Maureen Staskowski, Ph.D., CCC-SLP

1. 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.org

2. AcknowledgementsThank you to the many professionals and their school districts responsible for this documentWith Special thanks toDr. Lizbeth Stevens Keisha Nolan Karen Graham Terry Lange-Winkel Kendall Giovannini Lana Budde Tina Kunarski Jan McCosky Heather Webber Yvonne Belleman Andrea Phillips MSHA Staskowski 2007

3. Thank You to the many professionals & their school districts responsible for this document Belinda Andrews Deborah BeelerGeorgia BoyleMichele Bridges Robin BrightonDarlene Broome Kathleen Bungart Beth Burkhard YearyMary Lee Campbell Laurie CapoferiSheila Carrier-WoodsAngela Ciraulo Joan Cortright Gail CuriCandy Cutt Susan DilgardAmy Dinno Gail Elliott Kelly Falter Laura Griffith Marybeth Grosfield Katy Hime Anne Howard Cathryn KelenskeIlene Klegon Mary Ann Knittel Jill Konwinski Alicia Li Judy Lytwynec Dara Ludeus Lynn Marshall Shirley MatuszewskiMary McAuliffe Carrie McCarter-Barnes Arlene Millman Stephanie Nagy Nickola W. NelsonKimberly Renshaw Sue Rosko, Susan SwarzMegan ShuboySally Shumway Susan Smith Gail SpeiwakMaureen KeatingGail SterlingCarol Washchuk Katy WestAlesia Williams Jane WitkopAlex Johnson Johanna 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 Hardin Karen Sabuda Kathleen Juhl Lisa Boike Nancy Garan Katie Flannery Mary Towler Lee Timer MSHA Staskowski 2007

4. The Purpose • Resource for SLPs and administrators • Facilitate discussion related to practices and procedures • To inform It is NOT meant to • Provide policy or mandatory procedures • Supersede district policy MSHA Staskowski 2007

5. 1992 Last version released 1995 Addendum for Standards for Delivery 2006 Reorganization Updates MSHA Staskowski 2007

6. Why Revise? • Changes in Federal Laws & Regulations • Changes in State Rules and Regulations • Changes in Field & Professional Understanding • Changes in Population • Changes in Practice MSHA Staskowski 2007

7. The Guidelines: Outline • Preliminary Sections • SLI as Primary Disability • SLI as a Related Service • Special Issues MSHA Staskowski 2007

8. Preliminary Sections • Forward • School Practice & Professionalism • Workload Approach to Caseload • Culturally and Linguistically Diverse MSHA Staskowski 2007

9. Professionalism • ASHA and MSHA Code of Ethics • Individuals shall honor their responsibility to • Hold paramount the welfare of persons they serve professionally • Achieve and maintain the highest level of professional competence • Promote public understanding of the professions • Maintain harmonious interprofessional and intraprofessional relationships and accept the profession’s self-imposed standards MSHA Staskowski 2007

10. Professionalism • You show up • You show up on time • You show up prepared • You show up in the frame of mind appropriate to the task • You 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 experienced • You vigorously seek and tell the truth even those truths that may be less than flattering to you. P-3 MSHA Staskowski 2007

11. Feeling 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. MSHA Staskowski 2007

12. The Workload Approach to Caseload MSHA Staskowski 2007

13. SLP Workload Activity Clusters Indirect activities that support students in LRE/general education curriculum Direct services to students Activities that support compliance with federal/state/local mandates Indirect services that support students’ educational programs MSHA Staskowski 2007

14. Workload Activities WC-5

15. This 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) MSHA Staskowski 2007

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17. Examples of Flexible Scheduling Flexible Monthly Schedule • 4 week schedule • Allows for blocks of time for intensive treatment • Expands the “A-B” approach used in many highschools 3:1 Model • Three Weeks direct service: One week Indirect • Oregon implementation • SLP job satisfaction • Integration with general education • Less cancellations (and more make-ups) • More direct therapy time • More third-party billing Block Scheduling MSHA Staskowski 2007

18. SLI as a Primary Disability • Language • Articulation • Fluency • Voice Prevention Identification Assessment Intervention Dismissal School-age Students Adolescents Preschool Students Infants and Toddlers MSHA Staskowski 2007

19. Early Intervening / Response to Intervention for SLI L-7 MSHA Staskowski 2007

20. Sample form for documenting early intervening services Articulation Language Voice Fluency Learning Disabilities MSHA Staskowski 2007

21. Language Assessment MSHA Staskowski 2007

22. Michigan Rule 1710 Rule 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 educationalperformance, such as a language impairment, articulation impairment, fluency impairment, or voice impairment. MSHA Staskowski 2007

