepare for post-secondary education and careers.

Support for high school graduation for all types of students.

Support for interventions to help low-perforning students.

Support for high-performing schools servicing high poverty communities.

Support for measures of high school success, broken down by race, gender, ethnicity, disability status, Enlish learner status and family income.

Support for assessments for high school performance of English learners and disabled students.

COMMENT

The emphasis on high school success requires special education personnel to shift their focus away from basic skills instruction to content education leading to graduation and employment (cf. Middle School Exits). No Child Left Behind obliged special education teachers to define “progress in the general curriculum” as the development of essential skills leading to successful test performance. When special education pupils could not advance on their annual IEP goals, special education personnel carried on with basic skills instruction, not thinking of the ultimate purpose of instruction and how the stigma of being classified as a disabled child might even cause him or her to dropout out of high school, thereby failing because of special education status.

School SLPs Changing Roles

Though school SLPs work in special education, initiatives in general education influence speech therapy practices. The U. S. Department of Education has issued A Blueprint for Reform (March 10, 2010), on behalf of President Obama, detailing plans for renewal of the Elementary and Secondary Education Act, and professional groups are beginning to comment.

We do not hear much talk about reducing over-identification of at-risk children for special education placement. Instead, we hear more about flexible programming for at-risk children regardless of affiliation with general education and special education.

Looking at older trends in IDEA, and now current thinking about No Child reform, it is clear the SLP role is going to continue to change in the school setting. Continued pressure on isolated “pull out” service delivery, and a greater push toward “collaboration” are inevitable. Consensus points toward SLPs working more in support of remedial general education programs. Awareness of helping all special education pupils graduate from high school is a must. However, opportunities will appear to reduce pull out caseloads in favor of participation in collaborative programs. SLPs have quite an opportunity to take on leadership roles helping to design evidence-based programs. They do need more graduate research and leadership education, however.

There will be continuing change in what SLPs consider a “pathology.” Evaluation criteria changed with IDEA 1997 to include educational criteria, i.e., “progress in the general curriculum.” SLPs will have to fine tune their diagnostic skills to differentiate types of children who are not disabled but need remedial support. Practical application of knowledge of cultural and linguistic differences is a deficiency and emergency. RTI will continue to have a strong influence on the SLP role.

Educational speech-language pathology is rapidly becoming a separate specialty worthy of differentiated status at the graduate level.

8. “Struggling Students”

As renewal of No Child Left Behind is approaching, The National Association of State Directors of Special Education recommends the adoption of Universal Design for Learning (NASDSE, 2010). IDEA and NCLB should work smoothly together but there is an issue of how to shape curriculum standards; “…while we are pleased that the Administration is supportive of the principles of Universal Design for Learning (UDL), we want to encourage the Administration and Congress to incorporate these principles into the law and make them available for ALL students, not just students with disabilities.”

What is UDL? It is said to change assumptions for teaching and learning (cast.org3):

“Students with disabilities fall along a continuum of
learner differences rather than constituting a separate category

Teacher adjustments for learner differences should occur for all students, not just those with disabilities

Curriculum materials should be varied and diverse including digital and online resources, rather than centering on a single textbook

Instead of remediating students so that they can learn from a set curriculum, curriculum should be made flexible to accommodate learner differences.”

With this post details about how ULD would be implemented for at-risk children are lacking. Would it overlap with Response To Intervention? Would it cut down on the number of at-risk children sent to special education? Would programs be worked out cooperatively between general education and special education? Who would be in charge?

The notion of a continuum of ability overlaps with inclusion and least restrictive environment.

8. SLP Collaboration

In our posts we have addressed issues of RTI implementation and role implications for school personnel. Spectrum K12 School Solutions is continuing to survey national RTI adoption rates. For its 2009 report it found adoption rates are rising.

HIGHLIGHTS

“In April 2009, 71% of respondents indicated their districts are either piloting, in the process of district-wide implementation or have RTI in district-wide use vs. 60% in 2008 and 44% in 2007.

