SLP’s and RTI, Aye! Aye!

OSHA

September 2008

Learning Objectives

• Learn key components of RTI

• Become aware of new service delivery options for SLP’s in an RTI age

• Learn how to use data from school-wide screenings to gain insight into the language functioning of students

The State of the Profession• The Rabbit/Wabbit model

– Students either meet communication expectations for their age and grade level or they are placed in special education

• On the Run Referrals– Teachers stop you in the hallway on the first day

of school to tell you they “have one of YOUR kids”

• The More the Merrier test process– Administer many, many standardized tests to

discover the label that matches the symptoms

The State of the Profession

• The “Hotel California” Program (Judy Montgomery)– You check in, but you never

check out

• New and more demands for your services (but still only 24 hours in a day!)

Why RTI?

• Therapy in the janitor closet all

day is sad

• RTI makes you a SuperSLP!

What is RTI?

• A process in which research based methods are used to identify students most at risk for school failure.

• Providing evidence based instruction or intervention to support the learning needs of all students within the general ed setting

• Monitoring growth

• Making data-based decisions

What RTI is not…

• A program

• Something you buy

• A roadblock to special ed

• One more swing of the pendulum

• What you are already doing

• Something you will become an expert on today

What will we do?

• Be competent in the treatment of communication disorders, delays and disabilities

• understand the educational system• SLPs must see the “big picture”

– How our services work for and within the education system

• All professionals working together to create meaningful services for children

• A Few Things Done Well (Secord)

PL 108-447: IDEA 2004 Specific Learning Disability

• (B) Additional authority. In determining whether a child has a specific learning disability, a local educational agency may use a process that determines if the child responds to scientific, research-based intervention.

RTI and SLP’s

• SLP’s can work with reg. and spec. ed.

• Students don’t have to “qualify”

• Goals tied to curriculum (reading/writing)

• Provides proof that what we do works!

• Puts SLP’s in the spotlight

• Caseload becomes flexible and fluid

Key RTI Components

• Universal Screenings

• Researched Based Interventions

• Progress Monitoring

• Data Based Decision Making

*Sound familiar?

RTI

• RTI uses a continuum of frequency and intensity of services to provide instruction to students– Tier 1– Tier 2– Tier 3

Response to Intervention

Core Curriculum

Tier 1

Tier 2Tier 3 and Eligibility Decisions

Tier 1Provided by General Education

• Group oriented, low intensity

• Use teacher, Title I, tutors

• Focus on one skill (fluency, sight words)

• 3x weekly

• Weekly progress monitoring

Tier 2Provided by General Education

• Small group/individual, medium intensity

• Provided by teachers or Title I

• Daily interventions/ 15 minutes

• Documentation of % or number correct

• Weekly progress monitoring

Tier 3Provided by Special Education

• Individual/High intensity• Provided by Special Education teachers• Interventions are considered an extended

evaluation and require parent consent• Daily interventions for 20-30 minutes• Documentation of % or number correct• Maximum 45 school days (time from consent to

MEEGS)

Getting Started

Who’s running the show?

Don’t look now! It could be you!

RTI Team Examples• Bethany Schools

– School Coordinator• Speech-Language Pathologist

– School Core School RTI Team• SLP Regular Ed. Teachers• School Psychologist Special Ed. Teachers• Principal Title I• Counselor Parents

• Yukon Public Schools- Central Elementary– School Coordinator

• Speech-Language Pathologist– School Core School RTI Team

• SLP Regular Ed. Teachers• School Psychologist Special Ed. Teachers• Principal Title I• Counselor Parents

Go to the RTI meetings• ASHA

– “Collaborating with classroom teachers to provide services and support for students with communication disabilities.”

– “Identifying, using, and disseminating evidence-based practices for speech and language services or RTI interventions at any tier

– Tell, Show, DO* ASHA’s Responsiveness to Intervention: New Roles for SLP’s

Core RTI Committee• Coordinator

– Should be someone who works at the site daily– Offer guidance in research based data collection – Collect needed data from teachers – Analyze and identify persistent patterns of need within

schools– Liaison between regular ed and special education teachers– Collaborate with teachers to design appropriate

intervention plans – Provide intervention resources and materials as discussed

in RTI meetings

SLP as Team Member

• Attend RTI or grade level meetings– Why?

