Monthly Archives: January 2011

RTI and TIER 3 – Yesterday’s Special Education?

In the popular press stories review the successes of response to intervention in helping “struggling children” in American schools.  A close look at such reports indicates not much is said about Tier 3. 

Tier 3 brings in “specialists” but who they are, exactly, is not typically stated.  The children in Tier 3 are not in special education but might be.  It appears they are given interventions by special education and related services personnel (speech therapists, physical therapists, psychologists, occupational therapists, recreation therapists) who cross the line into general education in this special way.

Solving the problems of Tier 1 and Tier 2 instruction duplicates partly Title 1 programs, and this territory is familiar to teachers.  But this curious hybrid creature called Tier 3 gets little attention.

Girl Scouts Marching on Main Street.

At the same time there is no mention of how Tier 3 assessments and decisions will reduce the number of non-disabled minority children who often are placed in special education.

Old habits die hard.  Will non-disabled minority children be segregated in Tier 3 without FAPE protection?

RTI is exciting these days, but it masks the continuing problem of troublesome at-risk children being moved out of the classroom down the slippery slop toward special education placement.  Pressure comes from regular classroom teachers who, while sincere, do not want “hard-to-teach” children to deal with.  Their bias favors compliant female students who are able to stay on grade level.  Minority boys are more likely to arrive at Tier 3 for the special procedures.

Without an exact accounting of Tier 3, RTI is a  two-legged stool.

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Elementary and Secondary Education Act Blindspot

In early 2011 The Elementary and Secondary Education Act is in the news for broad opinions about reauthorization.  Poor achievement has been a nagging complaint but deep within the problem is a hidden problem.  The chief area of reform needing identification and clarification is the population of  “struggling children,” children who encompass a wide range of sub-populations (clinical, ethnic, atypical) and who pull down overall school performance.  Confusion over who these children are and how to help them holds back education. 

Within the The U. S. Department of Education there are projects within ESEA (Title programs) providing remedial support working parallel to special education programs that are chock full of children who do not belong there.  In the meantime, we have Response to Intervention, overlapping both ESEA and IDEA programs.   The Department of Education directs all three — ESEA, IDEA and RTI — through guidelines and regulations.  Right now, Congress is concerned with ESEA renewal and will not address overlap with IDEA.  It will turn around and address IDEA at reauthorization, again without true regard for ESEA. 

Gray skies in Paris

Special Education and General Education duplicate one another in part.

At the same time, as we have written here, the terminology flies around as though we all know what population we are talking about.  Now we talk about “struggling students.”

In the context of ESEA renewal, there will not be any hot discussion of  disproportionality and special education over-identification.

Talking about RTI, we will be obliged to stumble along without learning what “Tier 3” is really about.  Is it yesterday’s special ed?  Who are the children in Tier 3?  Minorities, misdiagnosed pupils, disabled?

We need one continuum of performing children as suggested by Universal Design of Learning with many fewer of these children finding their way into special education.

15. “Struggling Children”

The Elementary and Secondary Education act is being studied for reauthorization. President Obama in 2010 released his blueprint for reform.  Graduation from high school is a key aim.  It falls on related service personnel and special education teachers to move beyond IEP goals to long-term success. 

The section on education of students with disabilities is a summary of main points.

“While the primary funding for programs specifically focused on supporting students with disabilities is through the Individuals with Disabilities Education Act, the ESEA reauthorization proposal will increase support for the inclusion and improved outcomes of students with disabilities. The proposal will help ensure that teachers and leaders are better prepared to meet the needs of diverse learners, that assessments more accurately and appropriately measure the performance of students with disabilities, and that more districts and schools implement high- quality, state- and locally determined curricula and instructional supports that incorporate the principles of universal design for learning to meet all students’ needs.” 

Lion on top of cabinet

Inclusion is an old idea coming back into focus.  Some school administrators see it as a money saver.  Reformers see it as a way of cutting down on the overidentification of non-disabled minority children.  The arguements are not based on science but on opinions.

