Category Archives: SLP Exits

14. Dismissal / Exits

ALL EXPERTS received an inquiry from a mother over special education dismissal concerns she had with her son, and a reply was given by Expert Richard Taylor  (3/29/2010).  Mr. Taylor explained the mother had a right to request dismissal from special education though the school might contest it.  Jana wrote:

“My son is 12 years old, first year of Middle School. He has been in special education for about 2 years.  He is very upset about attending special education classes and often states the he wants to kill himself because of the embarassment.  He is passing all of his classes and until our last ARD meeting, the school provided no accomodations to him and didn’t even know that they should be letting him read aloud.  I don’t feel as though he needs the service any further.  What rights do have in regards to his dismissal.  I would like him taken out of any programs related to special ed. ” (sic)

The example affords us several observations about the special education exit process in American schools.

Stairs to the river, Paris

1. A percentage of special education children feel bad about being in special education, and educators do not really care much about the stigma involved.

2. Retention of the boy may not have depended on “progress in the general curriculum” criteria if he in fact was at grade level, something special educators often ignore.

3. The mother did not understand what her rights were to discontinue special education, a common problem among special education parents.

We have argued it is four times harder to dismiss a child from special education than it is to qualify that child.  IEP teams let children in fast without disagreement. They hand out piles of documents telling parents of their rights.  But they are a quiet as church mice about dismissal prospects.

For years there has been a perverse incentive to keep children in special education, and that is more money for the school.

Parents should be advised of the risks of special education placement and their rights to take a child out of special education.  In fact the stated general goal should be to quickly exit the child, or move rapidly to less restrictive placements.

http://en.allexperts.com/q/Special-Education-3018/2010/3/Special-Education-Dismissal.htm

We agree with Linda Schrock Taylor, who says, “The majority of those enrolled in special education classes should only remain in special placement for a limited time – just long enough for problems to be corrected and delays remedied. I have a sign on my classroom door, “THIS IS A STEPPING STONE, NOT A RESTING PLACE.”

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Middle School Speech Therapy Exit

The SLP is a member of the IEP team, and can influence placement and retention decisions.  They are group decisions, not ones made by individuals, and a vote is taken.  Speech therapists can speak up and advocate for dismissal.

A middle school speech pathologist had a 6th grade girl with a persistent /r/ problem.  She was also classified as learning disabled.  

The annual IEP meeting came up.  The girl could not be dismissed as speech child but the speech therapist took part in the general discussion about the LD placement.  There was no recommendation to dismiss but the resource teacher said she had made improvement in reading.  The therapist asked the regular teacher whether there were non special education readers in her classroom whose performances were below the girl.  She said there were.

 “Then is she ready for dismissal from learning disability placement?” the speech therapist asked. 

The team was taken aback by the questions but the principal said they had recently dismissed a child at the middle school.  There did not seem to be awareness that children who are in special education could be dismissed.  The team agreed to make a note about possible dismissal to be considered in one year.  National special education figures across the grades have shown that once LD children are placed they are carried all the way into high school.

In recent history, schools have benefitted financially from “carrying paper” on children who do not belong in special education.  The cost is small but the reimbursement level is higher.

Speech therapists have an ethical and legal responsibility to speak on behalf of children who are misplaced in special education.  In fact, they can follow the IDEA guidelines to vote NO against LD placements and sign the IEP form accordingly.  They may be out-voted but they do not have to go along with the group where placements are inappropriate.

Middle School SLP Exits

Elementary school is where basic skills characterize special education — reading, language, speech, computation, writing. Special education programs are akin to Response To Intervention. If the programs are effective, non-disabled children in time should be dismissed. Children with functional articulation problems should be coming out of speech. Moderate-to-severe language cases should be exited if they can “access the general curriculum.” Many learning disabled children should be overcoming literacy deficits.