• Connection between reading and language• Brainstorm solutions with teachers• Working to help students now will help keep your

caseload numbers lower• You learn about the curriculum• Teachers learn language strategies• Kids benefit from better instruction as a result of

collaboration• People quit calling you “speech teacher”

Everyone with their own responsibilities and concerns…

Meetings

Student Success

When you develop a plan together and carry out that plan as a team, the student gets a clear, step-by-step intervention that results in more progress.

Meetings

Use each professional’s expertise to develop a “Super Plan” of intense

service that will benefit the student.

School wide success occurs when students receive purposeful and

planned instruction focused on one common goal from all professionals.

Screenings

Goal of screenings

• The goal of screenings is to give a quick picture of who might have needs that should be further investigated

Help with School-Wide Screenings

• You will gain credibility if you are willing to jump in the trenches with them.

• You will gain insight into the pros and cons of each of the subtests

• ASHA– “assisting general ed. classroom teachers

with universal screening”– “serving as members of intervention

assistance teams…”*ASHA’s Responsiveness to Intervention: New Roles for Speech-Language Pathologists

Who gets screened?

EVERYONE

• Kids who…– appear average– are ELL (even non-English speaking)– are already identified as Learning Disabled– enroll in the middle of the semester

Why does this matter to SLP’s?

EVERYONE• Kids who…

– appear average • Screenings may reveal late emerging language issues

– are ELL (even non-English speaking)• Developing a data base of average ELL scores may help

differentiate between a language difference and a disorder– are already identified as Learning Disabled

• Is the therapy we are providing making an educational impact?

– enroll in the middle of the semester• Catch it early

Question

• As SLP’s, what “quick snapshot” information would you hope to gather through screenings?

Reading

• Oral Reading Fluency is most common type of screening– How many words a student correctly reads in

1 minute– Individually administered– Standardized passages are widely available– Correlates with State Test Outcomes,

classroom performance, later reading ability– DIBELS, EdCheckup, Aimsweb

Reading

• Other screeners– Students who are emerging readers (PK-1)

may be screened on these skills which have been shown to be highly predictive of later literacy achievement

• Nonsense Word Fluency• Phoneme Segmentation• Initial Sound Fluency• Letter Identification

Reading Screenings

• In addition to DIBELS consider…– Maze screens for grade 4 and up

• Research is revealing that maze passages are more helpful predictors of reading success for older students

• Incorporates comprehension and oral reading• Can be group administered in 3 minutes

Maze

Roger wasn’t much of an athlete. It wasn’t that he didn’t like (basket, sports, think). He really did like basketball. But (it, a, he) was better at tripping and crashing (into, one, sit) things than he was at making (sport, baskets, school). His classmates seldom asked him to (play, with, good) on a team when they played (television, basketball, practiced) at noon. Mr. Park never chose (it, from, him) to shoot baskets in front of (do, an, the) gym class.

Aimsweb, Grade 3 Passage 8

Writing

• Can be group administered

• A story starter is provided

• Student is given 1 minute to think about what he will write

• Student is given 3 minutes to write

Interventions

What is an intervention?

• Evidence based

• Preventative or remedial

• Systematic & Explicit

• An investigation into how a student learns best and the supports required for success

• Provides appropriate levels of scaffolding as children learn to apply new skills

What Interventions are NOT

• Interventions are not– Front row seating– Reduced work– Extra time– Trial special ed class– One size fits all– Daily testing

Key Components of Intervention

• Explicit Instruction

• High number of opportunities to respond

• Immediate feedback

• Opportunity to practice after correction

Evidence Based Interventions

• Evidence-based interventions link their methods to scientific research

• Where can I find info on this?– National Reading Panel– University of Oregon’s Big Ideas– Florida Center for Reading Research

• www.fcrr.org

– National Institute for Literacy– www.interventioncentral.org

Preventative/Remedial

• Preventative interventions– Provided when a student is not yet behind,

but showing signs that he may be “at-risk”– K-1st grade

• Remedial interventions– Provided when a student is significantly

behind peers– 2nd grade +

Systematic & Explicit

• Interventions are more effective when they provide systematic and explicit instruction on whatever component skills are deficient.

