Monthly Archives: December 2010

6. New School Phonology: More Reading

Katherina  On December 30, 2010 at 4:02 pm, commented about SLP phonology and reading intervention, 5. New School Phonology.  She says:

I couldn’t agree more. I work with students at the middle school level and young adults in a Youth Intervention Center and at a County prison. Recently I have been doing a co-therapy/teaching session with a Learning Support Teacher to address the needs of students that have not succeeded in any reading program and score at the first grade or below level. As the Sp/L I teach the Lindamood Phoneme Sequencing Program. The second part of the session, the Reading Teacher utilizes the Orton Gillingham Approach. So far, progress monitoring indicates that students are making significant progress. Any other thoughts for therapy?

The response written was as follows:

“This is an excellent contribution to the topic of integrated phonology/reading intervention with collaboration. This is the direction the field needs to take. Here is my experience: ” I experimented with three children, using phonological awareness training to treat articulation problems. I was able to address articulation and reading goals at the same time by using stress and syllable patterns, breaking down words, and practicing articulation. Recognition goals are easy to achieve, and recognition training cuts down on the motor demands of articulatory drill. Practice materials can include written words without changing method and goals.” Panagos, 2006.  The overall approach builds on the principles of prosodic phonology, where levels are interlaced and overlapping, from grammar to sounds.

I recently tried this procedure with a cleft palate child who had made little progress. Emphasizing recognition over sound production, and working at the syllable level, there was good progress.  Kids can process perceptual input without frustration. The rest I hypothesize occurs by generalization of learning.  Auditory processing generalizes to speech processing.  Reading practice facilitates speech generalization, inasmuch as they are both related to cognitive-linguistic processing across modalities.  Such a method — top down phonology — can be nicely conceptualized within the  framework of prosodic phonology.  (Panagos JM, Prelock PA. (1997).   Prosodic analysis of child speech. Topics in Language Disorders. 17, 1–10.)

Thanks. You made my day!

JMP

Advertisements

1. Future of School Speech-Language Pathology

This begins a series examining the future of American school speech and language pathology.  History is a part of it, and recognition of current trends is too.  Changes in public policy most certainly will be fast-moving.

An anchor point is a presentation of the principles of Universal Design of Learning.  From an earlier post, the following comments provide a framework:

“Universal design is consistent with Response To Intervention.  It can be used to sidestep artificial divisions between special education and general education.  Assessments honor gradations of abilities without categorization.  Low scores do not lead automatically to special education placement, allowing time for non-disabled children to be sorted out, helped and supported in the regular classroom.  Speech and language variations associated with language differences, dialects and slight delays can be programmed through collaborative efforts among general education teachers, special education teachers and related-services personnel.  Reading can continue to be the foundation of intervention without special education placement.  School speech therapists can promote oral language and language-based reading skills to contribute to the effort.  SLPs can move easily into the regular classroom and serve as general educators.  Dynamic assessment extends clinical assessment, consistent with a hybrid model of school speech and language as described in SSP.  This overall approach is different from inclusive education where children’s placements are forced on their performances for categorization purposes. 

How do we prepare school SLPs for this new age of non-categorizal thinking?  There is every indication that old academic training models are antiquated and the college professors must change the curriculum.  There is no reason to throw the baby out with the bath water but the language component needs expansion, updating and focus.  At this point reading appears to be nothing more than an item under language, when it represents an entire domain of learning.  A hybrid model of practice has far-reaching implications for basic theory and research.  The legal arena stemming from IDEA 2004 cannot be dropped into a course and covered in a single lecture.  Current school speech-language pathology is simply not nimble enough for Response to Intervention thinking.  University clinics have changed little since 1950.

On the other hand professional associations put out policy statements, trend information and continuing education materials that have no roots in academic curricula.  They are trying to invigorate change without coordination with SLPs in the schools and academic leaders.  Researchers are left out of the picture as they are engaged in scientific publication and trying to win tenure.

