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Michigan Speech-Language Guidelines Suggestions for Eligibility,Service Delivery,&Exit Criteria Revised Maureen Staskowski,Ph.D.,CCC-SLP March 9,2007 Available at www.michiganspeechhearing.org1AcknowledgementsThank you to the many professionals and their school districts responsible for this documentWith Special thanks to Dr.Lizbeth StevensKeisha Nolan Karen Graham Terry Lange-Winkel Kendall Giovannini Lana Budde Tina Kunarski Jan McCosky Heather WebberYvonne Belleman Andrea Phillips 2MSHA Staskowski 2007Belinda Andrews Deborah BeelerGeorgia BoyleMichele Bridges Robin BrightonDarlene BroomeKathleen Bungart Beth Burkhard YearyMary Lee Campbell Laurie CapoferiSheila Carrier-WoodsAngela Ciraulo Joan Cortright Gail CuriCandy Cutt Susan DilgardAmy DinnoGail Elliott Kelly Falter Laura Griffith Marybeth Grosfield Katy HimeAnne Howard Cathryn KelenskeIlene KlegonMary Ann Knittel Jill KonwinskiAlicia Li Judy Lytwynec Dara Ludeus Lynn MarshallShirley MatuszewskiMary McAuliffeCarrie McCarter-BarnesArlene MillmanStephanie NagyNickola W.NelsonKimberly RenshawSue Rosko,Susan SwarzMegan ShuboySally Shumway Susan SmithGail SpeiwakMaureen KeatingGail SterlingCarol Washchuk Katy WestAlesia Williams Jane WitkopAlex JohnsonJohanna Bauer Sandra Ponzetti Yvette Hyter Kelly Cosguff Colin Macpherson Annett Lauria Diane Shovan Elizabeth Semple Marianne Fish Julie Angeli Eileen Presnell Deanna DeVlaminck Rae Mendell Susan HardinKaren SabudaKathleen Juhl Lisa Boike Nancy GaranKatie Flannery Mary Towler Lee Timer Thank You to the many professionals&their school districts responsible for this document3MSHA Staskowski 2007The PurposeResource for SLPs and administratorsFacilitate discussion related to practices and proceduresTo informIt is NOT meant toProvide policy or mandatory proceduresSupersede district policy4MSHA Staskowski 20071992Last version released1995Addendum for Standards for Delivery 2006Reorganization Updates5MSHA Staskowski 2007Why Revise?Changes in Federal Laws&Regulations Changes in State Rules and RegulationsChanges in Field&Professional UnderstandingChanges in PopulationChanges in Practice6MSHA Staskowski 2007The Guidelines:OutlinePreliminary SectionsSLI as Primary DisabilitySLI as a Related Service Special Issues7MSHA Staskowski 2007Preliminary SectionsForward School Practice&ProfessionalismWorkload Approach to CaseloadCulturally and Linguistically Diverse8MSHA Staskowski 2007ProfessionalismASHA and MSHA Code of EthicsIndividuals shall honor their responsibility toHold paramount the welfare of persons they serve professionallyAchieve and maintain the highest level of professional competencePromote public understanding of the professionsMaintain harmonious interprofessional and intraprofessional relationships and accept the professions self-imposed standards9MSHA Staskowski 2007ProfessionalismYou show up You show up on timeYou show up prepared You show up in the frame of mind appropriate to the taskYou accept directions(including correction)from those who are more knowledgeable or more experienced You provide direction(including correction)to those who are less knowledgeable or less experiencedYou vigorously seek and tell the truth even those truths that may be less than flattering to you.P-310MSHA Staskowski 2007Feeling Frantic?How can we do all that is expected?Are your practices from the 21st century but your schedule from the 20th century?Many others feeling the same way have found a better way.11MSHA Staskowski 2007The Workload Approach to Caseload12MSHA Staskowski 2007SLP Workload Activity ClustersDirect services to students Indirect services that support students educational programsIndirect activities that support students in LRE/general education curriculumActivities that support compliance with federal/state/local mandates13MSHA Staskowski 2007Workload ActivitiesWC-514MSHA Staskowski 2007This approach takes into account Enrollment of a student into direct intervention,regardless of service delivery options,will add to the workload in other clusters of activity.