Eligibility Criteria for the area of

Speech and Language Impairments

Table of Contents ELIGIBILITY CRITERIA FOR SPEECH/LANGUAGE IMPAIRED SERVICES ................................................................. 3 INTRODUCTION........................................................................................................................................................................................3 ROLE AND RESPONSIBILITY OF THE SPEECH LANGUAGE PATHOLOGIST...................................................................3 STUDENTS SUSPECTED OF HAVING A SPEECH AND LANGUAGE IMPAIRMENT: THE IDENTIFICATION PROCESS........................................................................................................................................................................................................ 4 REFERRALS FOR A SPEECH AND LANGUAGE ONLY CASE STUDY EVALUATION ................................................................................4 THE ASSESSMENT PROCESS............................................................................................................................................................... 5 PROCEDURES FOR SPEECH AND LANGUAGE EVALUATIONS..................................................................................................................5 EVALUATION .................................................................................................................................................................................................5 ELIGIBILITY DETERMINATION ....................................................................................................................................................................5 IMPARTIAL DUE PROCESS HEARING ..........................................................................................................................................................6 OTHER FACTORS TO CONSIDER WHEN DETERMINING ELIGIBILITY .....................................................................................................6 THE SPEECH AND LANGUAGE EVALUATION ............................................................................................................................................6 SEVERITY RATING GUIDELINES..................................................................................................................................................................7 A RTICULATION /PHONOLOGY ELIGIBILITY ...............................................................................................................................................7 A RTICULATION /PHONOLOGY M ATRIX ......................................................................................................................................................9 DEVELOPMENTAL A GES TO PHONEME MASTERY .................................................................................................................................10 Illinois State Board of Education - 1990 Speech and Language Technical Assistance Manual.............................................10 POOLE NORMS..................................................................................................................................................................................10 Articulation/Phonology Measurement Instruments Commonly Used at BASSC.....................................................................10 LANGUAGE.................................................................................................................................................................................................11 PRAGMATICS................................................................................................................................................................................................11 LANGUAGE ELIGIBILITY MATRIX................................................................................................................................................12 LANGUAGE MEASUREMENTS COMMONLY USED IN BASSC..........................................................................................13 FLUENCY.....................................................................................................................................................................................................13 FLUENCY M ATRIX ......................................................................................................................................................................................14 CONTINUUM OF DISFLUENT SPEECH BEHAVIOR ................................................................................................................15 VOICE............................................................................................................................................................................................................16 VOICE M ATRIX ...........................................................................................................................................................................................16 EXIT CRITERIA.........................................................................................................................................................................................17 SPEECH-LANGUAGE ELIGIBILITY CRITERIA/MATRIX.....................................................................................................18 SERVICE DELIVERY MODELS ..........................................................................................................................................................20 M ONITOR .....................................................................................................................................................................................................20 INTEGRATED SERVICES..............................................................................................................................................................................20 COLLABORATIVE CONSULTATION ...........................................................................................................................................................20 THE SPEECH-LANGUAGE PATHOLOGIST FUNCTIONING AS A CONSULTANT :.......................................................................................21 VARIOUS APPROACHES TO COLLABORATIVE CONSULTATION.................................................................................21 TRADITIONAL (PULL -OUT M ODEL).........................................................................................................................................................21 INSTRUCTIONAL SERVICES........................................................................................................................................................................22 REFERENCES................................................................................................................................................................................................22 Definition And Examples Of Adverse Effect ....................................................................................................................................23 Cognitive Considerations...................................................................................................................................................................25 Functional Language Ability Profile (FLAP)..................................................................................................................................26 Pre-Referral/Child Study Team Request for Speech and Language ...........................................................................................27

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Eligibility Criteria for Speech/Language Impaired Services The following guidelines have been developed for determining eligibility for Speech and Language services within the Belleville Area Special Services Cooperative. Significant portions of this document have been taken directly from or closely align with the Technical Assistance Manual for Speech-Language published by the Illinois State Board of Education in August, 1993. INTRODUCTION Eligibility for special education and related services in the area of Speech and Language Impairment is determined through the IEP process beginning with the Child Review Team meeting. Determining the existence of a speech and language impairment is the first step in determination of eligibility for special education under the eligibility of Speech/Language Impaired. Subsequent to identifying an impairment, the adverse impact of the disability on the student's educational performance and the need for special education and related services must be documented. It is very important to note that, although this document provides guidelines, specific circumstances affecting a particular student must be taken into consideration. Cultural influences or differences and the primary language of the student must be taken into account prior to test selection and evaluation. Clinical judgment may necessitate modification of these guidelines. The guidelines described here are designed for a school population 3 to 21 years of age. All evaluation and interview data must be considered when determining the extent to which these children are adversely affected within their communication setting and the impact on future educational performance. Communicatively impaired children could be at risk for future academic failure without appropriate intervention and, therefore, may be eligible for speech and language services. These students are served through the continuum of service delivery models outlined later in this document. ROLE AND RESPONSIBILITY OF THE SPEECH LANGUAGE PATHOLOGIST Speech-language pathologists currently trained to work in school programs have a minimum of a masters degree and/or hold a Standard Special Certificate, (Type 73 or Type 3 and Type 9), in Speech and Language Impaired. According to 23 Illinois Administrative Code Part 226 rules, speech and language services may be made available as: • • •

Special education related services Special education resource programs Special education instructional programs

The scope of practice of the speech-language pathologist includes, but is not limited to: 1 Identification and evaluation of students with speech and language impairments 2. Participation in the determination of eligibility for special education and related services in the area of speech and language impairment 3. Participation in teacher and parent conferences including multidisciplinary conferences, IEP meetings, and annual reviews 4. Development and implementation of IEPs for all students eligible for special education and related services in the area of speech and language impairment 5. Provision of inservice programs to parents, teachers, students, administrators, and other professionals 6. Completion of required documentation and reports 7. Participation of child study and teacher assistance teams 8. Facilitation of curriculum and instructional modifications 9. Supervision of support personnel/CFY's 10. Participation in continuing professional education

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STUDENTS SUSPECTED OF HAVING A SPEECH AND LANGUAGE IMPAIRMENT: THE IDENTIFICATION PROCESS A student may be identified as eligible to receive a special education evaluation to determine if he/she has a speech and language impairment through teacher or school-based referral; parent, self or other agency referral; or group screening. The school district must publicize its referral procedures. These procedures must also be approved by the Illinois State Board of Education. Referrals for a Speech and Language Only Case Study Evaluation It is important to document referrals by completing a referral packet (forms A1, A2, A3) which includes: • • • •

The date of referral The referring agent The determination of the student's language use pattern and cultural background (this is made by determining the language(s) spoken in the student's home and the language(s) used most comfortably and frequently by the student); and The determination of the student's mode of communication (this is made by assessing the extent to which the student uses expressive language and the use he or she makes of other modes of communication as a substitute for expressive language).

