Pediatric SLP Collaboration

1. Pediatric SLP Collaboration April 3, 2019

2. Early Intervention(EI)/Early Childhood(EC) Collaborators • Family • Service Provider • Early Interventionist/Early Childhood Specialist-these same professionals act as: Behavior specialists and Autism Specialists • Speech/Language • SLP, private practice/medical-based • SLP-A • Interpreter • Motor/Sensory • OT; PT • Medical • RN • Developmental pediatrician, pediatric neurologist • Natural Settings • Community Preschool teacher/staff (e.g. Head Start Family Advocate or Interpreter) • Childcare Provider/staff • District • EI evaluation team members (e.g. school psychologist) • Oregon is one of few or the only state in the Union that has ECSE agencies that do the work of the school district.

3. EI/EC Team’s Roles and Responsibilities • -Communicate regularly with teachers/support staff (in-person or otherwise) • -Communicate with parents • -Collaborate with other specialists • -Create treatment materials • -Research evidence-based interventions • -Review and write IFSP goals • -Hold IFSP meetings • -Conduct evaluations (initial, transitional and exit) • -Attend bi-monthly regional team meetings • -Complete Medicaid billing • -Provide intervention directly to children (traveling 5-45 minutes to each site) • -Provide intervention coaching to parents/teachers

4. Early Intervention Collaboration Examples • ZAEL, 14mo, Spanish-speaking family • SLP lead service provider (Primary Service Model*) • IFSP: primarily communication goals and 1 motor goal • First home visit  adding new team members: PT, developmental pediatrician, Medically-based OT, pediatric neurologist • PUAL, 16mo twin, Russian-Speaking family • SLP lead service provider (Primary Service Model) • IFSP: primarily communication goals • First month of home visits with graduate student  Toddler Class transition and possible ASD supports, by preschool in a moderately restrictive classroom *The Primary Service Model is an EBP for children birth to 3. A single service provider is determined by the eval team and then consults with a multidisciplinary team(e.g. OT, SLP) to provide intervention on goals not in their wheel house.

5. Early Childhood Collaboration Examples • Communication Disorder (CD) Eligibility • + fine motor goals • Frequent informal consulting of OT after formal (Regional Referral Request) to create goals for IFSP in motor section • Learn and administer OT therapy interventions during therapy time/home visits • E.g. cutting, writing on horizonal surfaces, seating, sensory activities • + gross motor goals • Frequent informal consulting of PT after formal (Regional Referral Request) to create goals for IFSP in motor section • Learn and administer PT therapy interventions during therapy time/home visits • E.g. walking up/down stairs, stability ball exercises

6. Team’s Roles & Responsibilities • See infoCDS Word Document for Rules & Responsibilities for Pediatric Team Members • SLP Service Coordination Examples: • Email correspondence with DHS caseworker regarding upcoming IFSP mtg. • Provide information on workshops (e.g. potty training) given by agency OT to family during bi-monthly home visit • Accompany family on preschool visits before child’s 3rd birthday day and transition evaluation • Email correspondence with teacher(s) regarding IFSP/IEP goal implementation in class and goal progress • Advocacy to non-English speaking family regarding Parent Rights as defined by IDEA • Update goals on electronic records system • Attend OT/PT agency-hosted in-service on how to support motor goals during speech-language service delivery • Example of responsibilities related to IEP Document & Distribution • Artic only IEP: 15 pages (Invitation, prior written notice, meeting notes, IEP, Placement). Full articulation evaluation is about 24 pages (This doesn’t include the amount of documentation associated with more complex cases).

7. School-Age Collaborators • Family • Education • Reg Ed; Sp Ed; EA/IA • Specials/Electives • Speech/Language • SLP; AAC SLP • SLP-A • ESL/ELL • Motor/Sensory • OT; PT • Health/Medical • ASD specialist • RN • Behavior/Psych • Behavior specialist • Psychologist; Counselor • ABA Therapist* • District • School admin; district admin

8. Sample case collaborations: Family members plus….

9. Activity • Who would be in attendance for a pre-referral meeting? • Speech Sounds • Behavior • Out of State Transfer with an Active IEP (Language and AAC) • Who would be in attendance for an SPED eligibility meeting • Specific Learning Disability; Developmental Language Disorder • Hearing Impairment • TBI/Concussion • IEP & Service Delivery • Specific Learning Disability; Developmental Language Disorder • Hearing Impairment • TBI/Concussion

10. ASHA’s IPE/IPP • ASHA’s Definition and Information Regarding Interprofessional Education & Interprofessional Practice • https://www.asha.org/Practice/Interprofessional-Education-Practice/ • See ASHA’s Article Posted on infoCDS

11. Collaborative Service Delivery Models • 3:1 Service Delivery Model • Provides direct services on a monthly basis for 3 weeks and during the 4th week, the SLP is able to complete indirect service delivery tasks. • Consulting with parents • Consulting and collaborating with teachers • Co-Teaching • Observing students in classrooms and other contexts • Completing assessments (e.g., Formal and Dynamic Assessments) • Completing Documentation • Continue to Provide Direct Services to Level I priority students Note: This model was developed by Sharon Soliday, an Oregon SLP and CEO of the Hello Foundation. For her effort in developing and sharing this model with districts around the country, she was awarded the ASHA Rolland Van Hattum Award as recognition of exemplary commitment and contributions to speech-language pathology services within school settings. • Quarterly Collaboration Day at Early Childhood CARES • In response to Sharon Soliday’s service 3:1 model, Emily Mosqueda, MS, CCC-SLP advocated for regularly designated collaboration time for EI/ECSE specialists to ‘cross pollinate’ and support each other’s efforts. It has been part of the EC CARES annual calendar since Fall of 2015.

12. Team Decision Making • However, the key is to know that you are part of a “team” who may determine eligibility for an educational handicapping condition – which any eligibility must meet 3 criteria for special education eligibility and services: • Do assessment results suggest a disability is present? Level of service? • Is there an identified educational handicap? • Does the student require specially designed instruction at address their needs?

13. Client profile • Grade: 3rd (~8y); Primary Language: Ukrainian • Cog: SS=86 (WNL: 90-110) • Slower processing • Sustained attention challenges • Slight EF challenges • Speech sounds: lateral distortion /r, l/ • Lang-Rec: SS=86 • kind of understands overall message, misses details • Lang-Exp: SS=70 • disorganized structure, inaccurate syntax & vocab, multi-step directions • Pragmatics: Some challenges w making/keeping friends • Top S/L targets: • Intelligibility across settings • Syntax across settings • Organization of verbal & written expressive language

14. Pair & Share • CHARTR: • What are your Clinical Questions (skills, settings) • Collaboration: • Who are the people you want to talk to?

15. Questions?