Monthly Archives: July 2011

Diagnosing Education Over-Identification 2011

Disproportional placement of at-risk children in American special education programs – the over-identification problem — is part of a historical pattern to block unwanted children from school participation.  It dates back to the beginning of compulsory education in the 1920s.

The premise of efforts to reduce over-identification should be the view that many Americans do not want native American, handicapped, poor, Hispanic, bilingual, migrant and black children in schoolrooms but federal law and the supreme court have forced educators to take them in.  Internally, schools have used special education as a place to put unwanted children away from normal instruction as much as possible.

Right Calls

Those who work in schools who seek to behave correctly should be prepared for resistance to efforts to fairly place and exit children from special education, owing to a system where most participants do not grasp the historical issues in operation or are afraid of causing trouble.

One must learn to recognize eligibility plays as they develop and make the right call, the way NFL defensive backs anticipate the opponent’s strategy and play calling. The NFL back understands the other team wants to win but he can try to “jump the route,” get a pick, and take it to the house!

Diagnostics

We recommend asking four questions every time you are in a position to exit a child or determine placement:

1. Who refers?

2. Who evaluates?

3. Who places?

4. Who benefits?

Referrals

Teachers are the engine of special education referrals but parents, physicians and other interested parties contribute.  Teachers want to reduce the number of “difficult to teach” children.  When 20% of a class contains DTT children, the class is at risk for failure.  The DTT model is a powerful explanation of referrals.

Evaluators 

Related services people are the key here. They objectify and validate placements and retentions through evaluation procedures but their record is checkered, especially in using standardized tests, recognizing cultural differences and using correct placement criteria. Be alert!

Placement

The IEP (eligibility) team entails dynamic fast-moving processes with latent conflicts of interest influencing outcomes.  Seldom do members advocate for the child.  Each team member has something to gain from placing and retaining children in special education.  Reminders of compliance, speed and confusion work against contrary opinions.

Profits

Administrators gain funds for the district and compliance assurances (although Congress has acted to control this problem). Teachers avoid DTT children. Parents gain help for their children. Related services personnel gain secure employment.  General education avoids having to maintain remedial programs.

Comments

Together, these powerful forces work efficiently no matter what congress, researchers and journalists say.  Misplacement happens swiftly and surely, making detection almost impossible. Participants when questioned about over-identification are oblivious to the problem, or afraid to speak.

Stop sign along country road.

Now the problem of over-identification has spread in an ugly fashion to suspensions. It appears to be a different issue but it is cut from the same cloth of disenfranchisement. For 100 years schools and communities have demonstrated endless creativity to find new ways to segregate unwanted children.

Parents do not understand the risks of placement, and IEP meetings do not make this clear to them.  Parents often do not  understand the history or the legal paperwork of IEP meetings.  Disadvantaged families are even more at risk.

STOP!

A while back we proposed half in jest a direct approach.  It involves the local school administrator writing directly to the staff and telling them to stop placing so many children in special education, and stop keeping them there for an unacceptable length of time. Thinking on it, it is not a half-bad solution.  In fact, it is a powerful, proper and cost-effective solution.

States are supposed to monitor LEAs to make sure they are doing the job.  The STOP approach can do it.

“Dear Colleagues.  

I have noticed we have more than the predicted numbers of children in special education, and our district is part of a national pattern showing minority children in particular  too often go into special education.  The national reports indicate too that children are placed in the wrong categories, or some categories are over-used. Let’s try to cut back on our special education enrollment by 10%.  Each person must use his or her skills to make rock solid eligibility judgments.

I am providing a simple one page report form with a checklist and a place for comments.  Please turn this in to me by January 15.  We want to hear from you as to what you have done personally.  In the long-run such information might give us a knowledge base for what we can all do together to combat over-identification.

Thanks for all you do!  As usual, you will hear back from me on your report.

Missy Jane Rogers

Superintendent


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What Women Speech Correctionists Lost to the Men!