In addition, it is important to note that the date of the decision to refer a student is the actual referral date. This date begins the 60-school-day timeline during which the IEP process (referral, evaluation and placement) must be completed. After a referral has been initiated, the review team determines whether the referral is appropriate (i.e., whether or not to conduct an assessment). Parental consent must be obtained for an individual screening. Parental consent is not necessary when the speech-language pathologist does not have direct individual contact with the student (i.e., observations, teacher interviews, record reviews and student interviews). The building team decides whether or not the assessment is warranted and the parent receives written notice of this decision. If an assessment is warranted, the IEP team confers and agrees on what types of assessments are necessary. The parent or legal guardian must sign consent for the designated evaluations to be completed. A copy of the “Explanation of Procedural Safeguards for Parents of Students with Disabilities” must be explained and provided to the parent at that time.

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THE ASSESSMENT PROCESS Procedures for Speech and Language Evaluations Federal and state regulations require that the eligibility determination be multidisciplinary. This necessitates the involvement of at least three professional disciplines in determining eligibility. It also requires that the IEP and placement decisions be made at the conference at which at least three professional disciplines are represented. If following the initial conference it is determined that speech testing is the only domain requiring assessment, the Speech/Language Pathologist becomes the facilitator for the assessment process. The assessment should include vision an hearing screenings completed within the last six months, as well as the other components identified by the team at the Child Review Team meeting. Evaluation After parental consent has been obtained, the Speech/Language Pathologist is responsible for assuring necessary evaluations are completed:

Eligibility Determination After the evaluation components are completed, the Speech/Language Pathologist sends ISBE form 34-57E “Parent/Guardian Notification of Conference” to the parent. This form invites the parent to the conference which will be held to review their child's case study and determine eligibility for special education and related services. This form must be sent to the parents at least 10 calendar days before the conference. It must contain information regarding where the conference will be held, the purpose of the meeting, who will be invited to attend the meeting and who should be contacted for more information. Individuals who are required to participate in the conference include a local education agency (LEA) representative, a regular education teacher, and those who have conducted assessments with the student. During the conference, team members interpret evaluation data and make an eligibility determination. The team must arrive at a consensus regarding the student's eligibility for special education and related services. According to IDEA 1997 regulations, a student is eligible for special education and related services when and only when it is determined that a disability exists, that the disability has an adverse effect on the student's educational performance and that the need for specialized services to address the adverse effect(s) is present and documented. For example, speech and language impairments may affect the student's educational performance in the classroom and with peers. Articulation, fluency or voice disorders can create negative self-esteem that inhibits a student's performance in the classroom. Students with language disorders lack a strong language base that is the foundation necessary for learning to occur within the academic curriculum. They often lack proficiency in language arts that is central to the curriculum across all grade levels. These factors frequently mask the true ability level and actual proficiency of the student and can limit participation in the classroom exchanges and discussions. On the other hand, a student may have an articulation, fluency or voice disorder that does not create negative self-esteem, does not receive negative reactions to the disorder from the student and/or other students and does not inhibit the student's performance in the classroom. In this case, the disorder does not interfere with the student's ability to benefit from education. Therefore, no adverse effect on the student's educational performance can be documented, and the student is not eligible for special education and related services. For more examples and a definition of adverse effect, see examples in the Appendix. If, according to IDEA 1997, a student is determined eligible for special education and related services, an IEP must be developed for the child. It must be noted that the educational placement decision is made after the entire IEP is developed. *NOTE: The IEP meeting must also be conducted within 60 school days of the referral to be in compliance. Individuals who are required to participate in the IEP meeting include an LEA representative, the child's teacher and, for initial placement, a person knowledgeable about the evaluation procedures utilized in this assessment and the results. If the parent(s) does not attend the meeting, documentation of three attempts to arrange a mutually agreed upon time and place for the meeting needs to be in the student's temporary record.

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Impartial Due Process Hearing A parent or a school district may initiate a Level I due process hearing regarding the district's proposal or refusal to initiate or change the identification, evaluation, or educational placement of the student or the provision of a free, appropriate public education to the student. Other Factors to Consider When Determining Eligibility Several other factors need to be taken into account along with the state-recommended eligibility criteria when determining eligibility for special education and related services in the area of speech and language impairment. A student may be found not eligible for special education and related services in the area of speech and language impaired if his/her language functioning is commensurate with overall cognitive ability. Guidelines outlining procedures for determining if language scores are commensurate with cognitive potential can be found in the Appendix under “Cognitive Considerations.” This statement reflects the cognitive hypothesis, which claims that cognition is a prerequisite for language development, and therefore language depends upon and cannot develop beyond a student's underlying cognitive limits (Casby, 1992). Many speech-language pathologists recognize that there is a relationship between cognition and language; however, these professionals do not uphold the idea that language cannot develop beyond a student's underlying cognitive limits. They believe factors other than cognition can influence language development, and development in cognition (Casby, 1992). Therefore, these professionals recommend that, in addition to standardized testing results, the assessment team consider the following questions when determining eligibility for special education and related services in the area of speech and language impairment: • •

Do the student's communication skills meet his/her needs in current environments (i.e., if the student communicated better, would it make a significant difference )? Would working with this student significantly change his/her ability to communicate?

Other factors to consider when determining eligibility (i.e., existing disability, adverse effect and the need for specialized services) include: 1. 2. 3.

Does the identified speech and language impairment interfere with the student's educational, social, or emotional progress so as to consider it a disabling condition? Is the student's level of language functional for his/her level of adaptive behavior? Is a physiological factor such as an unrepaired cleft palate, enlarged adenoids, or orthodontia an interference?

A subjective rating scale such as the Functional Language Ability Profile (see Appendix for copy) may be used to address some of these areas and aid in eligibility determinations. As always, the assessment team must document the adverse effect on the student's educational performance and the need for specialized services to address the adverse effect(s) if it is determined that a disability exists. The Illinois State Board of Education supports this approach to eligibility determinations.

The Speech and Language Evaluation The purpose of the speech and language evaluation is to determine the degree and extent of oral language usage, receptively and expressively, and language processing abilities. Those areas of language competencies examined need to include rhythm (or fluency), voice, articulation, and language.* Language is the ability to use the symbols of language through proper use and understanding of words and meanings (semantics), appropriate grammatical patterns (syntax), and correct usage and understanding of meaningful word markers or elements (morphology). Areas usually assessed are receptive and expressive language and pragmatics. Articulation is the accuracy and precision of speech sound selection and usage and the rules that govern their production (phonology). Rhythm or Fluency is the flow of speech. It covers breaks or interruptions, repetitions, or prolongations in that flow. Usually the number and type of disfluencies are quantified based on conversational samples obtained under a variety of circumstances.

