Monthly Archives: June 2011

14. The History of School Speech Pathology

Cultural and Linguistic Barriers

“I became a teacher of students with disabilities in 1971. I was there when Public Law 94-142 planted its roots firmly in the soil of prejudice. Before 1975, we as a people of this nation prejudged and unknowingly misjudged who could benefit from public education. In our ignorance of how to educate, we assumed that some children could not be educated. The original P.L. 94-142 was enacted to provide keys to the schoolhouse door.” (Ratcliffe Testimony).

Resistance to Change

In 1994 the U. S. Department of Education archived a paper entitled, “Education Reforms and Students at Risk: A Review of the Current State of the Art” (EdReformStudies/EdReforms/chap1b.html). Striking was the candor:

“Throughout much of U.S. history, the separate and unequal schooling of diverse groups has been reinforced by social mores, justified by pseudo-science, and, in many cases, mandated by law. Ethnicity and class have been perhaps the most obvious and contentious bases for discrimination, but other student characteristics, such as gender and disability, have also been used to isolate and track students into “appropriate” courses regardless of potential or interest.”

Diversity

In 2000, the U. S. Department of Education published a summary of progress made attributed to IDEA legislation.  “Cultural and linguistic diversity” was now center stage because of the ever-increasing presence of minority children in schools:

IDEA has supported the provision of culturally relevant instruction for diverse learners in mainstreamed environments. Throughout the 1980s, IDEA-supported Minority Handicapped Research Institutes documented that culturally and linguistically diverse students with disabilities make, at best, limited progress in school programs that employ “watered-down” instruction in segregated environments. Building on and extending the work of these institutes, IDEA has supported the development and validation of culturally relevant assessment and intervention practices “(http://www2.ed.gov/pubs/).

The American Speech-Language-Hearing Association in the 1990s began to address issues of multicultural practices:

“Students and Professionals Who Speak English with Accents and Nonstandard Dialects: Issues and Recommendations” (1998), http://www.asha.org/docs

“Knowledge and Skills Needed by Speech-Language Pathologists and Audiologists to Provide Culturally and Linguistically Appropriate Services” (2004), http://www.asha.org/policy.

Brought on by the civil rights movement, “multiculturalism”was a growing national trend in all phases of society and education.

Over-identification 

Over-identification is the tendency of schools to place non-disabled children in special education.  In the mid-60s this tendency was already being identified:  In 1968:

“…Dunn, citing U. S. Office of Education statistics, reported that ‘about 60 to 80 percent of the pupils taught by [teachers in mild mental retardation or MMR classes] are children from low status backgrounds — including Afro-Americans, American Indians, Mexicans, and Puerto Rican Americans; those from nonstandard English-speaking, broken, disorganized, and inadequate homes; and children from other non-middle class environments” (Monarch Center).

Non-disabled children who were brought into schools by compulsory education and civil rights laws were excluded again through special education placement.  In May of 2002, The Alliance for Excellent Education reported:

“The reauthorization bill will undoubtedly attempt to reform a system in which race often plays a role in whether a child is labeled learning disabled. Currently, African-American students account for 16 percent of the U.S. student population, but represent 32 percent of the student in programs for mild mental retardation.” 

 SLPs

Disproportionality and over-identification remain SLP issues today.

 

 

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13. The History of School Speech Pathology

Progress in the General Curriculum

A problem growing out of the mental retardation rights movement promoted by The ARC and other groups was to find a way to make sure handicapped children were protected from curriculum neglect.  Before 1975 special education teachers often in isolated rooms taught silly things, like beads, blocks and colors.  And they continued doing so for long periods of time, even years. SLPs taught nouns likewise. The assumption seemed to be that mentally retarded pupils could not learn about Henry Ford and the assembly of automobiles.

Gradually, the “progress-in-the-general-curriculum” standard evolved to its current place in IDEA 2004.  Curriculum was eventually broadly conceived to include all the learning activities non-disabled children experience in a typical day.  Socializing in the cafeteria was included. Segregating handicapped from the lunchroom was no longer automatic.

 SLP Impact

The curriculum standard in one fell swoop forever changed the nature of speech-language pathology in schools, at the very least at the level of theories of learning and functionality, whether clinical supervisors at the university realized it or not, or whether written about in clinical textbooks.  Created was a hybrid model of clinical assessment and intervention.  Added to clinical criteria were questions of how handicapped school children processed knowledge.