However, the national trend is for middle school personnel to forego dismissal. Learning disability enrollments remain static until high school, where dropping out is the major exit procedure. Children with moderate-to-severe language disorders, often minority children, move toward high school enrolled in special education. Speech and language cases are pulled along with other disability categories. Parents are afraid exits will deny their children needed interventions.

For middle school children, it is often unclear who should recommend exits. School psychologist? Special education teachers? Speech-language pathologists? Reading specialists? Directors of special education? Regular education teachers? Parents?

Special education pupils in middle schools are at risk in two ways. First, there is stigmatization, and we know about that. Second, basic skills instruction doesn’t fit high school.

Middle school children should move beyond basic skills even if the skills are imperfect. In high school, they must participate in rotating classes and subjects. They should be able to self advocate so teachers know their special needs (i.e., modifications). Their esteem should be high. They should be able to communicate socially with peers regardless of their linguistic intelligibility. They should have sociolinguistic skills for using genres of speech across contexts. Where appropriate, they should be anticipating vocational placements that they are heading toward with high school graduation. Prolonged basic skills instruction can impede progress toward high school graduation. It reflects classic pre-1975 special education where children sat across the road in the old brick building doing meaningless tasks.

Not only do students get stuck in special education, they get stuck doing the same things over and over without anyone’s anticipation of where they should be going. There should be a 12-year philosophy of special education that points students from the beginning toward realistic and dignified lives. And they should leave special education if at all possible.

Managing SLP Exits

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. 

Girl Scouts Marching on Main Street.

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.

2. Dismissal / Exits

Strategic Eligibility Management (cf. 4. SLP Caseloads) or SEM is a system designed to regulate special education enrollments to prevent misidentification and work overload. As a principled system, it centers around the flow of eligibility determinations from the time of identification to that of disqualification. Practitioners can develop and improve skills to manage their caseloads or instructional lists.

“The approach taken to SEM is three fold:

1. Reduce the number of children enrolled in special education.

2. Support least restrictive environment.

3. Dismiss children who no longer belong in special education.”

SEM requires the development of background and perspective on national public policy trends in special education transcending any one discipline. There must be an appreciation of the biases operating to place and retain at-risk children. Trends arising from IDEA 2004 and subsequent regulations should be understood as they apply directly to daily eligibility decision-making. Waiting for full agency support is not a good idea.

It can be argued that dismissal procedures are the most important area of practitioner skill. Once a learning disability teacher or an occupational therapist understands the difficulties of exiting children from special education, he or she will be motivated to work back into the chains of decisions leading up to dismissal determinations. It is better to avoid misidentification in the first place.

1. Dismissal / Exits

We start off on the problem of exiting children from special education with an eye towards speech-language pathology. Whereas IDEA 2004 and its derivative regulations give some attention to misidentification of at-risk children at the point of placement, there is virtually no national spotlight on the neglected topic of helping at-risk children GET OUT of special education. Where children have been “misidentified” initially they continue to be “re-misidentified” every time they have an annual IEP meeting. In many schools, no one seems to care.

Advocates for children exiting special education are few and far between. A provocative essay was written by Linda Schrock Taylor in 2002. Here are some excerpts:

“Every year, thousands of our children disappear into the vagueness of special placements, never to be released from the labels and stigma; never to escape and again be seen as ‘normal.’ Many teachers must notice this engulfing, this entrapment, of our children; some teachers must surely strive to defeat this grave and senseless closure on potential; but the problem is rarely mentioned or discussed” (Linda Schrock Taylor).

“A few months ago, the superintendent of our district stopped to ask how things were going. I said that it had been a good year; that I had just released three students from special education – a 7th grader, a 9th grader, and an 11th grader – and hoped to release more in the Fall. His surprise and shock were clearly evident. Mr. S. said, “Linda, these things never happen! – well almost never! I recently asked a fellow superintendent if he ever heard of any kids getting OUT of special education, and that fellow said that it is very, very rare for that to happen.”