We support universal design of learning to move away from discrete population programming.

http://www2.ed.gov/policy/elsec/leg/blueprint/faq/diverse-learners.pdf

Education Reform and Speech-Language Pathology

Efforts to Reform No Child Left Behind are Moving Forward.  

We hope high school graduation becomes a key target, not paperwork compliance. 

We hope more innovation comes to keep at risk speech and language children ouf ot special education in the first place, letting them receive forward thinking response to intervention programs instead.

We hope speech-language pathologists think about how placing a child in special education can be a negative factor in whether he or she graduates from high school.

We hope school speech therapists work to increase the graduation rate of SLI children.

We hope professional organizations take the lead in preventing needless special education placements.  Think prevention!

We hope school speech pathologists make a true effort to screen out non-disabled minority children using their background in cultural difference.

We hope school SLPs make efforts to reduce their reliance on “pull out therapy” and consult to enhance children’s full educational experience.

We hope SLPs move forward on collaborative preschool programming designed to keep children out of special education.

We hope SLPs see the potential of cognitive models of intervention where generalization of learning can include reading targets.

We hope speech therapists in schools cut down on their heavy caseloads by exiting children from special education.

We hope university programs in communication disorders take the leadership in forming new curricula in cognitive, language  and reading prevention and intervention.  Educational speech pathology needs to come of age.

We hope the National Education Association takes the leadership in making RTI programs work for the speech and language impaired.

We hope school speech therapists apply the dual criteria of communication deficits versus educational impact in a spirited fashion.

Girl Scouts Marching on Main Street.

“So, do not underestimate the strength of this black hole, and the power of federal monies – education and Medicaid – to create and sustain the energy force that entraps and holds these children. Do notice how few honest steps are taken to bring about real reform – ones that would actually, and effectively, educate American children in general, and special education students, in particular. The most shocking and inexcusable aspect of the pretense, the mouth-service, given to “accountability,” is the dearth of professionals who actively attempt to get students OUT of Special Education. Few see any value in specifically structuring special education programs towards ‘repairing’ and releasing children; few feel any urge to commend an exiting child; few see the importance of choosing curriculum and methods that would prevent the need for such programs in the first place” (Linda Schrock Taylor).

15. New School Phonology: Prosodic Relationships

Within a framework of prosodic phonology we can see the true interrelationships between “speech” and “language” through the connecting principles of phonology. 

 A school child says, “He kicked the can, ” pronounced,   /’k:I duh ‘kae: /.   

 

It is traditional to say that there is an omission of final /k/, and the child might have a /k/ sound articulation problem. He is inconsistent.  The phonology interpretation  is that there is a final consonant deletion with movement of the past morpheme /t/ to the following word with initial consonant voicing.  The He morpheme is deleted by weak syllable deletion, since he + kick is a strong-weak (stress-unstress) sequence.   Length (/:/) is added to he to enlongate the intial footed sequence. The second (/:/) in can marks the underlying /n/.  The entire underlying syntactic representation is edited by various phonological processes, and processes operate across word, syllable and morpheme boundaries.

 

Uncontrolled phonological editing is a kind of an “articulation problem” but the problem is a deficiency in linguistic processing and prosody and not an ability to say sounds.

 

The idea that articulation is a matter of producing sounds is incorrect.   Restricting the diagnostic analysis to sounds blocks appreciation of the interactions of grammar and phonology, and deficits at higher levels of organization.   In the example we see how sentence morphology interacts with phonology, i.e., morpho-syntax.

 

Such an analysis solves the mystery of unexplained generalizations of learning, where articulation therapy seems to improve overall intellgibility others soon notice. 

 

An interesting implication of a failed viewpoint of over-categorization of speech and language sympoms is that practicing school SLPs believe scope of practice is expanding too fast and adding to workload.   Symptom treatment is a losing enterprise.

 

Assessment and treatment techniques spring up adding to the burden of having more and more therapies to master.  These techniques do not work on the principles of generalization.  So the school SLP must labor teaching every facet of speech and language almost from scratch.   Such micro-teaching is faithfully recorded in IEP records where the potential of generalization across the board and to academic subjects is obscured by unnecessary detail. 

