How CHC links School Psychologists with Speech Language Pathologists or how to collaborate besides using a staple

1. How CHC links School Psychologistswith Speech Language Pathologists(or how to collaborate besides using a staple) Andrew Shanock, Ph.D., NCSP Jacquelyn O�Connor, MA Jacqueline Butera, MA College of Saint Rose, Albany NY 1 shanocka@strose.edu

2. Goals of Presentation Change how we approach assessment Review the Federal Law Define CHC and Cultural Linguistic Demands How to assemble a Cross Battery Assessment How it impacts recommendations and interventions Show how we do the same or nearly the same tests Writing a Comprehensive SLP SP report Open up communication between SP�s and SLP�s 2

3. 3

4. 4

5. We like RtI Terrific Model for Early Intervention/Prevention No more Wait to Fail Early intervention lowers the risk of academic difficulty in the future Helps identify those who suffer from dispedagogia rather than a possible learning disability General Education movement Break down the walls between Spec Ed and Gen Ed. Teach everyone not just the middle Focus on the resources we have, not what we don�t have. 5

6. YAY RtI Allow me to do more than just test! We are not psychometricians, we are psychologists (no matter what APA may say) Gets me more involved in academics Pushes school psychologists to understand what is reading, writing, math, etc. We can actually use our consultation skills 6

7. Questions RtI still needs to answer How long for interventions How many interventions Differences between schools (even within districts) Reliability and Validity RtI only answers WHAT is happening, not WHY (especially at Tier III) 7

8. Comprehensive Assessment Can give us a better sense of the WHY? CHC, PASS, CHT, etc. Is NOT Discrepancy Analysis It is invasive Is no longer trying to find �g� Should be based on research and confirmatory data. Based on contemporary research 8

9. 9 Rather than Debating and Limiting Ourselves to a Single Approach, Consider an �Open Mind� Proposal Understand the benefits and limitations of RTI (Special Issue of Learning and Individual Differences; Compton, 2008) Understand that the �promise of RTI swamps the evidence� for it at this time (Speece & Walker, 2007, p. 287) Understand the benefits and limitations of contemporary cognitive assessment (Flanagan, Kaufman, Kaufman, & Lichtenberger, 2008) Understand that Tier II nonresponders are not well understood in terms of a) how they differ from responders; and b) the types of treatments/interventions that may be more or less successful for them (Flanagan, Ortiz, & Alfonso, 2008) Consider �third option� approaches to SLD Identification (Hale, Flanagan, & Naglieri, 2008; McCloskey, 2007)

10. 10 Rather than Debating and Limiting Ourselves to a Single Approach, Consider an �Open Mind� Proposal Entertain the idea that RTI and cognitive assessment can occur on a continuum Try not to blame psychological tests, but rather the people who use them inappropriately Understand that you must do what your state requires for SLD identification but you can add to those requirements in a manner that approaches best practices (Zirkel, 2008) Understand that neither RTI nor any other approach to SLD identification is a panacea � so don�t endorse any approach as a cure-all Entertain the idea that a balanced approach may be the best approach at this time

11. 5.29.08 11 President�s Message �I would hope that the goal here is to expand the methods of assessment available to the practitioner and not to limit them. It seems possible that these two very valuable approaches can be utilized along a continuum of collecting information about a child that would culminate in a very clear and comprehensive evaluation that would be of value to all.� Huff, L. (2005, February). President�s Message. NASP Communique, 33, 2-3.

12. 12 The American Educational System Structure

13. 13 School Psychologist and Speech Language Pathologists

14. 14 Shared office, separate lives For many initial evaluations, the school psychologist and the speech language pathologist are asked to do an assessment The assessments often happen in isolation of one another Little to no discussion about what abilities are to be tapped Every kid, no matter what the issue, gets the same battery of tests The SP and SLP share results at CSE as separate voices rather than one.

15. 15 Shared Office, Separate lives SLP�s and SP�s will do the same tests without knowing it We report on the same issues without reading each others report Expect parents and teachers to consolidate our findings Reports are filled with numbers and not information Multiple reports connected by a staple.

