Response to Intervention

Approximately two years ago, I posted a blog about a study group on Response to Intervention (RTI) for Articulation that I had just completed. I chose that subject for my blog because I found the subject forward thinking and I believed that it might generate some discussion. I did not, however, have much opportunity to practice RTI for articulation due to the fact that I was still working as a high school SLP. At the high school level, I had only occasional students with articulation needs, and when they did have articulation needs, they usually required interventions that are more intensive.

The blog did indeed generate much discussion and many responses were posted. Those of you that posted responses did a super job of interacting with each other and sharing ideas and information. You were far more knowledgeable and experienced with the subject of RTI for articulation than I was with only one study group in the subject to go on.

Now I am at a preschool setting and RTI for articulation could not be more relevant. In fact, I just wrote my first intervention plan for articulation last week. As I move down this path towards a "new way of doing business", I am faced with many issues and questions. Off the top of my head, here are some of them:

1. How do we identify students who should are candidates for RTI intervention, rather than traditional assessment and therapy. 2. Since RTI requires the use of "scientifically researched interventions", how do we ensure we are using the appropriate interventions? 3. Since all of us face large caseloads, how do we manage caseloads to include both IEP students and students on intervention plans and continue to be effective? 4. What is the best way to progress monitor and review intervention plans?

Each of these issues/questions makes good topics for a separate blog posting. I hope in future blogs to deal with each of these issues more in depth. Once again, I look to those in the field with experience to add their expertise and further the discussion.

I haven't posted a blog in quite a long time and I do apologize. Recently, I started a new position and have been playing catch up ever since. I moved from a position as a high school speech language pathologist to a position at our Early Childhood Special Education/Head Start site. Basically, because of training and experience I was able to move from the oldest students in our district to the youngest. Of course, some preparation was needed. This summer I dug out the tubs in my garage that had my early language, articulation and early literacy materials. I reviewed assessment tools that I had not looked at in a long time. As we started the school year, I asked one of the SLPs that have been at this site for 6 years so many questions. She was extremely helpful- but I probably drove her nuts. Last year I was immersed in a world of curriculum modifications, written language, state and alternate assessments, and real world transitions. Now I spend my time dealing with screenings, an onslaught of initial evaluations, early language acquisition, fronting and consonant cluster reductions! As I've gone through this whirlwind, I am reminded of one of the reasons I love our profession. There is always change and something new. The opportunities our profession presents us with keeps us fresh, creative and constantly learning. Change keeps us on top of our game and helps us better serve our clients and students. While pondering this thought, I remembered that there are many SLPs in my state of North Dakota and other states as well that deal with a great variety of change on a daily basis. In more rural areas, one SLP could serve all the students in Pre-K through 12th grade. Talk about being quick on your feet and being flexible. I certainly admire anyone who handles that much diversity and continues to meet kids needs, and do it well.

I have been a high school speech pathologist for almost three years. Throughout those three years, I have worked hard to define the role and duties of a high school speech pathologist. One of the reasons that I have continued to do this is that my district does not have a clear cut description of my roles and duties. In addition, there is some difference of opinion on the role of a high school SLP.

So after much thought, I came up with the following components of my program in order of importance: remediation of language skills as per IEP goals and objectives, teaching strategies to help students cope with their disability, accommodating and modifying general education curriculum, tutoring and transition. As a speech language pathologist, I should add conducting assessments to my list, but I didn't see that as one of my top duties. As an elementary and preschool speech pathologist, the list of assessments was endless. In my three years at the high school level, I have conducted only four initial speech and language assessments. The remaining assessments were all three year re-evaluations. The students were already in my program and the information that I sought through the assessments helped me better serve the students in the first two components on the list- remediation and teaching strategies.

I don't know if the list is perfect or covers every area- but it certainly helped me focus and prioritize my time. I was able to discuss these components with our district special education director and he appeared to agree with me. In fact, at a subsequent meeting of our high school special education department, he listed the same components as things we should be doing at the high school level.

I am most comfortable with the remediation, teaching strategies and modification components of my program. I have ongoing discussions with administrators about the tutoring component. I certainly acknowledge that my students cannot handle the general education curriculum without additional academic support. I'm just not sure I am the best person to be doing this. I am not the subject matter expert and I'm not sure it is the best use of my specialized training. The good news is that this has and will continue to generate some positive discussion in our school and district. The last component that I am not fully comfortable with is transition. Transition for high school students is extremely important. It could take up all my time if I let it. In addition, I have heard rumors that with the reauthorization of IDEA, the transition requirements will possibly becoming overwhelming. In the meantime, I continue to incorporate transition into my program in two ways. First, we have weekly whole group instruction on a variety of topics, such as available adult services, job applications, interviews, resumes, finding a job that meets your needs, etc. Second, I meet individual transition needs through the IEP process.

