Response-to-Intervention & Instructional Consultation- Teams: The SLP’s Role

1. Response-to-Intervention & Instructional Consultation- Teams: The SLP’s Role A Seminar Presented at the 2006 American Speech-Language-Hearing Association Convention, San Diego, CA by W. David Mills, Section Chief, Exceptional Children Division NC Department of Public Instruction, Raleigh, 27699-6356 dmills@dpi.state.nc.us; www.ncpublicschools.org/ec

2. What Will Be Presented Today • Information about the Problem-Solving/Response-to-Intervention approach to serving students who struggle • Information about the Instructional Consultation-Team Model for working with teachers who serve students who struggle • Implications for speech-language pathologists

3. More Specifically • What one State is doing to move toward a different way of providing services • The reason for this move • Explanation of P-S/RtI • Explanation of IC-Teams • Some interventions to consider • Some thoughts as to how the SLP can be instrumental in helping implement P-S/RtI and IC-T for the benefit of children and youth

4. Mel Levine wrote: Struggling children comprise a very large and heterogeneous group. They differ from each other in their strengths as well as in the reasons for their learning difficulties. However, they all share a deep desire to taste success and to feel good about themselves. Every one of them contains the seeds of mastery and gratification in life; none of them needs to fail. (Educational Care: A System for Understanding and Helping Children with Learning Problems at Home and in School. Cambridge, MA: Educators Publishing Service, Inc. 1994, pp 1-2)

5. IDEA ’04 – Some Specific New Wording of Interest • For SLD eligibility determination when addressing what excludes a student from being identified: “lack of appropriate instruction in reading, including in the essential components of reading instruction (as defined in section 1208(3) of the ESEA of 1965; lack of instruction in math; or limited English proficiency.

6. IDEA ’04 New Wording continued • “Specific Learning Disabilities – (A) In General – …when determining whether a child has a SLD as defined in section 602, a local education agency shall not be required to take into consideration whether a child has a severe discrepancy between achievement and intellectual ability in oral expression, listening comprehension, written expression, basic reading skill, reading comprehension, mathematical calculation, or mathematical reasoning.”

7. IDEA ’04 New Wording continued • “(B) Additional Authority. – In determining whether a child has a SLD, a local education agency may use a process that determines if the child responds to scientific, research-based intervention as a part of the evaluation procedures described in paragraphs (2) and (3)”

8. IDEA ’04 New Wording continued • When addressing evaluations, the law states that local education agencies must assure that assessments “are provided and administered in the language and form most likely to yield accurate information on what the child knows and can do academically, developmentally, and functionally….”

9. IDEA ’04 New Wording continued • Under the Findings section, “Almost 30 years of research and experience has demonstrated that the education of children with disabilities can be made more effective by – (A) …access to the general education curriculum in the regular classroom... (E) supporting high quality, intensive preservice preparation…for all personnel to ensure that all personnel have the skills and knowledge necessary to improve the academic achievement and functional performance of children with disabilities, including the use of scientifically based instructional approaches,… (F) providing incentives for whole-school approaches, scientifically based early reading programs,

10. positive behavioral interventions and supports, and early intervening services to reduce the need to label children as disabled in order to address the learning and behavioral needs of such children….”

11. Note Expectations from IDEA ‘04 • Lack of emphasis to the essentials in the teaching of reading means a student will not qualify for SLD identification. • No longer must there be a discrepancy between aptitude and achievement to qualify for SLD identification. • Emphasis is to be upon scientific, research-based interventions for students with SLD. • Assessments must produce information about what students can do academically, developmentally and functionally.

12. Expectations from IDEA ’04 continued • Emphasis for accessing the general curriculum is to be in the regular classroom. • School personnel are to have specific skills and knowledge to improve academic achievement and functional performance and in the use of scientifically based instructional approaches. • Schools are to emphasize scientifically-based early reading programs, positive behavior interventions and early intervening services.