16. 16 ASHA Guidelines for Assessment and Evaluation Assessment should be based on multiple sources of information to obtain a comprehensive picture of the child's functioning. (Division of Early Childhood, 2007) No single measure can provide sufficient information; therefore, assessment data should reflect multiple perspectives (ASHA, 2000) In addition to the use of various tools, assessment practices should include consultation with team members. (ASHA, 2005, 2008b) Hebbeler & Rooney (2009)

17. ASHA Guidelines for Assessment and Evaluation Emphasize the importance of professionals working as a team for assessment and service provision (DEC, 2007) Assessment should provide information to inform program planning and intervention decisions. go beyond the determination of eligibility for services to include the gathering of information that will be useful in making decisions for effective intervention planning. (ASHA, 2005) 17 Hebbeler & Rooney (2009)

18. Traditional System Issues CASE 1: THIRD GRADER READING DIFFICULTY WISC WIAT 18

19. Traditional System Issues CASE 2: SEVENTH GRADER WRITING DIFFICULTY WISC WIAT 19

20. Traditional System Issues CASE 3: FIRST GRADER MATH DIFFICULTY WISC WIAT 20

21. 21 Traditional System issues Little emphasis on early intervention and prevention False Positives and False Negatives IQ-Achievement Discrepancy � BAD (Identifying CHC Abilities, using consistency GOOD!) IEP�s did not implement scientifically based instruction Start program in September, find out if effective in May Overrepresentation of cultural/linguistic minorities in special education Stop Retention and Social Promotion More concern about being in compliance than child�s educational success � THE FORGOTTEN GOAL Within Student vs. Within System Darn those lazy kids. I sat them in the room for a half hour and nothing happened.

22. Traditional Systems Issue THIRD GRADE REFERRAL 22

23. 23 BREAKING NEWS THE EARLIER THE INTERVENTION THE LOWER THE RISK OF ACADEMIC DIFFICULTY IN THE FUTURE

24. 24 Related to Traditional Assessment? Inconsistencies in Identification 1988 27 % of identified children in Utah were ED, the ED rate in CA was 2.5 % of identified children Forness & Kavale, 1990 Huge Increases in Identification From 1976 to 2002 the classification of children with specific learning disabilities increased 300% President�s Commission on Excellence in Special Education July 1, 2002

25. 25 Related to the Traditional Model? Reading Failure 80% of of those with SLD (40-53% of all Sp Ed students) are there because they haven�t learned how to read Cultural Bias African American students are twice as likely as whites to be labeled MR and 50% more likely to be designated as emotionally disturbed (A New Era 2002, Gresham, 2002)

26. 26 Related to the Traditional Model? 6 million children currently in special education Federal funding is 8.5 billion dollars Placement in special education programs most often result in little gain or negative outcomes (A New Era 2002)

27. 27 Over thirty years of research has provided support for the termination of discrepancy as a way of identifying learning disabilities

28. 28 Validity � If discrepancy is true then�.. Learning disability is result of unexpected low achievement. Also implies that children with unexpected low achievement (LD) are distinct from expected low achievement (i.e., low achievement and low intelligence).

29. Assessment: Past & Future Traditional Model Definitional Concerns Discrepancy based models Wait to fail Disconnection of assessments Model of the Future Preventative approach Validated Models Response to Intervention CHC XBA (putting the why in RTI) Comprehensive Evaluations 29

30. IDEIA What are some of the details of the Federal Law? 30

31. 31

32. 32

33. 33

34. IDEIA 2004 Law 34

35. New York�s Response 35

36. 36 NYS Learning Disability DefinitionPast and Present A student with a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which manifests itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, neurological impairment, minimal brain dysfunction, dyslexia and developmental aphasia. The term does not include students who have learning problems which are primarily the result of visual, hearing or motor handicaps, of mental retardation, of emotional disturbance, or of environmental, cultural or economic disadvantage. A student who exhibits a discrepancy of 50 percent or more between expected achievement and actual achievement determined on an individual basis shall be deemed to have a learning disability [**language repealed**]

37. ALRIGHT ALREADY! TALK ABOUT CHC! 37

38. Any Overall or Global Score What is it? What is it made of? Does it really mean anything? Does it mean anything in relation to intervention? It�s the parts that make the whole It�s the parts that will identify the strengths and weaknesses that impact upon learning 38

39. Breaking up is not so hard to do It is using research can we identify the parts of �g� that impact learning Through the CHC model we can identify the subtests that measure various parts of �g� Through Cross Battery, we can create a full evaluation that connects the pieces which can describe the whole child. 39

