WVDE State Update Speech-language Pathology Services in WV Schools

WVDE State Update 2011 Speech-language Pathology Services in WV Schools
WVSHA ANNUAL Convention March 31, 2011 Kathy Knighton, Program Coordinator Office of Special Programs West Virginia Department of Education

AGENDA West Virginia Department of Education WVDE Update
Office of Special Programs (OSP) WVDE Update OSP Update WV School Data Report Upcoming Events “Hot” Topics Review of SLP Best Practices Guidance Document Next Steps

West Virginia Department of Education
Dr. Jorea Marple, State Superintendent of Schools Dr. Jack McClanahan, Deputy Superintendent Robert Hull, Assistant State Superintendent Division of Curriculum and Instruction Pat Homberg, Executive Director Office of Special Programs Dr. Sandra McQuain , Assistant Director Financial and Data Issues Phyllis Veith, Assistant Director Literacy Initiatives Ghaski Browning, Assistant Director Special Education - Monitoring and Compliance

Office of Special Programs (OSP) Staff
Annette Carey, Ruth Ann King Vision, Hearing & Deafblind Frances Clark PBS, Autism, Behavior Ginger Huffman, Preschool Mary Pat Farrell, MI, Co-teaching Lanai Jennings, Data Manager Linda Palenchar, RTI/LD Betsy Peterson, Parent Coordinator Vicki Mohnacky, Medicaid Ellen Oderman , SIG Karen Ruddle, Transition Allen Sexton, Online IEP Valerie Wilson, Technology RTI Specialists Complaint Managers Lorraine Elswick Kathy Hudnall Monitors Debbie Ashwell Susan Beck Matt Dotson Anne Monterosso

WVDE/OSP UPDATES WVDE/OSP WEBSITE: http://wvde.state.wv.us/osp
OSEP Federal Monitoring Response to Intervention (RTI) Statewide Training/Middle/High School Parent Flyer RTI SPECIALISTS ECPBS (Early Childhood Positive Behavior Supports) Francie Clark/Ginger Huffman On-line IEP Form -Allen Sexton Visual Phonics –Annette Carey Communication Matrix Training Alternate Identification and Reporting (AIR) Project Demonstration and evaluation of IDEA entitlements without disability labels

WVDE/OSP UPDATES Autism Focus
WV Autism Collaborative Community of Practice WVDE, Autism Training Center, Marshall Graduate College, WVU Develop guidance for LEA personnel serving students with Autism Spectrum Disorder (ASD) Provide decision making guidance that incorporates current research Outcomes Training to administer the Autism Diagnostic Observation Schedule (ADOS), the definitive assessment instrument for ASD Best Practice Document Provide professional Development to counties Autism Academies (on-going) School Outreach Trainer (Autism Center) Expand web based resources

WVDE School Data Report
WV DATA ANALYSIS ( ) 12/1 IDEA CHILD COUNT WV Total School Enrollment ,130 Students with Disabilities , % Preschool Special Needs , % Specific Learning Disabilities , % Speech/Language Impairments 14, % (unduplicated) Autism , % Behavior Disorders Other Health Impaired % PERSONNEL SLPS/ 29 Speech Assistants NATIONAL BOARD CERTIFICTION Totals: SLPs – 307 Audiologists – 8 Scottie Ford, Office of Personnel Preparation

UPCOMING EVENTS ASHA Conferences
2011 Schools Conference: July 8–10 National Harbor, Maryland Annual Convention: November 17–19, 2011 San Diego, California CAMP GIZMO : July 9-14, 2011 WV Schools For Deaf/Blind - Romney, WV WVDE Phonemic Awareness Project Refresher Training August 2011 WV Technology Conference August 2-4, 2011 Morgantown Waterfront Hotel 2011 Celebrating Connections: Feb Charleston Civic Center

“HOT TOPICS” Critical Personnel Shortage Cost of Contracted Services
Over Identification of SLI Students Articulation Universal PreK Expanded Preschool Population Low Dismissal Rates Ineffective Scheduling Inconsistent Program Implementation Role of SLP in Literacy Initiatives On-line IEP and Speech Related Services on Speech-only IEPs Increase in Autism Population Assistive Technology Funding Training Medicaid CEUs HealthCheck

Office of Special Programs West Virginia Department of Education
Speech-language Pathology: Services in WV Schools Guidelines for Best Practice Kathy Knighton Office of Special Programs West Virginia Department of Education

PURPOSE SLP RESOURCE Clarify State/federal regulations Reflect Best Practice Improve Consistency Assist SLPs, special education directors and school administrators: Facilitate speech-language services in their schools Improve outcomes for SLI students Special education practices and procedures for students receiving speech/language services are explained and clarified. Reference for SLPs/administrators regarding the delivery of services to students with speech-language impairments and the role of the SLP.

SLP WORK GROUP MEMBERS Alice Akers – Logan County
Tondra Elkins – Mingo County Marsha Fink – Raleigh County Lisa Jackson – WVSHA / Raleigh County Nancy Laughlin – Marion County Cheryl Prichard – WVU Bernadette Rush – Harrison County Kerynn Sovic – Jackson County Anna Smith – Putnam County Janet Stone – Monongalia County Terri Stark – Cabell County Thanks to Virginia Department of Education for allowing WV to use their resources from their guidance document.