“The majority of those enrolled in special education classes should only remain in special placement for a limited time – just long enough for problems to be corrected and delays remedied. I have a sign on my classroom door, “THIS IS A STEPPING STONE, NOT A RESTING PLACE.”

Taylor writes parents should be vigilant about remedial progress and ask this critical question: “When do you expect to complete the remediation, remove the label from my child, and remove my child from special education placement?”

Exits at 3-Year Reevaluation

For SLPs the three-year reevaluation under IDEA 2004 should be a landmark for evaluating for dismissal. The same can be said for learning disabled children. However, IDEA weakens school responsibility to take a hard look at progress and disability status. Parents can waive their rights to the reevaulation of their children, and they often do. Waiving reevaulation is portrayed as a time saver.

Every year a non-disabled child is kept in special education he or she is “re-misidentfied.” In the understanding of special education overidentification, this fact is lost on policy makers.

When SLI status co-occurs with SLD status, there is a tendency to drag SLI along from year to year as an add-on service. Curtailing reevaluations cuts down on time for IEP teams to reflect on the total welfare of the individual child.

Schools should advertise a goal of exiting many children by the end of three years. If they can’t do it, they should re-evaluate.

Here is the regulation (IDEA Legacy):

“A reevaluation conducted under 34 CFR 300.303(a):

…Must occur at least once every 3 years, unless the parent and the public agency agree that a reevaluation is unnecessary.”

Exit Difficulties

In a give-and-take exchange over one parent’s efforts to exit her daughter, we see how difficult it can be for some parents (City Data).

The mother (Pll) says:

“Why is there so much red tape connected to pulling a child out of the IEP program? Maybe a educator can answer this for me. Does the school get extra money from the government? Are they afraid of getting sued by a parent if the child drops out?”

A teacher (bigcats) replies:

“I’m not sure what your situation is, and I don’t know much about the financial side of things either..as a teacher, I would be reluctant to have a student who had an IEP stop having one unless they really seemed ready for that….I also would feel frustrated if there were some problem (speech, learning disability, etc.) that made it difficult for me to teach that child without additional services, yet those services were refused and I was held accountable for the student’s lack of success.”

Another (hey teach) teacher:

“I’m an educator and it doesn’t seem to be that difficult for a parent to remove their child from a Special Ed program. Yes, we do try to discourage such a move, because if the child did not need assistance, they would not be in the program in the first place. If a parent is determined to not allow their child to receive services, an IEP meeting is held, documenting all reasoning and opinions of both parents and teachers and then the parent signs their child out.”

Another (frogin4colorado) teacher:

“Yes, students who have an IEP bring in extra money for the school. This typically happens around Dec 1. Two, you are part of the team and you can deny services. The sped team will inform you of what could happen if no support is provided. After all is said and done, you can still deny services. But please be sure that it is what is best for your child before you do so. Can you get into the classroom and observe?

The mother (Pll) replies:

… My child has struggled with immaturity issues and is finally making great progress this year. I think the 1/2 hour a day (4 days per week) she spent in IEP would be better spent with her class. Yikes, I had to have two meetings with 6 faculty members before they would let me release her. Even though they started the first meeting showing papers and stats her great progress.

She adds:

“My daughter requested to be able to be with her class instead of leaving for four 1/2 sessions a week for resource (3 half hour sessions for math and 1 half hour for speech). She said she has been embarrassed and didn’t like being away from her new classmates.

[At a new school]. In the meeting yesterday I was surprised when the ‘team’ suggested waiting until December (or longer) so they can watch her progress since she is attending a new school this year. I said no and that I wanted to honor her request to be with her new classmates…

The ‘team’ wasn’t happy which was confusing to me because they just finished telling me how good she was doing! This is why I was wondering if there is money attached to resource or protocol that they don’t want to deal with…?

Another parent (LA_Parents) reports her experience:

…I want to get my son out of IEP and his teacher/school won’t let me. He is 5 1/2 yrs old now in Sp ed. Kindergarten.