40. 40

41. 41

42. One Battery Does Not Fit All Given that no individual battery contains sufficient indicators of all of the major CHC abilities, a cross battery approach has been developed to bridge the gap between theory and practice. Do more than simply choose another battery and give the whole darn thing. Be specific. 42

43. 43

44. 44

45. 45

46. 46

47. Is it All About Phonological Processing? �In the area of reading, a model suggesting that phonological deficits fully account for reading problems in virtually all children is now being amended (Snowling, 2008)� �Today, we are witnessing many children whose phonological skills have been remediated, and remediated well, and who continue to struggle to read fluently and with comprehension (Shaywitz, Morris, & Shaywitz, 2008)� 47

48. 48

49. 49

50. 50

51. Supporting Evidence for CHC theory Structural � Evidence from over 50 years of factor analytic studies Outcome Criterion � Evidence of differential relationships between diff. CHC abilities and external outcomes (i.e. reading, occupation, math, etc.) Neurocognitive � Links between CHC measures and neurological functioning Heritability � Differential heritability for different CHC abilities (i.e. Spatial relations vs. Visual Memory) Developmental � Different patterns of growth and decline across the life span (i.e. Gc vs. Gsm) 51

52. IQ � Not so smart What is it? What is it made of? Does it really mean anything? Does it exist? Does it mean anything in relation to intervention? IQ can no longer mean Wechsler FSIQ It�s the parts that make the whole It�s the parts that will identify the strengths and weaknesses that impact upon learning 52

53. THE WISC AND CHC

55. SO WHY DO A CHC EVAL Almost all new versions of cognitive batteries are based in CHC Stunning since CHC came out only 10 years ago Don�t waste time with unnecessary tests between our two evals and within our individual evals. Shooting with the LIGHTS ON Legally defensible. Less lawsuits. Parents and educators actually understand our reports and appreciate knowing why the child is struggling. Empowering for everyone! 55

56. Cross Battery is THEORY/RESEARCH focused NOT KIT FOCUSED 56

57. Let�s go through the steps! 57

58. Presumption of Normalcy Assessment should be driven by presumptions of normalcy rather than pre-conceptions of dysfunction. In the absence of any gross physiological trauma or developmental dysfunction, and given a history of appropriate and sufficient instruction and opportunity to learn, it is expected that an individual undergoing LD assessment will perform within normal limits on WJ III tests (i.e., standard scores of 90 to 110, inclusive). 58 Determination as to whether or not this hypothesis is supported involves comparing an examinee�s performance to the WJ III norm sample. Determination as to whether or not this hypothesis is supported involves comparing an examinee�s performance to the WJ III norm sample.

59. STEP 1: REASON FOR REFERRAL Individualize your assessment batteries. Don�t give WISC/WIAT/TOLD to every single kid who is referred. Know what cognitive/language abilities impact the specific academic concern Rule out exclusionary factors 59

60. 60 Summary of Relations between CHC Abilities and Processes and Academic Achievement (Flanagan, Ortiz, Alfonso, & Mascolo, 2006) see also Kevin McGrew�s website: www.iapsych.com

61. 61

62. STEP 2: CHOOSE A CORE BATTERY If you need an overall g, you have to do all the core tests. If not, then you can just do the ones that are related to the reason for referral. Not all cognitive batteries address the same cognitive areas. Need to know what the tests are actually measuring. 62

63. 63

64. The Step-by-Step CB Approach Identify the CHC abilities that are represented adequately on the core battery Review the CHC Cross-Battery Worksheets Identify the CHC abilities that are not represented or are underrepresented on the core battery and select tests to approximate/ensure adequate representation of these abilities 64

65. 65

66. STEP 3: CHOOSE A SUPPLEMENTAL Identify the Absence or Underrepresentation � Supplement your core with subtests from another battery (Hence the title CROSS BATTERY) Find Supplemental tests keep the number of batteries to a minimum (preferably two) Use confidence bands to identify what has been measured 66

67. This is where SP and SLP can get together and see what should be done next. How can we supplement rather than duplicate 67

68. 68

69. STEP 4: MAKE SCORES COMMUNICATE Convert Scaled Scores into Standard Scores See handout If crossing batteries, find Cluster Average. Need to understand Confidence Intervals If the Cluster score on one battery adequately measures a Broad Ability, use that score rather than averaging. 69