 

At least SLPs can take advantage of the public relations aspects of articulation treatment.   One can tell teachers they should expect improvements in writing skills and these directly result from “speech therapy.”

 

The simple truth is that when one manipulates a child’s linguist system by way of controlled communicative interactions (discourse) all hell breaks out and the child begins to add detail to his or her linguistic rule system across modalities.   A cognitive model predicts this at least partially.

 

A child for whom generalization effects go unnoticed, and unplanned for, in one sense continues to qualify for special education placement with risks of stigmatization, such as being teased for being placed in special education. There is a kind of lowered expectation for improvement resulting from selective assessment and intervention.

(Panagos J, M., & Prelock, P. A., 1997. Prosodic analysis of child speech. Topics in Language Disorders. 17, 1–10)

3. The Future of School Speech-Language Pathology

A necessary part of  our future is our history.

What’s past is prologue”  (William Shakesspeare)

Professor Judy Duchan publishes an online history of the field of communication disorders and sciences  — aka, speech correction, speech therapy, speech pathology, speech-language pathology — and remarks:

“There has been too little work in the field of speech-language pathology on the evolution and history of current practices. While nurses, psychiatrists, psychologists, and social workers can go to a number of historical sources in their fields, speech-language pathologists have only a smattering of such studies. It is my hope that the information provided in this website will serve to redress this notable blind spot in historical understanding of speech-language pathologists, especially for those practicing in the United States. I aim to provide a growing body of historical information that clinicians in America can use to trace their evolution and understand the thinking of their ancestors.”

http://www.acsu.buffalo.edu/~duchan/new_history/overview.html

One hypothesis is that the field has run helter-skelter into the future without paying attention.  A studied relationship with American education is nil.

What foundations do school speech-language pathologist have for rapid and high impact change?  Again nil!

For example, when caseloads swell and special education children are coming in like mad, on the basis of federal mandates, they can only throw up their hands and appeal for help to the burnout gods.  They lack insight into the historical and philosophical issues making “speech therapy” difficult in an impromptu fashion.

Update

Yes, the lack of historical perspective involved in ASHA policy is limiting.  Articles appear in the Leader without reference to past policies and lessons learned.  It suggests the management system is simply breaking down in the area of policy development.

2. The Future of School Speech-Language Pathology

Central to guiding the American profession of school speech-language pathology forward into the 21st Century is coordination of professional members working in the various parts of the field.  

Academic institutions preparing SLPs must know what school workers need, adapt curricula, update clinical training practices and promote changes in education colleges to support SLP preparation.  Some institutions do better than others. 

Overall,  faculties have been too slow to reform their educational programs, particularly at the graduate level.  The bloom of language theory and application ushered in in the 1970s flourished and then came the chill of winter.  It was difficulty to put in courses in language while courses in “cleft palate” and “cerebral palsy” lasted too long.  The traditional speech therapy curriculum did not yield to language while language expanded from syntax to semantics to pragmatics to cognition. 

For school SLPs, half of the graduate program should be in language.  A single course is the stone age.  And now “reading” is said to be in the scope of practice, and reading is an entire domain within itself.  School SLPs hunger for foundation work in reading, based on solid linguistic research.

Collaborative education needs to be a part of the SLP curriculum, along with RTI programming and qualitative assessment in the classroom.

More support for academic researchers is badly needed.  For the over 50,000 American SLPs, working in 100,000 national schools, the number of language researchers is far too small to cover all the emerging trends found in the school setting.  If there are 500 active SLP language researchers, they do so while having to work in the clinics,  teach large courses, show up for social gatherings and supervise clinical practice.  Deans hound them for publications and grants to win tenure while clinical faculty believe clinical education is high priority.  Young faculty members have their day jobs, and work on the weekends on their research. At the same time Ph.D. education has suffered so that programs do not have enough researchers to hire.

Some academic  deans know about speech and hearing problems, others know nothing.  Academic deans need to hear more about the field from professional groups.

