Current Issues in School-Based Speech-Language Pathology

1. Current Issues in School-Based Speech-Language Pathology Shelly Wier, MS, CCC-SLP Easter Seals Outreach Program swier@ar.easterseals.com 501-221-8415

2. Current Issues • Evidence-Based Practice • Responsiveness To Intervention • SLPs’ Role in the School Literacy Program • Status of the SEAS Goal Project • Show and Tell: New products, programs, ideas, and collaborative successes

3. EBP: What Is It? • “. . . the integration of best research evidence with clinical expertise and patient values.” - Sackett et al., 2000 • “. . . the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual students by integrating individual clinical expertise with the best available external evidence from systematic research.” - adapted from ASHA 2004

4. EBP: Why Should I Care? • You don’t want to say “Huh?” when a parent asks you why you are using a particular technique. • Your principal asked you how you were complying with the NCLB requirement to use scientifically-based practices. • You don’t want to go to a due process hearing without a rationale for what you are doing. • You are a conscientious professional and want to make sound decisions about intervention. • You know the students you serve don’t have time to waste with practices that may be ineffective.

5. Goal of EBP Current Best Evidence EBP Clinical Expertise Family/Student Values

6. PAIRS READ ACTIVITY Read Paragraphs 1-11 Stop at Paragraph 12 then Summarize: Go back and quickly write one concise sentence for each paragraph.

7. In reality EBP is neither . . .

8. nor . . .

9. Rather . . .

10. Responsiveness To Intervention Prior Knowledge Check A problem-solving framework that may be used to detect academic and behavioral difficulties and guide the use of research-based interventions to provide intensive instruction.

11. Current Approach IDENTIFICATION COMES TOO LATE TOO MANY STUDENTS “WAIT TO FAIL” PROCESS MINORITY REPRESENTATIONS WRONG STUDENTS COST OF ASSESSMENT AND SERVICES

12. Prevention Model New and improved pre-referral intervention (validated interventions and valid progress monitoring) that precedes a comprehensive evaluation.

13. Prevention AND Identification Children who remain unresponsive to increasingly intensive interventions are “eligible” for special education. No comprehensive evaluation is necessary.

14. Why SLPs Should Know About It? • You should be informed about what’s going on in the general education arena • It may be the alternative to regression analysis that your district chooses to implement • It has the potential to change the way SLPs are involved with learning problems, especially in literacy • It may impact your workload • It may begin to change the way we think about students with language impairments

15. Three-Tier Model • Tier 1: High quality instructional and behavioral supports are provided for all students in general education. • Tier 2: Students whose performance or rate of progress falls behind their peers receive specialized instruction or remediation in the general education classroom. • Tier 3: Comprehensive evaluation is conducted by a multidisciplinary team to determine eligibility for special education and related services.

16. The SLP and Tier I • Help identify appropriate, scientifically-based curriculum, assessment, and instruction in language and literacy • Explain the language base of literacy • Help identify signs of struggle with language within school-wide progress monitoring systems • Consult about appropriate adaptations for struggling students

17. The SLP and Tier II Consult with and model for the team delivering targeted interventions to help make instruction most beneficial for students with language-learning difficulties.

18. The SLP and Tier III • Provide curriculum-relevant language therapy for students who have not benefited from Tiers I and II • Engage other educators in a partnership to provide therapeutic intervention • Consult with other special educators to help make their intervention language-sensitive • Provide assistance to general educators in making appropriate accommodations

19. Issues • Number of Tiers • Movement across Tiers • Distinguishing Tier II and Tier III interventions • Length of time in Tier II prior to receiving “specialized instruction” in Tier III • Eligibility and identification • Reconfiguration of existing resources • Older students

20. Advantages of RTI ASSISTANCE IS PROVIDED IN A TIMELY MANNER ASSESSMENT AND INTERVENTION ARE CLOSELY LINKED DATA INFORMS & IMPROVES INSTRUCTION ENSURES THAT POOR PERFORMANCE IS NOT DUE TO POOR INSTRUCTION NON-RESPONDERS ARE NOT GIVEN A LABEL

21. RTI and SLI If SLPs are more involved in Tiers I and II, some language impairments may be prevented.

22. RTI and SLI Use of RTI can circumvent problems we encounter with identification using standardized norm-referenced tests.

23. RTI and SLI Providing tiers of instruction may help us identify a smaller group of students for intensive therapeutic services.

24. RTI and SLI Providing tiers of instruction may help us to become involved with a broader population as part of our workload.

25. What Will It Require? • Greater understanding and recognition of the role of language in curriculum and instruction on the part of educators • SLPs becoming more of a “front and center” resource to schools • Mechanisms that involve SLPs in all tiers while maintaining a reasonable workload • Transition from a “caseload” to a “workload” orientation

26. Let’s Chat Role in literacy SEAS Goals Project Show and Tell

27. Show & Tell Stations Video: Arkansas SLPs EBP: ASHA’s 4-Step Process RTI: Reading Interventions Review Self-Study Materials Review New Tests & Materials Bloom & Hicks