CONSIDERATIONS FORMAT CONTENT RESOURCES
Summary Recommendation of Speech Forums State Guidance Documents CONTENT Reflect best practice User-friendly Comprehensive, but not overwhelming WV Specific Issues RESOURCES ASHA Resources Web-based resources National/state resources The speech forums were held several years ago – one in the north and one in the south. SLPs from throughout the state participated. Their recommendations formed the foundation for this document.

TABLE OF CONTENTS ACKNOWLEGEMENTS FOREWORD INTRODUCTION
FEDERAL/STATE REGULATIONS IDEA Policy 2419 ROLE OF THE SLP Responsibilities Not Within the Role WV SPECIAL EDUCATION PROCESS: SPEECH-LANGUAGE Identification and Referral Evaluation/Reevaluation Eligibility Individualized Education Program Service Delivery Scheduling

TABLE OF CONTENTS……… MANAGEMENT OF SPECIAL POPULATIONS
Auditory Processing Disorder (APD) Autism Childhood Apraxia Cochlear Implant Deaf/ Hard of Hearing Dysphagia English Language Learners PROGRAM IMLEMENTATION Assistive Technology WV Early Childhood Education Literacy Response to Intervention Medicaid Section 504

TABLE OF CONTENTS….. PROGRAM IMPLEMENTATION REFERENCES APPENDICES
Personnel National Board Certification Use of Speech Assistants Coordination: School Based Programs Facilities REFERENCES APPENDICES Glossary/Acronyms/Online Resources Multi-tiered Model for Speech/Language Services WV Policy 2419 Eligibility Criteria Examples of Severity Rating Scales

FEDERAL/STATE REGULATIONS
Individual with Disabilities Act (IDEA) Federal special education legislation Entitlement for SWD Free appropriate public education (FAPE) Framework for the special education process to provide FAPE Provides federal funding to states for special education WV State Board Policy 2419: Regulations for the Education of Students with Exceptionalities in WV State special education policy Ages 3-21 and gifted students Speech-language Impaired The document incorporates both federal and state regulations. SLPs should be familiar with these regulations as they apply to speech-language students.

ROLE OF THE SLP IN SCHOOLS
GOAL: Maximize the potential of students as communicators within the educational environment. Changing Roles/Responsibilities Emphasize SLPs work with parents, teachers, administrators and others Despite the changing roles/responsibilities of the SLP throughout the years, improving the communication abilities of students has remained their primary purpose. SLPs work with parents, teachers, administrators and others to assess and treat students with communication disorders as they become 21st Century learners, problem-solvers and decision-makers. The school-based SLPs’ goal is to maximize the potential of their students as communicators within the educational environment and includes the following: A student–centered focus drives team decision-making Comprehensive assessment and thorough evaluation provide information for appropriate eligibility, intervention and dismissal decisions. Intervention focuses on the student’s abilities, rather than disabilities. Intervention plans are consistent with current research and practice. (ASHA, 2000)

ROLES/RESPONSIBLITIES: SLP
Identification of speech and/or language problems Screening, appraisal and diagnosis Refer for medical or other professional attention Provisions of speech and/or language services for the prevention of communication impairments Counseling and guidance for parents, children, and teachers regarding speech and/or language impairments. Participate in the county Child Find system Participate in SAT teams Administer State Assessments Participate in eligibility, evaluation and IEP Teams Intervention with students with communication disabilities Caseload management (scheduling, grouping, service delivery) Facilitate implementation of assistive technology Documentation Participate in Faculty Senate and other school groups Supervision of speech assistants Ongoing professional development Maintain professional certification Appropriate intervention in literacy models (RTI) List developed from a variety of resources: IDEA Policy 2419 ASHA

RESPONSIBILITIES NOT WITHIN ROLE OF SLP
Substitute teaching in the general /special education classroom. Teaching English to ESL/ELL students. Primary provider in reading intervention. SLPs are not credentialed as reading teachers but should participate in appropriate literacy interventions as expertise and experience dictates. Primary provider for students with selective mutism (does not preclude collaborative efforts). Provide speech therapy for students who are homeschooled unless determined by school district. SLPs may be assigned school duties/responsibilities as needed duties should not conflict with IEP implementation or professional responsibilities. This list was developed based on questions, concerns , issues that are routinely posed by SLPs, school administrators, teachers and parents.

WV SPECIAL EDUCATION PROCESS
Outlines the special education process and requirements in West Virginia Focus on the provision of services to students with speech-language disorders Specific implementation practices may differ in county school districts

IDENTIFICATION: SCREENING
CHILD FIND Locate, identify , evaluate SWD ages 3-21 Coordinate w/ WV Birth to Three Programs for children ages birth to three years SCREENING (Policy 2419 / WV State Code § ) Annual screenings: vision, hearing, speech and language Students entering preschool/kindergarten/WV public/private schools Developmental screening upon request of a parent or guardian 30 days of the written request Children identified through the screening referred for further evaluation. PUBLIC NOTICE REQUIREMENT 10 days prior to initiation of screening, provide public notice of the screening include purpose, types and dates of screenings and the means for parents to request their child not participate.