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Voice is the use of the voice and its observable characteristics including pitch, resonance, quality and volume. These characteristics are usually evaluated during a sample of conversational speech. A medical evaluation may be indicated under certain circumstances. *Cultural influences, differences, and the primary language of the student must be taken into account prior to test selection and evaluation. Severity Rating Guidelines A severity rating helps to determine the scope of intervention required to meet the needs of students with speech and language impairments who are eligible for special education and related services. Speech and language assessment data, case study conclusions and criteria on the Eligibility Criteria/Matrix should be utilized to determine the severity of the impairment. No attempt should be made to determine severity based on the eligibility matrix until an IEP is developed by the appropriate team and placement is subsequently determined. The IEP must be the foundation for the placement determination, not a severity rating. The severity ratings are divided into four categories - mild, moderate, severe, and extreme - each of which is given a point value on the basis of standardized test results, observations and clinical judgments. The amount of speech and language service a student receives may be proportional to the severity of his/her impairment and is in relation to the nature of the intervention model(s) and the goals and objectives determined by the IEP conference participants. It is understood that students frequently exhibit multiple types of speech and language impairment. In these situations, the speech-language pathologist may need to modify the amount of and the options for service delivery. For example, the service delivery models for a language and articulation impaired student may be a combination of integrative and pull-out. The following severity classifications apply to all disorder areas: MILD:

Impairment minimally affects the individual's ability to communicate in school learning and other social situations as noted by at least one other familiar listener, such as teacher, parent, sibling, or peer.

MODERATE:

Impairment interferes with the individual's ability to communicate in school learning and/or other social situations as noted by at least one other familiar listener.

SEVERE:

Impairment limits the individual's ability to communicate appropriately and respond in school learning and/or social situations. Environmental and/or student concern is evident and documented.

EXTREME:

Impairment prevents the individual from communicating appropriately in school and/or social situations.

This severity rating scale takes into account many viable service delivery models and is not intended to be used solely with the traditional group and individual options. Times listed reflect direct service, but not necessarily a pull-out model. A range of service delivery options should be utilized with these severity and time guidelines. The IEP must include a specific number of minutes per week, not a range of minutes per week. The number listed on the IEP should be considered the minimum number of minutes a student will receive in a week. Articulation/Phonology Eligibility The student with an articulation/phonological impairment is unable to produce sounds correctly in conversational speech. This impairment is typically characterized by the omission, distortion, substitution, addition, and/or inaccurate sequencing of speech sounds. Errors are not related to cultural or dialectical differences. A student is not eligible for special education related services in the area of speech and language (articulation/phonological) impairment when: 1. 2. 3.

Sound errors are consistent with developmental age or are within normal articulation development.* Articulation differences are due primarily to unfamiliarity with the English language, dialectal differences, temporary physical disabilities or environmental, cultural or economic factors.* The articulation errors do not interfere with the student's ability to benefit from education.

*Adapted from: The Michigan Speech-Language-Hearing Association (1990) Speech and Language Services in Michigan: Suggestions for Identification, Delivery of Service and Exit Criteria. 05-03-02 BASSC Resource Manual Speech Section.doc

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At times referrals may be made from physicians or dentists regarding tongue thrust or reverse swallow in students. Tongue thrust is not an articulation disorder in itself, although it is often found in tandem with interdentalization of /s/, /z/, and may result in interference with other speech sounds. Therefore, the speech therapist in the school setting does not specifically enroll students to eliminate tongue thrust or correct deviant swallow patterns that do not interfere with nutrition, but may enroll this student if the resulting articulation disorder meets the eligibility criteria. No goals should specifically address the swallow, but rather only the articulation disorder. Some students may demonstrate significant swallowing disorders including developmentally delayed or disordered patterns or loss of swallowing function due to brain injury or other circumstances. The decision to enroll a child for swallowing therapy should be made by all parties including the caregivers, teachers, school nurse, and occupational therapist as well as the speech pathologist. A feeding evaluation, feeding plan, and therapy plan may be established, if appropriate. Students may be candidates for augmentative communication if, after a significant period of intervention, it is determined that the student lacks an appropriate modality to communicate expressively. A “Request for Student Assistance” can be sent to the BASSC office for consultative services. If an evaluation appears appropriate, the child’s IEP team will need to convene a Child Review Team meeting to document the need for the augmentative communication evaluation and any other assessments that may be pertinent.

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Articulation/Phonology Matrix Severity Rating No Problems Minimal

Mild

Behavioral Descriptions Service Minutes Per Week No errors Student exhibits developmentally appropriate speech skills in the therapy room setting, but may require monitoring for successful generalization of skills. Speech is generally intelligible; prior intervention has eliminated all but developmental sound errors for which the student is not yet stimulable. Intelligible over 80% of the time in connected speech.

Recommended Minimum No eligibility Consultative services to teacher 30 minutes or less direct contact with student each Month.

20 minutes

No more than two speech sound errors outside developmental guidelines. Students may be stimulable for error sounds. Moderate

Intelligible 50-80% of the time in connected speech.

30 minutes

Substitutions, distortions and some omissions may be present. There is limited stimulability for the error phonemes. Severe

Intelligible 20-49% of the time in connected speech.

60 minutes

Deviation may range from extensive substitutions and many omissions to extensive omissions. A limited number of phoneme classes are evidenced in a speech-language sample. Consonant sequencing is generally lacking. Augmentative Communication System may be warranted. Extreme

Speech is unintelligible without gestures and cues and/or knowledge of the context. Usually there are additional pathological or physiological problems such as neuro-motor deficits or structural deviations. Augmentative communication systems may be warranted.

