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TWO REVIEWS FOR SLPs: Response To Intervention

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1 TWO REVIEWS FOR SLPs: Response To Intervention
Shelly Wier, MS, CCC-SLP Consultant for School-Based Speech-Language Pathology Easter Seals Outreach Program

2 Response To Intervention
Definitions State’s Basic Structure SLP’s Role INTRODUCTION First, we will review those few definitions we skipped this morning. Then we’ll review the basic structure for Arkansas’ Closing the Achievement Gap Model (CTAG), of which EIS and RTI are components, and our role within it, including potential responsibilities, interventions and resources to consider, budgeting time and monies, and the benefits and challenges of RTI. I encourage those of you who are already involved in some fashion to share your experiences so far, or plans you may have for next year.

3 Definitions (2.00) Data-Based Problem Solving and Functional Assessment Early Intervening Services Early Intervening Services Activities Response To Intervention Scientifically Based Research DATA-BASED PROBLEM-SOLVING AND FUNCTIONAL ASSESSMENT Data-based Problem-Solving is a systematic process based on the scientific method that can be used (a) to make decisions about the effectiveness of instructional programs, (b) to identify the need for and specify the focus areas for academic and/or behavioral interventions, and (c) to formatively and summatively evaluate intervention goals and outcomes. Data-based Problem-Solving has four primary steps: 1) Problem Identification and Description, 2) Problem Analysis and Functional Assessment, 3) Intervention Development and Implementation, and 4) Formative and Summative Evaluation. Functional Assessment, which occurs within the context of Data-based Problem-Solving, involves (a) the review of existing records and other sources of information, (b) diagnostic and historical interviews, (c) structured academic or behavioral observations, and (d) authentic, criterion-referenced, or norm-referenced tests. The goal of Functional Assessment is to determine why a specific problem or situation is occurring so that a strategic intervention can be directly linked to the assessment and solve or resolve the problem. Relationship to Response-to-Intervention: Response-to-Intervention is an inherent part of the Data-based Problem-Solving process in that, when a strategic intervention is implemented with a student, evaluation procedures must be in place to determine how well the student "responded to the intervention". Given a positive response, the intervention will either be maintained or faded out over time. Given a negative response, analysis must determine if the intervention was improperly selected, implemented, or evaluated; or if, simply, more time to allow the intervention to be successful is needed. EARLY INTERVENING SERVICES Early intervening services means coordinated, early intervening services, which may include interagency financing structures for students in kindergarten through grade 12 (with a particular emphasis on students in kindergarten through grade three) who are not currently identified as needing special education or related services, but who need additional academic and behavioral support to succeed in a general education environment.

Means activities implemented and coordinated by an LEA that include – Professional development (which may be provided by entities other than LEAs) for teachers and other school staff to enable such personnel to deliver scientifically based academic and behavioral interventions, including scientifically based literacy instruction, and where appropriate, instruction on the use of adaptive and instructional software; and Providing educational and behavioral evaluations, services, and supports including scientifically based literacy instruction. RESPONSE TO INTERVENTION (RtI) Response to intervention is the practice of (1) providing high quality instruction/intervention matched to student needs and (2) using learning rate over time and level of performance to (3) make important educational decisions. SCIENTIFICALLY BASED RESEARCH Section 9101 (37) of the federal Elementary and Secondary Education Act, as amended by the No Child Left Behind Act, defines scientifically based research as "research that involves the application of rigorous, systematic, and objective procedures to obtain reliable and valid knowledge relevant to education activities and programs." The statute then explains that this kind of research: 1) Employs systematic, empirical methods that draw on observation or experiment; 2) Involves rigorous data analyses that are adequate to test the stated hypotheses and justify the general conclusions drawn; 3) Relies on measurements or observational methods that provide reliable and valid data across evaluators and observers, across multiple measurements and observations, and across studies by the same or different investigators; 4) Is evaluated using experimental or quasi-experimental designs in which individuals, entities, programs, or activities are assigned to different conditions and with appropriate controls evaluate the effects of the condition of interest, with a preference for random-assignment, experiments, or other designs to the extent that those designs contain within-condition or across-condition controls; 5) Ensures that experimental studies are presented in sufficient detail and clarity to allow for replication or, at a minimum, offer the opportunity to build systematically on their findings; and (6) Has been accepted by a peer-reviewed journal or approved by a panel of independent experts through a comparably rigorous, objective, scientific review.

