福建省第二批省级服务业标准化试点.ppt

1,Michigan Speech-Language Guidelines Suggestions for Eligibility, Service Delivery, & Exit Criteria Revised,Maureen Staskowski, Ph.D., CCC-SLP,March 9, 2007,Available at ,MSHA Staskowski 2007,2,Acknowledgements Thank you to the many professionals and their school districts responsible for this document With Special thanks to Dr. Lizbeth Stevens,Keisha Nolan Karen Graham Terry Lange-Winkel Kendall Giovannini Lana Budde Tina Kunarski Jan McCosky Heather Webber Yvonne Belleman Andrea Phillips,MSHA Staskowski 2007,3,Belinda Andrews Deborah Beeler Georgia Boyle Michele Bridges Robin Brighton Darlene Broome Kathleen Bungart Beth Burkhard Yeary Mary Lee Campbell Laurie Capoferi Sheila Carrier-Woods Angela Ciraulo Joan Cortright Gail Curi Candy Cutt Susan Dilgard Amy Dinno,Gail Elliott Kelly Falter Laura Griffith Marybeth Grosfield Katy Hime Anne Howard Cathryn Kelenske Ilene Klegon Mary Ann Knittel Jill Konwinski Alicia Li Judy Lytwynec Dara Ludeus Lynn Marshall Shirley Matuszewski Mary McAuliffe Carrie McCarter-Barnes,Arlene Millman Stephanie Nagy Nickola W. Nelson Kimberly Renshaw Sue Rosko, Susan Swarz Megan Shuboy Sally Shumway Susan Smith Gail Speiwak Maureen Keating Gail Sterling Carol Washchuk Katy West Alesia Williams Jane Witkop Alex Johnson,Johanna Bauer Sandra Ponzetti Yvette Hyter Kelly Cosguff Colin Macpherson Annett Lauria Diane Shovan Elizabeth Semple Marianne Fish Julie Angeli Eileen Presnell Deanna DeVlaminck Rae Mendell Susan Hardin Karen Sabuda Kathleen Juhl Lisa Boike Nancy Garan Katie Flannery Mary Towler Lee Timer,Thank You to the many professionals & their school districts responsible for this document,MSHA Staskowski 2007,4,The Purpose,Resource for SLPs and administrators Facilitate discussion related to practices and procedures To inform It is NOT meant to Provide policy or mandatory procedures Supersede district policy,MSHA Staskowski 2007,5,1992 Last version released 1995 Addendum for Standards for Delivery,2006 Reorganization Updates,MSHA Staskowski 2007,6,Why Revise?,Changes in Federal Laws & Regulations Changes in State Rules and Regulations Changes in Field & Professional Understanding Changes in Population Changes in Practice,MSHA Staskowski 2007,7,The Guidelines: Outline,Preliminary Sections SLI as Primary Disability SLI as a Related Service Special Issues,MSHA Staskowski 2007,8,Preliminary Sections,Forward School Practice & Professionalism Workload Approach to Caseload Culturally and Linguistically Diverse,MSHA Staskowski 2007,9,Professionalism,ASHA and MSHA Code of Ethics Individuals shall honor their responsibility to Hold paramount the welfare of persons they serve professionally Achieve and maintain the highest level of professional competence Promote public understanding of the professions Maintain harmonious interprofessional and intraprofessional relationships and accept the professions self-imposed standards,MSHA Staskowski 2007,10,Professionalism,You show up You show up on time You show up prepared You show up in the frame of mind appropriate to the task You accept directions (including correction) from those who are more knowledgeable or more experienced You provide direction (including correction) to those who are less knowledgeable or less experienced You vigorously seek and tell the truth even those truths that may be less than flattering to you. P-3,MSHA Staskowski 2007,11,Feeling Frantic? How can we do all that is expected?,Are your practices from the 21st century but your schedule from the 20th century? Many others feeling the same way have found a better way.,MSHA Staskowski 2007,12,The Workload Approach to Caseload,MSHA Staskowski 2007,13,SLP Workload Activity Clusters,Direct services to students,Indirect services that support students educational programs,Indirect activities that support students in LRE/general education curriculum,Activities that support compliance with federal/state/local mandates,Workload Activities,WC-5,MSHA Staskowski 2007,15,This approach takes into account,Enrollment of a student into direct intervention, regardless of service delivery options, will add to the workload in other clusters of activity.,(Estomin, 1/2005),Kwame,MSHA Staskowski 2007,17,Examples of Flexible Scheduling,Flexible Monthly Schedule 4 week schedule Allows for blocks of time for intensive treatment Expands the “A-B” approach used in many highschools 3:1 Model Three Weeks