70. STEP 5: INTERPRET TOGETHER Combine our perspectives, knowledge, and clinical understandings to better understand the child. Are we talking a language deficit or a cognitive deficit or both? To heck with IEP DIRECT It�s time to be detectives. Follow the clues/data Confirmatory data should support any conclusions. 70

71. Look at CONSISTENCY Not DISCREPANCY 71

72. Integrated Ability Analysis (Flanagan et al., 2002) 72

73. Integrated Ability Analysis (Flanagan et al., 2002) 73

74. Integrated Ability Analysis (Flanagan et al., 2002) 74

75. 75

76. Assessment of Diverse Children:Dimensions of Standardized Tests Related to Bias Tests are culturally loaded: the majority of tests used by psychologists were developed and normed in U.S. and inherently reflect native anthropological content as well as the culturally bound conceptualizations of the test developers themselves. Many tests require specific prior knowledge of and experience with mainstream U.S. culture Tests require language (communication): linguistic factors affect administration, comprehension, responses, and performance on virtually all tests. Even nonverbal tests that reduce oral language requirements continue to rely on effective communication between examiner and examinee in order to measure optimal performance Tests vary on both dimensions: Tests vary significantly with respect to the degree that they are culturally loaded as well as the degree of language required 76

77. 77

78. 78

79. CHC Culture-Language Matrix Worksheet (Flanagan & Ortiz, 2001) 79

80. Let�s talkabout how to talk to our speech language colleagues

81. Why Combine SLPs measure many of the same abilities SPs do eg. Short Term Memory - Digits forward Makes sense as the Broad Abilities impact learning Don�t repeat testing Share different expertise and perspective on data. Accuracy of diagnosis Accuracy of intervention/intervention development

82. Saving Time Reduce number of subtests administered Based on referral Based on research Report Writing No more staple � Comprehensive Report Combine results and perspectives Parents don�t have to mix and match Feedback or IEP meetings Stop saying the same thing in different languages

83. LET�S TALK ABOUT Speech and Language Batteries

84. Test of Language Development- Primary & Intermediate Versions: Fourth Edition(TOLD-4) designed specifically to assess children�s receptive and expressive spoken language competences Published in 2008 Ages 4-0 through 8-11; 8-0 through 17-11 6 core subtests, 3 supplemental (Primary Version) 35 minutes to 50 minutes administration time normative sample characteristics based on sample conformed to U.S. 2005 school-age population census data

85. Rationale assess children�s expressive and receptive competencies in the major components of linguistics identify children who are significantly below their peers in language proficiency determine children�s specific strengths and weaknesses in language skills (composite indexes are Listening, Organizing, Speaking, Grammar, Semantics, and Spoken Language) document children�s progress in language as a consequence of special intervention programs

86. TOLD-P:4 subtest organization

88. Semantic Subtests ��study of the meaning of language; relationship between language and thought.� (P/I) Picture Vocabulary (Gc-VL) (P/I) Relational Vocabulary (Gc-LD) (P) Oral Vocabulary (Gc-VL) (I) Multiple Meanings (Gc-VL/LD)

89. Syntactic/Grammar Subtests ��the structure of the language (order and organization among words that determine the relationships between sound patterns and meaning through the formation of sentences). (P) Syntactic Understanding (Gc LS) (P) Sentence Imitation (Gsm MS) (I) Sentence Combining (Gc LD; Gsm MW) (I) Morphological Completion (Gc MY) (I) Morphological Comprehension (Gc MY) (I) Word Ordering (Gc LD)

90. Phonological Subtests ��the sound system of language (most important component is phonemics, the study of significant speech sounds).� (P) Word Discrimination (Ga US/U3) (P) Phonemic Analysis (Ga PC:A) (P) Word Articulation (Ga PC:S)

91. Redundancy

92. Test of Auditory Processing Skills � 3rd Edition(TAPS-3) Published in 2005 Ages 4-18 9 subtests; 1-hour administration Normed on 2,000+ students Individual subtest scores & cluster scores

93. Rationale Provide the information necessary to assess the auditory processing related to cognitive and communicative aspects of language Assess the auditory skills necessary for the development, use, & understanding of language Ability to comprehend auditory information

94. Three Major Indices Basic Phonemic Skills (3 subtests) Assessment of basic phonological abilities Auditory Memory (4 subtests) Measures basic memory processes III. Auditory Cohesion (2 subtests) Higher order skills