As professionals, we continue to analyze our skills, requirements and most importantly, the needs of our clients we serve. Then we make adjustments to our programs or services as necessary. I hope I have done this during the last three years and I hope I will always continue to do so.

Although I do very little articulation therapy at the high school, I try to keep current in as many areas of speech pathology as possible. So when some of the SLPs in my district formed a study group to look at a Response to Intervention (RTI) Model for Articulation, I joined the group.

Several of the elementary schools in our district are piloting RTI models for early language and literacy. These schools have been doing this for several years and the RTI programs are developing well.

For those of you who are not familiar with the RTI concept, the idea is aligned with the new IDEA and No Child Left Behind. The hope is to provide research based interventions using a multi-tiered approach in the hopes that we can improve the skills of "at risk" students before they go through the special education evaluation process.

The purpose of our study group is to explore the possibilities and options for starting an RTI model for articulation in our district. We've looked at screening tools, paperwork and treatment tools. Once again the hope is that if we identify "at risk" articulation problems early, we can provide some early intervention before more intensive speech therapy is needed.

We have looked at two models for information. In Louisiana, one district designed a "Quick Artic" program and San Diego created an RTI articulation program as well. There is not much information and research published about RTI articulation, so it has been difficult finding useful information. I'd love to hear if anyone has experience with this model. I will also share our recommendations and findings once we've finished our study group. Until then- Happy Halloween!

The special education department at our school has been working closely with school and district administrators to create a clear vision for our department and prioritize our many requirements. This in itself could be the subject of numerous blogs.

As we are working on arriving at this vision, I am often reminded that I am the only speech language pathologist in our building. The rest of our department is comprised of 3 teachers for Learning Disabilities, 2 teachers for Mental Retardation (yes- our district still uses that term) and 1 teacher for the Emotionally Disabled. Despite being the only SLP at our school, I know that there is a strong network of SLPs in our district.

This led me to thinking about the significance of observing peers. I have learned much by engaging in conversations with other SLPs, but nothing beats old fashion observation of other SLPs at work. We were all required to complete a certain number of observation hours during our undergraduate studies and have benefited from watching videos of therapy techniques during workshops and conferences. These observations should continue throughout our career. By observing our peers we can gain fresh ideas. We learn what works in different situations (and what may not work). We can take these observations with us and adapt the skills and techniques to our teaching style, setting and student's needs.

So think about making time to observe your peers. As a result of writing this blog, I am considering proposing to our district SLP team leader that we incorporate observations into our monthly SLP meetings!

Now that I know I can still post entries on my blog, I can elablorate more about starting back to school.

One of my highest priorities at the high school is to inform teacher about the student's needs. There are over 30 students on my primary caseload and each one has between 5 to 7 teachers. I cannot physically visit so many teachers before school starts to discuss each student. The special education department at my school has come up with a very useful form. It summarizes in list format the classroom accommodation and modifications for a student. We create one on every student and send it to all their teachers. We consistently put the form on purple paper. While we do provide IEPs to teachers, we have found this form a useful way to call teachers' attention to a student's needs in the classroom prior to the beginning of assignments and tests. The teachers have come to expect the "purple sheets" and appreciate a way to quick reference the needs in their classroom. Although I am not a fan of creating additional paperwork when we already generate so much, I truly like the "user friendly" form

My last attempt at posting comments on my blog did not work, so I will make this entry short. This way if it does not work, I will not lose another lengthy entry.

A majority if school based SLPs have gone back to work over the last few weeks. These first few weeks usually bring a frenzy of activity. Some of my highest priorities for these first few days have traditionally been creating a schedule, informing classroom teachers about students' needs, and learning about new students.

Do many of you face the same demands and priorities? Are there other things that must be accomplished before students start coming to your room for services? What does the beginning of the school year mean for you?

I am the wife of a military officer, and as a result, I have worked at a number of schools. No matter which school it was, I always encountered the debate, "Is it a good idea to hand select teachers for students on IEPs."

I am a firm believer that it is definitely a good idea to do so. I've learned, however, to make these selections carefully and to have solid reasons when requesting matches. We all know that there are teachers that just don't work well with IEPs and do not easily accomodate curriculum, but those reasons do not hold much water with administrators. They can be perceived as personal attacks, rather than keeping the students best interests at heart. I've begun to say things, such as this teacher relies on lectures and this student with auditory processing difficulties cannot follow the lecture or this teacher is very structured and this student with autism must have structure. It's a good idea to keep the focus on the student's needs and learning style.