IDENTIFICATION AND REFERRAL
Follow up / Re-screening : Responsibilities of SLP Refer for evaluation, if appropriate Refer to SAT, inform parents, refer to an outside agency Results documented/recorded in a consistent manner WVEIS procedures (New Screen on WVEIS) “At risk” rescreened as appropriate and results documented Staff development for teachers : speech-language referrals Teacher friendly materials including , developmental norms, etc. Hearing Screening Conducted by Audiologists, SLPs, school nurses, other qualified personnel Audiologists meet periodically with the personnel Ensure reliable/valid screening techniques are used Audiometers appropriately calibrated.

IDENTIFICATION: HealthCheck Initiative
WV HealthCheck (Kids First) Initiative Medical home for children in WV Includes: height, weight, hearing, vision, speech, language, growth and development Most children receive wellness exam free of charge Parents/guardians bring the Health Check form to public schools for pre-enrollment events HealthCheck and Child Find Requirements Health Check is sufficient to meet enrollment requirements May suffice for Child Find purposes as indicated in Policy 2419. Collaborate with Health Check medical providers Refer to county HealthCheck procedures WVDE Contact: Rebecca King “Tools for Schools” HealthCheck Memo

IDENTIFICATION AND REFERRAL
Student Assistance Team (SAT) Membership: at least 3 persons school administrator, current teacher other appropriate professional staff Student referral by teacher/other Students identified during screening do not require SAT referred for evaluation by the SLP according to county procedures Private/Religious Schools School District: Locate, identify , evaluate students suspected of needing special education enrolled in county private schools. provision of special education /related services determined in collaboration with the private/religious school SERVICE PLAN - rather than IEP Parent and Other Interested Persons or Agencies School-aged students: county must receive and process written referrals in accordance with SAT process Preschool, home-schooled , private school referrals processed directly by special education director or designee.

EVALUATION AND REEVALUATION
Evaluation Team Responsible for making decisions regarding a multidisciplinary evaluation and assessments Evaluation Procedures and Instruments Parent required participant Conduct with or without holding a meeting. If requested by the parent, a meeting will be held. Variety of assessment tools /strategies No single measure or evaluation used as sole criterion Technically sound instruments Assessments and other evaluation materials must be Not discriminatory on a racial or cultural basis Provided and administered in student’s native language document attempts to provide a qualified examiner Used for purposes for which they are valid and reliable Administered according to instructions Comprehensive enough to identify all special ed needs

Selection and administration of tests for students w/ impaired sensory, manual or speaking skills should be selected accordingly. Accurately reflect student’s abilities Include accommodations, such as assistive technology, etc. Consent Written parental consent within 5 school days School/county designates person responsible for documentation /process SLP usually responsible for obtaining consent for speech only referrals Evaluation conducted - EC convened within 80 days Timeline does not apply when (1) parent fails/refuses to produce student for evaluation (2) student enrolls in another district prior to EC Parent fails to respond within 10 school days of the initial request Mail or hand-deliver a second notice. Parent fails to respond –document reasonable measures Parent refuses consent – may use mediation or due process (Unless student is in a parental private placement or home schooled.)

Within 3 years of the date of the last EC More frequently if requested by the parent/educator Existing data reviewed including Current IEP, therapy logs, evaluations, information provided by the parent; assessments/observations May be conducted without holding a meeting - complete Reevaluation Determination Form Prior Written Notice (PWN) Written notice informing parent of district’s proposal /refusal to initiate/change student’s identification, evaluation, educational placement or provision of FAPE Provided within 5 days prior to implementing the proposed action …… unless related to a disciplinary removal which must be on provided on the same day. PWN is provided for: initial evaluation, reevaluation, initial placement notification of eligibility, IEP amendment, annual IEP revision, age of majority, suspension/expulsion, results of revocation of consent.

SPEECH/LANGUAGE ASSESSMENT
Conducting a Comprehensive Assessment Assessment: process of data collection and gathering evidence Evaluation: brings meaning to data through interpretation and analysis Balanced: Use of standardized and nonstandard assessment measures Student-centered, functional, descriptive, How current speech/language skills adversely affect the student’s educational performance. Use and Selection: Norm-Referenced Tests Multiple norm-referenced tests only as accurate as the results of the least accurate test selected Use of a single, well-validated, reliable measure, normed on a population comparable to that of the target student more effective Assessment Adaptations Disability/other issues may interfere with test administration protocol Adaptations such as enlarging the text or pictures, IntelliKeys, sign language Any deviation from the standard administration must be reported in the evaluation report. A comprehensive assessment combines standardized (norm-referenced) and non-standardized (descriptive or authentic) assessments to produce a picture of a student’s functional communication abilities and needs as they relate to the educational environment. A case history is essential for gathering information on speech-language development and other factors related to the student’s communication skills. Information gathered from parents and teachers provide valuable insight into the student’s effectiveness in communication

ASSESSMENT MEASURES Norm-referenced tests
Criterion-referenced measures, Curriculum-based assessment (including developmental scales), Dynamic assessment, Parent, student, teacher interviews and checklists Observations of the child in the educational environment Case History Review of student file for case information Written language samples, Oral language samples Ratings of intelligibility of speech. Observation in several settings for students for whom there are fluency or pragmatic concerns Oral-motor evaluation (

ASSESSMENT RESULTS Assessment Adaptations
Report should reflect that standard scores, percentiles, etc. could not be used and the test was administered for informational purposes. Any variation from the test directions is a non-standardized administration Must be clearly stated in the evaluation report Reports from other professionals Audiological Reports OT/PT Interpretation of Assessment Components Interpret data to create a picture of a student’s speech-language skills Do not rely on any one piece of information or assessment source. Identification of strengths and weaknesses Focusing on the classroom as a communication and language-learning environment will enable the SLP to identify how the child uses his/her speech-language skills in instruction, socialization, management, evaluation of knowledge, and literacy. If the student is eligible for speech-language services, this information will be crucial in developing the present levels of performance and goals for the IEP.