Some courses for school SLPs focus in on materials, methods and techniques as though there is no context for their applications.  The context entails questions about generalization of learning beyond the therapy room, and how reading techniques interface with speech and language methods.

The bridging point is full support for cognitive-linguistic theories of speech and language practice.  One-shot diagnostic prescriptive therapies based on conditioning paradigms have to be seriously questioned as to validity. 

The notion of “clinical population” has to be reworked and the notion of “struggling students” has to be integrated with current thinking.  Categories derived from clinical models can invite incorrect placement in special education.  This is evident when a standardized language test is given on language different pupils and a set cut off level is used for placement.   The discrepancy model  has been called into question.

The implications of  the clear problem of the overidentification and over-retention of at-risk children, particularly, non-disabled minority children, must be spelled out and addressed.  Perhaps it will help decision makers by saying it is an “opportunity” rather than a scandal.  One can make school SLP assessment exciting in that placement and retention decisions can be aligned with vital public policy and educational trends helping SLPs fit into the times.  Clarity and accuracy can be fun goals to reach.

Key is reducing special eligibility placement and dismissal rates while minimizing least restrictive environment.

http://education.umn.edu/NCEO/OnlinePubs/Synthesis44.html

School Speech Therapy and Special Education Overidentification

American school speech-language pathologists continue to make placement recommendations for a large percentage of all special education children, second only to Specific Learning Disability.  The number has been growing, and many of the children placed and retained are incorrectly identified.  Many are non-disabled minority children.  An effect never considered is how speech and language designation reduces chances for academic success.  While the costs of special education grow, SLI children and others are not receiving the academic support they need to graduate with peers.  A recent report from the Center for Public Education makes these clear.  In 2006 the diploma graduation rate for SLI children 67.45, slightly higher than SLD pupils[www.centerforpubliceducation.org].

SOLUTIONS

The Center for Public Education sets forth recommendations for reducing the overidentification of at-risk children for special education placement:

“The vast majority of students today who are identified with disabilities might have been classified as simply “low achieving” just a few years ago. However, their achievement still lags behind that of non-disabled students. The booming growth of special education—along with the accountability measures of NCLB—makes the achievement of students with disabilities something educators cannot ignore. While specific solutions are elusive due to the lack of research, when schools and districts target resources and support, the achievement of students with disabilities does increase.

In order to accurately evaluate your district’s needs and goals, you should consider the following questions:

1. What is the special education population in our district? How does it break down by disability? By racial/ethnic group? By family income?

2. How are our district’s special education students performing relative to other students? Has this performance changed over time?

3. What goals could we reasonably set for special education students, keeping in mind the group’s diversity?

4. How much of our special education dollars are federal? State? Local?

5. Do we have enough special education teachers? Do they meet the “highly qualified” definition? Do they have enough resources and support?


5. New School Phonology: Practice Deadend!

For 100 years traditional articulation therapy has prevailed.  

Window looking out.

HISTORY 

In the 1970s a burst of research and practice explorations associated with the work of Professor David Ingram demonstrated theory superiority of the phonology model over medical phonetic model.  Phonology proved to be tied to higher level cognitive-linguistic processing and learning, and generalization was central to the arguments for using phonology in schools.   The phonetic was a part of phonology at the same time.  Hence, the scope of phonology theory included sound production theory. 

Yet classical articulation therapy continues to dominate university clinical training and school practice.  It is widely proposed on websites across the internet as standard practice.  One finds expositions for parents saying articulation therapy is best practice for their children.  It is the  dominant view in English-speaking countries as well as America.   In schools, the phonology model has been all but abandoned, partly because it us thought to be too complicated and impractical.  It is also deeply embedded in school culture,  defining the professional role of the speech-language pathologist.

ADVANTAGES

School SLPs have lost the advantages of a phonology model:

1. Integrates language, auditory processing, phonological process recognition, reading, morphology, apraxia of speech, phonological process analysis, oral-motor performance and sound production into one practical system. 