(Estomin,1/2005)15MSHA Staskowski 200716MSHA Staskowski 2007Examples of Flexible SchedulingFlexible Monthly Schedule4 week scheduleAllows for blocks of time for intensive treatmentExpands the“A-B”approach used in many highschools3:1 Model Three Weeks direct service:One week IndirectOregon implementationSLP job satisfactionIntegration with general educationLess cancellations(and more make-ups)More direct therapy timeMore third-party billingBlock Scheduling17MSHA Staskowski 2007 SLI as a Primary DisabilityLanguageArticulationFluencyVoicePreventionIdentificationAssessmentInterventionDismissalSchool-age StudentsAdolescentsPreschool StudentsInfants and Toddlers18MSHA Staskowski 2007Early Intervening/Response to Intervention for SLIL-719MSHA Staskowski 2007Sample form for documenting early intervening servicesArticulationLanguageVoiceFluencyLearning Disabilities20MSHA Staskowski 2007Language Assessment21MSHA Staskowski 2007Michigan Rule 1710Rule 340.1710 of the Michigan Special Education code provides the following definition of a speech and language impairment:Subrule(1)A“speech and language impairment”means a communication disorder that adversely affects educational performance,such as a language impairment,articulation impairment,fluency impairment,or voice impairment.22MSHA Staskowski 2007Eligibility Guide/Team SummaryLanguageArticulationVoiceFluencyAssessment ActivitiesL-823MSHA Staskowski 2007InputTeacher L-13Parent L-15Student L16/17Use interview or other techniques to Define/explore the presenting problemDetermine the aspects of the curriculum/school performance affected Review MLPP,MEAP,teacher assessments,medical reports,private therapists.Review of Pertinent Information24MSHA Staskowski 2007Consideration of Cultural and Linguistic DifferencesEnvironmental and Economic Differences L-1825MSHA Staskowski 2007Curriculum-Based Language Assessment26MSHA Staskowski 2007Curriculum-Based Language AssessmentGuiding questions:What language skills are needed for successful participation in this part of the curriculum?What does the student usually do when attempting this task?What language skills and strategies might the student acquire to become more successful?How should the task be modified?(Nelson,1989;Nelson,1998)L-1927MSHA Staskowski 2007CBLA Examples page L-20A teacher reports that student has difficulty understanding the classroom discussion and the textbook.Together,you have agreed that these difficulties would most likely be observed during social studies.The SLP decides to observe a classroom discussion and group assignment,then to take the student to the therapy room and discuss what went on.The SLP helps the student by showing the student how to use imagery and questioning as they discuss the content and complete the assignment.A teacher reports that a students language is confusing and hard to follow(disorganized discourse).Together,you have agreed that these difficulties would most likely be observed during a story retelling task.The teacher described how they typically do retellings and the SLP simply brought the task to the therapy room.The task is completed with no help,then varying degrees of help.In some instances,the SLP may add the student to a language intervention group working on something similar.The teacher reports that a student has difficulty following oral and written directions.Together you have agreed that these difficulties would most likely be observed during a science lab project.This could be an observation in the classroom followed by a brief retell of instructions outside the classroom,or the SLP may decide to review oral and/or written directions for a home science project in the therapy room.A teacher reports that a student has difficulty with pragmatics.Together,you have agreed that these difficulties would most likely be observed when the student is participating in cooperative groups for science experiments.This could be an observation in the classroom followed by a brief retell of instructions outside the classroom or in the therapy room.28MSHA Staskowski 2007Tools for YouCBLA Language Assessment and SummaryReading Assessment and SummaryWriting Assessment and SummaryL-35-4029MSHA Staskowski 2007Record Results of RTIorDynamic AssessmentTry out language strategies or skills that might help the student access the curriculumHow does the student respond to intervention?Single or multiple sessionsIn the classroom,in a group,or aloneSLP or other team members30MSHA Staskowski 2007Collect oral and written samples and consider comprehension&expression of oral/written language Language SamplesOral and written Portfolio Probes AssessmentL-41-45L-23-2431MSHA Staskowski 2007Methods for Collecting Language SamplingReceptiveDirection TasksMain Idea TasksDetails,Inference and Synthesis Tasks,or Comprehension Strategy ProbesThink Alouds Questioning HierarchiesComprehension/Retelling(MLPP)EvaluationAnalysis/Analysis Tools/ChecklistsReading Miscue Analysis of Children with Suspected Listening Difficulties Teacher Checklist for Listening Early Identification of Language Based Reading Disabilities A Checklist Language Speech and Hearing Services in SchoolsEXPRESSIVE LANGUAGE-Speaking and Writing Probes/Sample TypesNarrative Curriculum based retelling task grades 1-8 Childrens Narrative Developmental Stages and Strategies Oral Language(MLPP)Expositive Compare/Contrast,Sequence,Question/Answer,Problem/Solution,Cause/Effect,Persuasion,Description,or Explanation 32MSHA Staskowski 2007Test ProfileNot the first activityBased on the information collected so farSelected carefully for purpose and the population Multiple assessments-doesnt mean multiple tests Compared to IQ not sole criterion33MSHA Staskowski 2007Tests and IQ34MSHA Staskowski 2007Why not compare solely to IQ?