SPEECH-LANGUAGE REPORT
History Recent hearing screening Oral exam Evaluation results Observations Strengths/Weaknesses Preferred mode of communication (oral, sign, augmentative communication) Assessment results fully explained Existing and predicted impact of speech-language impairment on the child’s ability to access and progress in the general education curriculum Child’s emerging abilities may serve as prognostic indicators in determining his/her potential for improvements Recommendations Speech-language Assessment Report The purpose of the report is to communicate evaluation findings to the committee so that all team members, including the parents, can meaningfully participate in the eligibility discussion. Therefore, the report should be written in easily understood language without extensive use of professional jargon and should include the following components:

ELIGIBILITY EC within 80 days of receipt of consent
Membership: parent, administrator or designee, teacher and appropriate personnel with expertise in the areas evaluated. SLP must be included when speech-language evaluations have been conducted For a speech-only EC meeting, the SLP may act as the administrator designee and the special educator. IDEA: Students progress in the general curriculum. EC determines “child with a disability” - not due to lack of instruction or limited English proficiency Information from a variety of sources Page 43 – Policy 2419

ELIGIBILITY Determine adverse impact on educational performance
Disabilities that do not adversely impact the child’s educational performance do not qualify the child for services under IDEA. Speech- language pathology services may be considered as special education or a related service When more than one exceptionality is present EC determines primary exceptionality based on adverse impact and progress in the general curriculum Policy 2419 outlines the specific categorical requirements and criteria for eligibility considerations in WV

ELIGIBILITY Three-Prong Test of Eligibility
Meets State Eligibility Requirements: (Refer to Policy 2419) Experiences Adverse Effect on Educational Performance Based on presence of a disability resulting in need for special education and related services, not on the possible benefit from speech-language services. Document adverse educational impact Needs Special Education: Specially designed instruction is required to meet needs of the student If EC determines that the child is not eligible… Information relevant to instruction provided to the child’s teacher or appropriate committee.

ELIGIBILITY CONSIDERATIONS
Determination of Adverse Impact Consideration must be given to the academic, vocational, and social-emotional aspects of the speech-language disability. Preschool Criteria Considerations Case history Assessment in various environments. Hearing screening for preschoolers is critical due to the high incidence of fluctuating or permanent hearing loss. Consistent nondevelopmental phonemic errors or phonological processes Unintelligibility to significant members of the child’s home and/or school environment. Articulation or phonological processes/patterns that cause significant concerns to the child, which may limit social, emotional, or academic functioning.(ASHA) Academic: Reading, math, and language arts with the impact determined by grades, difficulty with language-based activities, difficulty comprehending orally presented information, and/or difficulty conveying information orally. Social: Communication problem interferes with the ability of others to understand the student, peers teasing the student about his/her speech-language disability, the student having difficulty maintaining and terminating verbal interactions, and/or the student demonstrating his speech-language skills. Vocational: Job-related skills that the student cannot demonstrate due to the speech-language disability including the inability to understand/follow oral directions, inappropriate responses to coworkers’ or supervisors’ comments, and/or the inability to answer and ask questions in a coherent and concise manner. Teacher’s comments provide contextually based information on the student’s speech-language skills and needs in the general curriculum program. Preschoolers - the effect on their ability to participate in appropriate activities.

ELIGIBILITY CONSIDERATIONS
Students with Significant Disabilities Based on individual needs !! Verbal communication not an effective means of communication, Need for an alternative means of communication must be considered Functional communication Cognitive Referencing Comparison of IQ scores/language scores to determine eligibility Inconsistent with IDEA’s requirement to determine services based on individual needs (ASHA, 2000). Speech-Language Severity Rating Scales (SRS) Tools for describing the severity of a speech-language impairment, communicating with eligibility and IEP team members, and providing consistency (refer to Appendix). Professional Judgment Speech-Language Severity Rating Scales (examples in Appendix) Speech-language Severity Rating Scales (SRS) are designed to describe the severity of a communication disorder, based on assessment using multiple measures, considering multiple aspects of communication. SRS are valuable tools for describing the severity of a speech-language impairment, communicating with eligibility and IEP team members, and providing consistency among SLPs. Attainment of a certain point value on a severity rating does not guarantee eligibility for special education rather; it describes the results of the speech-language assessment in consistent terms. The EC considers the severity rating in conjunction with other information as the team determines eligibility. A particular severity rating does not specify or predict a certain level of service. The level of service is determined by the IEP team.