In too many programs research is the lowest priority and students are not obliged to learn research skills.  Students even though they face great debt to go to school want modern methods to be competitive for employment.  They engage in magical thinking that the research just appears for them to use quickly for practical purposes.  And when they arrive on their jobs, they do not see themselves as having obligations to advance knowledge they can use.  If RTI comes along, or reading collaboration is critical, they wait for someone to deliver new information to them without making research efforts to implement and publish.

Academics find it almost impossible to do research in schools.  There are real access issues and it is difficult to drive away from campus to visit schools to collect data.  The research methods they have learned in graduate school give emphasis to “hard data” studies conducted in labs.  Deans respect them.  Survey and descriptive data are needed from schools to see what practice trends are materializing.  “Soft research” may not win a professor tenure.  At the same time on-campus researchers do not even know what the questions are to ask? 

Some research topics, such as to how accurately SLPs evaluate children for special education placement, appear to be objectionable in that SLPs might be embarrassed by patterns of documented misdiagnosis.

Without a strong background in language and cognitive science, they fall into the historical patterns of “speech therapy” where “articulation therapy” is king.

As our writing makes clear, public policy formulation at the national level has outpaced the profession.  Students are not exposed to national federal issues in education that directly impact the nature of school clinical practice.  School SLPs should read the new laws when they come out.  Otherwise, they are obliged to deal with second-hand information drifting down to them from state departments of education.

State professional organizations struggle to help members fight heavy caseloads but only a few SLPs help out.  What happens in Wisconsin is unknown to SLPs in Alabama. There is great need for coordination of state SLP school organizations for maximum effect on school standards.

The key organization to coordinate academic and school practice concerns, research, policy, practice and public relations is the American Speech-Language-Hearing Association.  It is the only entity available to coordinate all parts of the profession.  In the 1950s, the academic centers coordinated the “American Speech and Hearing Association.”  Then the academics established central offices.  The last university to hold ASHA was Wayne State University in Detroit.  The academic centers gave up a great deal of procedural control of the profession, by delegation of functions  to many  non-professional staff.

The National Education Association, many say, has become its own institution.

On the one hand the Association’s long arm reaches back into academic preparation to ensure students receive proper and ethical training.  When school SLPs lack training in reading as advocated by the Association, it must take pains through accreditation regulations that certified SLPs have the right background.  Here is a great coordination problem.  How does the Association keep academic preparation current with its own public advocacy?  

Simply publishing journals, holding conferences and posting electronic communications are insufficient without the right content.  The right content is relevant applied research with precise recurring focus so that school SLPs eventually “hear” the message about critical trends and practice changes.

Why are so many boys placed in school caseloads?  Why are so many non-disabled black, hispanic and native American children placed in special education?  How can SLPs “prevent” communication disorders through correct evaluation?  Researchers and policy makers have to ask the right questions to generate the right content.

SLPs lack an interest in research.  These attitudes begin in graduate school and continue on into practice.  It is unlikely academic researchers will ever have sufficient capacity to address practice issues in schools.  Then who is going to do the research? 

This is a pervasive problem in American schools.  Too little research is published to guide instruction.  Policies are made without research foundations; hence recent calls for evidence-based practice.

Even where there is a profound need among school SLPs, how do they participate in a process of reforming Association regulations and academic preparation?  In online publications we do not see requests for survey opinions and feedback commentary. There may be a few quick  notices to send it comments but systematic opinion studies are rare.

Communication is closed and top down.  Academic programs do a better job of soliciting donations than they do soliciting opinions about what school SLPs need to know?

Continuing education credits are weak because research foundations are weak.  Announcing that such and such is a “hot topic” does not solve applied problems.  In any area of research, 50 solid studies are needed to establish a foundation for practice.

Take for example the question of how school SLPs can evaluate language in the classroom.  Bravo to a few hearty SLPs who take it upon themselves to write up something on the topic but miscellaneous anecdotal findings are just that. 