Behavior, Discipline, Climate Curriculum, Instruction, and Assessment CORE CURRICULUM Let me start by giving you the Big Picture. This is Arkansas’ overall organizational framework for maximizing student achievement. The training is called CTAG – Closing the Achievement Gap. Obviously, this entire system is beyond the scope of today’s workshop. We will focus briefly on one piece – [click] the multidimensional model for Academic Instruction and Intervention – because this is where Early Intervening Services and Response To Intervention are part of the system. This multi-dimensional model of academic instruction and intervention is designed to enable students to achieve and is based on the provision of quality instruction. [Within the system, the same multidimensional model is used for behavioral instruction and intervention.] The three tiers (or circles), which you may have previously seen organized in a pyramid, represent prevention of failure (green), strategic intervention (yellow), and intensive needs intervention (red). The concept is based on one core principle: We can effectively . . . Teach all children Intervene early Use a multi-dimensional model of service delivery Use problem-solving methodology Use research-based, scientifically validated interventions/instruction Monitor student progress to inform instruction Use data to make decisions Use assessments for three different purposes: (1) screening; (2) progress monitoring; and (3) diagnostics. S P R I N T Academic Instruction & Intervention Behavioral Instruction & Intervention Parent and Community Outreach Professional Development, Mentoring

6 Multidimensional Model
Universal Interventions All students Preventative Proactive There are three essential components necessary for successful implementation of this piece of the system: Use of a multi-dimensional model, Use of a problem-solving method, and An integrated data collection/assessment system Let’s start with the multidimensional model. Green (Tier 1): Universal or Core Instruction Instruction - The first, best intervention against school failure is universal instruction for all students, with differentiation as needed. Quality core instruction at grade level should enable approximately 80% of students to achieve proficiency or advance. Assessment at this level involves screening and progress monitoring. A screening assessment such as the system of Arkansas assessments (Qualls Inventory, ITBS, Benchmark Exams, and EOC) will screen students not meeting proficiency. Our Reading First schools use DIBELS to screen students that may be at risk. A plan of progress monitoring should be in place for periodic checks of “marker variables.” Proactive assessment procedures are best employed at least 3 times per year and are used as a general screening for all students. They typically categorize students as ‘proficient,’ ‘developing,’ and ‘deficient’ in the target skill. Professional Development should be ongoing and related to core classroom instruction. I think one role for the SLP at this tier is in collaborating with and educating colleagues regarding the language foundations necessary, not only for communication, but for literacy and learning, in general. We also need to teach “core educators” to be aware of the impact on students (good or bad) of their own speech and language patterns/habits, and how they can improve their teaching by simplifying, modifying, and/or visually supporting their skills. Another role would involve whole class lessons that could address a variety of wide-spread deficiencies (overidentification), such as phonological awareness or vocabulary development. You would need to determine what the most frequent area of need is and target that. Think “preventative.” Any questions or comments? Targeted Group Interventions Some students (at risk) Group format High efficiency Rapid response Intensive Interventions Individual students Assessment-based High intensity Longer duration