23. Eligibility Guide / Team Summary Language Articulation Voice Fluency Assessment Activities L-8 MSHA Staskowski 2007

24. Input • Teacher L-13 • Parent L-15 • Student L16/17 Use interview or other techniques to • Define/explore the presenting problem • Determine the aspects of the curriculum/school • performance affected • Review of Pertinent Information Review MLPP, MEAP, teacher assessments, medical reports, private therapists... MSHA Staskowski 2007

25. Consideration of Cultural and Linguistic Differences Environmental and Economic Differences L-18 MSHA Staskowski 2007

26. Curriculum-Based Language Assessment MSHA Staskowski 2007

27. Curriculum-Based Language Assessment Guiding 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-19 MSHA Staskowski 2007

28. CBLA Examples page L-20 • A 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 student’s 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. MSHA Staskowski 2007

29. Tools for You • CBLA Language Assessment and Summary • Reading Assessment and Summary • Writing Assessment and Summary L-35-40 MSHA Staskowski 2007

30. Record Results of RTIorDynamic Assessment Try out language strategies or skills that might help the student access the curriculum How does the student respond to intervention? • Single or multiple sessions • In the classroom, in a group, or alone • SLP or other team members MSHA Staskowski 2007

31. Language Samples Curriculum-Relevant Samples Oral and written Portfolio Probes Assessment Collect oral and written samples and consider comprehension & expression of oral/written language L-23-24 L-41-45 MSHA Staskowski 2007

32. Methods for Collecting Language Sampling Receptive Direction Tasks Main Idea Tasks Details, Inference and Synthesis Tasks, or Comprehension Strategy Probes Think Alouds Questioning Hierarchies Comprehension/Retelling (MLPP) Evaluation Analysis/Analysis Tools/Checklists Reading 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 Schools EXPRESSIVE LANGUAGE- Speaking and Writing Probes/Sample Types Narrative Curriculum based retelling task grades 1-8 Children’s Narrative Developmental Stages and Strategies Oral Language (MLPP) Expositive Compare/Contrast, Sequence, Question/Answer, Problem/Solution, Cause/Effect, Persuasion, Description, or Explanation MSHA Staskowski 2007

33. Test Profile • Not the first activity • Based on the information collected so far • Selected carefully for purpose and the population • Multiple assessments-doesn’t mean multiple tests • Compared to IQ not sole criterion MSHA Staskowski 2007

34. Tests and IQ MSHA Staskowski 2007

35. Why not compare solely to IQ?(Cognitive Reference) Based on faulty assumptions • Students with commensurate language and IQ scores won’t benefit from language therapy. • IQ scores are stable. • There are nonverbal IQ measures Research has shown that they do benefit. IQ scores actually fluctuate across tests and within the same tests over time. Consequently, discrepancies are unstable Many question whether any measure is truly language free MSHA Staskowski 2007

36. Problems with cut-off scores • Intent-appropriately identify student as disabled • Avoid over-identification or under-identification • Identifies unevenly across tests • No cut-off in Michigan Rules or IDEA • Practice in Michigan using 11/3SDarbitrary • Cut-off scores may be different across tests (Plante, 2003) MSHA Staskowski 2007

37. Test Guidelines • Knowing 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 guidelines • The committee suggests that continuing to use 1 1/3 SD as one contributing factor to the overall assessment is reasonable. (unless there is evidence that the cut-off should be greater for that test) MSHA Staskowski 2007

38. The lesson in all of this….. Tests alone are not reliable means of identifying students with communication disabilities that adversely affect school performance. MSHA Staskowski 2007

39. Acceptable 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) MSHA Staskowski 2007

40. Form Impressions regarding • Presence of a Disability • Adverse affect of Disability on Educational Performance MSHA Staskowski 2007

41. Language Intervention MSHA Staskowski 2007

42. Goal Setting • From the authentic assessments • Selected as a team • Related to helping the student access the curriculum • Reference Michigan Curriculum Framework or Grade Level Expectations (Reading /Math) • Annual goal - 12 months, STO/outcomes steps to measure progress toward that annual goal MSHA Staskowski 2007

43. L-47 MSHA Staskowski 2007

44. MSHA Staskowski 2007

45. Curriculum Relevant InterventionGoal Monitoring • Team responsibility • Addressing Goals • Noting progress • Service delivery fits the goal/strategies • Progress data analyzed • Intervention approach adjusted • Team considers next steps MSHA Staskowski 2007

46. So……. what has changed? MSHA Staskowski 2007

47. Culturally Linguistic Diverse Populations Michigan Guidelines Karen Graham – L’Anse Creuse

48. Cultural Competence of the SLP • The awareness of the SLP’s 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 student’s culture. • Self Assessment for Cultural Competence. Got It? ASHA web site. www.asha.org/about/leadership-projects/multicultural/ Graham, 2006

49. Basic Interpersonal Communication skills Develops informally through conversations and social interactions Cognitive Academic Language Proficiency Develops through organized instruction of literacy skills in school settings. BICS and CALPS Graham, 2006

50. Second Language Acquisition • Conversational 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, 2006