direct service: One week Indirect Oregon implementation SLP job satisfaction Integration with general education Less cancellations (and more make-ups) More direct therapy time More third-party billing Block Scheduling,MSHA Staskowski 2007,18,SLI as a Primary Disability,Language Articulation Fluency Voice,Prevention Identification Assessment Intervention Dismissal,School-age Students Adolescents Preschool Students Infants and Toddlers,MSHA Staskowski 2007,19,Early Intervening / Response to Intervention for SLI,L-7,MSHA Staskowski 2007,20,Sample form for documenting early intervening services,Articulation Language Voice Fluency Learning Disabilities,MSHA Staskowski 2007,21,Language Assessment,MSHA Staskowski 2007,22,Michigan Rule 1710,Rule 340.1710 of the Michigan Special Education code provides the following definition of a speech and language impairment: Subrule (1) A “speech and language impairment” means a communication disorder that adversely affects educational performance, such as a language impairment, articulation impairment, fluency impairment, or voice impairment.,MSHA Staskowski 2007,23,Eligibility Guide / Team Summary,Language Articulation Voice Fluency,Assessment Activities,L-8,MSHA Staskowski 2007,24,Input,Teacher L-13 Parent L-15 Student L16/17,Use interview or other techniques to Define/explore the presenting problem Determine the aspects of the curriculum/school performance affected,Review MLPP, MEAP, teacher assessments, medical reports, private therapists.,Review of Pertinent Information,MSHA Staskowski 2007,25,Consideration of,Cultural and Linguistic Differences Environmental and Economic Differences L-18,MSHA Staskowski 2007,26,Curriculum-Based Language Assessment,MSHA Staskowski 2007,27,Curriculum-Based Language Assessment,Guiding questions: What language skills are needed for successful participation in this part of the curriculum? What does the student usually do when attempting this task? What language skills and strategies might the student acquire to become more successful? How should the task be modified? (Nelson, 1989; Nelson, 1998),L-19,MSHA Staskowski 2007,28,CBLA Examples page L-20,A teacher reports that student has difficulty understanding the classroom discussion and the textbook. Together, you have agreed that these difficulties would most likely be observed during social studies. The SLP decides to observe a classroom discussion and group assignment, then to take the student to the therapy room and discuss what went on. The SLP helps the student by showing the student how to use imagery and questioning as they discuss the content and complete the assignment. A teacher reports that a students language is confusing and hard to follow (disorganized discourse). Together, you have agreed that these difficulties would most likely be observed during a story retelling task. The teacher described how they typically do retellings and the SLP simply brought the task to the therapy room. The task is completed with no help, then varying degrees of help. In some instances, the SLP may add the student to a language intervention group working on something similar. The teacher reports that a student has difficulty following oral and written directions. Together you have agreed that these difficulties would most likely be observed during a science lab project. This could be an observation in the classroom followed by a brief retell of instructions outside the classroom, or the SLP may decide to review oral and/or written directions for a home science project in the therapy room. A teacher reports that a student has difficulty with pragmatics. Together, you have agreed that these difficulties would most likely be observed when the student is participating in cooperative groups for science experiments. This could be an observation in the classroom followed by a brief retell of instructions outside the classroom or in the therapy room.,MSHA Staskowski 2007,29,Tools for You,CBLA Language Assessment and Summary Reading Assessment and Summary Writing Assessment and Summary,L-35-40,MSHA Staskowski 2007,30,Record Results of RTI or Dynamic Assessment,Try out language strategies or skills that might help the student access the curriculum How does the student respond to intervention? Single or multiple sessions In the classroom, in a group, or alone SLP or other team members,MSHA Staskowski 2007,31,Collect oral and written