7 Notes Continued Yellow (Tier 2): Targeted or Supplemental Instruction
Instruction - Approximately 20% of students will need targeted interventions in addition to the core instruction to achieve proficiency. Examples of supplemental instruction may include small group work, peer groups, after school or before school tutoring, guided reading, guided writing, etc… A student may enter and exit the additional intervention level as needed for success, based on individual progress monitoring. Intensity . . . Small groups (1:1, 1:3, 1:5, 1:10) 10-12 wks, 3-4 sessions/wk, min/session Scripted, specific intervention Point system for motivation Immediate corrective feedback Mastery before moving on More time on difficult tasks More response opportunities Fewer transitions Setting goals and self-monitoring Assessment at this level involves screening and progress monitoring. Assessment must determine whether remedial efforts are producing the desired improvement in rate of learning. Fuchs (1996) when describing CBM indicated that students achieve the most when . . assessments were conducted twice per week, ambitious goals were set, data were displayed on graphs, and teams used preset data utilization rules in analyzing data. These guidelines can also be useful in choosing practices for Tier 2. Professional Development should be ongoing as well as targeted on supplemental interventions. I think this might be the tier that allows SLPs to provide services to those mild S/L kids that we sometimes can’t serve, like kids with mild 2-3 articulation errors , or ones who don’t quite qualify for SPED, but will in another year or so without help.

8 Notes Continued Red (Tier 3): Intensive Interventions
Instruction - And finally, a fraction of those (20%) students, 3%-5%, may need intensive intervention to accomplish proficiency. 1:1 Reading Recovery is an example. Again, the student may enter and exit the different levels as needed for success, based on progress monitoring. Assessment at this level should include screening, diagnostic testing, and progress monitoring. Assessment must be capable of 1) reliably distinguishing which students are significantly deficient in the target skills as well as 2) determining an individual’s rate of progress. Professional Development should be ongoing, targeted, and specific to student needs. I think it’s difficult right now to distinguish our role at Tier 3 with the direct special education services we currently provide – maybe it’s even difficult at Tier 2. The level of intensity of intervention at these tiers that best RTI practice suggests challenges that which we currently provide. I mean, how can we hope to provide minutes daily to an RTI student or group when we can’t do it for the students on our caseloads who need it. Schools could almost hire a full time SLP just to provide preventative services and intensive G.E. interventions. Special education should be reserved for students who are well below their peers and who 1) have not demonstrated progress when provided effective instructional interventions, or 2) have interventions that improve performance but can’t be maintained within Tier 1 or 2. How are some of you already participating in RTI? Or plan to next year?

9 Problem Solving Model 1. Problem Identification
What is the problem? So, that’s the multidimensional model. Coupled with a problem solving model, here’s how it should work, ideally, within a school . . . If a student is not achieving, the teacher refers?/recommends them to the building’s G.E. problem-solving team, who should employ the following 4-step method: Problem identification: What is the problem? This is a statement based on data. Problems are best defined as a discrepancy between a desired state and what is occurring. Problem Analysis: Why is the problem occurring? When? With whom? How often? These are questions you must ask based on the data. This analysis must focus on instructionally relevant and changeable variables. A multimethod, multi-informant assessment should be completed that results in the development of plausible hypotheses regarding 1) critical skill and performance deficits underlying the identified problem and 2) specific curriculum and instructional recommendations directly linked to the hypotheses that may remediate the problem.” Intervention Design and Implementation: What are we going to do about it? The “we” should be more than the classroom teacher. Once factors contributing to a student’s learning problem are identified, an instructional plan can be developed that: --is based on analysis of the problem, --is goal directed and focused on measurable objectives, --identifies who will do what, when, and how (Tier level), --contains specific methodologies for monitoring the effectiveness of the interventions, --contains all specific forms, documents and personnel support that will be required for implementing the plan, and --fits the resources, values, and skills of the people in the setting. Response To Intervention: Is the intervention working? This is a statement based on data. What response did the student show related to the intervention? Now what do we do? At all levels of the system, the effectiveness of the programs and interventions that are put in place must be evaluated with data. Data-based decision-making is the key tool used by implementers. This step (question) is the key to a self-correcting methodology. Actions taken as part of evaluating the intervention plan include: progress is monitored frequently and repeatedly across time, trends in performance are used to gauge the effectiveness of the supports and interventions, ineffective intervention plans are changed in a timely manner, and intervention plans are modified as appropriate to address emerging needs. 4. Response to Intervention Is the intervention working? What do we do now? 2. Problem Analysis Why is the problem occurring? 3. Intervention Design & Implementation What are we going to do about it?