13. OSEP Holds State Accountable For • Improvements in academic achievement of students with disabilities (SWD), • Increased graduation rates of students with SWD, • Decreased drop-out rates of students with SWD, and • Attention to disproportionality (reduce over-representation of minorities in special education).

14. Some Major Concerns in Special Education in NC • Questionable approaches for identifying students with disabilities, particularly students with specific learning disabilities • Inappropriate and over-referrals for special education services • Over-representation of minorities in certain areas of special education classification, particularly mental disabilities and behavioral-emotional disabilities

15. Concerns as Noted by Guy McBride • A review of Orton records -- the risk of suicide is much higher among poor readers (Frank Wood) • Research has shown students with SLD had more difficulty accessing appropriate health care as adults • Almost 50% of adolescent suicides had previously been diagnosed as having learning disabilities (1985, Dr. Peck, Crisis Intervention with Chronically and Acutely Suicidal Adolescents – Youth Suicide (pp 112-122), NY; 1988, Young, Leenaars, and Rourke, A Childhood Learning Disability Predisposes Those Afflicted to Adolescent and Adult Depression and Suicide Risk, Journal of Learning Disabilities, 22 (3) (pp 169-175).

16. Concerns continued • 75% of children with reading disabilities in grade 3 who did not receive early intervention continue to have difficulties learning to read throughout life. (Reid Lyon’s testimony before the Committee on Education and the Workforce, a committee of the US House of Representatives, July 19, 1997) • 35% of students identified with SLD drop out of high school. (Washington Summit on Learning Disabilities, 1994)

17. Concerns continued • The literature is replete with information stating that 30% to 70% of young offenders have experienced learning problems. • Students with special learning needs are often not identified until 4th or 5th grade. • These same children may have been referred as early as kindergarten.

18. Scenario by Guy McBride • Johnny is referred in kindergarten, tested, and his mother is called. • “We’re terribly sorry to have to tell you this, but we think it’s better just to be blunt. Because your son Johnny couldn’t read, we referred him, but the testing shows – this is hard for us to say – the testing shows he’s not disabled. “But don’t worry, we’re going to refer your

19. little boy again next year, and maybe by then he’ll have fallen far enough behind to qualify for some help.” • “If this is what we do, it hurts kids…. And it makes us look stupid.” (Guy McBride is a school psychologist with the Burke County School System in North Carolina. He serves on the North Carolina Department of Public Instruction’s Problem-Solving/Research-to-Intervention Planning Team.)

20. Why Make Changes in Eligibility Determination for SLD? • According to Jim Deni, Professor, Appalachian State University and member of NC Study Team: • During 1980s and 1990s, the number of students with LD label has been escalating special education costs with little or no effect. • Most academics and some professional organizations acknowledge the IQ discrepancy approach as flawed.

21. Why Make Changes continued • Evaluations are based on standardized tests. • Evaluation assumes relationship between IQ achievement. • Difficulty in linking assessment to school expectations • Difficulty assessing progress/growth • Little collaboration of school resources • Heavy reliance on pull-out programs

22. Why Make Changes continued • According to Speece & Shekitka (2002) 70% of 218 members of the editorial boards of several scholarly journals stated that IQ/achievement discrepancy should plan no role in how reading disabilities should be operationalized. • By the mid 1980s, pre-referral intervention was seen by policy makers, academics, and practitioners as a solution to the apparent over-identification of LD populations.

23. Why Make Changes continued • Despite their popularity, pre-referral interventions have failed to reduce the number of students identified as LD and there is little empirical evidence that the interventions used by teacher assistance teams (school support teams, etc.) are implemented with fidelity. • According to Telzrow et al (2002), reliable implementation of teacher assistance teams remains elusive.

24. The Commentary Section of The School Psychologist, Winter 2005 • Nothing in the current and past versions of the IDEA statute or regulations requires that standardized tests be given to determine a child’s eligibility for special education. Moreover, there is nothing in…IDEA reauthorization…that mandates a RtI model, although we believe that the best interests of children are served by a strong RtI component in eligibility determination.