One last point I'd like to make is that I am always concerned about overloading certain teachers. We do not want to cause burn out by requesting the same teachers over and over again. Look for unique pairings of students and teachers. For instance, a secondary teacher who assigns a large number of projects may seem intimidating to some of my students, but it could also be a great way for a student with language difficulties to express their knowledge in a wide variety of ways.

Best of luck dealing with the debate in your work setting and good luck in requesting those matches.

Summer is in full swing. We just finished 4th of July, yet there are signs popping up that school will be back in session soon. I saw supply lists and workers stocking the shelves with school supplies yesterday in Walmart. For me, however, the sure sign that school is fast approaching is that my students schedules for next are ready to be mailed. Each year when they are ready, the office calls me and I run over to school to review them, make recommended changes, etc.

As I was doing this yesterday, I was reminded of how much we as Speech Language Pathologists must know about the curriculum. At the high school level, as a case manager I assist my students in filling out their registration materials and select required classes and electives. I must know what they be working on in the classes in order to make sound recommendations. I must also know what they will be required to do so that I can anticipate when they will experience difficulty and thus provide academic support. I also provide recommendations about modifications and accomodations to the IEP team. (This is a great subject for a later blog!) Therefore, I must be familiar with the curriculum.

I began thinking to myself, is this specific to the high school setting and I quickly realized "no". As an elementary and preschool SLP, I also needed to be familiar with the curriculum. I didn't have select classes, but I sometimes made recommendations on teachers ( another great subject for a later blog!!) and I certainly had to anticipate when my students would struggle with the curriculum. Best of all, I was able to maximize time in the classroom co-teaching.

So as SLPs, do we have to masters of all trades and be able to teach all classes. I don't believe that is necessary. We'd kill ourselves trying to be a expert in every subject, especially at the high school. We do, however, have to make ourselves familiar with what our students are learning in the classroom and know what they are expected to do. Some of the ways that I do that is reading over textbooks and talking to teachers. I try to spend some of my prep time observing in classrooms. I have started keeping files of teacher's assignments, test, and possibly notes so that I can review this material. There are so many novels used at the high school level and they aren't all the same as the ones I've read at school (ok there are also some that I just can't remember). unfortunately, I don't have time to read them all, so I listen to some on CD when I'm driving. Those are just some of my suggestions. If anyone would like to share their ideas on becoming familiar with curriculum that would be great.

I guess that's all for now. After all, it still is summer and the lake is waiting.

School is out for the summer. For school based SLPs this means many things. For me it means cherished time with my family. This includes swimming lessons, horse shows, time at the lake, shopping trips with teenagers, lunches out and a variety of other activities. For most of us, the summer also includes some professional development time, be it exploring new ideas or therapies or expanding a particular interest in our field.

Two weeks ago I attended a 4 day workshop sponsored by our school district entitled " Using Technology to Differentiate Instruction for Students With Disabilities." Most of the participants were special educators and SLPs from our district, but there were a handful of general education teachers as well. As SLPs, we are familiar and competent using differentiated instruction and we hope that we can assist the teachers in our building to use more differentiate instruction, especially with students on our caseload. The purpose of the workshop was not to focus on using technology as a therapy tool, but rather use technology to make curriculum more accessible and more manageable to our students. Although I cannot share four days of material in this blog, I would like to mention some helpful points.

Technology can be used to differentiate instruction by providing visual representation of material, using graphic organizers, providing recognition, providing feedback and allowing for more interaction in the classroom. This follows the concept of Universal Design. To learn more about Universal Design you can visit www.cast.org. We discussed several means of using technology for visual representation. Some tools that I found helpful ( I am already using them!) are United Streaming, Microsoft Drawing, Microsoft Tables, and Inspiration. We also explored using Smart Boards and ActivBoards to promote interaction, visual learning and feedback. Two other programs to promote accessiblity for our students our Kurweil and Premier Suite. I know just listing a few sites and programs may not be that helpful, but my hope is that it might be a jumping off point. It might be something to research further or discuss with colleagues in your building.

The last thing we discussed at the workshop was the reality of cost and budget. Technolgy is expensive. We must be know what we want and how it will help not only our students, but many students in our buildings. Schools do not have money to waste. We want to make informed decisions. When we have all our ducks in a row, we have a much greater chance of convincing administrators to purchase useful technology.