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Developmental Ages to Phoneme Mastery Current research continues to demonstrate discrepancies in ages of speech sound acquisition. This dilemma is characterized by the findings of the 'Iowa Articulation Norms Project and Its Nebraska Replication' (Smith, Hand, Freilinger, Bernthal, Bird, 1990). These findings suggest 'that ages of acquisition for most of the tested consonant singles have either remained constant or have moved to slightly later ages.' These researchers also found that 'demographic variables that might have been expected to influence the outcome failed to do so, although sex of the child was a significant factor in the preschool years.' The following are collected developmental norms: Illinois State Board of Education - 1990 Speech and Language Technical Assistance Manual AGE

Sound

3

b, p, m, n, w, b, vowels, diphthongs (such as “oy”)

4

k, g, t, d, ng, y

5 6

f v, th (voiceless), I

7

s, z, sh, ch, j, zh, r, hw, th (voiced)

POOLE NORMS AGE 3.5 years 4.5 years 5.5 years 6.5 years 7.5 years

Sound b, m, h, p, w d, n, , t, j, g, k f l, , , , v r,s, , z

Information prepared from Poole, I., (1934). The genetic development of consonant sounds in speech. Elementary English Review, 11, 159-61. Articulation/Phonology Measurement Instruments Commonly Used at BASSC AAPS APP-R G-F SPAT

Arizona Articulation Proficiency Scale Hodson Assessment of Phonological Processes-Revised Goldman-Fristoe Test of Articulation Structured Photographic Articulation Test (featuring Dudsberry) Conversational Speech Sampling

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Language The student with a language impairment demonstrates impairment and/or deviant development of comprehension and/or use of a spoken symbol system. This may include: 1. 2. 3.

Language form - the portion of language that refers to the utterance/sentence structure of what is said (phonology, morphology, syntax) Language content - the portion of language that refers to meanings of words and sentences including abstract concepts of language (semantics) Language use - the context in which language can be used and the purpose of communication (pragmatics). Individuals with pragmatic problems demonstrate difficulty in communicating effectively although form and content may be intact

In some situations, severity of the disabling condition caused by a language impairment may need to be determined by factors other than standardized tests. In these cases, eligibility and severity would need to be determined by the impact of the language impairment on the student's communicative, academic and social competence, thereby adversely impacting educational performance. Clinical observations, language samples, and consultation with other school personnel are important components in determining eligibility of language impaired students (Casby, 1992). Pragmatics Speech-language pathologists take into consideration the student's use of pragmatics along with other case study assessment information obtained to determine eligibility for services. Pragmatics include: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

The ability to use verbal labels to name objects, actions or attributes appropriately. The ability to use language to request objects or information or to fulfill needs. The ability to use language to relate previous incidents. The ability to use language to relate original ideas. The ability to use language to express emotions and moods. Adherence to the basic rules of conversation, including imitating, turn taking, and staying on topic. Adherence to the social rules of conversation such as maintenance of personal space, eye contact, posture and volume. The ability to determine listener’s reception and interpretations. The ability to react to various speech setting appropriately. The ability to understand and react appropriately to idioms, figures of speech, inferences and humor.

A student is not eligible for special education and related services in the area of speech and language impairment when: 1. 2.

Language differences are primarily due to environmental, cultural, or economic factors including non-standard English and regional dialect; Language performance does not interfere with the student's ability to benefit from education.

It is very important to note that the criteria should be interpreted as guidelines and may vary with specific circumstances affecting a particular student.

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Language Eligibility Matrix Recommended Minimum Service Minutes per Week

Severity

Criteria

Mild

The student demonstrates a deficit in receptive, expressive or pragmatic language as measured by two or more diagnostic procedures/standardized tests. Performance falls from 1 - 1.5 standard deviations below the mean standard score, generally standard scores between 85 -78.

30 Minutes

Moderate

The student demonstrates a deficit in receptive, expressive or pragmatic language as measured by two or more diagnostic procedures/standardized tests. Performance falls from 1.5 to 2.0 standard deviations below the mean standard score, generally standard scores between 78-70.

40 Minutes

Severe

The student demonstrates a deficit in receptive, expressive or pragmatic language as measured by two or more diagnostic procedures/standardized tests (if standardized tests can be administered). Performance is between 2.0 to 2.5 standard deviations below the mean standard score, generally standard scores between 70 - 62. Augmentative communication systems may be warranted.

60 Minutes

Extreme

The student demonstrates a deficit in receptive, expressive or pragmatic language which prevents appropriate communication in school and/or social situations. Performance on standardized tests (if standardized tests can be administered) is greater than 2.5 standard deviations below the mean standard score, generally standard scores below 62. Augmentative Communication systems may be warranted.

90 Minutes

*Adapted from The Michigan Speech-Language-Hearing Association (1990). Speech and Language Services in Michigan: Suggestions for Identification, Delivery of Service and Exit Criteria .

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Language Measurements Commonly Used In Bassc ASSET Bankson Language Test Bracken Basic Concepts Scale(BBCS) Boehm Test of Basic Concepts(BTBC) Clinical Evaluation of Language Fundamentals-Preschool (CELF-PS) Clinical Evaluation of Language Fundamentals-3rd edition (CELF-3) Developmental Sentence Analysis (Laura Lee) Expressive One-Word Picture Vocabulary Test-Revised (EOWPVT-R) Expressive One-Word Picture Vocabulary Test-Upper Extension (EOWPVT-UE) Functional Communication Profile (FCP) Functional Language Ability Profile (FLAP) Language Processing Test (LPT) Preschool Language Scale-3 (PLS-3) Peabody Picture Vocabulary Test-Revised (PPVT-R) Receptive One-Word Picture Vocabulary Test-Revised (ROWPVT-R) Screening Test for Auditory Processing Disorders (SCAN) Structured Photographic Expressive Language Test-2nd Edition(SPELT 11) Test for Auditory Comprehension of Language-Revised (TACL-R) Test of Early Language Development (TELD) Test of Language Development-intermediate (TOLD-1) Test of Language Development Primary -2nd Edition (TOLD:P-2) Test of Pragmatic Language (TOPL) Test of Problem Solving (TOPS) Test of Word Knowledge (TOWK) The Listening Test The WORD Test

Fluency A fluency impairment is defined as the abnormal flow of verbal expression. It is characterized by impaired rate and rhythm of connected speech and may be accompanied by struggle behavior. Consideration must be given to the student's chronological age and perception of the problem by the student and parents, the contextual situations in which the student functions and the overall impact on educational performance. A student is not eligible for special education and related services in the area of speech and language (fluency) impairment when disfluencies: 1. 2. 3.

Are part of normal speech development Do not cause the speaker to modify behavior Do not interfere with the student's ability to benefit from education

A tape-recorded sample of a minimum of 100 words or 200 syllables from 2 different situations (reading, monologue or connected speech) is recommended to determine eligibility and severity. The sample should be taken from a variety of circumstances and/or settings.

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Fluency Matrix

Severity

Behavioral Description

Recommended Minimum Service Minutes Per Week

Mild

2-4% atypical disfluencies within a speech

Recommended consultative services to teacher(s).

sample of at least 100

words. No tension to minimal tension.

Moderate

Rate and/or Prosody: Minimal interference with communication. 5-8% atypical disfluencies within a speech sample of at least 100 words. Noticeable tension and/or secondary characteristics

40 minutes

are present.

Severe

Extreme

Rate and/or Prosody: Limits communication. 9-12% atypical disfluencies within a speech sample of at least 100 words. Excessive tension and/or secondary characteristics are present.