Magical thinking extends to professional publications where Jane Doe and Judy Jones report on how they have successfully coordinated articulation therapy with RTI programming.  Editors believe that if a news note appears in print somehow a contagion of RTI projects will result and sweep the country.  Cheerleading isolated projects is not a program to improve the foundations and patterns of school SLP practice in the U. S.  Grassroots relations with schools need to be carefully orchestrated with productive outcomes in sight.  Writing one’s congressman is not a program.

What must be done with the two separate universes of “speech therapy” and “speech pathology?”  How is that they allowed to co-exist without reform?

Some vocal school SLPs have in effect argued the profession is trying to do too much.  A small profession needs concentration and priority.  Why should SLPs take on reading intervention when their caseloads of traditional disorders are overflowing?  Perhaps it is just another fad and distraction.  “Boutique speech pathology.”

13. New School Phonology: Misidentification of Accent

The dynamics of the misplacement of at-risk children as played out in IEP meetings can be illustrated with a case study example drawn from prior practice some 10 years ago.  

A seventh-grade teacher referred a boy for speech and language evaluation because he had a “terrible speech problem” in class. He was hard to understand and he did not speak much. The teacher insisted he go to special education because he needed help badly.

The boy was a native American child. The first step was to review academic records. It turned out when he entered school he was tested for knowledge of his native language and was regarded as a competent speaker of Navajo. However, he did not take instruction in English as a second language because the school district dropped the program for lack of funding.

In an interview with the boy he was at first reluctant to talk until we found a good topic, rodeo riding. He became animated and highly verbal in English talking of riding, keeping horses and competition. The topic was a marker of male experience, such as English-speaking boys talking about baseball rather than dolls.

Although fluency and English grammar were at least adequate, phonological intelligibility was low. Simply stated, the boy had a heavy Navajo accent when speaking English. He was not disabled by any reasonable standard.

At the team meeting to consider the SLP;s findings, the recommendation not to place the boy in special education was not well received. The teacher in good faith argued the boy needed help and asked where else could he go? He was being held back academically by poor speech. The team accepted the SLP’s recommendation with difficulty.

Many processes are illustrated by this case example. Although the teacher did care about the Navajo boy, the speech accent made him hard to teach. Teachers know about “articulation problems” but they do not know about accent problems. The school district had no system for remediation other than special education. The team leaned toward placement to solve the teacher’s problem, and the SLP had to carry the full justification for saying no. There was pressure to place a minority child adding to the SLPs caseload. Once minority children are placed in special education, they tend to stay there. It would take a very intense program of accent reduction to prove an exit from speech was the right decision. The SLP would serve as remedial teacher.

Yes, there are times when SLPs take on children because of perceived need only. However, placing minority children in special education to provide remedial assistance can have grave impact on their lives far exceeding the risks of having a relatively minor “speech problem.”

“…students who are placed in special education have a higher likelihood of obtaining a certificate instead of a diploma. They also experience lower levels of achievement, high drop-out rates, low wages, increased teenage pregnancy, and social isolation” (Emstac).

16. RTI Success

Dick Nitsch, director of pupil services, reports (The Herald Times Reporter, January 2011) that  the Two Rivers School District in Wisconsin is at work implementing a Response To Instruction program making use of the three-tier model suggested by national experts and The No Child Left Behind Act.   “Response to Intervention (RtI) is an intervention framework that is designed to help students who may be struggling in core academic areas, for example language arts and math. The components of RtI have been underscored in the No Child Left Behind Act and have recently been added as a major component to the state of Wisconsin’s learning disability eligibility criteria.” 

Tier III (intensive) level of intervention provides more intensive services and targeted interventions…[and] typically involve the use of  specialists (for example Title I reading, special education, etc.)…” 

The overall plan is operated within general education.  No mention is made of how RTI data are used to place children in special education within the framework of IDEA 2004.  No mention is made of SLP participation.

 

 

12. New School Phonology: The Fragmentation Problem

Old notions of speech therapy fragment current  thinking about school phonology. Here are some illustrations of the point.

