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Michigan Speech-Language Guidelines S uggestions for Eligibility, Service Delivery, & Exit Criteria Revised. Maureen Staskowski, Ph.D., CCC-SLP. March 9, 2007. Available at www.michiganspeechhearing.org.

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slide1

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

slide2

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

slide3

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

the purpose
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

slide5

1992

Last version released

1995

Addendum for Standards for Delivery

2006

Reorganization

Updates

MSHA Staskowski 2007

why revise
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

the guidelines outline
The Guidelines: Outline
  • Preliminary Sections
  • SLI as Primary Disability
  • SLI as a Related Service
  • Special Issues

MSHA Staskowski 2007

preliminary sections
Preliminary Sections
  • Forward
  • School Practice & Professionalism
  • Workload Approach to Caseload
  • Culturally and Linguistically Diverse

MSHA Staskowski 2007

professionalism
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

professionalism10
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

feeling frantic how can we do all that is expected
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

slp workload activity clusters
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

this approach takes into account
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

examples of flexible scheduling
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

sli as a primary disability
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

slide19

Early

Intervening /

Response to

Intervention

for SLI

L-7

MSHA Staskowski 2007

sample form for documenting early intervening services
Sample form for documenting early intervening services

Articulation

Language

Voice

Fluency

Learning Disabilities

MSHA Staskowski 2007

slide21

Language Assessment

MSHA Staskowski 2007

michigan rule 1710
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

slide23

Eligibility Guide /

Team Summary

Language

Articulation

Voice

Fluency

Assessment Activities

L-8

MSHA Staskowski 2007

input
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

consideration of

Consideration of

Cultural and Linguistic Differences

Environmental and Economic Differences L-18

MSHA Staskowski 2007

curriculum based language assessment27
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

cbla examples page l 20
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

tools for you
Tools for You
  • CBLA Language Assessment and Summary
  • Reading Assessment and Summary
  • Writing Assessment and Summary

L-35-40

MSHA Staskowski 2007

record results of rti or dynamic assessment
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

language samples
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

methods for collecting language sampling
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

test profile
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

tests and iq

Tests and IQ

MSHA Staskowski 2007

why not compare solely to iq cognitive reference
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

problems with cut off scores
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

test guidelines
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

the lesson in all of this

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

acceptable levels of sensitivity specificity levels by
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

form impressions regarding
Form Impressions regarding
  • Presence of a Disability
  • Adverse affect of Disability on Educational Performance

MSHA Staskowski 2007

slide41

Language Intervention

MSHA Staskowski 2007

goal setting
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

slide43

L-47

MSHA Staskowski 2007

curriculum relevant intervention goal monitoring
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

so what has changed

So……. what has changed?

MSHA Staskowski 2007

culturally linguistic diverse populations

Culturally Linguistic Diverse Populations

Michigan Guidelines

Karen Graham – L’Anse Creuse

cultural competence of the slp
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

bics and calps
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

second language acquisition
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

bidialectal
Bidialectal
  • Students who use dialect of English other than SAE are called Bidialectal.
  • Example: Southern Dialects of English
  • Students can be dialectal in other languages as well.

Graham, 2006

use of interpreters
Use of interpreters
  • Interpreters can be used throughout the pre-referral and assessment process.
  • Should be fluent in both oral and written modalities of the student.
  • Facilitators of language between the parents/caregivers and the SLP.

Graham, 2006

interpreters
Discuss roles and responsibilities

Review key concepts, phrases, words, and procedures

Remind the interpreter that he/she must not alter, omit, or add to the communication.

Ask the interpreter if specific words/concepts are not translatable.

Ask about cultural considerations

Interpreters

Graham, 2006

slide54

Team Summary

CLD

Referral Decision

Similar Format

LD

CI

Add Service Decision

Graham, 2006

MSHA Staskowski 2007

guide team summaries
Guide Team Summaries
  • Input
  • Observations
  • Curriculum
  • Classroom modifications
  • Dynamic Assessment
  • Referral
  • Other Considerations

Graham, 2006

assessment
Assessment
  • Nonstandardized approaches should be the primary method of gathering information.
  • Standardized testing- consult the examiners manual for interpretations of responds

Graham, 2006

language dominance
Language Dominance
  • It is important to determine the dominant language
  • Bilingual English Proficient
  • Limited English Proficient
  • Limited in Both Languages

Graham, 2006

extended case history
Extended Case History
  • Language development
  • Student’s residency
  • Cultural beliefs
  • Language dominance
  • Exposure to primary and secondary language
  • Student’s academic history

Graham, 2006

language samples59
Language Samples
  • Obtain language samples in both languages
  • Obtain language samples across settings
  • Obtain language samples with multiple partners
  • Look at multiple formats
  • Curriculum Based Language Assessments

Graham, 2006

test selection and use
Test Selection and Use
  • Look at the normative sample of test. Does it adequately represent the student’s culture?
  • Does the student have some familiarity with the language of the test?
  • Does the student have some familiarity with situations presented in the test?
  • Is the vocabulary geographical or cultural specific?
  • Does the test display a potential for bias?