Reading Example

A current example concerns whether SLPs should teach reading.  The simple analysis below reveals the underlying phonological and orthographic processing are almost one and the same:

Cognitive-linguistic relations:

Teacher-pupil discourse –Question/Answer–  Orthographic content

SLP-client discourse –Question/Answer– Phonological content 

Processing requirements are the same and one would expect linguistic generalization of learning between domains.  Phonological intervention is inherently a part of reading instruction.  SLPs can address the two-fold problem of clinical learning + academic learning in parallel and together.  And in fact they must, according to IDEA.

Board of Education v. Rowley

The question of knowledge processing was  brought out in the Rowley case. The Supreme Court disagreed with lower courts saying Amy Rowley did not need sign language interpretation to access the curriculum, and that a hearing an aid was enough (Karl Boettner,  University of Puget Sound Law Review, Vol. 7:183) :

“Amy Rowley was a highly motivated, intelligent, eight year old deaf girl. The district drafted Amy’s IEP, as the EHA requires, in the fall of her first grade. Her parents participated but were not satisfied with the results. The district’s Committee on the Handicapped” (COH) began Amy’s IEP process by developing a recommendation for Amy’s school. Although Amy’s parents had presented expert testimony that Amy needed a sign language interpreter, the COH’s recommendation did not include an interpreter. The COH did, however, recommend that Amy’s IEP include a hearing aid, a tutor and a speech therapist.”

Therefore, the speech therapists alone was not able to make the decision solely on the basis of clinical judgment and observations.  The speech therapist and the team had to also consider whether Amy would understand classroom instruction without sign language.  Again, this situation illustrates two-fold assessment. SLPs can’t fall back only on the “Everything-I-learned-in-Graduate-School” clinical standard.  The school setting requires more, particularly, an account of knowledge processing in addition to speech and language deficiencies.

Disco

“Saturday Night Fever is a 1977 drama film starring John Travolta as Tony Manero, an immature young man whose weekends are spent visiting a local Brooklyn discothèqueKaren Lynn Gorney as his dance partner and eventual friend (they never do date in the film and the film closes with their agreement to be friends), and Donna Pescow as Tony’s former dance partner and would-be girlfriend. While in the disco, Tony is the king.”  Wiki

12. The History of School Speech Pathology

IEP Prescription 1975

EHA of 1975 along with subsequent legislation took education by the ear and insisted it would make sure handicapped children received a free and appropriate public education. “Appropriate” was partly ensured by something called an “Individual Education Program.” Educators had to write a “lesson plan,” so to speak, for each special education child as though they could not do it on their own. This IEP creation was portrayed as an exercise in democratic ideals but when in fact it was heavy-handed and demanded accountability. As state organizations (SEAs) got set up, they sent auditors to schools to see whether IEPs were on file for all special education children.  Nothing was left to imagination and chance. Educators had to show they were protecting the FAPE rights of the handicapped in an official document to that effect. Plus parents now had rights to disagree and appeal!

IEP Details

Specifically, congressional prescription for documentation was defined in detail:

“…define an individualized education program as follows:

[a]n IEP is a written statement for each handicapped child prescribing specialized instruction to meet his or her unique needs.

The IEP is developed in meetings which are to include the handicapped child if appropriate, the child’s parents or guardian, the child’s teacher, and a representative of the school district qualified to provide or supervise the program of instruction for the child.

The IEP must include (1) a statement of the child’s current educational performance, (2) a statement of short-term instruction objectives and annual goals, (3) a statement of specific educational services to be provided to the child and the extent to which the child will be able to participate in regular school programs, (4) a statement of dates for initiation and duration of the services, and (5) an evaluation by objective criteria at least yearly to determine whether instruction goals are being met and such evaluation is to include the child’s parent or guardian. 12. H. R” (Karl Boettner,  University of Puget Sound Law Review, Vol. 7:183)

SLP Role Change

You might have asked school SLPs in 1980 to wear t-shirts saying, “WE’RE ON THE FAPE TEAM!” The truth was they were on the FAPE team whether they wanted it or not, otherwise no employment.  And if they didn’t know how to be on the Team, they had to learn fast!

Being on the FAPE team meant you were in the business of providing legal documentation for speech and language impaired school children to such an extent their rights were protected.