60 minutes

Rate and/or Prosody: Interferes with communication. More than 12% atypical 90 minutes disfluencies within a speech sample of at least 100 words. Excessive tension and/or secondary characteristics are present. Rate and/or Prosody: Prevents communication.

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Continuum of Disfluent Speech Behavior More Usual Typical Disfluencies Hesitations (silent pauses) Interjection of sounds, syllables or words Revisions of phrases or sentences Phrase repetitions One syllable word repetitions Two or fewer repetitions per instance, even stress, no tension

Part-word syllable repetitions Two or fewer repetitions per instance even stress, no tension

c r o s s o v e r

B e h a v i o r s

Stuttering Atypical Disfluencies One syllable word repetitions. Three or more repetitions per instance or uneven stress. Part-word syllable repetition. Three or more repetitions per instance or uneven stress.

- --- --- - - Sound repetitions Prolongations Blocks Increased tension noted, e.g., tremor of lips or jaw or vocal tension. More Unusual

Developed by: Hugo Gregory, Ph.D., Professor June Campbell, M.A., Clinical Supervisor Diane Hill, M.A., Clinical Supervisor Northwestern University Department of Communication Sciences and Disorders

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Voice A voice impairment is defined as any deviation in pitch, intensity, quality, or other attribute which consistently interferes with communication; draws unfavorable attention; adversely affects the speaker or the listener; or is inappropriate to the age, sex or culture of the individual. Voice quality may be affected by either organic or functional factors. Consideration must be given to age, sex, environment, and perception of the problem by the student, parents, speechlanguage pathologist, and other school personnel or medical specialists. A student is not eligible for special education and related services in the area of speech and language (voice) impairment when vocal characteristics: 1. 2. 3.

Are the result of temporary physical factors such as allergies, colds, abnormal tonsils or adenoids, short-term vocal abuse or misuse Are the result of regional, dialectic or cultural differences Do not interfere with the student's ability to benefit from education

A tape-recorded speech sample of a minimum of 100 words of connected speech is recommended to determine eligibility and severity.

Voice Matrix Severity

Behavioral Description

Mild

Voice difference including hoarseness, nasality, denasality, pitch or intensity inappropriate for the student's age; disorder is of minimal concern to parent, teacher, student or physician.

Recommended Minimum Service Minutes Per Week Consultative services to teacher and parent

Medical referral may be indicated. Moderate

Voice difference is of concern to parent, teacher, student or physician. Voice is not appropriate for age and sex of the student.

30 minutes per week

Medical referral may be indicated. Severe

Voice difference is of concern to parent, teacher, student or physician. Voice is distinctly abnormal for age and sex of the student.

60 minutes

Medical referral is indicated. Extreme

Speech is largely unintelligible Due to aphonia or severe hypemasality. Extreme effort is apparent in production of speech.

90 minutes

Medical referral is indicated.

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Exit Criteria (Eligibility vs. Non-eligibility) Exit decisions must be individualized, based on developmental norms and the current best practices, as determined by the appropriate team. A student is no longer eligible for special education services and related services for speech language services when it is determined that: 1.

The need for specialized services to address the adverse effect(s) on educational performance is no longer present

2.

The disability no longer has an adverse effect on the student's educational performance

3.

The disability no longer exists

4.

The student is not motivated to attend to and/or participate in speech-language services (this must be documented)

5.

Further improvement is precluded by interference of physiological factors

6.

Maximum gains have been achieved from therapeutic intervention as evidenced by lack of further progress

This determination of eligibility or noneligibility is made at the IEP meeting on the basis of the data collected or other available assessment information.

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Speech-Language Eligibility Criteria/Matrix CLINICAL JUDGMENT MAY NECESSITATE MODIFICATION OF THESE GUIDELINES. Mild

Moderate

Severity of Disorder

Impairment minimally affects the individual's ability to communicate in school learning and/or other social situations as noted by at least one other familiar listener, such as teacher, parent, sibling, or peer.

Impairment interferes with the individual’s ability to communicate in school learning and/or other social situations as noted by at least one other familiar listener.

Articulation/ Phonology

Intelligible over 80% of the time in connected speech.

Intelligible 50-80% of the time in connected speech.

No more than 2 speech sounds errors outside developmental guidelines. Students may be stimulable for error sounds.

Substitutions and distortions and some omissions may be present. There is limited stimulability for error phonemes.

Language

The student demonstrates a deficit in receptive, expressive or pragmatic language as measured by two or more diagnostic procedures/standardized tests. Performance falls from 1 to 1.5 standard deviations below the mean standard score. Generally standard scores between 85-78.

The student demonstrates a deficit in receptive, expressive, or pragmatic language as measured by two or more diagnostic procedures/ standardized tests. Performance falls from 1.5 to 2.0 standard deviations below the mean standard score. Generally standard scores Between 78-70.

Fluency

2-4% atypical disfluencies within a speech sample of at least 100 words. No tension to minimal tension.

5-8% atypical disfluencies within a speech sample of at least 100 words. Noticeable Tension and/or secondary characteristics are present.

Recommend consultation to teacher(s). Rate and/or Prosody Minimal interference with communication. Voice

Voice difference including hoarseness, nasality, denasality, pitch, or intensity inappropriate for the student's age is of minimal concern to parent, teacher, student or physician. Medical referral may be indicated.

Rate and or Prosody Limits communication.

Voice difference is of concern to parent, teacher, student or physician. Voice is not appropriate for age and sex of the student. Medical referral may be indicated.

BY THE AGE OF 7 YEARS, THE STUDENT'S PHONETIC INVENTORY IS COMPLETED AND STABILIZED (HODSON, 1991 ASHA CONVENTION) ADVERSE IMPACT ON THE STUDENT'S EDUCATIONAL PERFORMANCE MUST BE DOCUMENTED. 05-03-02 BASSC Resource Manual Speech Section.doc

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Speech-Language Eligibility Criteria/Matrix, Cont. CLINICAL JUDGMENT MAY NECESSITATE MODIFICATION OF THESE GUIDELINES Severe

Extreme

Impairment limits the individual's ability to communicate appropriately and respond in school learning and/or social situations. Environmental and/or student concern is evident and documented.

Impairment prevents the individual from communicating appropriately in school and/or social situations.

Intelligible 20-49% of the time in connected speech. Deviations may range from extensive substitutions and many omissions to extensive omissions. A limited number of phoneme classes are evidenced in a speech-language sample. Consonant sequencing is generally lacking.

Speech is unintelligible without gestures and cues and/or knowledge of the context. Usually there are additional pathological or physiological problems, such as neuro-motor deficits or structural deviations.

