Facilitated Discussion ~ Response to Intervention Context, Evidence, Process

1. Facilitated Discussion ~Response to Intervention Context, Evidence, Process Kentucky Big East Coop Special Ed Directors June 28, 2013 JoAnn Wiechmann, EdD, CCC-SLP

2. Disclosure Relevant financial relationship(s) & relevant nonfinancial relationship(s) • I have thefollowing relevant financial relationship(s) in the products or services described, reviewed, evaluated or compared in this presentation. • ARtIC Lab ™, published by Super Duper, Inc. • Language Lab™, published by Super Duper, Inc. • Description of financial relationship: I receive publication royalties on these products.

3. 3 Discussion Strands • RTI: What Is It? • RTI: Where Does It Fit in Public Education? • RTI: Why Does It Matter Now? • RTI: Do SLPs in Schools Have a Role? • RTI: What is the Evidence Base for RTI? • RTI: How can SLPs manage adding RTI to full caseloads?

4. RTI: What is It? RTI Defined

5. RTI is the practice of • Providing high quality instruction/ intervention matched to student needs and • Using learning rate over time and level of performance to • Make important educational decisions. • RTI provides support w/ increasing intensity as needed

6. Goal of RTI • Ensure that all children and adolescents have access to high-quality instruction and learning opportunities and • Struggling learners are identified, supported and served early and effectively. • Interventions are generally provided in the areas of: • Academics (reading, math, S/L) • Behavior

7. …in other words… There are systems in place to help every child meet grade level expectations in academics and behavior… “Whatever it Takes!” (individualized, just-in-time, prevent failure, through general education)

8. RTI Hypothesis • If the student responds to an intense diet of instruction, then s/he probably does not have a language learning disability or articulation disorder

9. RTI • Is part of the general education system • Parallels the spirit of individualized education programs ~ previously available only through an “IEP” in special education • Emerged out of political agendas (funding, No Child Left Behind, national standards, era of accountability) • Is probably here to stay • So…we better figure out how to be part of it!

10. RTI: Intuitive and Innovative • Intuitive: makes sense that professionals check to see if instruction is working…to determine if the learner is responding…and if not responding, someone takes action to do something about that. • Innovative: public education is universal but has not been individualized. The burden has been on the learner to fit the mold; not for the system to flex for the needs of each individual.

11. RTI: Where Does It Fit in Public Education?

12. Public Education in a Democracy • Democracy is based on the premise that well-educated, well-informed citizens will give input to the advancement of the society. • The universal right to a public education is not found in the Constitution of the United States of America, • So public education becomes the responsibility of the states and each local community.

13. Texas Education Code §4.001(for example…implements the state constitution…) The mission of the public education system of the State of Texas is to ensure that all Texas children have access to a quality education that enables them to achieve their potential and fully participate now and in the future in the social, economic, and educational opportunities of our state and nation. The mission is grounded on the conviction that a general diffusion of knowledge is essential for the welfare of this State and for the preservation of the liberties.”

14. Public Education in the USA • States and Local Communities • establish schools and colleges, • develop curricula and learning standards, • determine requirements for graduation, • establish a means of funding schools. • Federal Funding = Purse Strings Legislation • If you want $, then follow all the rules • Current Administration Favors National Standards • Common Core State Standards • NCLB and IDEA aligned accountability systems

15. What about…The Purpose of Special Education… To prepare students for further education, employment, and/or independent living

16. Special Education • Based on federal education laws and the premise that “all children can (and get to) learn” • In order to access federal funds, states and local school districts must follow federal statutes, regulations, and rules • Speech Path listed as a special education instructional or related service in P.L.94-142 (1973 – first special ed federal law)

17. SLP Services in Schools • SLP services are provided to students who have communication disorders that result in an adverse effect on educational performance • The setting affects the service delivery…services not in isolation… • Educational relevance is required! • Important to link SLP clinical services to grade level standards

18. RTI: Why Does It Matter Now?

19. Context for Change • Two movements changed conditions in America’s schools: • Standards-based reform • Improving America’s Schools Act and Goals 2000: Educate America Act (1994) • Challenging academic content and performance standards; Assessments aligned with standards • Accountability for student performance • NCLB Adequate Yearly Progress • IDEA 2004