samples and consider comprehension & expression of oral/written language,Curriculum-Relevant Samples,Language Samples,Oral and written Portfolio Probes Assessment,L-41-45,L-23-24,MSHA Staskowski 2007,32,Methods for Collecting Language Sampling,Receptive Direction Tasks Main Idea Tasks Details, Inference and Synthesis Tasks, or Comprehension Strategy Probes Think Alouds Questioning Hierarchies Comprehension/Retelling (MLPP) Evaluation Analysis/Analysis Tools/Checklists Reading Miscue Analysis of Children with Suspected Listening Difficulties Teacher Checklist for Listening Early Identification of Language Based Reading Disabilities A Checklist Language Speech and Hearing Services in Schools EXPRESSIVE LANGUAGE- Speaking and Writing Probes/Sample Types Narrative Curriculum based retelling task grades 1-8 Childrens Narrative Developmental Stages and Strategies Oral Language (MLPP) Expositive Compare/Contrast, Sequence, Question/Answer, Problem/Solution, Cause/Effect, Persuasion, Description, or Explanation,MSHA Staskowski 2007,33,Test Profile,Not the first activity Based on the information collected so far Selected carefully for purpose and the population Multiple assessments-doesnt mean multiple tests Compared to IQ not sole criterion,MSHA Staskowski 2007,34,Tests and IQ,MSHA Staskowski 2007,35,Why not compare solely to IQ? (Cognitive Reference),Students with commensurate language and IQ scores wont benefit from language therapy. IQ scores are stable. There are nonverbal IQ measures,Many question whether any measure is truly language free,Based on faulty assumptions,Research has shown that they do benefit.,IQ scores actually fluctuate across tests and within the same tests over time. Consequently, discrepancies are unstable,MSHA Staskowski 2007,36,Problems with cut-off scores,Intent-appropriately identify student as disabled Avoid over-identification or under-identification Identifies unevenly across tests No cut-off in Michigan Rules or IDEA Practice in Michigan using 11/3SD arbitrary Cut-off scores may be different across tests,(Plante, 2003),MSHA Staskowski 2007,37,Test Guidelines,Knowing there is not a specific requirement for standard deviations from the mean in regulations or law, districts may develop their own practices. An overwhelming number of reviewers (SLPs and administrators) wanted specific guidelines The committee suggests that continuing to use 1 1/3 SD as one contributing factor to the overall assessment is reasonable. (unless there is evidence that the cut-off should be greater for that test),MSHA Staskowski 2007,38,The lesson in all of this,Tests alone are not reliable means of identifying students with communication disabilities that adversely affect school performance.,MSHA Staskowski 2007,39,Acceptable levels of sensitivity & specificity levels by,Clinical Evaluation of Language Fundamentals4 CELF-4) Clinical Evaluation of Language Fundamentals-Preschool 2 (CELF-P 2) Preschool Language Scales 4 (PLS-4) Structured Photographic Elicitation Language Test Preschool (SPELT-P) Test for Expressive Morphology (TEEM) Test of Language Competence-Expanded (TLC-E) Test of Narrative Language (TNL) Test of Early Grammatical Impairment (TEGI),(Spaulding, Plante, & Farinella, 2006),MSHA Staskowski 2007,40,Form Impressions regarding,Presence of a Disability Adverse affect of Disability on Educational Performance,MSHA Staskowski 2007,41,Language Intervention,MSHA Staskowski 2007,42,Goal Setting,From the authentic assessments Selected as a team Related to helping the student access the curriculum Reference Michigan Curriculum Framework or Grade Level Expectations (Reading /Math) Annual goal - 12 months, STO/outcomes steps to measure progress toward that annual goal,MSHA Staskowski 2007,43,L-47,MSHA Staskowski 2007,44,MSHA Staskowski 2007,45,Curriculum Relevant Intervention Goal Monitoring,Team responsibility Addressing Goals Noting progress Service delivery fits the goal/strategies Progress data analyzed Intervention approach adjusted Team considers next steps,MSHA Staskowski 2007,46,So. what has changed?,47,Culturally Linguistic Diverse Populations,Michigan Guidelines Karen Graham LAnse Creuse,48,Cultural Competence of the SLP,The awareness of the SLPs own cultural values and standards which could impact the assessment and intervention process. It is necessary to understand the history and social customs of the students