Augmentative communication system may be warranted.

Augumentative communication systems may be warranted.

The student demonstrates a deficit in receptive, expressive or pragmatic language as measured by two or more diagnostic procedures/standardized tests (if standardized tests can be administered). Performance is between 2.0 to 2.5 standard deviations below the mean standard score with standard scores generally between 70-62. Augmentative communication systems may be warranted.

The student demonstrates a deficit in receptive, expressive or pragmatic language which prevents appropriate Communication in school and/or social situations. With measured performance (if standardized tests can be administered) falling greater than 2.5 st standard scores generally less than 62. Augmentative communication systems May be warranted.

9-12% atypical disfluencies within a speech sample at least 100 words. Excessive tension and/or secondary characteristics are present. Rate and/or Prosody Interferes with communication.

More than 12% atypical disfluencies within a speech sample of at least 100 Words. Excessive tension and/or secondary characteristics are present. Rate and/or Prosody Prevents communication.

Voice difference is of concern to parent, teacher, student or physician. Voice is distinctly abnormal for age and sex of the student.

Speech is largely unintelligible due to aphonia or severe hypernasality. Extreme effort is apparent in production of speech.

Medical referral is indicated.

Medical referral is indicated.

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Service Delivery Models Students who have been identified as speech and language impaired have traditionally been served through a pull-out model. There are numerous reasons for the speech-language pathologist to consider alternative service delivery modes, including: • • • • • • • • •

To provide a range of services appropriate to the needs of each student To provide a more natural communication environment To promote generalization from the therapy environment to other communication settings To provide an opportunity for interprofessional training To provide an opportunity for peer modeling and reinforcement To more effectively integrate the student’s communicative goals into the educational program To provide for a better understanding of overall student achievement To provide for more teacher involvement in specific communication skills development; and To reinforce and supplement clinical activities

These issues, the necessity for a multidisciplinary approach and the least restrictive environment, have made it necessary to investigate alternate service delivery models.

Monitor IEP’s are developed for students in this group. A student who has not exhibited carryover or generalization of skills may benefit from this service delivery option. This model is structured to provide feedback in the classroom from the teacher, consultation between the teacher and the speech-language pathologist and/or intermittent intervention with the pathologist. This model achieves these goals: 1. 2. 3.

To establish carryover of therapy gains to the instructional setting, To provide feedback to the student from peers and other adults, To enhance generalization of skills acquired.

Integrated Services In an integrated-service delivery model, the speech-language pathologist provides direct services to students with speech and language impairments across educational activities/settings in cooperation with other education professionals. This model addresses one of the most consistent problems when providing therapeutic services: carryover or generalization of skills. In order to facilitate the student's use of emerging or acquired speech and/or language skills, the speech-language pathologist works with the student in a variety of settings: classrooms, community, and/or social. By working with the various service deliverers (teacher, occupational therapist, physical therapist, etc.) in multiple educational environments, the speech-language pathologist maximizes opportunities for the student to achieve the stated goals on the individualized education program (IEP). The ability to provide ongoing assessment, to modify therapeutic techniques, to teach strategies and to relay feedback to the student are enhanced when the speech-language pathologist can observe, treat and gather data in multiple settings with the input of additional professionals. This model is also referred to as the transdisciplinary or multidisciplinary team approach. This model achieves these goals: 1. To provide therapy in a natural setting; 2. To involve the classroom teacher and other education professionals in the therapeutic process (Knowledge and skills are shared between the speech-language pathologist, the classroom teacher and other educational professionals.); 3. To promote the generalization of skills. Collaborative Consultation According to Idol, Paolucci-Whitcomb and Nevin (1986), 'Collaborative consultation is an interactive process that enables people with diverse expertise to generate creative solutions to mutually defined problems. The outcome is enhanced, altered, and produces solutions that are different from those that the individual team members would produce independently. The major outcome of collaborative consultation is to provide comprehensive and effective programs for students with special needs within the most appropriate context, thereby enabling them to achieve maximum constructive interaction with their nondisabled peers. Collaborative consultation is a viable service delivery model using the classroom as a more natural environment and giving communication development more meaningful contexts.” 05-03-02 BASSC Resource Manual Speech Section.doc

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The speech-language pathologist functioning as a consultant: 1.

Demonstrates teaching of alternative instructional approaches

2. 3. 4.

Co-teaches lessons based on the learning styles of students Instructs groups for the purpose of reteaching abstract course material Provides direct study skill instruction and materials based on curricular content developed in conjunction with the classroom teacher Adapts instructional materials based on classroom teacher-defined curricular objectives Recommends and provides supplemental materials to reinforce and explain course content Prepares and/or adapts test materials specific to needs of students Observes and/or charts behavior and performance of students with disabilities Facilitates socialization goals Makes recommendations to regular/special instructional staff regarding instruction of students with disabilities based on observations Communicates with education staff and parents regarding progress Provides ongoing inservice to parents and teachers on special education techniques

5. 6. 7. 8. 9. 10. 11. 12. 13.

Various Approaches to Collaborative Consultation Ongoing Direct Intervention is defined as the combined use of direct therapy and collaborative consultation where the consultation is based on ongoing direct contact with the student. The teacher and consultant jointly devise activities designed to follow up on therapy goals. The teacher implements and monitors programs in the classroom. Students being served by this model must have an evaluation and IEP. Intermittent Intervention is defined as consultation regarding a student or group of student following a diagnostic evaluation. Consultation is based on periodic intervention with the student by the speech pathologist. The teacher and consultant devise a program which is implemented in the classroom by the teacher. Students being served by this model must have an evaluation and an IEP. No Direct Intervention involves consultation regarding a specific student or group of students where the consultant has no direct contact with the student. This type of consultation would occur for students perceived to have special needs as well as those who are not eligible for special education and related services. These students would not necessarily have an IEP. This model achieves the following goals: 1. To facilitate the integration of speech and language goals into the curricular goals and objectives of the student 2. To provide increased opportunities for carryover of speech and language goals through additional reinforcement and practice within the classroom 3. To coordinate adaptation of curriculum, instructional materials, test materials and supplemental materials needed to permit the speech-language impaired student to benefit from the classroom 4. To increase the positive communicative interactions of students within the classroom Traditional (Pull-Out Model) The traditional model has been the most frequently utilized service delivery model in the area of speech and language impairment. By utilizing this model, students with all types of impairments and varying degrees of severity are treated by a speech-language pathologist in the following manner: Students are seen individually, or in small groups, during specified blocks of time throughout the school day in a room specifically designed for this purpose. The traditional service delivery model can be used in combination with other therapy models. This model achieves these goals: 1. To provide therapy in an intensive manner without intrusions or distractions to the student 2. To teach new skills

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Instructional Services Students whose primary disability is speech and language and whose needs are so great that they cannot be achieved satisfactorily in regular classes with the use of appropriate supplementary aids and services have the option of being placed in an instructional (self-contained) special education class for students with speech and language impairments. The following should be considered when determining a student's placement in this program: 1. 2. 3.