SLPs had the requisite clinical skills to fill out the IEP paperwork, and to do necessary testing where applicable.  But they were not used to the added legal accountability entailed, or the added work load requirements. SLPs in the 1970s were trained to make lesson plans so now in effect they were doing paperwork twice.

And SLPs were in the vice,too, like education.  Gradually their employment contracts said they must properly submit the paperwork as a job responsibility.  There were real teeth in this IDEA requirements filtering down through the 50 states.

They did not learn these new skills in their college programs.  It was helter-skelter to learn them.

SLPs had to justify their plans orally to peers and parents. Prior to 1975, they were free lancers.

11. The History of School Speech Pathology

Busing

 

In the early 1970s courts began to address the issue of continued separate education of whites and blacks, long after the supreme court decision in Brown versus Board of Education in 1954.  To counteract the delay, “busing” was used to move black children to white schools.  

 

Resistance to bringing black children into schools paralleled resistance to bring handicapped children into schools, corrected by EHA 1975.  

 

We see massive citizen resistance historically to letting all children into schools according to compulsory education laws of the early 1900s.  Black children, Native Americans and the handicapped had nothing in common culturally and circumstantially.  They were excluded groups at the hands of Americans who wanted to keep education pure.  A Wikipedia post presents this useful post on resistance to busing:  

 

“Restore Our Alienated Rights (ROAR) was an anti-desegregation busing organization formed in Boston, Massachusetts by Louise Day Hicks in about 1974. The group’s purpose was to fight off U.S. Federal Judge W. Arthur Garrity’s court order requiring the city of Boston to implement desegregation busing — an order intended to eliminate de facto racial segregation in its public schools.   To supporters, ROAR’s purpose was its namesake; i.e., to protect the “vanishing rights” of white citizens. To its many opponents, however, ROAR was a symbol of mass racism coalesced into a single organization.”

 

Native Americans numbers in ordinary government schools reached a high point in the late 1960s. They brought different cultural and linguistic patterns into the mainstream classroom.

 

SLPs

 

School speech-language pathologist and other related services personnel in the 1970s were faced with the growing inclusion of excluded groups. Black children were coming into SLP caseloads. Experts pointed out cultural and linguistic differences as affecting communication skills and learning styles. As of the 1970s, more pressure was placed on school SLPs to develop background in language, culture and communication.  However, speech-language professors in the universities were just beginning to include language courses in the curriculum.  The exotic idea of socio-linguistics was only on the horizon and in the end never caught on much. In the 1970s school SLPs were left on their own to understand “Black English” issues.

 

A fundamental issue existed as well: The majority of speech pathology students were white students, a factor in perpetuating the circumstance of school SLPs being white females.  

10. The History of School Speech Pathology

Related Services and IDEA

In 1975 school speech pathologists might say: “We don’t have to worry about least restrictive environment because we are not teachers!”

We see how this argument might be used because “speech therapy” was a separate occupation in 1975, and speech therapists worked in hospitals, too.  Or in private practice. There was pride in that fact, that this was a separate allied health related field and not a branch of education. There was a core curriculum at the universities emphasizing clinical science. Education was not a part of that.

But…..interestingly……the courts and congress disagreed!

Speech Pathology

Under the provisions of different laws, the result was to…” define free appropriate public education as special education and related services that (a) have been provided at public expense, without charge and under public supervision; (b) meet the standards of the state educational agency; and (c) provide an individualized education program for each child at the preschool, elementary, or secondary school level. 

 [and] “…define related services as transportation, and such developmental, corrective, and support services as a handicapped child requires to benefit from special education. These services are to include early identification and assessment of handicapping conditions, medical services necessary for diagnosis and evaluation, speech pathology, audiology, psychological counseling, physical therapy, occupational therapy, and recreation”  (Karl Boettner,  University of Puget Sound Law Review, Vol. 7:183).

Now there was no doubt: Speech pathology was a part of education, and was responsible for helping assure a free and appropriate public education for the handicapped children they served.

Impact on Education

More subtle is the fact that education itself was changed to include clinical education and support.  One can say this is the end of the chalk and blackboard era. 

A reason for this shotgun marriage was the history of school pragmatism.  With compulsory education came  problems of serving all kinds of different children and   traditional teachers couldn’t handle everything alone.  They were faced with clinical issues.