culture. Self Assessment for Cultural Competence. Got It? ASHA web site. /about/leadership-projects/multicultural/,Graham, 2006,49,BICS and CALPS,Basic Interpersonal Communication skills Develops informally through conversations and social interactions,Cognitive Academic Language Proficiency Develops through organized instruction of literacy skills in school settings.,Graham, 2006,50,Second Language Acquisition,Conversational skills often approach native proficiency with about two years of exposure to English. Academic proficiency may require five or more years to reach proficiency levels.,Graham, 2006,51,Bidialectal,Students who use dialect of English other than SAE are called Bidialectal. Example: Southern Dialects of English Students can be dialectal in other languages as well.,Graham, 2006,52,Use of interpreters,Interpreters can be used throughout the pre-referral and assessment process. Should be fluent in both oral and written modalities of the student. Facilitators of language between the parents/caregivers and the SLP.,Graham, 2006,53,Interpreters,Discuss roles and responsibilities Review key concepts, phrases, words, and procedures Remind the interpreter that he/she must not alter, omit, or add to the communication.,Ask the interpreter if specific words/concepts are not translatable. Ask about cultural considerations,Graham, 2006,MSHA Staskowski 2007,54,Team Summary,CLD Referral Decision,Similar Format LD CI Add Service Decision,Graham, 2006,55,Guide Team Summaries,Input Observations Curriculum Classroom modifications Dynamic Assessment Referral Other Considerations,Graham, 2006,56,Assessment,Nonstandardized approaches should be the primary method of gathering information. Standardized testing- consult the examiners manual for interpretations of responds,Graham, 2006,57,Language Dominance,It is important to determine the dominant language Bilingual English Proficient Limited English Proficient Limited in Both Languages,Graham, 2006,58,Extended Case History,Language development Students residency Cultural beliefs Language dominance Exposure to primary and secondary language Students academic history,Graham, 2006,59,Language Samples,Obtain language samples in both languages Obtain language samples across settings Obtain language samples with multiple partners Look at multiple formats Curriculum Based Language Assessments,Graham, 2006,60,Test Selection and Use,Look at the normative sample of test. Does it adequately represent the students culture? Does the student have some familiarity with the language of the test? Does the student have some familiarity with situations presented in the test? Is the vocabulary geographical or cultural specific? Does the test display a potential for bias?,Graham, 2006,61,Test Modification,Test modification is an alternative way of assessing skills of a CLD student. It can involve addition, deletion or modification of test items Beware: Violation of test reliability, and validity. Reword instructions, allow extra time for responses Increase the number of practice items Test beyond the ceiling Ask for explanation of incorrect responses. Dynamic assessment,Graham, 2006,62,Intervention,Bilingual Speech and Language Pathologist Most studies recommend early intervention in the students native language Provide a cultural linguistic framework to facilitate language skills In service training Consultative Training ESL staff to facilitate language skills in the classroom,Graham, 2006,63,Web Sites,www. Look under web casts Differentiated Reading Instruction From Babbling to Books Assessment of English Language Learners English Language Learners in Middle and High School Comprehension: Helping English Language Learners Grasp the Full Picture ASHAs web site under Multicultural issues,Graham, 2006,MSHA Staskowski 2007,64,Articulation,MSHA Staskowski 2007,65,Articulation: Special Issues,Lateral Lisp Intelligibility Single Sound Errors,MSHA Staskowski 2007,66,Development Sounds Charts: The Challenges,Controversy Type of research 50% versus 90% Two sets of well-respected data What to do?,MSHA Staskowski 2007,67,Articulation Team Summary,MSHA Staskowski 2007,71,What is Adverse Effect on Educational Performance,Academic and nonacademic performance. Letters from Department of Education IDEA - Curriculum is Academic Nonacademic Extracurricular,MSHA Staskowski 2007,72,Fluency,MSHA Staskowski 2007,73,Whats New,Risk Fac