25. The School PsychologistWinter 2005 continued • The EHA/IDEA has never required the assessment of cognitive or perceptual processes as part of determining SLD eligibility. • …there is no substantial body of evidence that cognitive processing domains and measures improve SLD identification, control prevalence, translate into more effective instruction, or improve prediction of the outcomes of interventions.

26. The School PsychologistWinter 2005 continued • Comprehensive evaluation in a RtI model focuses on direct assessment of teachable skills related to the curriculum that inform decision makers about what to teach and how to teach it. (From Gresham, F. M., Reschly, D.J., Tilly, W.D., Fletcher, J., Burns, M.; Christ, T., Prasse, D., Vanderwood, M., and Shinn, M. Comprehensive Evaluation of Learning Disabilities: A Response to Intervention Perspective. This is a critique of the “American Academy of School Psychology Statement on Comprehensive Evaluation for Learning Disabilities by AASP Ad Hoc Committee on Comprehensive Evaluation for Learning Disabilities, Volume 58, Number 3, Summer 2004.)

27. NC Specific Learning Disabilities: Eligibility Study Team • Commissioned in 2000-2001 by the State: • To examine the process used in NC to determine a student eligible for special education in the area of SLD • To conduct a comprehensive study of the SLD eligibility process of other states and make a recommendation for recommendation

28. Study Team Participants • 17 members representing • School psychologists • Speech-language pathologists • University speech-language pathology, special education and school psychology personnel • Local directors of special education • Classroom teachers • State education agency personnel • Private practice psychologists • School compliance personnel

29. Experts Presenting to the Study Team • Frank Wood, Wake Forest University • Dawn Flanagan, St. Johns University • Jim Deni, Appalachian State University • Stephen Hooper, UNC at Chapel Hill • Gail Rodin, Center for Learning, Memory and Attention, Raleigh • Jeff Grimes, Heartland Area 6 Schools, Iowa • Ben Barbour, Horry County Schools, South Carolina • Todd Gravois, University of Maryland • Renee Bradley, OSEP • Robert Pasternack, Sp. Ed. & Rehab Services, DC

30. Topics of Study by the Team • IQ/achievement discrepancy model • Regression model • Problem-solving model • Instructional Consultation Teams • Curriculum-based assessment/measurement • Cross battery assessment • SLD definition • Processing deficits • Reading deficits • Early and preventative interventions • State and federal regulations

31. Some Thoughts Guiding the Team • It is not special education that most children need, it is education that is special. (Brogdan, OH) • Special education is not the answer to poor general education. (Mills, NC) • If children don’t learn the way we teach, then we must teach the way children learn. (Villa, CA)

32. SLD Eligibility Study Team Beliefs • All children can learn. • Educators, parents, and students are collectively responsible for meeting the student’s educational needs. • Parents have a vast knowledge about their children and should be included as partners in the educational process. • Students should be assisted when concerns arise. • Students’ needs are to be met in the general education setting whenever possible.

33. SLD Eligibility Study Team Beliefs continued • Educators, parents, and students deserve the resources necessary to meet the educational needs of the student. • The problem-solving process provides best practice educational strategies to address student needs. • The best educational strategies are based upon empirical research and accurate, ongoing information/data collected and reported on student progress.

34. What a Better Way to Determine Eligibility Is Expected To Do • Integrate the resources of general, compensatory and special education • Broaden the range of intervention alternatives • Provide increased flexibility in the use of all personnel • Promote the general education classroom as the preferred environment for delivery of services • Enhance the outcomes of services for all students • Promote the involvement of parents in the decision-making process

35. What a Better Way to Determine Eligibility Is Expected To Do cont. • Benefit the students through procedures used to directly and frequently monitor intervention effect • Benefit the students through an outcome criterion, focusing on student gains • Address the issues of over-identification and misidentification of students for special education • Result in earlier and more appropriate interventions for students • Result in the acquisition of new professional skills

36. The Better Way to Determine Eligibility • Will not result in keeping students out of special education • Will not “open the floodgates” to special education • Will not delay services to students who need help • Is not simply a procedural model • Is not just using curriculum-based assessment/measurement (CBA/CBM) or functional assessment, or general education interventions, or the like • Is not doing what has always been done