 

CATEGORIES

 

1. Commercial Products.   Companies publish speech, language and hearing materials for school speech-language pathologists.   Authors are often working practitioners.   Materials correspond in rough manner to professional scope of practice categories.   To use only one example, LinguiSystems (East Moline, Ill, Spring catalog, 2011) divides speech and language products accordingly:

 

Language

Vocabulary and Concepts

Articulation

Apraxia

Phonological Awareness and Reading

Listening and Auditory Processing Grammar

 

All of these categories are interrelated in the actual processing of language.   For a catalog they are handy divisions.   But they are not an analogue of how the mind works in an SLI child being considered for enrollment in special education.

 

2. Scope of Practice.   The American Speech-Language-Hearing Association publishes information on scope of practice for speech-language pathologists.  This is made available to the public to state what SLPs can and cannot do.   Here language scope is defined:

 

“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”

 

Again, the interrelationships among the sub-categories of langauge are not spelled out.

 

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

 

3. Wikipedia.   Wikipedia is an internet-based open source enterprise allowing individuals and groups of individuals to publish information on a wide range of topics of public interest.  A recent description of speech-pathology distinguishes language and language processing and literacy:

 

“….language (i.e., phonology, morphology, syntax, semantics, and pragmatic/social aspects of communication) including comprehension and expression in oral, written, graphic, and manual modalities;

 

language processing; preliteracy and language-based literacy skills, phonological awareness.”

 

We see the taxonomic approach to specific areas of deficit.   This breakdown is like the ASHA scope of practice but notice phonological awareness is separated from phonology.

 

In a related section we learn about speech sound disorders:

 

“Speech sound disorders involve difficulty in producing specific speech sounds (most often certain consonants, such as /s/ or /r/), and are subdivided into articulation disorders (also called phonetic disorders) and phonemic disorders. Articulation disorders are characterized by difficulty learning to physically produce sounds.”

 

Now “articulation” is completely disassociated from language and phonology.

 

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

 

Another Wiki entry for school speech pathology defines articulation problems without reference to phonology.

 

“An articulation disorder may be diagnosed when a child has difficulty producing phonemes, or speech sounds, correctly. When classifying a sound, speech pathologists refer to the manner of articulation, the place of articulation, and voicing. A speech sound disorder may include one or more errors of place, manner, or voicing of the phoneme.”

 

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

 

FRAGMENTATION CONSIDERED

 

Fragmentation such as illustrated above results from the application of the “diagnostic-prescriptive” philosophy in which symptoms are classified and treated as independent disorders.  This view ignores dynamic assessment and relational thinking such as that which can be achieved via cognitive models.   When “processing” is mentioned it remains a category of treatment, not an integrating principle of assessment and intervention. 

 

Professor Judy Duchan traces the growth of speech-language pathology and describes the how different categories of intervention evolved as entities added to scope of practice. 

 

http://www.acsu.buffalo.edu/~duchan/new_history/overview.html

 

In structural linguistics prior to the modern era classification was considered to be the essence of characterizing the language system.   Leonard Bloomfield was known for it.    The American linguist Noam Chomsky and colleagues circa 1960 expressed the relationsional principle with reference to “sound-meaning” correspondences.   Phonology builds relationships between thoughts, speech and perception when talking about linguistic performance. It has had that historical role since Paul Broca identified the “faculty of speech” in 1861 though modern cognitive science has moved welll beyond localization of function.   Cognitive processing rests in the realm of “linguistic performance” as Chomsky called it.   During the “moment of speech,” there is a dynamic interplay among components of speech and language to achieve adaptive fluent expression.

 

The interrelationships among language abilities is the basis for generalization of learning.  SLI children are incapable of processing discrete categories as described in commercial catalogues.  They use a wide  variety of processing strategies to drill down into specific details, and accordingly see relationships and generalize.  When therapies are poorly constructed, as in very restrictive drill and practice routines, the children continue to process beyond the material presented, generalizing on their own.  SLPs might not even notice these generalizations.  Teachers and parents sometimes report progress in other areas SLPs are surprised to hear about.