Documentation of severe speech and language delays/impairments, academic delays, social/emotional delays, and average cognitive potential Documentation of academic failure, low motivation, high frustration, and poor self-image and interpersonal relationships Documentation that previous educational programming made little impact and progress was virtually at a standstill

If placement is to be made in a regular education building that is not the student's home school, the student's IEP must identify reasons that make this placement determination appropriate.

The appropriately certified provider for such a service is the individual holding a Type 10, or Type 3 and Type 9 Special Certificate endorsed for Speech and Language Impaired. The teacher is responsible for the students' total academic curriculum. Curriculum is adapted as needed to meet the specific speech-language goals of each student. This model achieves these goals: 1. To provide a modified or an alternative curriculum for a student 2. To provide language learning in a structured, yet natural environment 3. To enhance pragmatic language learning and usage References Casby, Michael W. (1992). The Cognitive Hypothesis and Its Influence on Speech-Language Services in Schools. Language, Speech, and Hearing Services in Schools, 23, 198-202. Gregory, Hugo; Campbell, June; & Hill, Diane. Continuum of Disfluent Speech Behavior. Northwestern University. Idol, Loma; Paolucci-Whitcomb, P.; & Nevin, A. (1986). Collaborative Consultation. Aspen Publication: Rockville, Maryland. The Michigan Speech-Language Hearing Association. (1 990). Speech and Language Services in Michigan: Suggestions for Identification, Delivery of Service and Exit Criteria. Smith, A.B.; Hand, L.; Freilinger, J.J.; Bernthal, J.E.; Bird, A. (1990). The Iowa Articulation Norms Project and Its Nebraska Replication. Journal of Speech and Hoofing Disorders, 56, 779-798. Resources Included: A.

Definition and Examples of Adverse Effect

B.

Cognitive Considerations

C.

Functional Language Ability Profile (FLAP)

D.

Pre-Referral/Child Study Team Request for Speech and Language

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APPENDIX A Definition And Examples Of Adverse Effect The term adverse effect is taken from the federal regulations for Part B of the Individuals with Disabilities Education Act (IDEA), the federal law that mandates educational services for students with disabilities. Under Section 300.5 of those regulations, the definitions of the impairments covered by the law include adverse effect as one of the components that must be demonstrated in a student's disability in order for that student to be eligible for the entitlements of the law. For example, the term deaf is defined as a hearing impairment “....which is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, which adversely affects educational performance.” In Illinois, adverse effect has been defined as problems resulting from the manifested characteristics of the student's disability which interfere with learning and educational performance in school. This means that the effect of the impairment on the students is such that they are not able to benefit from the regular instructional program offered to others of their age group. The adverse effect is not the actual impairment, but rather the impact of that impairment on the student's ability to learn without specially designed instruction. (Note: Due to the individual nature of each student's impairment and its impact on their learning and educational progress, it is difficult to give examples of adverse effect without reinforcing general concepts that may not be appropriate for a specific student. Please keep this in mind when reviewing the following examples of adverse effect on educational performance.) Two issues pertaining to communication in educational settings should be considered in attempting to determine if a communication problem is an educationally disabling condition. The first involves the fact that language is the primary medium of education. To the extent that a student has not mastered the skills necessary to understand, express and use language, the student's access to the primary medium of education is limited. The second is that communication is the process through which education takes place. To the extent that a speech and language impairment affects the student's ability to participate in active, interactive communication with others in the educational setting (including peers as well as adults), the student is prevented from participating in the process of education. Keeping in mind the interaction of the speech and language problems with the medium and process of education will facilitate the consideration of an adverse effect on educational performance. Several misconceptions regarding the adverse effect on educational performance must be addressed. The first involves a restriction of the definition of educational performance. The definition of educational performance must not be limited solely to consideration of academic performance. The student does not need to be below grade level or failing in an academic area to be eligible as speech and language impaired. Examples of students who may be succeeding academically but are still eligible as speech and language impaired include the following: • A bright student who is disfluent and has related problems contributing to class discussions, giving book reports, and answering questions orally • A first grader who is ahead of peers in many areas, but has non-developmental articulation errors that affect intelligibility during “show and tell”, phonics instruction, and other educational activities requiring oral responses • A third grader who is an above average reader, but whose voice disorder inhibits his classroom verbal interactions, resulting in reluctance to give book reports, do oral reading and join in class discussion Another misconception is that any deviance in communication constitutes a disability. A speech or language deviation does not necessarily constitute an adverse effect on the student's ability to function in the educational setting any more than deviations like mild muscle incoordination or poor eyesight necessarily interfere with educational functioning. Students having muscle incoordination or poor eyesight are not automatically determined to be PH/C or VI. The deviation in functioning must be shown to interfere with the student's ability to perform successfully in the educational setting. Similarly, the speech and language deviation must be shown to interfere with the student's ability to perform in the educational setting before Speech and Language Impaired eligibility is determined. The effect of the speech and language deviation on social/emotional development also must be carefully considered. The key issue to be addressed is whether the deviation interferes with the student's ability to establish and maintain social relationships and experience sound emotional development. Self consciousness about a speech or language deviation or teasing by peers does not by itself necessarily constitute an impediment to social relationships and emotional development. Careful documentation of limitations of social relationships and sound emotional development must be directly linked with the speech and language deviation to establish the existence of an adverse effect on educational performance. 05-03-02 BASSC Resource Manual Speech Section.doc

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The documentation of effect on educational performance must clearly indicate two things: the manner in which the student's communication deficit affects his performance in the educational setting, and the adverse nature of the effect. Also, in considering the effect on educational performance, the student's present educational setting must be the point of reference. The idea that while a student's communication deviance is not currently causing an adverse effect but may cause an adverse vocational effect in the future does not allow us to determine that he is disabled now. Documentation of the effect on educational performance can be obtained by having the regular education teacher complete a checklist detailing behaviors of the student in the classroom which may indicate an adverse effect on educational performance. Checklists might include specific questions such as: “Does the student participate in class discussion?”, “Does the student understand verbal directions?”, “Does the student make errors in spelling on the same sounds he misarticulates?” Responses on the checklist must be related to the speech and language impairment and judged to be indicative of a significant problem. As stated earlier, adverse effect is only one of the components required to determine a student's eligibility for special education services. The four components are: • Completion of a regulatorily correct assessment • Existence of an impairment as identified by the evaluation • Adverse effect of the impairment on learning and educational performance • The need for specially designed instruction as a result of the impairment and its adverse effect The cycle of eligibility determination is completed when an IEP is developed which specifies the services that will be provided to address, and as much as possible, remediate the adverse effect. The goals and short-term objectives of the IEP must be directed to the reduction or remediation of the specific adverse effect for that student and not the general characteristics of the impairment, e.g., students with language development problems should not automatically receive articulation therapy because they are identified under the speech-impaired category. Sources: Illinois State Board of Education, Department of Special Education Staff The Michigan Speech-Language-Hearing Association (1990). Speech and Language Services in Michigan: Suggestions for Identification, Delivery of Service and Exit Criteria.