2. Integrates discrete scope of practice categories into a single management system centered around principles of cognitive-linguistic therapy.

3. Provides a principled foundation for collaborative intervention.

4. Allows for the observation of generalization across discrete clinical domains.

5. Consistent with a hybrid model of school speech-language pathology where clinical and educational concepts merge.

6. Represents a more powerful learning framework than articulation therapy.

7. Accommodates description of sound variation stemming from linguistic and cultural differences.

School SLPs and Over-identification

The recent history of American special education is that too many children have been placed. Here are assorted reasons mentioned in policy debates.  SLPs and special eduction teachers can begin to address issues of eligibility placement and retention with a better appeciation of the powerful factors pushing on them to over-subscribe children who should not be in special education.  Certainly this applies to the placement of  non-disabled minority children.

Professional organization such as the National Education Association should take the lead in mitigating factors leading to the over-identification of at-risk children.

1. There were federal financial incentives to enroll children in special education.

2. Professional misdiagnosis.

3. Variations of state and local policies and regulations.

4. General education deficiencies in providing programs for at-risk children.

5. Use of special education as a remedial service for general education.

6. Over-use of the learning disability category.

7. Placement of more males than females.

8. Over-placement of minority pupils.

9. Limited special teaching skills of general education teachers.

10. Lack of pre-referral early intervention programs.

11. Over-lapping disability symptoms.

12. Referral of hard-to-teach children to special education.

13. Attorneys assisting parents with placement decisions.

14. Lack of variety of valid testing procedures.

15. Over-use of the IQ-discrepancy model.

16. Under-identification of of some disabilities.

17. Administrative pressures to place.

18. Late identification of children with learning disabilities.

19. State-to-state variation in eligibility criteria.

20. Special education placement of limited English pupils.

21. Parent pressures for special education services.

22. IEP bias toward MOST RESTRICTIVE ENVIRONMENT.

23. Changing program criteria from early intervention to preschool to elementary.

24. Misevaluation of poor, health-at-risk and migrant children.

25. Inadequate personnel preparation for linguistic and cultural differences.

26. Failure of states historically to reduce misidentifications.

27. Continuing misidentification of children already placed in special education.

28. Inadequate school programs for limited English children.

29. Over-concern of administrators with procedural compliance.
    
30. Shifting intellectual, social, emotional, linguistic and cognitive symptoms over the first eight years of life.

31. Inadequate early reading instruction for at-risk children.

32. Inadequate school-based training programs for teachers and special education specialists.

33. Prejudice against children with racial, linguistic and cultural differences.

34. Lack of strong advocacy by professional organizations to reduce over-identification.

35. A lack of local leadership to reduce over-identification.

35. Insufficient monitoring of transfer IEPs for incomplete, out-of-date and incorrect records.

36. No Child Left Behind pressures for high performance.

37. Bias operating in IEP teams.

38. Poor communication with parents to disclose the risks of special education placement.

39. Over-placement of Attention Deficit Hyperactivity Disorder children.

40. Misplacement of emotionally disturbed children.

41. Need for remedial reading specialists to evaluate for early disabilities.

42. Inadequate numbers of specialists to make proper evaluations.

43. Inadequate long-term local record-keeping on the characteristics of at-risk and special education pupils.

44. More research on how eligibility determinations are made at the local level.

45. Inadequate staff training for the proper use of eligibility criteria.

46. Quick referrals (45 days) to special education without prior child study.

47. Classifying children too early without trial intervention.

48. Inadequate advocacy by state agencies to reduce over-identification.

49. Inadequate resources targeted at reducing over-identification.

50. Inadequate data on how placements are made, how they vary, and what persons are involved.

 

5. New School Phonology: Reading

Print and speech processing are related to the same underlying cognitive-linguistic processes.  Phonology is an aspect of both.  Speech provides the foundation for reading, and reading supports the growth of speech.  A  child learns to say hafta and later learns it is spelled have to.