In another post we noted: 

“The American Occupational Therapy Association (AOTA) was established in 1917.   In 1921 in the United States physical therapists formed the first professional association called the American Women’s Physical Therapeutic Association.  School psychology was founded between 1910 and 1914 when schools wanted help to select children for special education.  Speech pathology was organized in 1925 to help children with speech problems.  The Council of Exceptional Children was organized in 1922 at Teachers College, Columbia University.” 

The stellar work of these “helping professions” proved indispensable, carrying forward to the point where congress codified the fact of their contributions. The final result was one of defining speech pathology as a component of education. To work in a government school, speech pathologists  were to accept a role which included the principles and practices of education.

9. The History of School Speech Pathology

SLPs and Least Restrictive Environment 

SLPs have not responded much to least restrictive environment in terms of real universal decision-making guidelines and implementation. There are many ways to make the argument.  Here is one.

 

Hypothetical

 

A child enters special education at age 6 years with multiple articulation errors. The IEP says three sessions a week 20 minutes each in the therapist’s office.  The child leaves the classroom for the service.

 

At the end of the first years half the errors have been eliminated. The SLP says the child is not finished and needs more articulation therapy as before.

 

At the end of the second year the child only has one error left and is highly stimulable. The child can self correct and also make use of prompts to correct the last error sound.  The therapist says the child needs to”clean up that error”

and return the following year but for only 40 minutes a week in a group situation.

 

Tests

 

From appearances this looks like an application of least restrictive environment.  Intensity has dropped and the child is interacting more with other children during group sessions.

 

But two tests are NOT met.  

 

One, could the child now stay in the classroom all the time but receive prompts from the teacher and her assistant to correct the last stimulable sound? The SLP in this case would demonstrate a technique to prompt during reading exercises.

 

The second unmet test is whether the child should remain in special education at all.  We know that the child will receive linguistic training during literacy experiences and parents know how to help at home.  The risk is the child now older will be embarrassed to leave the classroom in front of her normal peers.  This is the stigma factor.

 

The SLP is holding onto a more restrictive procedure placing the child at risk socially and academically. Children in special education are less likely to graduate from high school. One can say with a clear mind it is better for a child to have a minor problem and have the benefits of full educational opportunity than to stay indefinitely in special education.  

 

Placing children in special education is a RESTRICTION BIG TIME!

 

8. The History of School Speech Pathology

What was the impact of IDEA legislation on education, special education and related services? Huge, but SLPs were not paying any more attention to it than was required of them day to day.

The Kennedy family advocated for retarded citizens. This is Mrs. Kennedy. Her husband was President John Kennedy, and he too advocated for rights of children.

 

Impact of IDEA

Educators had developed a comfort level with not having handicapped children in school buildings.  Professors in schools of education taught to the system of old practices.  New teacher recruits learned on the job and internalized old school procedures.  Likewise special education teachers and related services personnel were in an old groove.

Congress and the courts spelled out what had to be done.  After all, the system had failed for so long it could not be trusted to self correct.  Parents knew that and they continued to push for “appropriate” procedures and safeguards.  Schools were in a vice!  No escape!

This is not to say educators did not respond.  They are great professionals and troopers when push comes to shove. But they were dragged kicking and screaming to admit fundamental changes in teaching handicapped children had to be made. They still complain today when the topic of “mainstreaming” comes up.

The University of Buffalo School of Public Health and Health Professionals (http://atto.buffalo.edu/) provides an excellent summary of special education laws as they have evolved from 1975.

Least Restrictive Environment

If you are a congressman or judge trying to guarantee equal education for the mentally retarded, beyond guaranteeing they have a right to be physically at school, you must figure out a way to prevent warehousing.  That is, how do you prevent the superintendents from placing all retarded children in an old dilapidated buildings across the road from the main campus? Yes, you can’t exclude them from school as in years past but you can segregate them on school grounds so no one has to bother with them.

Least restrictive environment established a continuum of placements from high restrictive to hardly restrictive.  The key idea is to give special needs children time with their peers in normal learning situations, as much as possible.

Special education did adjust to this requirement.  For example, resource rooms sprang up allowing for part-time placements outside of the regular classroom.  However, self-contained placements continued whether least restrictive or not.

Related services personnel adapted less successfully to EHA of 1975. Perhaps they did not see themselves as educators, and educators did not see them as educators.  Hence, for they to follow their traditional service delivery patterns was comfortable for everyone. Related services people, after all, were hired hands employed to do specific tasks. They were not hired to be knitted into the fabric of education, even though many had degrees in education.