In a prior post we gave a snapshot of the success of early speech correction teachers in laying the foundations for modern American school speech-language pathology. In 1931 they merged with the American Academy of Speech Correction.    A secure service niche in the profession was ensured but what did the school correctionists lose in the bargain? Here is our assessment.

Recognition:  After the merger the speech correction group disappeared. Current historical commentary dates the beginning of the    field as 1925 as though nothing had transpired before 1925.

 

Independence:    Speech correction teachers were organized and set their own agenda.    With the merger, their independence was lost. They were subsumed into an organization with an altogether different vision of what the future should hold.

 

Respect:  Some academic founders objected to having speech correction teachers mixed in with the”high minded’ academicians. Correctionists were viewed as second-rate professionals and that position was maintained for decades.

 

NEA Affiliation:    Speech correction teachers lost their primary affiliation with the National Education Association, whose mission was more closely tied to their own.

 

Organizational Roles:    By 1947, men occupied all the important executive and committee assignments, virtually shutting out the school correctionists.    In fact, membership rules effectively closed them out.

 

Clinical Models:  For 20 years (1905-1925) a growing speech correctionist group developed successful and widely practiced school methods and techniques which were absorbed by the Academy upon merger without credit and honor. 

 

Scholarship:  Academy men created journals publishing papers on their special interests and viewpoints (e.g. stuttering). Speech correction teachers lost opportunities to write scholarly ideas about school practice (e.g., play therapy).

 

Academic Positions:    Men dominated the college positions and women took lesser positions as clinical supervisors. Men had the doctorates, women the master’s degrees. 

 

Curriculum Development:  Academy men strictly imposed medical model coursework on school SLP students. Education content was not included.

 

Certification:  The correctionists lost any hope of influencing certification programs.    Corrrectionists graduated with speech therapy backgrounds when they needed an education backgrounds.

 

Accreditation:  No meaningful channel for speech correctionists to promote school-related standards.

 

Revenue:  Correctionists lost control of  the revenues their participation generated. Tuition fees funded departments, and membership fees funded ASHA, but the speech correctionists had no voice.

 

Doctoral Education:  After the merger, doctoral programs later gradually went down hill, and clinical doctorates were shut out entirely. School SLPs did not acquire the doctoral degrees in the numbers they needed to improve school practice and to take leadership roles in education. In the 1970s, some traditionalists argued against the master’s degree for speech correctionists.

 

Executive Director Position:    Speech correctionists were excluded a priori from the position of Executive Director of ASHA. A direct chain  from the male founders to the present day promulgated medical model thinking: Wendell Johnson (1931-1941, Iowa, de facto;  D. W. Morris, 1941-1948, Ohio State;  George A. Kopp, 1948-1957, Wayne State; Kenneth O. Johnson, 1958-1980, Stanford Medical;  Frederick T. Spahr, 1980-2003, Pennsylvania State). The last in the chain is a woman but no language specialist has ever  been selected, nor a doctoral-level professional with extensive school background.

 

Men and Women

 

Professor Duchan introduced into the history of the field a gender factor. One who reads the history is struck by the fact that women were the early speech correctionists and men were the early academics. When the merger took place, men became the dominant force of organization whereas women became service providers. As one reads into the 1970s it is clear the men ran the show, controlled everything, and didn’t show any signs of letting go. Only a few women who fit the mold the men provided played minor parts, but did not receive the grand awards the men did. Accordingly, Professor Duchan developed her list of “founding mothers” as an historical counter-balance to show women deserved more credit than the men gave them. Professor Duchan referred to “good old boys” holding sway over ASHA, passing on the opportunities to one and another.  Executive Director Spahr upon retirement reflected about it this way:

 

“The association wasn’t intentionally being discriminatory, but some of our practices had a disparate effect,” Spahr remembers, recalling a volunteer leadership and staff that consisted predominately of white males. “The established leaders chose who they knew, so we were perpetuating the status quo. We made conscious efforts to increase the number of females and racial and ethnic minorities involved in the leadership of our organization.” http://www.asaecenter.org/ Resources/EUArticle.cfm?ItemNumber=11817

 

Sexism is explanation of the large imbalance of opportunity for women who preferred education. What is important is the function of educational speech pathology was held back, along with the women, and not allowed flourish and develop along the natural path. Eventually in 1970s, some staff support was devised in first efforts to get suggestions from school personnel but it was less than too-little-too-late. It was tokenism with deleterious effects, as we saw when 1975 arrived. The dominant position was strict medical model thinking and that was impractical in 1975.