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Appendix B Cognitive Considerations

The purpose of the cognitive considerations form is to compare the student's standard language scores to standard scores in other ability areas. This process helps differentiate the ”slow learner” who is functioning in language at the expected level, from the student who is truly language disordered and is functioning below the expected level. Examples of these types of situations may include: 1.

The student demonstrates a 15 point (or greater) discrepancy between WISC-III performance score (or a similar IQ performance score from another test) and language skills as judged by the results of language testing. Student shows significant discrepancy between ability and language performance and demonstrates deficits on one or more descriptive measures. Student may be eligible for speech-language services if he/she meets other eligibility requirements (adverse effect, etc.). Example: WISC-III Performance IQ 98 Verbal IQ 76 CELF-3 Receptive 81 Expressive 76 Has difficulty completing assignments in class; seldom speaks in full sentences; seems to lose his train of thought often and will change topics without completing a thought or answering the questions asked of him.

2.

If a student demonstrates no discrepancy between WISC-III performance score and language abilities as judged by the results of language testing, the student's language appears to be commensurate with abilities. Student shows no difficulty in functional communication as judged by the speech-language evaluation. Since language skills are measured to be commensurate with cognitive abilities, language therapy services are not indicated. Example:

WISC-III Performance IQ 75 Verbal IQ 72 CELF-3 Receptive 72 Expressive 72

This student has difficulty keeping up with the class and it takes several repetitions to assure that he has grasped new concepts presented. He socializes well and speaks easily with his friends. He can make his wants and needs known effectively in the classroom situation. 3.

The student demonstrates no discrepancy between WISC-111 performance score and the language testing results. However, two descriptive language measures indicate that the student has difficulty communicating and that this difficulty causes an adverse educational effect and therefore, the student may be eligible for speech/language services to address functional communication skills. Example:

WISC-III Performance IQ 81 Verbal IQ 79 CELF-3 Receptive 84 Expressive 81

This student does well in communicating in guided, structured tasks, however, in the classroom he has difficulty attending and completing tasks assigned. He has difficulty following directions. Results of the Functional Language Assessment Profile indicate he has skills below those of his classroom peers and significant weaknesses are noted in the pragmatic areas of topic maintenance, turn taking, transitions, and conversational initiation skills. *Adapted from the Anchorage School District Speech-Language Services Manual, June, 1990.

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Appendix C Functional Language Ability Profile (FLAP) (FLAP to be completed by SLP. SLP may elicit input from teacher and/or parent.) Student: Observer Total Points: Average Score: Age: Date: Informants: Key: 1,2 = Below average 3,4,5 =Average 6, 7 = Above Average Student compare to peers in ______Regular Education ______Special Education classroom 1. Auditory Attention 2. Vocabulary comprehension 3. Sentence comprehension 4. Consideration of listener needs

5. Organization, purpose, and control

6. Vocabulary

7. Use of language to describe 8. Use of language to question 9. Use of language to explain 10. Quality of structure

Inattentive; easily distracted. Comprehension of words/concepts is significantly delayed. Does not comprehend longer, more complex units of information. No awareness of listener; speaks without any effort to evoke understanding from others; egocentric comments. Rambles: no sense of order or of getting to the point; rattles on without purpose; cannot tell a story in proper sequence. Expressive vocabulary is significantly delayed; has word-finding difficulty; uses non-specific sequence Includes few details; listener has visualizing what is being described Has difficulty asking questions; asks inappropriate questions Instructions are confusing, out of sequence; directions are non-specific Omissions of structural elements, including word endings; uses only simple, active, declarative sentences; word order difficulties in question formations.

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1234567

Attentive: good listening skills

1234567

Understands words/concepts expected compared to peers

1234567

Follows complex directions; follows sequence of a story

1234567

Monitors effectiveness of communication; provides sufficient information; provides sufficient information based on listener need.

1234567

Gets to the point; controls language; organizes and coherently presents ideas

1234567

Uses flexible and precise vocabulary

1234567

Provides complete description of situation or object that features some details and subordinates others Obtains information or assistance by asking appropriate questions

1234567

1234567

1234567

Gives specific, sequential directions to location; gives complete explanation on “How to” tasks Includes all structural elements; mature sentence patterns; maintains constant tense reference within a paragraph or story; mature use of phrases.

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Appendix D Pre-Referral/Child Study Team Request for Speech and Language Student

Birthdate

Name of person making request

Age

Grade

Date

Teacher information is required in order to determine if there is a need for a referral to special education for diagnostic evaluations of speech and language skills. Please answer the questions and return the form to your school Speech Therapist. He/she will contact you to discuss your concerns.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21.

Yes Does this student avoid speaking in class? To others? Does he/she communicate with a lot of gestures instead of speech? Does this student seem frustrated when trying to speak? Do peers tease this student about his/her communication problems? Is this student's auditory discrimination adequate for sounds and words? Does he/she make errors in writing on the same symbols that he/she makes errors on in articulation? (example: spelling) Do most of his/her mispronunciations during oral reading occur on the articulation error sounds? Is this student's grammar (syntax) adequate for his/her age? Do you feel comfortable when you try to communicate with this student? Does this student's voice quality make it difficult to understand the content of his/her verbal message? Does this student lose his/her voice during or by the end of the day? Is this student able to project loudly enough to be adequately heard in the classroom during recitation? Does the student have difficulty with the fluency or flow of his/her speech? (Are there hesitations or prolongations?) Does this student appear to always turn the same ear toward the teacher or other source of sound? Does this student appear to have more difficulty in understanding material that is presented auditodly than visually? Does this student leave out words when asked to repeat several words or sentences? Does this student appear to concentrate on the speaker's lips when listening? Is this student aware of his/her communication problem? What is your major concern about this student? Are parents aware of your concern?

No

Disposition: _____Suggestions provided _____ Checked Status _____Special Education Referral Adapted from: The Michigan Speech-Language Hearing Association (1990). Speech and Language Services in Michigan: Suggestions for Identification, Delivery of Service and Exit Criteria.

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