(Cognitive Reference)Students with commensurate language and IQ scores wont benefit from language therapy.IQ scores are stable.There are nonverbal IQ measuresMany question whether any measure is truly language free Based on faulty assumptions Research has shown that they do benefit.IQ scores actually fluctuate across tests and within the same tests over time.Consequently,discrepancies are unstable35MSHA Staskowski 2007Problems with cut-off scoresIntent-appropriately identify student as disabledAvoid over-identification or under-identificationIdentifies unevenly across tests No cut-off in Michigan Rules or IDEAPractice in Michigan using 11/3SD arbitraryCut-off scores may be different across tests(Plante,2003)36MSHA Staskowski 2007Test GuidelinesKnowing there is not a specific requirement for standard deviations from the mean in regulations or law,districts may develop their own practices.An overwhelming number of reviewers(SLPs and administrators)wanted specific guidelinesThe committee suggests that continuing to use 1 1/3 SD as onecontributing factor to the overallassessment is reasonable.(unless there is evidence that the cut-off should be greater for that test)37MSHA Staskowski 2007The lesson in all of this.Tests alone are not reliable means of identifying students with communication disabilities that adversely affect school performance.38MSHA Staskowski 2007Acceptable levels of sensitivity&specificity levels by Clinical Evaluation of Language Fundamentals4 CELF-4)Clinical Evaluation of Language Fundamentals-Preschool 2(CELF-P 2)Preschool Language Scales 4(PLS-4)Structured Photographic Elicitation Language Test Preschool(SPELT-P)Test for Expressive Morphology(TEEM)Test of Language Competence-Expanded(TLC-E)Test of Narrative Language(TNL)Test of Early Grammatical Impairment(TEGI)(Spaulding,Plante,&Farinella,2006)39MSHA Staskowski 2007Form Impressions regardingPresence of a DisabilityAdverse affect of Disability on Educational Performance40MSHA Staskowski 2007Language Intervention41MSHA Staskowski 2007Goal SettingFrom the authentic assessmentsSelected as a team Related to helping the student access the curriculumReference Michigan Curriculum Framework or Grade Level Expectations(Reading/Math)Annual goal-12 months,STO/outcomes steps to measure progress toward that annual goal42MSHA Staskowski 2007L-4743MSHA Staskowski 200744MSHA Staskowski 2007Curriculum Relevant InterventionGoal MonitoringTeam responsibility Addressing GoalsNoting progress Service delivery fits the goal/strategiesProgress data analyzedIntervention approach adjustedTeam considers next steps45MSHA Staskowski 2007So.what has changed?46MSHA Staskowski 2007Culturally Linguistic Diverse PopulationsMichigan GuidelinesKaren Graham LAnse Creuse 47Cultural Competence of the SLPThe awareness of the SLPs own cultural values and standards which could impact the assessment and intervention process.It is necessary to understand the history and social customs of the students culture.Self Assessment for Cultural Competence.Got It?ASHA web site.www.asha.org/about/leadership-projects/multicultural/Graham,200648BICS and CALPSBasic Interpersonal Communication skillsDevelops informally through conversations and social interactionsCognitive Academic Language ProficiencyDevelops through organized instruction of literacy skills in school settings.Graham,200649Second Language AcquisitionConversational skills often approach native proficiency with about two years of exposure to English.Academic proficiency may require five or more years to reach proficiency levels.Graham,200650BidialectalStudents who use dialect of English other than SAE are called Bidialectal.Example:Southern Dialects of EnglishStudents can be dialectal in other languages as well.Graham,200651Use of interpretersInterpreters can be used throughout the pre-referral and assessment process.Should be fluent in both oral and written modalities of the student.Facilitators of language between the parents/caregivers and the SLP.Graham,200652Interpreters Discuss roles and responsibilitiesReview key concepts,phrases,words,and proceduresRemind the interpreter that he/she must not alter,omit,or add to the communication.Ask the interpreter if specific words/concepts are not translatable.Ask about cultural considerationsGraham,200653Team SummaryCLDReferral DecisionSimilar FormatLDCIAdd Service DecisionGraham,200654MSHA Staskowski 2007Guide Team SummariesInput ObservationsCurriculumClassroom