Old house in small town

 

What is missed by the Duchan analysis is the men didn’t do all that well either, in the long run.

 

The men of the American Academy of Speech Correction gained a source of revenue from training female speech correctionists but they lost out on their wish to establish a male-oriented high level research field. Doctoral education eventually faded, and speech centers became training centers rather than places for research.  At some universities the campus clinic became a financial liability. Master’s students were not asked to do thesis research and the students could not see beyond completing degrees and getting jobs. Academic departments had to compete with the national association for authority in clinical education. To be the president of the association no longer represented the dominance of academic values. The president was that of a non-profit organization, a far cry from the founder’s reserved place as academic leaders.  The mentoring role once played and loved was eliminated. In the 1970s their advice to retain the B.A. degree for certification was ignored. In the end founding fathers lost their leadership roles to the point where numbers of men entering the field declined steadily. Signs indicated men were no longer attracted to the field. The great granddaughters of the “founding mothers” took over once and for all. Whether they represented any better their grandmothers’ zeal for quality in American schools is an open question. 

 

So it was a marriage of convenience and that is how it turned out. 

18. SLP Eligibility Management: Evaluation

To prevent over-identification, and disproportional representations, special education personnel must be sensitive to the processes which put children in special education, and be able to diagnose them instantaneously as the rush to place and comply happens around them.  Three questions must be asked:

1. Who makes the referrals?

2. Who evaluates?

3. Who urges placement?

As to the evaluators, it is interesting to note non-traditional specialties were put on the FAPE TEAM by the courts and congress in 1975, making them a legal part of education, under “related services.”  SLPs are on the evaluator list and are involved in misplacements.  It is also interesting that evaluators tend to take their cues from teachers, administrators, parents and IEP team members.  An evaluator who wishes to reduce the number of non-disabled minority children in special education faces pressures to place and retain.

In a prior post, we offered this about evaluators:

Related Services and Over-identification

We see there are too many children placed in special education, and often incorrectly. States allow great latitude for local school decision-making, with variable results. Who are the decision makers? What are their relative contributions to placing a child in special education? Is there much known about the process?

“Related services personnel (counselor, interpreter, medical personnel, occupational therapist, mobility specialist, physical therapist, rehabilitation counselor, school health personnel, transportation specialist, social worker) with exceptions do not make major decisions for child eligibility (IDEA 2004). They contribute evaluation data and opinion but defer to the determinations of the IEP team.

The related services having direct responsibilities for recommending special education eligibility include audiology, speech-language pathology, psychology and early intervention personnel:

Audiologist: “Identification of children with hearing loss.”

Speech-language pathologist: ” Identification of children with speech or language impairments.”

Early intervention: ” Early identification and assessment of disabilities in children means the implementation of a formal plan for identifying a disability as early as possible in a child’s life.”

Psychologists: “Administering psychological and educational tests, and other assessment procedures”

17. SLP Eligibility Management: On Guard!

8. SLP CASELOAD CUTS

Here’s an older post that packs a punch!  Your admission of the problem of over-identification gives you confidence to be watchful at every turn. You known it’s happening right under your nose, and now it’s time to bring it out for the fight.

“Let’s talk about practical techniques for reducing the SLP caseload by way of Strategic Eligibility Management – practical points.

OVER-IDENTIFICATION

First, assume you are placing too many children in special education.

National statistics and trends suggest SLPs are a part of the problem, especially with respect to phonology, language and learning disability where there is a lot of judgment involved.