INDIVIDUALIZED EDUCATION PROGRAM
Special education/related services necessary to meet the unique educational needs of student Required membership in Policy 2419 – within 30 days SLP on team for any child with a speech-language impairment Special considerations: Policy 2419 Present Level of Performance (PLEP) Foundation for IEP - Identifies strengths and weaknesses. Describes how student’s speech-language impairment affects involvement/progress in the general curriculum Performance in academic/functional areas. Written in language understandable to all Test scores self-explanatory or an explanation included. Sources of information: formal tests, informal tests, observations, anecdotal reports, curriculum-based assessments, interviews, and checklists Preschool students: Include how speech-language impairment affects participation in appropriate activities

Annual Goals Measurable goals developed from PLEPS Designed to meet speech-language needs and enable progress in general curriculum (or in age appropriate activities for preschool children). What do we want the child to be able to do in a year? Include timeframe, condition, behavior and the evaluation procedure with performance criteria. WV Alternate Performance Task Assessment (APTA) Each goal must have at least two benchmarks/objectives Access to General Curriculum SLP must have a understanding of the WV CSOs identify effect of any speech-language disorder on student’s academic performance, become familiar with the grade-level curricula developed integrate their services with the general education curriculum. Instructional materials used by the student provide the best source of materials for school-based SLPs

Transition Considered for all students including students who have a speech-language impairment. (age 16) IEP Team discuss the child’s goals and how he/she will prepare for adult life. Services Completed after goals written Based on student needs to meet annual goals and progress in the general curriculum, Related services; supplementary aids and services for student, or those provided by school personnel on behalf of student; Program modifications in instruction and assessment. Beginning and ending dates, frequency, location, and duration of services; extent of participation in general education

State Assessment Completed for all children enrolled in a grade level requiring an assessment Accommodations same as those used in instruction and assessment during the year Reporting Progress Follow local procedures and timelines for reporting progress. Progress must be reported for each annual goal as indicated in the student’s IEP. IEP Reviewed Annually ONLINE IEP Purpose: guide instruction and increase the capacity of special /general educators to provide more effective instruction for students with disabilities. Decision making process aligned to the WV CSOs.

DISMISSAL Responsibility of the eligibility committee (Policy 2419)
Unless Speech is related service – then IEP Considerations for Dismissal: Student met IEP goals. Parent submits written request to exit student from service. Within 5 days – provide PWN to parent and cease services. Intervention no longer results in measurable benefits, Student unwilling or unmotivated to participate in therapy. Extenuating circumstances such as medical, dental, social, etc. Disorder no longer has an adverse affect on educational performance. No longer needs special education or related services to participate in the general curriculum.

DISMISSAL EC team reviews existing data collected from a variety of methods Performance data collected during sessions Formal/informal assessments Teacher observation/reports Parental reports of performance outside the school environment Student self-reporting Parent does not agree with the recommendation for dismissal given PWN – services cease. DOCUMENTATION!!

CASELOAD Caseload size not mandated by federal regulations
Determined by state WV maximum caseload of 50 students for SLPs Includes all students eligible for special education/related services (duplicated and unduplicated). Caseload maximum should be lower for part-time personnel or persons assigned other responsibilities in proportion to the amount of time spent as a service provider such as: SLPs supervising speech assistants Lead SLPs who have administrative responsibilities SLPs assigned preschool or severe populations that require additional time for technology and classroom consultation SLPs responsible for phonological awareness intervention

CASELOAD (refer to Policy 2419, chapter 6, section 4-B.)
Travel time MUST be considered when caseloads and extra duty assignments are determined. (refer to Policy 2419, chapter 6, section 4-B.) Waivers to maximum limits may be requested in writing May require on-site visit, will be considered on a case-by-case basis and remain valid for the current school year only Waivers should only be considered in the most extreme situations when other options are not available and will not be issued without documented justification.

SERVICE DELIVERY Effective service delivery is dynamic and changes with the needs of the students. Services provided directly to the student or indirectly through consultation IEP team makes decision about the type and amount of direct and indirect services Decisions based upon PLEPS progress made in services received to date, assessment results, IEP goals, and any objectives/benchmarks. Collaboration with parents, general educators, special educators, and other service providers. Direct Services Pull-Out Therapy Integrated Therapy Individualized service in a less restrictive setting – student not removed from classroom SLP has exposure to classroom communication including: levels of adult and child communication ,daily routines, language of the curriculum, vocabulary demands, and the student’s coping strategies. General/special education teacher and SLP jointly plan, teach, and assess progress within the classroom setting.

SERVICE DELIVERY Indirect Services or Consultative
Provided when IEP specifies support for school personnel on behalf of the student Providing information/demonstrating effective instructional and facilitation procedures Analyze, adapt, modify, and create instructional materials /assistive technology for targeted students Monitor the student’s progress Consultative services may be provided to family members Community-Based Instruction Facilitates the development of skills that are required for success in life. Opportunities to practice daily living /work skills in a community setting SLP may participate in generalization of skills or provide consultation to teachers

SERVICE DELIVERY PRESCHOOL STUDENTS
Consider student’s preschool environment Extent communication needs will be met Prior to “pulling-out” preschool students , collaborate with the PreK teacher regarding the most appropriate intervention Strong language based interventions in the class implemented daily provide an opportunity for students with delayed language skills to acquire these skills SLP and teacher observe and monitor the student’s progress to determine if a referral for more intense intervention is needed. Homebound Students Follow County Procedures Home Schooled Students