Graham, 2006

test modification
Test Modification
  • Test modification is an alternative way of assessing skills of a CLD student.
  • It can involve addition, deletion or modification of test items
  • Beware: Violation of test reliability, and validity.
  • Reword instructions, allow extra time for responses
  • Increase the number of practice items
  • Test beyond the ceiling
  • Ask for explanation of incorrect responses.
  • Dynamic assessment

Graham, 2006

intervention
Intervention
  • Bilingual Speech and Language Pathologist
  • Most studies recommend early intervention in the student’s native language
  • Provide a cultural linguistic framework to facilitate language skills
  • In service training
  • Consultative
  • Training ESL staff to facilitate language skills in the classroom

Graham, 2006

web sites
Web Sites
  • www. readingrockets.org Look under web casts
  • Differentiated Reading Instruction
  • From Babbling to Books
  • Assessment of English Language Learners
  • English Language Learners in Middle and High School
  • Comprehension: Helping English Language Learners Grasp the Full Picture
  • ASHA’s web site under Multicultural issues

Graham, 2006

articulation

Articulation

MSHA Staskowski 2007

articulation special issues
Articulation: Special Issues
  • Lateral Lisp
  • Intelligibility
  • Single Sound Errors

MSHA Staskowski 2007

development sounds charts the challenges
Development Sounds Charts: The Challenges
  • Controversy
  • Type of research –

50% versus 90%

  • Two sets of well-respected data

What to do?

MSHA Staskowski 2007

articulation team summary

Articulation Team Summary

MSHA Staskowski 2007

what is adverse effect on educational performance
What is Adverse Effecton Educational Performance
  • Academic and nonacademic performance.
  • Letters from Department of Education
  • IDEA - Curriculum is
    • Academic
    • Nonacademic
    • Extracurricular

MSHA Staskowski 2007

fluency

Fluency

MSHA Staskowski 2007

what s new
What’s New
  • Risk Factors
  • Cluttering Inventory
  • Teasing and Bullying
  • Parent Handout

MSHA Staskowski 2007

voice

Voice

MSHA Staskowski 2007

sli as a related service

SLI as a Related Service

MSHA Staskowski 2007

sli as a related service speech and language services for students with other primary disabilities
SLI as a Related ServiceSpeech and Language Services for Students with other Primary Disabilities
  • Autism Spectrum Disorders
  • Cognitively Impaired
  • Early Childhood Dev.
  • Physically Impaired
  • Otherwise Health Impaired
  • Learning Disabled
  • Severely Multiply Impaired
  • Emotionally Impaired
  • Traumatically Brain Injured
  • Hearing Impaired
  • Visually Impaired

MSHA Staskowski 2007

michigan special education code
Michigan Special Education Code

Rule 340.1710

Subrule (4) Students who have a communication disorder, but whose primary disability is other then speech and language may be eligible for services under R. 340.1745 (a).

Rule 340.1745(a)

The speech and language services provided by an authorized provider of speech and language services shall be based on the needs of a student with a disability as determined by an individualized education program team after reviewing a diagnostic report provided by an authorized provider of speech and language

MSHA Staskowski 2007

considerations for related services
Considerations for Related Services
  • Eligibility under primary impairment.
  • Diagnostic report documents need for service
  • Standardized test scores are not required
  • Allows for fluid service provision for students who need changing amounts of speech and language support throughout school career

MSHA Staskowski 2007

learning disabilities
Learning Disabilities
  • New laws
  • What the student needs… who does what? Page LD13

MSHA Staskowski 2007

cognitive impairments

Cognitive Impairments

Team Summary Guide

MSHA Staskowski 2007

common issues
Common Issues
  • Transitions
  • Intelligibility
  • AAC
  • CBI/Vocational Instruction
  • Behavior

MSHA Staskowski 2007

traumatic brain injury

Traumatic Brain Injury

MSHA Staskowski 2007

hearing impaired

Hearing Impaired

Auditory Processing

SIFTER

MSHA Staskowski 2007

slide84

ECDD

MSHA Staskowski 2007

special issues
Special Issues
  • Auditory Processing
  • Assistive Technology
  • Feeding and Swallowing
  • Selective Mutism

MSHA Staskowski 2007

thank you

Thank You!!

MSHA Staskowski 2007