Second, go over No Child Left Behind procedures in your school.

This is an old act going back to the civil rights era of the 1960s designed to help “struggling students.” Some schools will have some kind of child study program and pre-intervention planning. Plan to make use of it.

Third, push back on teacher referrals.

See if you can get the pre-intervention committee to meet and organize concrete suggestions for referring teachers. Participate and suggest techniques. Stress that pupils must be showing academic difficulties to be placed in special education. Try to prevent hasty referrals to special education, which require legal response within 60 days. Here is where the placement expectation gets set up because a referral is formal.

Fourth, promote a preschool intervention program to reduce referrals and placements.  Someone’s got to do it! It is hard to see that the 100,000 American schools are making rapid progress in this area. States cut out preschool programs. Check with your state requirements for preschool placement. Obviously functional articulation cases are suspect.

Fifth, flat out be on guard about admitting minority children, especially those with limited English.

Watch out for boys from minority groups. They have double jeopardy because they are boys. Watch out for the “hard to teach.” Watch out for emotional disturbed and hyperactive children. Most schools do not know what to do with “struggling students” and they tend to stick them in special education for remedial help.

Sixth, don’t misinterpret standardized test results for minority children. School psychologists have been doing this for a long time, to the point where IDEA 2004 knocked back reliance on standardized tests, and promoted wide arrays of evidence-based assessments.”

Seventh, watch out for shake and bake IEP meetings which are carried out in a hurry or carried out routinely, and which retain the child in special education.  Watch out for the quick 3 year re-evaluation meeting, perhaps having it waived.  This  is a leak!

Comment

Marsha in the office is a wonderful woman, a grandmother who brings in baked items every Thursday.  But she helps create the rush to compliance, calling out folks who are late with their paperwork or who don’t know the rules.  Sometimes she gets wrapped

Mr. Chang, swan-goose and friend, Lakeside, Arizona

up in herself, thinks she is the compliance officer for the director and the state.  In her rush to get paperwork done, critical eligibility decisions are washed out. And Mrs. Dykstra, the director, lets Marsha have her way.  She doesn’t want to cross Marsha. Marsha is the Zarina of Paper.

16. SLP Eligibility Management: Categories

In 1975 school speech-language pathology changed forever.  U. S. courts and  the U. S. Congress imposed on government education strict rules for the ways in which handicapped school children were to be placed and retained in special education. States had not been able to fix the problems of misplacement of minority children, and their systems of eligibility identification were in need of great improvement. Accordingly, a system of categories of children eligible for special education was originated and revised.  SLPs were obliged to use this system, with particular reference to the SLI category.

School speech pathology has evolved over 100 years and in this evolution it has developed a stellar record of assessment and intervention practices for service to at-risk children.  Where no other specialty is available, SLPs have refined methods of intervention adaptable to any disability implicating communication performance. Therefore, one sees SLPs assigned to all of the categories of disabled school children for “speech therapy” services.  SLPs apply behavioral, linguistic and cognitive training methods centering around speech, language and hearing interaction in the family and in the classroom.  The methods are of a cognitive and social nature so they support development in the general curriculum, which is what the IDEA law requires.

Yet, many SLPs are not well prepared to understand the nuances of the IDEA categories, weakening their positions to speak to issues of eligibility; indeed, abuses of eligibility. Uninformed SLPs fall into the patterns of sustaining disproportional representations of non-disabled minority children in special education.  Their outlook fits the cliche, “If you are not part of the solution, you are part of the problem.”  Their narrow focus on the speech and language impaired means they sit on IEP teams without contributing more broadly, in the spirit of FAPE as intended by Congress in 1975.

In our posts we describe each of the 14 disability categories for an initial overview. Full study is necessary for effective practice in schools.  See Categories.

 

15. SLP Eligibility Management: Prevention

Monitoring Misidentification for SLPs

In “helping professions” prevention is too often counter-productive.  If we prevented all health problems many would be unemployed.  In American schools, IDEA SAYS WE SHOULD PREVENT NON-DISABLED CHILDREN FROM BEING PLACED IN SPECIAL EDUCATION.  ASHA’s concept of prevention is generic. A school SLP has a specific job to do.