20. Context for ChangeResearch and Policy Considerations • National Reading Panel (2000) • Identified essential components of early reading instruction • Important in special ed since most students with LD have reading problems • President’s Commission on Excellence in Special Education (2001) • Focus on results not identification process • Focus on prevention • General ed first

21. Context for ChangeResearch and Policy Considerations • National Summit on Learning Disabilities (2002) • Sponsored by OSEP/USDE • Traditional LD identification not grounded in research • Supported “response to quality intervention” • National Research Council Panel on Minority Representation (2002) • No research to confirm benefit of special ed for minority students • Should focus on prevention and early intervention • 4-Tier system of intervention and treatment

22. Platform for Change to RTI • In place for a decade • Let’s work on systems, guidelines, procedures for data-driven decisions, and intervention approaches • So that… • SLPs have a clear, well-defined, and measurable contribution for RTI: • Intervention for Prevention and Identification

23. Context for Change (a little more)Special Ed may not work well… • Research studies show little benefit from special education services for closing achievement gap • Special Ed instruction has been ~ • Too general • Unsystematic • Provided too late…after history of failure

24. So…In this era of accountability… • We need to make sure all students meet grade level expectations • We need to make sure we teach students to read in a way that matches how they learn • We need deep understanding of the language underpinnings of literacy • We need deep appreciation for the fact that without an intact language system…it is very hard to “do” school.

25. RTI: Do SLPs in Schools Have a Role?

26. Speech-Language Pathology Services [CFR §300.34(c) (15)] • Identification; • Diagnosis and appraisal of specific speech or language impairments; • Referral for medical or other professional attention needed for habilitation of speech or language impairments; • Provision of speech and language services for the habilitation or prevention of communicative impairments; and • Counseling and guidance of parents, children, and teachers regarding speech and language

27. The definition of speech-language pathology services in IDEA 2004 paves the way for involvement of the school-based SLP in RTI.

28. Roles and Responsibilities of SLPs in Schools: 2010 ASHA Position • Critical Roles in Education • Working Across All Levels • Serving a Range of Disorders • Ensuring Educational Relevance • Providing Unique Contributions to the Curriculum • Highlighting Language & Literacy • Addressing Cultural and Linguistic Diversity • Range of Roles & Responsibilities • Prevention • Assessment • Intervention • Program Design • Data Collection & Analysis - Accountability • Compliance

29. Roles and Responsibilities in Schools2010 ASHA Position • Collaboration • Collegiality with Educators • Collaboration within the Community • Partnerships with Universities • Partnerships with Families • Partnerships with Students • Leadership • Advocacy • Communication • Supervision and Mentorship • Professional Development • Parent Training • Lifelong Learning • Research

30. ASHA Position Statement includes Prevention in Roles and Responsibilities of School-Based SLPs!!

31. SLPs in RTI: Define R&R across Tiers • Tier 1 • All Students: effective, engaging, rigorous, individualized, standards-based instruction • Universal screening procedures • Periodic progress monitoring • School-wide behavior expectations/standards • The key to RTI working well for students • Tiers 2 & 3 • Students struggling to meet expectations get help • Focused intervention on specific target skills needed to support success in Tier 1 • Frequent progress monitoring of target skills

32. Tier 1 SLP Activities • Direct Services • Expanded speech and language screening • Additional support in the classroom • Classroom time during small group instruction to work on speech or language development • Assist young children with “good speech” in centers • Provide lessons • Co-teaching bursts • Indirect Services • Classroom observations, parent education, student support teams, homework programs, C&I consultation, staff development

33. Tier 2 SLP Activities • Direct Services • Focused intervention on specific skills ~ generally articulation and language • Intervention provided in addition to Tier 1 • Frequent progress monitoring • Frequent intervention ~ intervention period measured in terms of hours (15 to 20 hours) • Correct production of target followed by opportunities for mass practice • Indirect Services • Observe Tier 2 students to identify when struggle linked to speaking, listening, reading, writing; assist with progress monitoring; communicate Tier 2 progress to teacher & parent