95. Basic Phonemic Skills �Provide quick assessments of very basic phonological abilities that allow one to discriminate between sounds within words, segment words into morphemes, and blend phonemes into words� Word Discrimination (Ga-US/U3) Phonological Segmentation (Ga-PC:A) Phonological Blending (Ga-PC:S) Overall, a strong measure of Ga

96. Auditory Memory �Measures basic memory processes, including sequencing� Number Memory Forward (Gsm-MS) Number Memory Reversed (Gsm-MW) Word Memory (Gsm-MS) Sentence Memory (Gsm-MS) �Basic memory� is really Gsm, and primarily Memory Span

97. Auditory Cohesion �Higher order linguistic skill that requires the student not only to understand exactly what is said, but also to be able to use inferences, deductions, and abstractions to understand the meaning of a passage� Auditory Comprehension (Gc-LS) Auditory Reasoning (Gc-KO) Not so much �reasoning� as it is Gc

98. Redundancy

99. Redundancy for CELF-4

101. WIAT-III Listening Comprehension Measures listening comprehension at the level of the word, sentence and discourse. Two testlets make up whole Standard Score Receptive Vocabulary: Identify picture corresponding to a spoken word Oral Discourse Comprehension: Listen to narrative & answer question RV: Student must identify a picture that corresponds to a spoken word (e.g. �Point to�.) Parallels Picture Vocabulary on TOLD, where the is asked to point to one of four pictures that best represents the meaning of a word read by the examiner. ODC: Student listens to a brief narrative from a recording and answers a question. Parallels Understanding Spoken Paragraphs on CELF, where the student is read a brief passage (which cannot be repeated) and is then asked a question, which can be repeated once, about main idea, detail, sequence, inference and prediction; Auditory Comprehension on TAPS (although here the passage is read by the examiner, not a recording)RV: Student must identify a picture that corresponds to a spoken word (e.g. �Point to�.) Parallels Picture Vocabulary on TOLD, where the is asked to point to one of four pictures that best represents the meaning of a word read by the examiner. ODC: Student listens to a brief narrative from a recording and answers a question. Parallels Understanding Spoken Paragraphs on CELF, where the student is read a brief passage (which cannot be repeated) and is then asked a question, which can be repeated once, about main idea, detail, sequence, inference and prediction; Auditory Comprehension on TAPS (although here the passage is read by the examiner, not a recording)

102. WIAT III: Oral Expression Measures listening comprehension at the level of the word, sentence and discourse. Three testlets make up whole Standard Score Expressive Vocabulary (Gc): Provide a definition - Oral Word Fluency (Glr): Name words in a specific category Sentence Repetition (Gsm): Repeat a sentence verbatim EV: Student is provided with definition and asked to provide a one-word answer (e.g. �Tell me the word that means a tool used to look in someone�s ear.�) Parallels ????? OWF: Student is asked to name as many words as they can in a specific category in 1 minute (e.g. Name as many Speech & Language Batteries that you can). Parallels Word Associations on CELF, Retrieval Fluency on WJ-COG, SR: Student is read a sentence and asked to repeat it verbatim (e.g. The speech-pathologist is nice.) Parallels Recalling Sentences on CELF; on Sentence Memory on the TAPSEV: Student is provided with definition and asked to provide a one-word answer (e.g. �Tell me the word that means a tool used to look in someone�s ear.�) Parallels ????? OWF: Student is asked to name as many words as they can in a specific category in 1 minute (e.g. Name as many Speech & Language Batteries that you can). Parallels Word Associations on CELF, Retrieval Fluency on WJ-COG, SR: Student is read a sentence and asked to repeat it verbatim (e.g. The speech-pathologist is nice.) Parallels Recalling Sentences on CELF; on Sentence Memory on the TAPS

103. LET�S LOOK AT A REPORT

104. Conclusions CHC and RtI should be used in concert SLP�s and SPs use similar measures SLP�s and SPs can combine knowledge and experience to better interpret data, allowing for more specific diagnosis and recommendations. End the worry about getting an overall �g� Be theory/research based, not kit based

105. References Cross Battery Assessment http://www.crossbattery.com/ Dumont and Willis - ATDR http://alpha.fdu.edu/~dumont/psychology/ATDR.htm Kevin McGrew�s Intelligence Corner http://www.iqscorner.com/ Andrew Shanock, Ph. D., NCSP shanocka@strose.edu, 518-337-4843