This all started when my son was 3 1/2 yrs old. His speech was delayed. So we went through IEP process and had eligibility for
developmental delay. He did not learn much from school, but we worked with him and after a year, he was at a point comparable to other kids of his age.

We thought that he would get out of IEP. But to our surprise, during annual IEP, he was recommended for one more year in sp ed Kindergarten. In the IEP meeting we asked them what is it that other kids of his age can do and my son cannot ? But the IEP team did not listen to us….

Also, my son switched to another school in september , where his IEP continued. The new school said that we do not have a chance to evaluate the child and need more time to decide. Until then he will continue with his IEP…

…We have been working with my son. And I can tell, he is comparable or better kids of his age. He doesn’t have to be in sp ed. But the school has been giving indications that he will continue in sp ed next year in 1st grade as well. I have been frustrated. My son does not need sp ed. The school just needs kids in sp ed to get their funding….”

Another (wsop) parent reports:

“… In my case the school district was pushing for an autism dx, probably for the funding. At the same time they were not offering services such as speech, OT, etc., but wanted to place him in a self contained classroom, and in fact were insisting on this! Who wins in this situation? My son was and is totally capable of being educated in a typical classroom with his typical peers, but they wanted all the funding that comes with an autism dx and the cheapest route for them was to stick him in a self contained. Sounds like a barrier to learning to me.”

Another parent (marylee54):

…finally got my son out of special ed. Basically, you can take them out anytime. Request a dismissal ARD that’s what the D in ARD stands for Dismissal. Write up something to the effect that you request to discontinue any further special ed services.

They didn’t like it, tried to keep the IEP open with modifications, yadda, yadda, but I stood my ground. legally, they can’t force your kid onto a program without your consent, although they try to make you think they can.

My son was diagnosed with ADHD, which I doubt, and placed in Spec Ed about 3 years ago. His school experience has been negative since then. he detests being pulled out for “resources” it was affecting his peer relationships, and basically benefiting the school via funding, and giving the teachers an excuse for not teaching him….”

(We’ve edited comments for focus and readability. There are more interesting comments to read at City Data.Com.)

13. SLP Dismissal / Exits

Briefcase on the counter at the old man's bar in Paris

The “progress-in-the-general-curriculum” eligibility criterion has been in effect since the 1970s but it is never critically reviewed in its application. “In 1980, ASHA [ American Speech-Language Hearing Association ] sought and received clarification on this policy interpretation from the US Department of Education” (Kathleen Whitmire, 2002). Can a stutterer with good academic achievement be denied eligibility? The 1980 answer was no:

” … an interpretation which denies needed service to speech [or language] impaired children who have no problem in academic performance is unreasonably restrictive in effect and inconsistent with the intent of the Act and regulations…The extent of a child’s mastery of the basic skill of effective oral communications is clearly includable within the standard of “educational performance” set by the regulations. Therefore, a speech [or language] impairment necessarily adversely affects educational performance when the communication disorder is judged sufficiently severe to require the provision of speech [-language] pathology services to the child.”

This early interpretation did not anticipate many developments within the IDEA framework. It turned out that special education personnel were over-identifying at-risk children, including non-disabled children. SLPs placed non-disabled minority children with weak language skills. The stigma of placement and the need to dismiss children from special education did not receive much attention in 1980. Something closer to the “strict interpretation” was needed to balance the eligibility process. The “strict interpretation” was liberal with respect to over-placing at-risk children.

Sidewalk artist, Montmartre, Paris.

Liberal use of the impaired-communication criterion actually worked against SLPs. One speculates they stayed too close to clinical criteria and helped over-identify non-disabled children, thereby increasing their caseloads and “burnout.” It also filled in for the lack of general education pre-service programs where some speech-impaired children could receive support without stigmatization.

Educational speech-language pathology can be strengthened by clear understandings of how communication problems impact curriculum performance. Response To Intervention invites SLPs to make more decisions about prevention of academic failure from the point of view of speech and language development.