34. RTI: What is the Evidence Base?

35. 3 Examples • ARtIC Lab (Super Duper) • Effectiveness for preventing referrals • Cost savings • Language Lab (Super Duper) • Effectiveness for preventing referrals • Program evaluation data • Story Lab (Pasadena ISD, Tx) • Locally developed

36. Evidence Base for Articulation(based on tracking results from ARtIC Lab) • Tier 2 Intervention Program for 1st – 3rd graders • One or two simple sound errors ~ may or may not meet eligibility criteria for IEP services • Nonstimulable for target sounds • Monitor students who are stimulable; treatment probably is not warranted. • Research suggests that stimulable sounds will develop without intervention (Gierut, 2007).

37. Evidence Base for Articulation(based on tracking results from ARtIC Lab) • 3 – 4 30 minute sessions/week • Groups of 3 – 5 students • Station rotation • Quick correct production • Mass practice ~ drill, drill, drill • SLP monitors productions and shapes sounds • Treatment selection and randomization are key!

38. Data Collection • Summer pilot program • Data collection in 2006 – 2007 • RTI services • IEP services • More data collection in 2007 - 2008

39. Summer Pilot Program: Quantitative Data

40. 2006-2007 Fall Data • 18 elementary campuses • 89 RtI students • 97% (87) Responders • 3% (2) Non – Responders needed referral for special education evaluation

41. 2006-2007 Fall Data(same approach for students with IEPs) • Students with an Individualized Education Program (IEP) for articulation • 18 elementary campuses • 91 students with an articulation IEP • 25 dismissed or ready for dismissal • 27% reduction in caseload

42. 2007-2008 Fall Data(data snapshot 1 – 20 hours of intervention) • Elementary campuses: 21 • RtI students: 110 • 97% (107) Responders • 20% of Responders (22) exited RTI • 80% of Responders (85) continued • 3% (3) Non-responders referred for special education (speech) evaluation • The closer to 20 hours of intervention, the more students are ready to exit

43. Cost SavingsArticulation (only) Referral • Paper • Approximately 52 pages per student • 52 pages X 89 = 4,628 pieces of paper • Time investment • Approximately 7 hours X 89 students = 623 hours • Personnel costs • Approximately $24,920 to test/place 89 students • Preventing pull-out IEP services? Priceless.

44. Evidence Base for Language(based on tracking results from Language Lab) • Tier 2 intervention program K – 4th grade • Students struggling with oral language • Fail reading comp portion of reading universal screener • Fail story retell screener • Teacher concern • Groups of 4 – 5 students • 2 – 3 30 minute sessions/week

45. Evidence Base for Language(based on tracking results from Language Lab) • Station rotation • Homework Component • Designed to work on: • Nouns, adjectives • Verbs, adverbs • Connecting language • Narrative skills • Story Station with SLP • Work on target skills through connected narrative language

46. Language Lab: RTI Program • Data Outcomes of Pilot Programs • 3 districts (2 Texas, 1 Nevada) • Spring 2010 pilot focused on program development • Fall 2010 pilot focused on student responsiveness • During the fall semester, 81% of students exited or were progressing at the expected rate to recommend continuing Language Lab • 19% students did not respond at expected rate-referred for special education testing • Limitation: n of 32

47. Program Evaluation Language Lab • Studied SLP reported effectiveness of the program • Examined utility, feasibility, and accuracy of Language Lab as a program for use with students struggling with oral language

48. What were the Outcomes? Research Question 1: How effective were the instructional strategies in the program in reducing the need for referral for special education evaluation? • Data sorted by responders and non-responders • Responders—exited (n=131) or continued in program (n=111) • Non-responders—referred (n=102) • 70.3% reduction in referrals (n=242)

49. What were the Outcomes? Research Question 1: • Overall effectiveness ratings (effective/very effective • Exited students 90% • Continued students 60% • Referred Students 70% • Value ratings for Intervention Data (effective/very effective) • 90% of SLPs

50. What were the Outcomes? Research Question 2: In what ways did the program improve oral language and narrative skills? • Common Themes • Student Improvement • Generalization of Skills • Specific Instructional Strategies