School speech pathologists were wedded to pull-out service delivery dating back to the early beginnings of the field.  It was business as usual for SLPs.

Pull-Out Erosion 

But the laws brought in handicapped children who had severe conditions and certainly had communication disorders qualifying them for speech services.  Pull-out didn’t work very well for children in wheelchairs who could not quickly go to the speech therapy room for articulation therapy.  SLPs were obliged to adapt and go where the handicapped children were if necessary.  What’s more, two 30 minute sessions a week of treatment was of insufficient “intensity” for more involved cases. Articulation therapy on a pull out basis could not be sustained as universal treatment for school children. Language and communication were more relevant abilities to target.

The seeds of consulting speech pathology were being planted.

Pull-out was under pressure but SLPs clung to it in the 1980s.  Administrators began to ask for more flexible speech services and that trend remains strong in 2011 (see response to intervention, for example). The American Speech-Language Hearing Association (ASHA) responded with advisory documents written by expert panels indicating how school SLPs might approach new school practice demands. But there was no way it could quickly force university to adopt the radical ideas IDEA represented.  University clinics were designed to teach pull out one-on-one as the desirable mode of service delivery. University professors busy with research couldn’t be going off campus to supervise practice in collaborative settings.

One can’t locate information from the 1990s as to how speech pathologist began to follow LRE and the continuum principle. For the most part, the profession school speech-language pathology has ignored this part of the federal law.

Some school SLPs continue to work almost exclusively on a pull-out basis.  I. E., a restrictive basis.

7. The History of School Speech Pathology

Turning Point

Parents successfully mobilized for the retarded but they needed legal, political and legislative victories.

The turning point came with a federal district court case Parc v. Pennsylvania (1972). “In 1971, Attorney Thomas K. Gilhool represented the Pennsylvania Association for Retarded Citizens v. Commonwealth of Pennsylvania (PARC v. Commonwealth) in a case that resulted in a landmark decision which affirmed the right to education at public expense and due process for children with disabilities. He used Brown v. Board of Education in his arguments” (NAPPE).  The finding laid the foundation for FAPE rights.

There were many measures mandated for all special education service providers eventually finding their way into IDEA legislation. The skills required to exercise these responsibilities had not been taught in college training programs.  The role of the speech pathologist was  changing dramatically and to this day remains under pressure.

EHA

Congress passed the Education For All Handicapped Children Act of 1975 (EHA).  It caused panic among educators.  In Ohio, there was commotion over which agency would be the lead agency (SEA). There was talk of how teachers were going to “mainstream” handicapped children into the classroom. EHA forced schools to find all handicapped children and make sure they were in school. The word “mainstreaming” meant dealing with difficult disabled children during everyday classroom lessons.  

Among educators, there was no sense of celebration from the beginning of IDEA legislation.  It was more a sense of concerns over teaching loads and difficulties. One can imagine a celebratory atmosphere among teachers who wanted  “to help all the children.” From this time forward changes in federal law and regulations evoked concerns about managing change rather than accepting it for the benefits and opportunities. There was no sense of teachers repaying a debt owed to the handicapped, correcting an historic wrong.

Parents 

Meanwhile parents were in a different state of mind. They celebrated a final solution of an old and painful problem:

 “We were vulnerable, ridiculed and victimized at the turn of the century and it took 75 years to fight back, and try to overcome this legacy of menace and dangerousness. Now we are brought to the point when many felt it was time to develop statute which would uphold safeguards to bar the past from becoming a part of our future.”

There were speech pathologists who were pleased with mainstreaming approaches based on their personal humanitarian principles.  However, their reactions overall were more like school teachers’. “This is making my job harder!”

School Folklore

In this period a bit of political folklore originated —  That parents are adversarial and the lawyers who help them cannot be trusted.  Suspicion of parents became a kind of institutional defense mechanism disconnected from history and national perspective.  Even young teachers coming into the system were socialized to believe  they might be sued by parents if they didn’t watch out! In fact, thousands upon thousands of IEP meetings go on every year with no problems.  Parents typically are happy to have the help and go along with school preferences. Educators continue to resent the intrusions of the courts and congress obliging them to correct historical wrongs done to the handicapped.