RTI is being increasingly implemented across all grade levels with a significant increase in high school implementation compared to 2008 (51% having some level of implementation in 2009 compared to 16% in 2008)……..

Academic implementation leads behavior implementation by a large degree with reading more prevalent than math…

A majority of districts continue to report RTI implementation is being led through a unified effort between general education and special education…. “

NEW SURVEY

Spectrum K12 School Solutions’ current survey is being cosponsored by:

NASDSE (National Association of State Directors of Special Education)

AASA (American Association of School Administrators),

CASE (Council of Administrators of Special Education)

CONCLUSIONS

Here, we emphasize two points for special education personnel participating in cooperative school programs for “struggling students” who might be considered for special education eligibility:

1. Survey data help practitioners prepare for abrupt and significant changes in their role functions.

2. RTI programmers should advocate for the reduction of initial and continuing special education placements.

Speech Therapy versus Speech Pathology

For the school setting “Speech Therapy” is an obsolete title.  The case has been made (cf.  4. Educational Speech Pathology) for a hybrid model incorporating educational theory, medical views, school practices and federal regulations into assessment and intervention.  The medical model contributes but is not  inclusive.

Gray skies in Paris

Yet times change slowly.   A google search for frequency of mention shows these numbers:

Speech therapy—–8,320,000

Speech pathology—–1,222,000

Speech-language pathology—–943,000

7. SLP Collaboration

A new SLP joined an IEP team to discuss next year’s plan for an eight year old autistic girl. She was high functioning and verbal but with issues of pragmatics and social interaction. The SLP chimed in saying a collaborative plan might be a suitable approach to enhance essential communication and learning skills. The girl could spend more time in the classroom for natural peer interaction.

There was a moment of dead silence. The SLP went on to mention a few intervention ideas. No response.

Then the school psychologist spoke up and said he didn’t care for the idea much. “I’m a meat and potatoes man,” he said. The team settled on a plan for pull out services.

After the meeting, the director called the SLP to her office and asked shortly: “Now, what’s this collaboration thing you’re talking about?”

Three months later the director circulated a special education magazine to the staff. The cover announced that the whole issue was devoted to the topic of collaboration in special education.

There is no guarantee local school personnel will know about collaboration, have skills in it, or be receptive to it.

6. SLP Collaboration

The American Speech-Lanaguage-Hearing Association (ASHA) has published a survey study concerning “Role Ambiguity and Speech-Language Pathology” (The ASHA LEADER, December 15, 2009, pages 12-15) in which a number of issues are raised about SLP collaboration. A national sample of 4,708 members was used for the survey.
Sixty-five % were clinical service providers. Findings can be found online [http://www.asha.org/Publications/leader/2009/091215/RoleAmbiguity.htm]

The report documents the problems SLPs have participating in collaborative programs and offers eight general solutions.

A major concern was whether other specialists “encroached” on SLP practice. Half those surveyed said they had experienced it. Pinpointed were academic language therapists (89%), occupational therapists (65%), teachers (58%), nurses (55%) and reading specialists (50%). Encroachment centered around language/literacy (64%), autism (63%), learning disabilities (59%), early intervention (53%) and dysphagia/swallowing disorders (52%).

The SLPs thought other specialists did not know enough about SLP practice, and 71% thought ASHA should do something about encroachment, together with state associations (42%), state licensure boards (41%) and individual facilities (39%). Although ASHA recognized the challenges collaboration presents (time, money, information gaps, training, conflict), it took this position:

“It is ASHA’s position that SLPs do not “own” any aspect of their scope of practice, nor can they dictate what another profession can or cannot do. Clearly, speech-language pathology shares professional boundaries with related professions, and SLPs need to understand other team members’ expertise while articulating the value of their own unique knowledge and skills.”

Ellen Estomin (ASHA Leader, April 6, 2010) on behalf of the ASHA’s school-based SLPs said they agree with the part that says SLPs cannot dictate what other professionals do, or do not do, but they disagree with the part that says SLPs do not “own” aspects of scope of practice. Having an ethical code of conduct, extensive training, defined scope of practice and prescribed roles and responsibilities, SLPs should confidently communicate their strengths to the public.