Advocated here is a broader approach to eligibility management. Each SLP should strive to minimize misidentifications and to exit children promptly. All criteria should be considered in proper balance to prevent needless placements in special education.

12. SLP Dismissal / Exits

Once a child is made eligible for school speech therapy, aggressive use of least restrictive environment (LRE) should begin immediately to move that child toward dismissal. Try to reduce service time, restrictions and workload in an ethical manner from the very beginning.

DROP THE PULL-OUT MODEL

A school speech therapist who does “pull out” treatment 100% of the time is not following the least restrictive environment requirements of IDEA 2004. LRE contexts should be graded so that most children quickly move away from out-of-classroom instruction to consultation, support and dismissal. Combine pull out with consultation. Try collaboration. Use pre-service programs. Tune into the “progress in the general curriculum” criterion as a guidepoint.

IEP teams are more likely to accept an absolute dismissal from special education when intervention is graded away from direct service, including homework assignments and teacher consultation. More data are then available to justify dismissal.

CASE MANAGEMENT MODEL

The direct service model should be replaced by a case-management model. It gives emphasis to exit strategies using a variety of methods and contexts in a progressive and flexible manner. It lets the school speech therapist use time creatively to find relevant interventions as the child advances.

A case management approach can start with a cover statement in the IEP as to service requirements:

Service — “Minimum 50 minutes per month: goal performance assessment, direct training, teacher consultation, progress review, homework, pre-service programming.”

The cover statement does not jettison direct intervention for a few children who need a jump start. But it does allow time for intelligent re-assessment and review. It reduces the go-go stress of the weekly direct service schedule.

“Justification,” you ask?

IDEA 2004 states there must be annual goals for progress in the general curriculum, and the child must demonstrate progress yearly. It does not say — HOW? –that progress should be achieved. Pull out intervention is only one technique. Pushing a child properly into general education pre-intervention programming is another. Sending out homework assignments is another.

“When developing the intervention plan, the team should take into consideration the full spectrum of service delivery options when deciding which options are appropriate for meeting the individual needs of the child. It may be appropriate to provide a mix of options, e.g., classroom-based, individual pull-out, and consultation, to help the child establish basic speech-language skills, examine attitudes and beliefs, and apply skills in various contexts. In addition, these options should be reviewed and changed over time as needed, as the child’s needs change” (Kathleen Whitmire, SLP).

Here is an example of the caseload approach:

A 4th grade child with a neglected moderate hearing loss was supposed to receive pull out treatment for speech reading and articulation. The SLP recommended audiological assessment for possible hearing-aid use. The school secretary, principal, mother and teacher thought later there had been some kind of miracle. With aids the boy was immediately able to follow everything in his class perfectly. He was bright and had trained himself to speech read without instruction. Direct service was dropped and teacher consultation was initiated to enhance classroom support. The boy no longer had to be pulled out of class in front of the other children, and he was very much aware of their looks. His direct service time was reduced and the SLP was free to do other things. Everybody won!

CHANGING ROLE

“Isn’t pull out the best model,” you ask?

In 2008, Cirrin and Gillam published a review article suggesting there is no evidence of pull-out’s superiority over other service delivery methods. What’s more, there was no data showing that a particular number of direct sessions per week is optimal (Cirrin, F. M., & Gillam, R. B., Language intervention practices for school-age children with spoken language disorders: A systematic review. Language, Speech, and Hearing Services in Schools, 39, 110-137, 2008). This opens the door to flexible management.

With the changing role of the school speech-language pathologist in the U. S., a case-management model is just better for doing all the things an SLP has to do. It might be true that evidence-based, preschool programs, in which SLP participate collaboratively, might well reduce overidentifications, cut down on needless direct service, be more effective, increase communication with teachers, limit LRE constraints, and reduce workload, all at the same time. There is no need for dismissals when at-risk children are never placed in special education in the first place.

Are you open to it?