STUDENTS with SIGNIFICANT DISABILITIES
Should be based on individual needs of students Functional Communication IN the Educational Environment Expected communication outcomes Increased access to learning and greater independence and participation in home, school, work, and community. Intervention Include assistive technology, environmental modifications and instruction of communication partners. Limited use of “Pull-Out” Model for service delivery Interdisciplinary team should offer services and supports Parent Consultation

SCHEDULING Flexible approach to service delivery
Minutes of therapy reflected per month, rather than per week Provision of intense services early in the year, with the amount of time reduced later in the year Scheduling students on a monthly basis SLPs must always provide the total amount of service written on the IEP Use of a range is not considered acceptable Service provider and the parents may view the expected time requirements differently. SLPs and their administrators of special education should work together to discuss new scheduling formats prior to implementation. Make-up Therapy OSEP Letter Creating a schedule that meets the needs of individual students as well as allowing time for other responsibilities is a challenge. SLPs can increase the effectiveness of their program and have greater control over their schedules if a flexible approach to service delivery is maintained. When IEPs are written appropriately, frequency, duration, and setting can provide built-in flexibility for SLPs Provision of the same frequency and duration to each student violates the requirement that services be individualized and leaves little room for flexibility and creativity within a SLPs schedule. SLPs must always provide the total amount of service written on the IEP, regardless of the wording of the frequency and duration statement. Use of a range is typically not considered acceptable because the service provider and the parents may view the expected time requirements differently.

FLEXIBLE SCHEDULING OPTIONS
Provision of intense services early in the year, with the amount of time reduced later in the year. This approach can be used to teach a new skill and give the child time to master without long periods of time between therapy sessions. (5 minutes kids) Scheduling students on a monthly basis may be most useful for students who are monitoring their own performance and need periodic opportunities to check in with the SLP to gauge their progress prior to dismissal. Flexibility in service delivery can be built into IEPs and the SLPs ’s schedule in a variety of ways. Minutes of therapy should be reflected per month, rather than per week. In addition to accommodating student and classroom needs, this SLP is better able to capitalize on opportunities to integrate services in the classroom or during school events and to reschedule sessions to accommodate absences. This type of frequency and duration statement allows the SLP scheduling options that can change to meet the students’ needs. SLPs and their administrators of special education should work together to discuss new scheduling formats prior to implementation Whatever the type of scheduling option used, it should be clearly documented in the student’s IEP and include dates, frequency and duration statements. If the student’s speech or language needs change, the IEP team needs to reconvene to make appropriate adjustment.

FOR ALL SERVICE DELIVERY MODELS, IT IS ESSENTIAL THAT TIME BE MADE AVAILABLE IN THE WEEKLY SCHEDULE FOR COLLABORATION and CONSULTATION WITH PARENTS, GENERAL EDUCATORS, SPECIAL EDUCATORS, AND OTHER SERVICE PROVIDERS.

MANAGEMENT OF SPECIAL POPULATIONS
Auditory Processing Disorder (APD) Assessment conducted by a team: audiologist, SLP, classroom teacher and others Services on an individual basis and the educational significance of the APD Processing speech in a noisy background; Attention and distractibility problems; Slow, delayed responses to verbal stimuli; Auditory Memory Behavior; Language delays SLP liaison among the teacher, audiologist, parent and others in determining and implementing the most appropriate intervention plan within the school setting. APD is NOT a disability category under IDEA. Autism: Role of SLP Team member working with students diagnosed with autism. Specialized instruction may be direct, indirect or a combination of these based upon the communication needs of the identified student. SLP functions as liaison among the teacher(s), classroom support personnel, parent, and others in determining and implementing the most appropriate communication system within the school setting

Childhood Apraxia of Speech (CAS) : Motor speech disorder. Assessment/diagnosis of CAS is often very difficult Therapy Intensive, individual, and frequent therapy is more successful Focus on improving the planning, sequencing, and coordination of muscle movements Sign language or an augmentative and alternative communication system. Cochlear Implant: Role of SLP Evaluate child's spoken or signed communication abilities Make recommendations for intervention. Speech therapy approaches include: auditory/oral, auditory/verbal, cued speech and total communication Determine appropriate strategy is a decision that must be made by professionals in collaboration with the family and supported by the child's school and home environments STUDENTS WITH COCHLEAR IMPLANTS Due to advancements in technology, schools have experienced an increase in the number of children entering school with cochlear implants. SLPs play a critical role on the team of professionals facilitating educational planning for these students. The SLP will evaluate the child's spoken or signed communication abilities and make recommendations for intervention. The speech and language development of children who receive cochlear implants is much different from other children. Many factors must be considered when planning intervention including the age of child, preferred communication style, hearing history, learning style and family support. Speech therapy approaches include auditory/oral, auditory/verbal, cued speech and total communication and determining the appropriate strategy is a decision that must be made by professionals in collaboration with the family and supported by the child's school and home environments.