10 Integrated Assessment
SHOULD . . . Directly assess specific skills in standards Assess “marker variables” that lead to ultimate instructional targets Be sensitive to small amounts of growth Be brief, repeatable, and easy to use Have a direct relationship to instructional decision-making For the model, actually the entire system, to work effectively it is critical that implementing schools have technological systems that help them manage their data. How else are you going to measure “responsiveness?” However, this is more of an administrative issue. There are many systems available that can help with this process, but having one is imperative. Schools will need to consider progress monitoring assessment systems that meet these criteria. Directly assess the specific skills embodied in state and local standards Marker variables: Enough progress in enough time; related to the scope and sequence or goals and objectives; should be curriculum based. Brief, repeatable and easy to use: Administered efficiently over short periods, administered repeatedly (using multiple forms), readily summarized in teacher-friendly data displays, and can be used to make comparisons across students. For example, reading fluency, which is directly related to comprehension, can be easily measured in words correct per minute (wcpm), whereas comprehension itself is measured by complexity of thinking, which is more difficult and lengthy to measure. Have direct relevance to the development of instructional strategies that address the area of need. Now, in addition to assessing students’ performance, the RTI system itself should contain a means of comprehensive assessment to ensure system and treatment fidelity. An infrastructure of support that ensures recommended interventions are provided A means of appraisal of school personnel’s success in providing scientifically validated interventions Essential components of interventions are articulated Appropriate levels of effectiveness (fidelity) are defined Determinations made through direct observation of providers

11 Serving Individual Students
New Roles for SLPs Program Design Collaboration Serving Individual Students SLPs working in districts that choose to implement RTI procedures are uniquely qualified to contribute in a variety of ways to assessment and intervention at many levels, from system wide program design and collaboration to work with individual students. SLPs offer expertise in the language basis of literacy and learning, experience with collaborative approaches to instruction/intervention, and an understanding of the use of student outcomes data when making instructional decisions. Program Design SLPs can be a valuable resource as schools design and implement a variety of RTI models. The following functions are some of the ways in which SLPs can make unique contributions: Explain the role that language plays in curriculum, assessment, and instruction, as a basis for appropriate program design Explain the interconnection between spoken and written language Identify and analyze existing literature on scientifically based literacy assessment and intervention approaches Assist in the selection of screening measures Help identify systemic patterns of student need with respect to language skills Assist in the selection of scientifically based literacy intervention Plan for and conduct professional development on the language basis of literacy and learning Interpret a school's progress in meeting the intervention needs of its students Collaboration SLPs have a long history of working collaboratively with families, teachers, administrators, and other special service providers. SLPs play critical roles in collaboration around RTI efforts, including the following: Assisting general education classroom teachers with universal screening Participating in the development and implementation of progress monitoring systems and the analysis of student outcomes Serving as members of intervention assistance teams, utilizing their expertise in language, its disorders, and treatment Consulting with teachers to meet the needs of students in initial RTI tiers with a specific focus on the relevant language underpinnings of learning and literacy