modificationsDynamic AssessmentReferralOther ConsiderationsGraham,200655AssessmentNonstandardized approaches should be the primary method of gathering information.Standardized testing-consult the examiners manual for interpretations of respondsGraham,200656Language DominanceIt is important to determine the dominant languageBilingual English ProficientLimited English ProficientLimited in Both LanguagesGraham,200657Extended Case History Language developmentStudents residencyCultural beliefsLanguage dominanceExposure to primary and secondary languageStudents academic historyGraham,200658Language SamplesObtain language samples in both languagesObtain language samples across settingsObtain language samples with multiple partnersLook at multiple formatsCurriculum Based Language AssessmentsGraham,200659Test Selection and UseLook at the normative sample of test.Does it adequately represent the students culture?Does the student have some familiarity with the language of the test?Does the student have some familiarity with situations presented in the test?Is the vocabulary geographical or cultural specific?Does the test display a potential for bias?Graham,200660Test ModificationTest modification is an alternative way of assessing skills of a CLD student.It can involve addition,deletion or modification of test itemsBeware:Violation of test reliability,and validity.Reword instructions,allow extra time for responsesIncrease the number of practice itemsTest beyond the ceilingAsk for explanation of incorrect responses.Dynamic assessmentGraham,200661Intervention Bilingual Speech and Language PathologistMost studies recommend early intervention in the students native languageProvide a cultural linguistic framework to facilitate language skillsIn service trainingConsultativeTraining ESL staff to facilitate language skills in the classroomGraham,200662Web Siteswww.readingrockets.org Look under web castsDifferentiated Reading InstructionFrom Babbling to BooksAssessment of English Language LearnersEnglish Language Learners in Middle and High SchoolComprehension:Helping English Language Learners Grasp the Full PictureASHAs web site under Multicultural issuesGraham,200663Articulation64MSHA Staskowski 2007Articulation:Special IssuesLateral LispIntelligibilitySingle Sound Errors65MSHA Staskowski 2007Development Sounds Charts:The ChallengesControversyType of research 50%versus 90%Two sets of well-respected dataWhat to do?66MSHA Staskowski 2007Articulation Team Summary67MSHA Staskowski 200768MSHA Staskowski 200769MSHA Staskowski 200770MSHA Staskowski 2007What is Adverse Effecton Educational PerformanceAcademic and nonacademic performance.Letters from Department of EducationIDEA-Curriculum is AcademicNonacademicExtracurricular71MSHA Staskowski 2007Fluency72MSHA Staskowski 2007Whats NewRisk FactorsCluttering InventoryTeasing and BullyingParent Handout73MSHA Staskowski 2007Voice74MSHA Staskowski 2007SLI as a Related Service75MSHA Staskowski 2007SLI as a Related ServiceSpeech and Language Services for Students with other Primary DisabilitiesAutism Spectrum DisordersCognitively ImpairedEarly Childhood Dev.Physically ImpairedOtherwise Health ImpairedLearning DisabledSeverely Multiply ImpairedEmotionally Impaired Traumatically Brain InjuredHearing ImpairedVisually Impaired76MSHA Staskowski 2007Michigan Special Education CodeRule 340.1710 Subrule(4)Students who have a communication disorder,but whose primary disability is other then speech and language may be eligible for services under R.340.1745(a).Rule 340.1745(a)The speech and language services provided by an authorized provider of speech and language services shall be based on the needs of a student with a disability as determined by an individualized education program team after reviewing a diagnostic report provided by an authorized provider of speech and language77MSHA Staskowski 2007Considerations for Related ServicesEligibility under primary impairment.Diagnostic report documents need for service Standardized test scores are not requiredAllows for fluid service provision for students who need changing amounts of speech and language support throughout school career78MSHA Staskowski 2007Learning DisabilitiesNew lawsWhat the student needs who does what?Page LD1379MSHA Staskowski 2007Cognitive ImpairmentsTeam Summary Guide80MSHA Staskowski 2007Common IssuesTransitionsIntelligibilityAACCBI/Vocational InstructionBehavior81MSHA Staskowski 2007Traumatic Brain Injury 82MSHA Staskowski 2007Hearing ImpairedAuditory ProcessingSIFTER83MSHA Staskowski 2007ECDD84MSHA Staskowski 2007Special IssuesAuditory ProcessingAssistive TechnologyFeeding and SwallowingSelective Mutism85MSHA Staskowski 2007Thank You!86MSHA Staskowski 2007
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