Window looking out.

SLPs want to manage special education eligibility correctly and in this way ethically keep caseload size and workload under control. IDEA 2004 regulations provides the legal basis to reduce overidentification and disproportionality in all private and public U. S. schools.

idea.ed.gov (Legacy 2007) provides a summary of what state and local school districts “must” do to monitor incorrect placements in special education. Here is the basic requirement:

“The State must have in effect, consistent with the purposes of 34 CFR Part 300 and with section 618(d) of the Act, policies and procedures designed to prevent the inappropriate overidentification or disproportionate representation by race and ethnicity of children as children with disabilities, including children with disabilities with a particular impairment described in 34 CFR 300.8 of the IDEA regulations.[34 CFR 300.173] [20 U.S.C. 1412(a)(24)]“

PREVENT is the operative word. When an SLP avoids an inappropriate placement, a measure of prevention is taken and caseload is reduced by one.

Moreover, the state must monitor local school districts to see they are doing their jobs to reduce overidentification and disproportionality:

“…in accordance with §300.646(a) of the IDEA regulations, the State or the Secretary of the Interior must…require the LEA to publicly report on the revision of policies, practices, and procedures described under §300.646(b)(1) of the IDEA regulations.”

These prevention measures assume background knowledge of the fact that too many American school children are placed in special education via misdiagnosis, and many of these children are from minority groups.

SLPs in their schools should feel free to explore this topic with administrators. They are in the same lifeboat.

14. SLP Eligibility Management: System Leaks

In a prior post, called SLP Caseload Eligibility, we had some important things to say about thoughtful pre-planing and investigation of what we call “leaks” in the system. This is highly original work indicative of our Famous Blog. First, one should try to work with other SLPs in the district to see how non-disabled children are being placed in special education.  You want to cut your caseload, no? This is the way to do it, find out where the leaks are in your system.  This is caseload management at its best. You’ll be surprised of the number of actors who are teaming up to pump the wrong children into special education.

“As a part of Strategic Eligibility Management (SEM), the alert SLP must start off whittling away at his or her individual caseload to reduce size and misidentifications in an ethical manner. Beyond this, the SLP is interdependent with other SLPs who might be creating placement “leaks” in the special education system. Caseloads are passed on from preschool to high school, and one can inherit the shaky eligibility judgments of others. Some SLPs also exit children rarely because of the difficulties of doing so. Sometimes SLPs do find themselves cleaning up a poorly managed caseload. Chances are new graduates do not know about the over-identification of at-risk children because it didn’t come up in their graduate programs and because of the stigma associated with it (cf. Why Over-identification). They are working strongly for compliance, getting along and keeping their jobs.

Placement “leaks” in the system must be diagnosed. Where and how are they occurring? Who is involved and how can they be gently influenced to make better professional judgments? How does peer pressure come into play? Where is judgment breaking down?

POINTS OF ENTRY

Child find. According to IDEA, schools must advertise in the community for referrals of at-risk children. They must arrange for screening sessions open to the public. Which SLPs are involved with this? Are they influenced by staff opinions?

Parents. Any parent can within a district (LEA) refer his or her child directly to the office of special education. The school by law must respond. Pressure is placed on the school for quick action, action that usually entails placement. “Rush to judgment” must be controlled.

Transfers. Children who bring active IEPs into the school district transfer their eligibility. The school may review the adequacy of the plan and how it will be carried out. It can review the disability judgment. Too often special education placement is automatically accepted. SLPs should flag questionable IEPs.

Home schooling. Parents who home school within the LEA are entitled to special education services. They must go through the standard eligibility procedures. One must watch for short-cuts in standard procedures.

LEA schools. Private and charter schools within the LEA can refer their pupils via parents to special education. The LEA must take the referral. Such referrals sometimes come in during the summer, when SLPs are on vacation.