12 Notes Continued Collaboration cont’
Collaborating with school mental health providers (school psychologists, social workers, and counselors), reading specialists, occupational therapists, physical therapists, learning disabilities specialists, and other specialized instructional support personnel (related/pupil services personnel) in the implementation of RTI models Assisting administrators to make wise decisions about RTI design and implementation, considering the important language variables Working collaboratively with private and community-employed practitioners who may be serving an individual child Interpreting screening and progress assessment results to families Helping families understand the language basis of literacy and learning as well as specific language issues pertinent to an individual child Serving Individual Students SLPs continue to work with individual students, in addition to providing support through RTI activities. These roles and responsibilities include the following: Conducting expanded speech sound error screening for K-3 students to track students at risk and intervene with those who are highly stimulable and may respond to intense short-term interventions during a prolonged screening process rather than being placed in special education Assisting in determining "cut-points" to trigger referral to special education for speech and language disabilities Using norm-referenced, standardized, and informal assessments to determine whether students have speech and language disabilities Determining duration, intensity, and type of service that students with communication disabilities may need Serving students who qualify for special education services under categories of communication disabilities such as speech sound errors (articulation), voice or fluency disorders, hearing loss, traumatic brain injury, and speech and language disabilities concomitant with neurophysiological conditions Collaborating with classroom teachers to provide services and support for students with communication disabilities Identifying, using, and disseminating evidence-based practices for speech and language services or RTI interventions at any tier.

13 New Assessment Roles Shift from traditional, standardized approaches to a more pragmatic, educationally relevant model Shift from a ‘within child’ deficit paradigm to a contextual perspective Greater emphasis on instructional intervention and progress monitoring PRIOR to special education referral Expansion of the SLP’s assessment ‘tool kit’ Additional professional development Expertise in language may be called upon to ‘round out’ the comprehensive profiles of students having problems Speech-language pathologists (SLPs) can play a number of important roles in using RTI to identify children with disabilities and provide needed instruction to struggling students in both general education and special education settings. But these roles will require some fundamental changes in the way SLPs engage in assessment and intervention activities. Regarding assessment, there are challenges to SLPs working in districts that undertake the shift from traditional standardized approaches to a more pragmatic, educationally relevant model focused on measuring changes in individual performance over time. Such challenges include the shift from a "within child" deficit paradigm to a contextual perspective; a greater emphasis on instructional intervention and progress monitoring prior to special education referral; an expansion of the SLP's assessment "tool kit" to include more instructionally relevant, contextually based procedures; and most likely the need for additional professional development in all of the above. In addition, the use of formal evaluation procedures may still be an important component of RTI in many districts. Teams must still conduct relevant, comprehensive evaluations using qualified personnel. SLPs' expertise in language may be called upon to round out comprehensive profiles of students having academic or behavioral difficulties.

14 New Intervention Roles
Incorporate prevention and identification of at-risk students Direct services can be provided to IDEA students, as well as to struggling students, teachers, paraprofessionals, and families Increase indirect services in the form of collaboration and consultation Decrease in time spent on traditional models of intervention (e.g. pull-out therapy) Reallocation of time based on entire workload rather than number of IDEA students served Regarding intervention and instructional support, SLPs must engage in new and expanded roles that incorporate prevention and identification of at-risk students as well as more traditional roles of intervention. Their contribution to the school community can be viewed as expertise that is used through both direct and indirect services to support struggling students, children with disabilities, the teachers and other educators who work with them, and their families. This involves a decrease in time spent on traditional models of intervention (e.g., pull-out therapy) and more time on consultation and classroom-based intervention. It also means allocation and assignment of staff based on time needed for indirect services and support activities, and not based solely on direct services to children with disabilities.

15 Problems to Avoid Screening vs progress monitoring
Lack of scientific basis Inconsistent rule-based decision-making Frequency of data collection Decisions influenced by other factors Focusing on levels of performance Lack of fidelity Confusion between ‘screening’ and ‘progress monitoring’ Lack of scientific basis for interventions (e.g. more of the same) Inconsistent rule-based decision-making (e.g. flexible cut scores) Frequency of data collection for progress monitoring Letting factors other than data to influence decisions Focusing on levels of performance rather than rate of improvement (slope) Lack of fidelity measures for interventions