Deaf/Hard of Hearing: Role of the SLP Collaborates with teacher of the deaf and others to optimize each child's potential Work with the audiologist/teacher of the deaf to ensure settings are appropriate for the child’s hearing and be proficient in trouble-shooting simple problems School-based person who works with FM auditory trainers or other sensory devices. If the SLP is not fluent in sign language when working with a student who uses manual communication, the use of an interpreter will be needed Dysphagia IDEA/Section 504 mandate services for health-related disorders that affect the ability of the student to access educational programs and participate fully. Team approach in treatment of students : SLP, OT, PT, School Nurse, Child’s Teacher, Child nutrition representative, Cafeteria manager ,Parent, Building administrator SLPs must have the appropriate skills needed to provide feeding/swallowing services Lack in experience and expertise may result in harm to the student. It may be necessary for the school district to contract with a person outside of the school district that has the expertise to work with the student and/or provide training for the SLP (see ASHA document” Guidelines for Speech-language Pathologists Providing Feeding and Swallowing services in the schools” ) Deaf/Hard of Hearing SLPS are part of a team of professionals working with students who are deaf and hard of hearing. The SLP should work in collaboration with the teacher of the deaf and others to optimize each child's potential. This collaboration requires (1) an understanding and respect for the unique background, educational preparation, knowledge, skills, and experience of participating professionals; (2) a recognition and appreciation of the shared knowledge, expertise, and responsibilities of the professionals; and (3) a consideration of programming and service delivery systems that stimulate the development of interpersonal communication skills and literacy (ASHA) If the SLP is not fluent in sign language when working with a student who uses manual communication, the use of an interpreter will be needed to ensure the accuracy of communication. Frequently, the SLP will be the school-based person who works with classroom teachers when students are using FM auditory trainers or other sensory devices. The SLP should work closely with the audiologist and teacher of the deaf to ensure that the settings are appropriate for the child’s hearing and be proficient in trouble-shooting simple problems.

ELL (English Language Learners) Students SLPs should not provide direct instruction in ESL Collaborate with ESL instructors to identify students with disabilities Challenge for SLPs: Distinguishing communication differences related to linguistic or cultural factors from communication disorders.

PROGRAM IMPLEMENTATION Special Topics
Assistive Technology (Definitions in Glossary) Meet educational needs of children w/ communication disorders Considered for all students going through the special education process SLP Role: Facilitating access to assistive technology IEP Team Responsibilities Determine if an AT necessary for student to meet educational needs/receive FAPE Required as part of special education, related services, or supplementary aids and Describe full extent of devices and services(s) as well as the amount of such services(s) Not conditional on lack of funding. IEP should describe the required features of the device needed to meet the student’s needs rather that specific name of a device Home use

WV EARLY CHILDHOOD SYSTEM
WV BIRTH TO THREE PROGRAM Serves Children with Disabilities Birth to Three Responsible for Contacting LEA Developing Transition Plan Universal PreK WV State Board of Education Policy 2525 PreK system in WV for all four year olds and 3 year olds with IEPs Full implementation by all school districts is required by 2012 SLPs: Universal PreK Identified PreK students may be served in Universal PreK classrooms. PreK students with an IEP must be entered into the data system including students that receive speech therapy SLP enters data on SPEECH ONLY students who are not in WV-Pre-k classrooms

LITERACY: Role of the SLP
Spoken language provides foundation for reading/writing Children with CD often exhibit academic problems SLPs have specialized knowledge /experience to build critical language/literacy skills. Relationship between early spoken language/early pre-literacy abilities Address difficulties involving phonological awareness memory and retrieval; Teach children to use tactile--kinesthetic and auditory cues in reading and writing Analyze language demands of textbooks, academic talk and curriculum Serve on school teams addressing strategies to enhance literacy Provide direct services to children with oral language disabilities Collaboration with other educators SLP's contribute in the areas of: Prevention Identifying At-Risk Children Assessing Providing Intervention Documenting Outcomes Program Development Advocating for Effective Literacy Practices (ASHA’s Literacy Gateway) Spoken language provides the foundation for the development of reading and writing. Spoken and written language share a reciprocal relationship, building on each other to result in general language and literacy competence. Students who have problems with spoken language frequently experience difficulties learning to read and write and students with reading and writing problems often experience difficulties using language to communicate, think and learn. Research shows that children with communication disorders may perform at a poor or insufficient academic level, struggle with reading, and have difficulty understanding and expressing language. SLPs have the specialized knowledge and experience needed to identify communication problems and to provide the help that children need to build critical language and literacy skills. SLPs are often the first professionals to identify the root cause of reading and writing problems through a child's difficulty with language. SLPs help children to build the skills they need to succeed in school and in life. Key elements of a SLP’s academic training relating to early language and literacy development include skills to: Build and reinforce relationships between early spoken language and early pre-literacy abilities and consider influences of parent-child interactions in early shared storybook interactions Address difficulties involving phonological awareness memory and retrieval; Teach children to use tactile--kinesthetic and auditory cues in reading and writing Analyze how the language demands of textbooks, academic talk and curriculum may stress a student’s capabilities at different age and grade levels; and

RESPONSE TO INTERVENTION
Process of academic support for ALL students through tiered instruction, progress monitoring, and appropriate intervention Process to gather data prior to determining eligibility for SLD Role of SLP in RTI : Participant in the literacy efforts of a community. ASHA: Supports the role of SLPs through policies on literacy, workload, and expanded roles and responsibilities. Not as primary instructor but resource for schools /interventionist when appropriate. Provide documentation to the EC for SLD students receiving speech/language services. WVDE Phonological Awareness Project Increase student achievement by emphasizing the importance of phonemic awareness as an early teachable reading skill. Focus on early literacy skills at the first grade and kindergarten levels SLPs implement IPAP (Tier 2 Intervention)