0-3 years. Children who are made eligible for remedial support services must transfer into the LEA shortly before age 3 years. They bring an eligibility determination with them. The determination can be based on various disability criteria, and SLPs might believe they are obligated to accept the transfer information as is. Medical opinions must be translated into educational categories.

3-6 referrals. Kindergarten teachers and sometimes Headstart teachers can refer children to special education. Some at-risk children are identified through screening programs. Special education criteria change with regular school placement. How do developmental criteria translate into educational criteria?

6-21 referrals. At-risk children are often referred by elementary teachers as their academic learning patterns become evident. Referrals can be made throughout the school years, as, for example, in cases of traumatic head injury (TBI). Some teachers make questionable special education referrals. Pre-interventions must be considered, too.

Eligibility criteria vary with age, program and disability. Misidentifications can occur at any step. For example, migrant children sometimes bring out-of-date IEPs to their next school. Hurried acceptance can sustain misidentification.

National Society for the Study and Correction of Speech Disorders

Scattered reports in the public domain establish ongoing American school speech correction activities very early in the 20th century. Speech correction teachers drew knowledge from medicine, phonetics, psychology and public speaking but their roots were in education. Children with speech defects had difficulty with spelling and saying their letters, which caused teachers to correct speech as they taught.   There are children in schools with genetically based speech, language and hearing problems presenting themselves to every generation of elementary teachers. Groups organized around the need to help them.

Early school surveys showed there were large number of speech-defective children who needed services:  

 

“Examples of the surveys conducted could well begin with Thorpe’s preliminary work in 1903 and that of Conradi in 1904, and would include Ferreri in 1911, list McDonald, Blanton, Brown, and Wallin in 1916, and conclude with what was by no means the last of these pioneer surveys, Stinchfield’s report on college students.”

 

CLARENCE T. SIMON (1954) http://www.archive.org/stream/

historyofspeeche012803

mbphistoryofspeeche012803mbp_djvu.txt 

 

School Programs

 

Some say 1910 was the year school speech language pathology started in the United States.   It is a good round number to work with. But there was already a much activity before 1910. For example:

 

“Speech correction in the public schools apparently began with a New York City class in 1908, the work being prompted by the increased sense of responsibility for the handicapped which had led to the earlier establishment of “ungraded classes…” Other cities soon followed the example if not the exact pattern of New York to establish the pattern of public school speech correction. Chicago in 1910, Boston in 1912, with Detroit, San Francisco, Grand Rapids, and eight cities in Wisconsin by 1916 were early on the list.”

 

CLARENCE T. SIMON (1954) http://www.archive.org/stream/

historyofspeeche012803 mbphistoryofspeeche012803mbp_djvu.txt 

 

Jennie Hedrick gave a paper to the National Society for the Study and Correction of Speech Disorders in 1921 in Atlantic City and proclaimed the “speech correction movement” was “sweeping the nation” like a “huge wave,” and that speech correction teachers could learn from association with the medical field.

 

http://www.tandfonline.com

/doi/abs/10.1080/00335632209379377

 

Scholarship

 

By 1930 there were school leaders in the field of speech correction engaged in scholarship.   At a symposium on stuttering in Chicago the following presentations were made:

 

“Basis for Work with Stutterers in Grand Rapids Public Schools.” Miss Eudora P. Estabrook, Grand Rapids, Michigan. 

 

“Methods Used in the Treatment of the Stuttering Child in the Public Schools of Omaha (Nebraska).” Miss Alice Liljegren, Omaha. 

 

“The Treatment for Stuttering in the Public Schools of Wisconsin.” Miss Lavilla A. Ward, Madison, Wiscons

 

http://archpedi.ama-assn.org/cgi/reprint/41/6/1496.pdf 

 

Organization

 

From the beginning of the speech correction movement  “…groups with special interests in speech correction were formed within the National Education Association.” The National Education Association (NEA) was established in 1857.