It is clear the school-based SLPs are correct. ASHA properly certifies graduates in accredited institutions, and states add legal certification requirements. IDEA 2004 regulations and state statutes specify the legal foundations for SLP functions, functions in the past ASHA has lobbied for to Congress. School SLPs “own” articulation, whereas they do not “own” literacy:

“Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance” (Office of Special Education and Rehabilitation Services, Education: 34 Code of Federal Regulations, Section 300.8, Oct. 30, 2007).

It can be argued SLPs encroach on reading specialists when they assert rights to be accepted into literacy circles. Saying you have literacy expertise is not the same as Congress saying you have literacy expertise.

5. SLP Collaboration

Let’s say there are four kinds of collaboration.

DEFINITIONS

1. Inspirational. “Everyone-work-together-positively-for-the-good-of-struggling-children.” This type is quite idealistic but inspirational for young SLPs. It makes for a spirit of cooperation on the job. If collaboration opportunities crop up, SLPs are encouraged to join in and offer their expertise. Inspirational collaboration can lead to creative partnerships:

“Moving out of a pull-out therapy setting and into the classroom can prove to be beneficial for students, teachers, and speech-language pathologists (SLPs). Changing settings to provide therapy develops a relationship between the classroom teacher and the SLP. This relationship offers a creative solution to many…” questions of caseload management, peer interaction, and transference of learning to the classroom (Richmond, Super Duper).

2. Promoted. This type is where professional organizations promote types of collaboration thought to be important to the professions and school children. A 2001

Girl Scouts Marching on Main Street.

position statement by the the American Speech-Language-Hearing Association (ASHA) argued for SLP involvement in literacy programs:

“That document stated SLPs have a critical role in the development of literacy for students with communication disorders of any severity and that SLPs are to contribute to literacy efforts within their school districts and communities on behalf of other students. The ASHA document further stated those roles were to be carried out collaboratively with others who possessed expertise in the development of reading, writing, and related processes” (Hammond et al., Speech Pathology2).

3. Negotiated. This type concerns role relationships and assignments for cooperative projects. At issue is negotiating changes in job descriptions and school expectations. SLPs depend on pull out services, and administrators believe this is their proper role. They do not necessarily think of related service personnel functioning on educational teams.
SLPs must change expectations.

Weak negotiations can bring about diminution of role standing: “Ehren (2000) expressed a concern regarding collaborative SLPs becoming classroom teachers or aids. She asserted that determining the roles professionals take in spoken and written language-based skills is compounded by the pervasive and critical role language plays in school learning” (Speech Pathology2). It is normal for teachers to think language and literacy are the domains of educators and not SLPs.

4. Mandated collaboration. On the basis of national trends associated with IDEA 2004, local school districts are implementing prevention programs such as response to intervention. Administrators have money to train staff and the responsibility to develop plans for staff assignments. They can change job descriptions following program guidelines and employment agreements under “other duties as assigned.” SLPs might not want to participate in response to intervention but they are obliged to. They may prefer traditional direct service.

CONCLUSION

We see degrees of collaboration ranging from preference to obligation. The most provocative is mandated collaboration. Since 1997 SLPs have been integrated into special education in support of “progress in the general curriculum.” As IDEA has evolved, the law has moved toward imposing collaboration on SLPs regardless of their scope of practice. If someone says SLPs must be assigned to cooperative literacy education, it becomes a fact.

Here, we argue collaboration is simply best practice and should be adequately taught at the preservice level of SLP graduate education. Language and literacy should be within scope of practice as related domains and taught accordingly, if they are essential to the changing theories and legal foundations of public education. It should not be advisory and left to inspiration and creativity.

Neither should collaboration lose its direction: All programs should have as their general purpose to reduce the needless placement of at-risk children in special education. Why go to the trouble of creating expensive complicated service delivery plans if we lose sight of what is really important — to prevent over-identification of American school children.