37. Conclusions of Study Team • No modifications of the IQ/achievement discrepancy model would serve to eliminate the “wait-to-fail” premise of the existing identification practice • Instead, develop a RtI model to eliminate the practice of being reactive to student learning problems • Recommend a request for rule replacement for the present State regulations and adopt a P-S/RtI model (From a presentation by Tom Layton, Professor of Speech-Language Pathology at NC Central University, and Mike Booher, Supervisor of Psychological Services, Guilford County Schools, NC, 2004)

38. Other Work of the Study Team • Visited Horry County Schools, South Carolina • Visited Heartland Area 6 Schools, Iowa • Attended 6th Annual Innovative Practices in Special Education Conference • Wrote procedures for P-S/RtI Pilot Study • Established criteria for pilot schools selection • Sent suggested procedures and selection of pilot school criteria to State Education Agency for consideration

39. Five LEAs in NC are Pilots • Burke County Schools • Guilford County Schools • Harnett County Schools • New Hanover County Schools • Bertie County Schools

40. What is the PS/RtI Model? • It is an approach to developing interventions and ensuring positive student outcome – rather than determining failure or deviance (Deno, 1995). • It is sometimes called Problem-Solving • It is sometimes called Response to Intervention • It is sometimes called Responsiveness to Interventions • It has been called Resistance to Interventions

41. RtI refers to an individual, comprehensive student-centered assessment and intervention concept that has generated several models used in schools. RtI is sometimes referred to as a problem-solving method. RtI models focus on applying a problem-solving framework to identify and address the student’s difficulties using effective, efficient instruction and leading to improved achievement.

42. PS/RtI Principles • Hahn, Kreykenbohm, and Jenkins of New Hanover County Schools (NC) state: • Assessments should have a relationship to positive child outcomes, not just perditions of failure. Assessments without this relationship do little to benefit children and waste time and resources. • Brief screening measures of IQ can be used to rule out mental retardation if suspected, otherwise IQ measures have no place in SLD diagnosis.

43. PS/RtI Principles continued • RtI operationalizes disability by documenting slow rate of learning and large differences from age or grade expectations despite high quality, scientifically based interventions. • Assessment in RtI focuses on achievement, behavior and the instructional environment. • Note these things are measurable and changeable, relate to child outcomes, and allow for in-depth analysis of performance relative to peers.

44. PS/RtI Principles continued • Comprehensive assessment includes screening in all areas that impact achievement (hearing, vision, etc.), followed by assessments in current academic skills and behaviors and of the instructional environment and the interventions used. • Attention is given to time allocated for instruction, academic learning time, pacing of instruction, opportunities to respond, etc.

45. PS/RtI Principles continued • Assessment is designed to help teachers/interventionists know what to teach.

46. PS/RtI’s Focus • Measurement of intervention effectiveness • Early identification and early intervention • A graduated series of increasingly intense interventions guided by data-based decision making

47. Steps in a P-S Model • Define the problem – what is the problem and why is it happening? • Develop an assessment plan – what are we going to do? • Implement the plan – carry out the intervention • Evaluate – did the plan work?

48. NC Problem-Solving Model Level 4 IEP consideration Level 3 Consultation with extended PS team Amount of resources needed Level 2 Consultation with other resources Level 1 Consultation between teacher & parent Intensityofproblem

49. P-S/RtI Team A P-S/RtI Team at each school implements the P-S/RtI process. The team is made up of a core of two-to-four classroom teachers and other school personnel as needed. The student’s parent and the student’s teacher join the core team.

50. Level 1 – Teacher is case manager • Consultation between teacher and parent, including student when appropriate • Define the problem – They discuss concerns • Develop a plan – They brainstorm interventions to address problem • Implement plan – They put interventions in place, collect information and set a time to evaluate effectiveness • Evaluate – They determine effectiveness of interventions, if there is a need for more interventions, or if movement to Level 2 is needed