 

(Lubinski, R., Golper, L. A. C. & Frattali (2007). Professional issues in speech-language pathology and audiology, United Kindom: Cengage Learning. Accessed online July 2011: //www.cengagebrain.com) 

 

(http://www.nea.org/home/12172.htm)  

The Metro in Paris

 

Speech correction teachers  joined The National Society for the Study and Correction of Speech Disorders in 1918, approximately. This signalled movement away from NEA though college preparation remained in education. 

 

(http://depts.washington. edu/lend/seminars/modules/pdfs/splprint.pdf)

 

Walter Babcock Swift was a founder and president of the Society. “He was widely known as an advisor to public school programs throughout the United States providing suggestions for how to set up speech therapy services.”    

 

(J. Duchan, http://www.acsu.buffalo.edu/)

 

Smith published, Speech Defects in School Children and How To Treat Them. Boston, NY and Chicago Houghton Mifflin Co. 1918 (wiki)

 

Until 1931,The National Society for the Study and Correction of Speech Disorders had some success but lacked organizational patterns, strong academic ties, and a mission suitable for school speech correction. 

 

(C. Van Riper, ASHA Magazine, November 1981; Volume 23:11, pp. 855-858)

 

At a meeting of the American Academy of Speech Correction in 1930 Pauline Camp proposed an alliance with Academy.   This effectively ended the 

The National Society for the Study and Correction of Speech Disorders about 1931. The Academy offered the resources of an established academic network.

 

(C. Van Riper, ASHA Magazine, November 1981; Volume 23:11, pp. 855-858).

 

Comments

 

From 1905 to 1930 American school correction teachers provided services to speech-impaired children. Services spread from state to state. Speech correction teachers were organized through the National Education Association, college education departments, state agencies and local school districts. Speech correctionists laid the foundation for modern school practice, developing the “pull-out” model for the treatment of articulation, stuttering, voice and hearing problems. They laid the foundation for modern articulation therapy, and worked on stuttering methods for children. Their alliance with professors and reseachers in the American Academy of Speech Correction provided Academy members with concrete speech correction models, strategies and techniques to use in the design of later certificate programs. Academy members were heavily  invested in stuttering methods for adults rather broad educational approaches for children. Speech correction grew in public education at a fast rate so as to demonstrate varied practices in professional settings. Demonstrated programs of clinical supervision were transfered to college clinics. Growth in speech correction provided the engine of development in the speech therapy branch of the profession, thereby giving structure to medical model concepts which were abstract and ill-defined. Growth in numbers provided the financial resources for the academic departments and professional organizations. Without the contributions of school speech-language pathology, the field would be a skeleton of its current self.

 

Varied sources cite the beginnings of American speech pathology as orginating in the year 1925, when a tiny number of speech professors started the Academy over dinner. In fact, the profession was already established in schools in content and organization at that time. A preference for the later date of 1925 denies the contributions of educational speech pathologists to the field.

13. SLP Eligibility Management: Adverse Effects

 If we use narrow SLP clinical criteria, we can overlook potential side effects of special education placement.  In a prior post, we went over this point.

One of our themes at SSP is that school speech-language pathologists along with other specialists do not consider among their special education placement criteria the potential of negative impact on long-term academic success.   It seems routine.   He or she has an “artic problem” so give the test and make the placement.   All seems innocent.   However, we have no data on whether being singled out as a special education child carries with it a stigma and impairs motivation to achieve. 

 

The National Center for Learning Disabilities (NCLD) is publishing now (February, 2011) a parent poll on LD child optimism for post-secondary achievement. 

 

“Is your child optimistic about college and a career?

 

Yes. She has confidence and drive. 36.6%

 

No. She thinks her LD limits her options. 26.8% Somewhat.

 

She’s waking up to the possibilities.   20.7%

 

I’m not sure. She doesn’t like to discuss it.   15.9%” 

 

SLI status overlaps with SLD status, and many SLI children have dual placements.   We guess that a survey for SLI children might look the same — overall, not much optimism.