6. The History of School Speech Pathology


1970s

For school speech pathologists in 1970, the sky was about to fall. In the 1960s, in university programs for speech pathology, there was little or no talk of civil rights. That was something happening in the evening news when Rosa Parks refused to move to the back of the bus.   Or George Wallace stood in the schoolroom door.   Or police dogs attacked protesters.   The civil rights movement was not a part of speech pathology.   School speech pathologists were working on articulation and professional organizations.

The states had neglected laws to fully implement compulsory education so school speech pathologists were insulated artificially from excluded groups. “Congress found that although nearly all States had laws mandating public education for all handicapped children, there had been little or no enforcement of the mandates. H. R. REP. No. 332, 94th Cong., 1st Sess. 10 (1975)” (University of Puget Sound Law Review [Vol. 7:183]). That was about to change, a change of public policy that would slam school speech pathology.

The Run up to IDEA

Excluding and improperly educating retarded children infuriated parents of retarded children. Years and years of public policy abuse of the handicapped caused deep pain.   The issue raged as a civil rights issues rage, crossing boundaries of disability, and addressing fundamental issues of education rights.   “The deinstitutionalization movement of the 1970s reflected a concern for the civil rights of mentally retarded” (http://www.infoplease. com/ce6/sci/A0859577.html, 2011).

Instrumental in the movement was The ARC (http:// http://www.thearc.org/), The National Association of Retarded Citizens, according to NAPPE (Network of Advocates for Promising Practices in Education,2011).   The ARC was a part of the deinstitutionalization movement, forming in 1950.   In the 1960s it opened offices in Washington, D. C.  It became an advocacy powerhouse.

 

“The Arc’s memberships are key players in the enactment of Public Law 94-142, the Education for All Handicapped Children Act which guarantees a free appropriate public education for all children with disabilities.”

 

“The Arc helps negotiate a deal with school authorities to amend the Education of the Handicapped Act to provide services to infants, toddlers, and preschoolers with disabilities.” 

 

Reading the list of accomplishments achieved by the ARC, one sees its enormous influence on the everyday practices of school speech-language pathologists since 1960. 

 

5. History of School Speech-Language Pathology

1960s

In the 1960s money was flowing into schools and universities.  Research was encouraged and paid for.  On the horizons were significant changes in the speech pathology practice.  The “scope of practice” expanded as a result of research studies, speech science applications and linguistic theory.  Professor Duchan refers to “The Linguistic Era from 1965 to 1975 during which time we came to treat language disorders as separable from speech disorders and as being linguistic in nature…” Later pragmatics added to the language area amplifying the intensity of curricular change.  The new interest in “that language stuff” brought about tension among faculty, clinical supervisors, students and clinicians.  It came on hard and fast, taking no prisoners. 

In 1978 the American Speech and Hearing Association became the American Speech-Language-Hearing Association. This was massive change in scope of practice to say nothing about critical changes in theory.

Scope of Practice Issues Arise

The language boom meant more “structures” to assess and   target in therapy.  For example, morphology came into focus and whole new area of intervention developed.  Vocabulary instruction became ever more complicated than the era of teaching nouns to retarded children.  What’s more, language was said to be nested in cognitive processing.  Teaching language structures required children to process the structures and not just produce them as memorized forms.  One should expect clients to learn strategies of processing and generalize structures.  

In the period authors created language tests for the components of grammar and semantic ability.  Speech therapists were not accustomed to extensive testing protocols and the interpretation of statistical outcomes.

School speech pathologists were now being pushed out of their comfort zone, doing stuttering, hearing, voice, vocabulary and articulation.  It meant more work to absorb new ideas and apply them to ever increasingly complex cases, including minority children with different styles of speaking and learning coming into schools as a result of civil rights acts. They were required to justify their plans to IEP teams and to report progress at the end of the year.  Their instruction had to be tied to the curriculum standards of the school.

One Experience

Work demands were changing and increasing, as SLP  Cindy Montalbano recounts.  She started in the field in the 1980s, servicing a variety of schools with few complications of practice. Now SLPs have office locations and are more of an integral part of the staff.  They do more case management and consulting.  There is more emphasis on working in the classrooms in cooperating with teachers (http://cjmonty.wordpress.com/speech-therapist/).  This is of course the time when IEP planning and meetings were required of all related services specialists.  Fostering and documenting integrative planning was a premise of IDEA regulations.