A child with an “articulation problem” can benefit from reading instruction, and a child with a reading problem can benefit from speech training.

Weak syllable deletion is central to speech and print improvement.  A weak syllable can be a function word, a word ending, a word syllable and a sound sequence.  Teachers focus on word endings in language arts, teaching children how to manage stressed and unstressed syllables for sentence construction.  Samples of early writing show weak syllable deletions.

Many reading-impaired children suffer from inadequate speech and language foundations.  Phonological proccess instruction for reading improvement feeds directly into speech.  Accurate perception of syllables is achieved.

Although school SLPs are speech specialists, and teachers are reading specialists, there is no boundary in the learner’s mind.  We have signs of over-specialization with little or no collaboration.  Spelling practice helps with sound articulation.

Preschool intervention with rich linguistic experiences can help the at-risk child read and speak without special education placement.  One expects generalizations in both directions.   Speech therapy generalizes to reading growth, and vice versa.

A principle of Universal Design of Learning is cognitive processing for all types of children across the spectrum of ability.

4. New School Phonology: Articulation Exits

We need to step back away from our last post about articulation exits.  It is a fact that phonology / articulation issues continue past the point where all sound errors have been corrected.  Morpho-syntax problems reflecting cognitive-linguistic deficit need to be treated.  For example, weak syllable deletion limits word development, syntax expression, and sound performance.

Literacy support as provided by teachers helps the problem.  Children learn about “endings” in their language arts training.  Should SLPs be involved? These children continue to be SLI children.

Morpho-syntax intervention falls under the language component of scope of practice, which includes the following:

“language (comprehension and expression)

  • phonology

  • morphology

  • syntax

  • semantics

  • pragmatics (language use, social aspects of communication)

  • literacy (reading, writing, spelling)

  • prelinguistic communication (e.g., joint attention, intentionality, communicative signaling)

  • paralinguistic communication”

http://www.asha.org/docs/html/SP2007-00283.html#sec1.1

We must further explore the implications of a morpho-syntax view of school articulation management within an IDEA 2004 framework and associated programs such as early intervention and RTI.

With preschool screening and intervention, a segment of classical articulation cases would be viewed as language and learning disabled (SLD) rather than exclusively SLI cases.  Special education placement and retention would be affected by this reclassification process.

3. New School Phonology: Articulation Exits

School speech-language pathologists along with physical and occupational therapists are known to exit elementary school clients in a more timely fashion than other special education children are exited,  particularly specific learning disability children.  SLD children are at risk for long-term placements. 

Speech sound improvement is supported both by intervention and natural development.  Many complete natural development by age 8 years.  Special educators and IEP teams are used to speech therapy dismissal recommendations.   Some children continue on because of resistant sound errors such as /r/, /l/ and /s/.  The stigma for continuing special education placement is less for articulation problems than it is for mental retardation, autism and learning disability.

For developmental speech sound errors — “functional” errors where there is no obvious physical cause — a reasonable question is whether now in 2010 most of these children should be placed in special education in the first place.  Rapid national development of Response To Intervention (RTI) suggests that broader early linguistic programming coupled with reading stimulation carried out by SLPs in collaborative efforts can scaffold development without special education placement.  Those children who do not respond to tier cycles can still be considered for later placement, so a safety net available.  Reading and speech are related allowing for the operation of cross-modal stimulation.

When SLPs recommend placing phonology clients in special education, they do not seem to consider social stigma.  General figures indicate special education children are less likely to graduate from high school.  They may or may not notice language and dialect differences.

Exiting routine articulation clients from special education is time-consuming.  Paperwork justification of dismissal takes a lot of time.  It is better not to admit in the first place.

Reduction of time spent in direct intervention conducted in the therapy room means more time for collaboration.