• Systematic -methodical in procedure

-follows an instructional sequence

• Explicit -skills are taught directly

-nothing left to chance

Investigations

• Literacy interventions should– Pinpoint the breakdown in skills– Focus on specific skills– Start with the least amount of intensity and

frequency– Increase in intensity and frequency as needed

in order to achieve success

Interventions

Any time spent “testing” should be prescriptive!

Will the information I get from this tell me how to specifically help this student?

What we’ve learned so far…

• RTI is a regular education initiative that involves a lot of stuff that SLP’s know a lot about!– Screenings– Monitoring Progress– Data Based Decisions– Literacy

• So, what else is there?

Why should SLPs be involved in reading?

• Students who received intensive, explicit instruction in reading also significantly increased their receptive/expressive language scores! (Torgeson et al, 2001)

• Prevention through intervention in K-1 results in fewer remediation needs in upper grades!

What are you waiting for?

Let’s get started

• Step One- Clean House– Monitor/Dismiss kids who have reached

plateau– Dismiss kids who are ELL and not language

disordered– Dismiss kids whose difficulties do not affect

their education (tongue thrust that does not affect speech or attract adverse attention)

Speech Difference?

• 3rd grader with a frontal lisp who gets As & Bs in her class does not have a disability. She does have a speech sound error. She deserves the services of a SLP to improve her communication. This can be done through speech RTI.

• Students who need direction for the specific placement of articulators, intensive supervised practice and a strong generalization program can be served this way.

Change How You Think

Did you know?

• Students with SLI receiving regular therapy did not show significant improvement vs. normal development over a 4 year period of time.

• “…there is little evidence that supports the current model of dispersed intervention delivered over the years.”

YIKES!(Ukrainetz, 2006)

Re-schedule• Short-term intensive intervention within caseloads (4x/wk for 9

weeks). Between intervention periods, SLP provides consultation (Ukrainetz & Justice, 2006)

• SLP’s may consider using a cycles approach to increase availability of service through short, frequent, and intense sessions over a grading period (Moore-Brown, 2006)

• “…it is crucial that SLP’s increase their intensity of their intervention services. There is evidence that short-term intense intervention makes large, lasting differences in reading and language (Ukrainetz, 2006).

• Significant improvements made in short term intensive intervention. These gains were maintained during the next school year. (Torgesen et al, 2001)

Don’t panic it’s easy!

Wow!

• Caseload of 52

• Each gets short-term, frequent, and intensive instruction for a grading period.

• Directly service 13 per grading period

• Consultation and monitoring through data collection between direct therapy periods.

Time Monday Tuesday Wednesday Thursday Friday

8:00 Charting

8:30 Group 1 Group 1 Group 1 Group 1

9:00

9:15 Consultation

9:30 Interventions

10:00

10:30 Group 2 Group 2 Group 2 Group 2

11:00

11:15 Consultation

11:30 Lunch Lunch Lunch Lunch Lunch

12:00 Planning Planning Planning Planning Planning

12:30 Interventions

1:00 Group 3 Group 3 Group 3 Group 3

1:30

1:45Consultation

2:00 Interventions

2:30

New artic kids

• Choose eligibility criteria and stick to it– California Code of Regulations (must meet all 3)

• Significantly interferes with communication• Attracts adverse attention• Adversely affects educational performance

– A child with a speech deficit that mildly reduces intelligibility who does not meet the above criteria is not eligible for special education speech services (CA Code of Regulations)

www.csha.org/resource.htm

New artic kids

Teachers flag students with possible artic needs during

reading screens. SLP follow up

Multiple Sound Errors that are not developmentally appropriate

Single Sound ErrorsMultiple Emerging Sounds

Errors Appropriate for Age

IEP RTI Re-screen in 6-12 months

********** Public SchoolsResponse to Intervention Services

Permission to Enroll in the Articulation Response to Intervention Program******** Public Schools offers an Articulation RTI program for students with mild speech differences or who demonstrate evidence of emerging sounds. Your child has been offered an opportunity to participate in this program to strengthen his/her speech skills.