SPECIAL TOPICS………. Section 504 (Rehabilitation Act of 1973) Medicaid
State-federal program provides funding to counties based on low-income and students with disabilities SLPs are eligible for certification as individual Medicaid providers Contact county boards of education or RESAs to obtain information regarding provider status Section 504 (Rehabilitation Act of 1973) Protects the rights of individuals with disabilities in programs and activities, including schools, that receive federal funds Not part of IDEA - no additional funding General education mandate, but often confused with special education Each school district has procedures for maintaining compliance under Section 504 and developing 504 plans for students SLPs should follow their school district’s procedure A Section 504 coordinator has been identified in all school systems, and should be contacted for questions or information

IMPLEMENTING SCHOOL PROGRAM
Personnel (Professional Support Staff) SLP Qualifications Recruitment/Retention of Personnel Advertise WVDE Job Bank/ASHA Journals/WVSHA website Offer Incentives Salary Supplements Pay Expenses to National/State Conferences Moving Expenses (Brochure) National Board Certification WV recognizes professional certification SLPs must apply for the salary supplement through the WVDE, Office of Personnel Preparation

IMPLEMENTING SCHOOL PROGRAMS
Use of Speech Assistants Supervised by certified SLP Authorization for 1 year from the WVDE/ Bachelor’s degree in speech pathology or communication disorders Not eligible to be Medicaid providers. Refer to “Guidelines for Speech Assistants” document for additional information Contracted Services WV State Board Policy 5202 addressed the credentials of contracted employees Telepractice (Telespeech or Teletherapy) Innovative approach: Uses real-time, two-way interactive teleconferencing to deliver speech therapy services in rural settings. WVDE has collaborated with LinguaCare Associates, Inc

COORDINATION: SCHOOL BASED PROGRAMS
Lack of consistency across counties Program coordination suggestions: Lead Therapist: To facilitate communication among county SLPs Planning time and Communication Identify a county-wide battery of tests to be used for assessments Consistent forms to maintain log of therapy sessions, document student progress, speech report, etc. Develop county-wide guidelines to outline county specific procedures for the delivery of speech/language services (screening procedures, materials, test instruments, etc ) Facilities: Resources WVDE Policy/ ASHA Guidelines

REFERENCES/APPENDICES
A. GLOSSARY B. ACRONYMS C. ONLINE RESOURCES Assistive Technology Cochlear Implant Literacy Program Implementation Students with Significant Disabilities WV Birth to Three Program WVDE Resources D. SPEECH THERAPY INTERVENTION: A Multi-tiered Model of Service Delivery E. WV POLICY 2419: SPEECH-LANGUAGE CRITERIA F. EXAMPLES OF SEVERITY RATING SCALES Adapted from Maine Department of Education

MULTI-TIERED MODEL FOR SPEECH-LANGUAGE SERVICES
RTI model: Students with speech-language impairments National attention; Growing caseloads, increased paperwork and low dismissal rates, New approach to providing effective, efficient services Traditional approaches often result in students enrolled in programs for long periods of time without making significant progress Significant time and burdensome paperwork to navigate the special education system for a young child with a mild speech disorder that may correct without intervention. SLPs provide intervention within the general education environment with the educator, parent and the student prior to referral for special education Observe the speech and language skills to determine if a disorder is present that requires referral for special education The RTI model has unique implications for students with speech-language impairments and is being imTraditional approaches to speech therapy often result in students being enrolled in programs for long periods of time without making significant progress. SLPs must dedicate significant time and maintain burdensome paperwork to navigate the special education system for a young child with a mild speech disorder that may correct without intervention. This model allows the SLPs to provide speech/language intervention within the general education environment with the educator, parent and the student prior to referral for special education. The student has the opportunity acquire age appropriate speech and/or language skills in a regular education environment. The SLPs and teacher have the opportunity to observe the child’s speech and language skills to determine if a disorder is present that requires referral for special education. In this model, students in Tier 1 and Tier 2 do not have an IEP.

“Step-Up” to Speech

RTI MODEL: Speech/language Services
NOT A MANDATED PROGRAM! Students selected for this intervention are those with mild articulation and language delays. Students with significant speech and language issues must be referred and evaluated immediately. Students identified for Tier 1 and 2 do not have IEPs. Targeted students not be referred for special education until Tier 3. SLP responsible for implementing the special education process. Parent Involvement IS KEY!!!

NEXT STEPS Disseminate Guidelines
WVSHA Available on Website: RESA Workshops Special Ed Directors/ SLP SPECIAL EDUCATION LEADERSHIP CONFERENCE April 11-13, 2011 AIR PROJECT “Step-up” to Speech Post Power Point on Web Site Resources RTI in Action ASHA: Roles and Responsibilities of Speech-language Pathologists in Schools

THANK-YOU!!!!! 3/28/2017

WVDE State Update Speech-language Pathology Services in WV Schools

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WVDE State Update Speech-language Pathology Services in WV Schools

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