Also known as: Therapy, Therapy, Who has the Therapy…
As a school-based SLP it seems as though there are regulations for everything. There are rules for how many days documents can be unfinalized, how many days between meetings, and who can receive services. In fact, North Dakota has adopted speech-language guidelines to help determine who qualifies for services and who doesn’t. These are very thorough and great guidelines written by the Department of Education and a group of SLPs.
A recent discussion on ASHA’s School-Based Issues SIG Forum made me think..are there times when it’s actually illegal to help someone? There may be…
According to ND Guidelines, a student has to qualify with a moderate speech or language disability to receive services. For language impairment, that means the student must score a “moderate” or higher on a rubric. Essentially, a score of 77 or lower on two assessments plus the academic component. For articulation, the score must be essentially the same although the assessments include one formal assessment plus connected speech intelligibility (or PCC) and academic impact. For the most part these guidelines are very helpful. But, what do we do for those kids with only one or two articulation errors?
On the ASHA Sig, there have been people talking about “seeing” those students informally in the hope that they only need services for 6 months or so. Others put them on 504 plan. Yet others are simply not able to work with them. The ASHA Forum is currently discussing whether these ideas are illegal in regard to IDEA.
Thankfully, in my area, we have Speech Intervention Plans. A speech Intervention Plan is specifically set up for those students who don’t (or won’t) qualify for special education – articulation only. They cannot be used for language therapy at all. Here’s how it works…
A student is screened/tested. If they won’t/don’t qualify then a Speech Intervention Plan (SIP) is offered. A SIP is a two-year intervention plan and is designed for those mild articulation cases. Thankfully, it has our unit’s “seal of approval” and I’m very confident that it’s legal. The students have been identified, parents are informed and sign off on the plan, and progress reports must be sent home similar to IEPs. The only differences really are 1) less paperwork, and 2) there is no “special education” label.
A SIP allows me to see a student for a sound error for which they would otherwise not qualify. After all, I only have two years – so I have to make sure that I can reasonably expect good results in that two-years. Unfortunately I have been on the side where I “inherited” someone on a speech-intervention plan for /r/, /l/, and “th.” This student made great progress – but two years was simply not enough time to remediate everything. When the two years were up, the student continued to have difficulty with vocalic /r/. Unfortunately, this alone was not enough to qualify for an IEP and the student had to be dismissed. I don’t know whether or not the student would have qualified for an IEP before services began.
Needless to say, this isn’t the “norm.” Usually students come in, receive their articulation therapy, and are dismissed. These students have a lot of success and it’s wonderful to be able to say “you’ve graduated!” However, I have learned to be cautious and if there’s a chance the student will qualify for an IEP – to go for an IEP rather than the “simpler” SIP.
The idea of sending a student to middle school with a frontal lisp or an /r/ error bothers me…tremendously. Yet, these students (without the SIP) would not qualify for services. For those areas that have no plan in place for these students, are we doing them a disservice? Are we hurting the students? Will they try looking for work with these errors? Will they be considered less favorably in an interview process because of their speech errors? When does a speech difference have an “educational impact” (NOTE: NOT academic…educational).
On the ASHA Sig, the discussion varied… A LOT. So…I’ve turned to you… What do you do for those students with only one or two sound errors? Are you able to see them? Do you sneak them in as “speech buddy” or are you able to formally work with them? Are you required to look the other way hoping they outgrow the issue without assistance? Let me know here…I’m really looking forward to seeing the responses!
Until then…Adventure on!
Mary
Speech Adventures 
Here in New York State we have something called a 504 plan. These are for kids who do not qualify for an IEP, but have needs such as SP,OT, PT and special Ed services. We put a lot of kids on these in grades K-2. Then by second grade they are re evaluated, because by then it is usually more clear if they are LD, etc. Goals and progress reports are required, they run for a year, and are reviewed each year just like an IEP, but there is no limit on the number of years.
Oops, forgot to say, the 504 plans are typically used for speech kids who we recommend 3x per week or more for. Or for those that maybe only get 2x per week, but also get one or more other services such as OT, PT, SEd, etc. Our kids with maybe two errors, or an /r/ we see under speech improvement services. No paperwork is required for speech improvement. We do Not even need parent permission. We do send a notice home at the student will be getting speech improvement, but an actual permission is not required. Of course, if a parent says they do not want it we honor that. I work in an inner city district and unfortunately most of our parents do it even empty backpacks to read papers sent home:( Anyways, for my speech improvement kids, I do have an informal list of goals/daily log sheets, I take attendance, and I do send home a very basic quarterly progress report…although it is not required. Last year I also,started a 5 minute kids program, where I had kids with one error that I saw for 5 minutes each day 1:1. It worked best with the kindergarten aged kids who had s cluster reduction or fronting errors.
We have 504 plans here too – but it’s more for those students who don’t need/qualify for an IEP but still need some accommodations in the classroom.
Hi Mary,
As usual, your blog is another great topic for discussion! I follow a similar program that you describe, with a Speech Improvement Class. Jennifer Taps, SLP, from San Diego City Schools developed a detailed, wonderful, thorough manual. This is an incredible reference tool to address this issue. It is posted on the CA Speech-Language-Hearing Assoc.’s website, so I hope she doesn’t mind my sharing it here. http://www.csha.org/pdf/CSHAArticulationManual.pdf It is 73 pages covering every detail, including flowcharts for the referral process, permission forms, and even whether it’s the Speech Improvement Class, is a school-based service, or IEP, or 504.
I hope others find this as helpful as I have. Please give Jennifer the credit, by keeping her name on any of the forms, or materials that you use. She deserves all the credit for her hard work on this project, and her generosity of sharing this gem!
Maryann Potts,
Redding, CA
Thank you! and Thank Jennifer too. I appreciate your response.
LOVE the plan and love that the area endorses it! We are starting RTI right now and I want to see some kids on an intervention basis only, but I’m scared of the legal issues around it since nothing about it is “official”. Ugh!
I really, really hope we can start offering SIP classes!!!! I’m reading up on Jennifer’s pdf right now!!!
I hope you are too. It really helps with being able to see kids without an IEP.
For us to have a 504 plan in IL, there has to be an official medical diagnosis.
In my district, we see students informally, but don’t have a set timeline for them. In fact, I inherited a few fifth graders with a stubborn lateral /s/ and vocalic /r/ that have never had an IEP. As a group, we’ve been talking about what happens next. We have a district policy that students have to have at least 2 sounds for an IEP…but it sounds like a similar situation to your end of the two years…. what happens if they *don’t* get it by then?
I am really late on this discussion but in Minnesota our eligibility criteria for an articulation disorder allows for a student to qualify for an IEP for articulation if they are 9 years old and have any consistent speech sound error. Fortunately, this allows for students with just one error to legally qualify for services.
One question about SIPs…how are you recognized by your school district for this amount of your time being used for students not on an IEP? Our FTEs for SLPs are determined by the number of students included in the federal child count. Any student that is not on an IEP would not be counted; therefore, my time doing interventions would not be taken in account when determining staffing for my school. I would love to do more informal speech improvement plans but my job would be affected by it.
Thankfully, or not depending on your perspective, I’m the only SLP in the district, so there’s no question about FTEs, etc.
There is a form that we use to report the demographics, etc. of the kids on SIPs. They don’t count toward the federal childcount, but the co-op recognizes them as necessary (as does the state). When I report my end of the year numbers – I report students I case managed, students I saw (but didn’t case manage), students on SIPs, and students I saw through RTI.
I’m hopeful that as RTI becomes more and more entrenched in the schools – and the SLPs become more involved in the process, more districts will move to a workload management style than a caseload management style.