16 Budgeting (Time & Monies)
A few details Allowable activities FAPE Reporting requirements Significant disproportionality Absent this . . . Many LEAs already have AITs or CSTs in place to provide support for G.E. students experiencing problems. IDEA ’04 now allows for a portion of Part B funds to support such activities. Details No more than 15% of IDEA Part B money; Combine it with other $$$ LEAs develop and implement for students K-12, with emphasis on K-3, who are not identified under IDEA, but who need additional academic and behavioral supports to succeed in general ed environment. Should not be confused with either Section 619 Preschool Grants or Part C Early Intervention Programs Allowable Activities Professional development for staff, which may be provided by other entities, to enable the delivery of scientifically-based academic and behavioral interventions, including literacy and the use of adaptive/instructional software. Must be capacity-building Planned so that new staff can be successfully integrated Continuing/Ongoing Don’t forget to address beliefs and personal theories Evaluations/Screenings: to identify who qualify, to identify areas in need, to monitor progress Services and supports based on these evaluations, including literacy: Scientifically-based instruction, not home-grown practices, [What Works Clearinghouse at These services are not considered a denial or guarantee of entrance into special ed, nor do they include procedural safeguards. Scientifically-based

17 Notes Continued FAPE EIS do not limit or create a right to FAPE under IDEA. Students who receive EIS must be evaluated for IDEA eligibility within the required timelines if they are suspected of having a disability. Reporting requirements Number of children served by EIS Number of children served by EIS who subsequently receive sped and related services under Part B during the preceding two year period. Basically, keep records and follow EIS students for two years to see if they are found eligible for special education later. Significant disproportionality Requires LEAs to revise their identification and placement policies, procedures, and practices Requires LEAs to reserve the maximum amount of funds for EIS, for use particularly with those groups that were overidentified Absent this . . . LEAs decide whether to use IDEA funds for EIS Don’t need approval from the state Districts have flexibility to be creative

18 Let’s Talk Your Questions and (hopefully) Some Answers
[Reference RTI Resources to Consider handout]

19 The foundation for SLPs' involvement in RTI has been established through the profession's policies on literacy, workload, and expanded roles and responsibilities. The opportunities for SLPs working within an RTI framework are extensive. To some, these opportunities may seem overwhelming—where in the workday would there be time to add all of these activities to our current responsibilities? Certainly if the traditional roles continue, it would be difficult to expand into these new roles. The point of RTI, however, is not to add more tasks but to reallocate time to better address prevention and early intervention, and in the long run serve more students up front rather than at the point of special education evaluation and service. Where RTI has been faithfully implemented, this seems to be the outcome. Some districts report reductions in special education referral and placement; even where placement rates have remained stable, staff nevertheless report a change in the way they spend their time. The reallocation of effort will hopefully lead to more effective interventions, both for students who remain in general education and those who ultimately qualify for more intensive services. Successful RTI programs rely on the leadership of a strong principal or designated leader who has budgetary power and the ability to bring all educators to the same table to share professional development, children, time, space, money, and curriculum resources. The sharing of resources is sometimes a stumbling block, yet strong leaders can overcome these barriers by keeping the focus on the children being helped. SLPs can begin the RTI process by sharing with principals the benefits of an RTI approach and the support offered through IDEA, including the incentive that 15% of a school's special education funds can be used to launch the RTI process.

20 To meet this challenge, SLPs will need to be:
open to change—change in how students are identified for intervention; how interventions are selected, designed, and implemented; how student performance is measured and evaluated; how evaluations are conducted; and how decisions are made; open to professional development—training (as needed) in evidence-based intervention approaches, progress monitoring methods, evaluation of instructional and program outcomes, and contextually based assessment procedures, and the implications for both preservice and in-service training; willing to adapt a more systemic approach to serving schools, including a workload that reflects less traditional service delivery and more consultation and collaboration in general education classrooms; willing and able to communicate their worth to administrators and policymakers—to educate others on the unique contributions that SLPs can make consistent with the provisions of IDEA '04. IDEA '04 does not mandate significant change or prohibit traditional practices. Rather, it encourages the adoption of new approaches that promise better student outcomes. Such innovations in education offer numerous opportunities to enhance speech-language services to the benefit of all students.

21 Please complete your workshop evaluation before leaving.
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