 

In the case of non-disabled minority children, how would the survey look?

 

Special education children are singled out and over time administrators, teachers and pupils see them as different.   Expectations are lowered.   Special education children are more likely to drop out of school.  

 

Imminent renewal of No Child Left Behind suggests interest in improving graduation rates at American high schools.   Graduation should be a factor in early IEP planning.   Efforts should be made to exit children wrongly placed in special education.

 

SSP supports Response To Intervention as an alternative to speech and language placement in special education.  Better to work to improve Tier 3 and prevent needless placements.   SLPs have a professional responsibility to promote prevention of communication disorders.

 

 

Impact of School Speech Therapy on Pupil Achievement

 

12. SLP Eligibility Management: Data

Managing SLP Exits                                                                                       

Aggregate data are a must for caseload management.  

On the one hand, each and every eligibility determination must be made on an individual basis. That’s the right way. Data must be collected and the eligibility criteria considered.  The IEP paperwork should be checked for guarantees on ethnic and linguistic background.  For learning disability, each team member can vote no as recorded on the IEP forms. In all cases, the academic performance criterion should be weighed against disability criteria. 

 

On the other hand, you can’t see the forest from the trees unless you also have lots of data for your caseload and desirably from your school district. For example, if your caseload is chock full of Hispanic pupils with limited English, you must discipline yourself to see the issue in particular cases. You might have to say: “This is a child with limited English and communication skills but it is not a disabled child.” Administrators do not like to hear it because this statement implies the school is not providing adequate catch-up support of limited English children. A teacher might demand help because there is an apparent need. For a teacher it is only a practical matter.

A clown on mainstreet.

 

Here is an early post illustrating how one might study a caseload patterns on the exit side.

 

A school speech-language pathologist worked in a middle school on a one-year plan to exit children from special education.   During the year, 26 pupils were in the caseload. One child had a speech-only IEP.  Three children transferred in from other schools, and two of the three transferred out. 

 

Twelve of the 26 children were minority pupils (Hispanic or Native American), and 14 were Caucasian. Six of 26 were female students, and 20 were male. Eleven of the 12 minority students were classified specific learning disability (SLI), whereas four of 14 Caucasian students were classified SLI.   Ten Caucasian pupils were classified as autistic, hearing-impaired, retarded or speech-language impairment (SLI).   One female SLI pupil had a persistent /r/ problem.

 

Over the year, seven children were exited from speech and language services. Subtracting two who left the district, 17 children remained on the list to continue the following year. The exit rate was 27% for the year.

 

Of the 17 pupils on the continue list, 13 had been marked for dismissal but could not be dismissed for various reasons:

 

Parents insisted on continuation (3)

Parents were not phoned personally on time (3)

Parents could not be given timely office notice (3)

Summer IEP meetings were to be held (1)

Exit evaluations were not completed or were inconclusive (3)

Six of the seven exited SLI children were classified as specific learning disability (SLD). 

 

A list of 10 pupils projected to transfer to the middle school in the next school year included seven minority students with SLD classifications with SLI support.

 

COMMENT

 

The study is a microcosm of national issues of special education misidentification.   An emerging one is that females are under-represented in special education programs.   Another is that the learning disability category is over-used and this is where minority pupils are placed for remedial services.   SLP services are added to the SLD placements.

 

Even with an aggressive aim of reducing SLI and SLD placements in the middle years, many hindrances operate to keep the children in special education.   But without a systematic approach to caseload management, numbers grow and improvement declines. Seeking to exit minorities from the SLP caseload is both an ethical choice and a means of preventing SLP burnout.

 

The present report demonstrates the value of ethical total caseload management.”

 

Postscript

 

Here is an excellent original piece by Mary Steppling, Patricia Quattlebaum, Debbie E. Brady (2007). Toward a Discussion of Issues Associated With Speech—Language Pathologists’ Dismissal Practices in Public School Settings, Communication Disorders Quarterly. vol. 28 no. 3 179-187.