The goal of a Response to Intervention program is to provide the least intrusive, effective intervention that creates an acceptable rate of learning. Your child will begin the program using techniques which cause the least amount of disruption to their instructional day (home programs, brief speech instruction time, etc). Success of these techniques will be monitored weekly or biweekly. If these techniques are not effective more intense methods may be considered (increased speech instruction, eligibility for special services, etc). The SLP is responsible for planning and implementing the curriculum; however, a trained adult may provide some lessons. Placement and practice methods are individualized for each student, as appropriate.

Students are expected to complete any assignments at home. The speech-language pathologist works with the classroom teacher and parents to reinforce and monitor progress.

If you have any questions, please contact a speech-language pathologist at ______________________________

Student’s Name_____________________________________ Grade_____ Teacher________________________

_____ I am not interested in the Articulation Response to Intervention Program at this time.

_____ I would like to enroll my child in the Articulation Response to Intervention Program. I understand that this is a general education opportunity. My child may be instructed by general ed. or special ed. personnel, but is not enrolled in special education at this time.

Parent Signature_________________________________________________ Date_____________________

*Adapted from San Diego City Schools Articulation Differences and Disorders Manual

Articulation RTI ModelsQuik Artic-Louisiana Artic. Resource Center, San DiegoSound Inventory Tier 1-teacher and family supportSound probes=>75% Tier 2-30 min 2x/wkIntervention 2x/wk 30 min 20 weeks, if neededMin of 8 weeks, Max of 9 mos. Homework required or droppedStephen Mire, smire@tpsd.org Jennifer Taps, jtaps@sandi.net

Speedy Speech, Chicago Artic Lab, Super Duper Publications5-7 min 3x/day, 4x/wk 1st-5th gradeHomework required 30 minutes 4x/wkTier 1=8 wks Approx. 10 weeksTier 2= 8 more wks superduperinc.comTier 3=Evaluate for IEPdkuhn@nssd112.org

Language RTIWork with what you’ve got

Reading

Math

DIBELS BEARS Lit. First

Reading? Pause to Consider…

• What SLP’s know• Phonological Awareness• Vocabulary• Comprehension• Writing• Spelling

• Big Ideas for Reading• Phonemic Awareness• Alphabetic Principle• Accuracy/Fluency• Vocabulary• Comprehension

Why RTI?

• “While it is not the responsibility of SLP’s to provide the basic teaching of reading to all children, it is imperitive that they understand the principles of scientifically based reading instruction and how basic reading skills relate to the core curriculum (NCTQ, 2006).”

Analyze the Reading/Writing Data

• Look at the data through an SLP lens• ASHA

– “Explain the interconnection between spoken and written language”

– “Help identify systemic patterns of student need with respect to language skills”

– “Consulting with teachers to meet the needs of students in initial RTI tiers with a specific focus on the relevant language underpinnings of learning and literacy”

*ASHA’s Responsiveness to Intervention: New Roles for Speech-Language Pathologists

Through an SLP LensInitial Sounds, Phoneme Segmentation, Nonsense Words,

Reading Fluency

• Many of these early literacy skills are what SLP’s are working on every day

• SLP’s are detectives– Why might reading fluency be low?– Why are nonsense words low, but sight word

scores high?

• SLP’s have a critical role to play because these difficulties all have language underpinnings.

Through an SLP Lens Comprehension

• DIBELS retell fluency– “Identifies the student who can read accurately and

with speed but does not comprehend or remember what was read

– If a student’s retell is below 25% and they read at least 40 wpm they are at risk of having comprehension difficulties

– This subtest is very dependent on examiner ability and SLP’s may want to provide training.

Through an SLP Lens Vocabulary

• Word Use Fluency– “Provides an indicator of the student’s vocabulary

knowledge and expressive language skills.”– Benchmark scores have not yet been developed;

however, if your school uses the DIBELS database you can obtain local norms.

– Students below the 20%tile may be considered at risk for poor language

*DIBELS: The Practical Manual. Answers to Questions About Administering, Scoring, and Interpreting DIBELS. Linda Farrell, Hancock, C; Smartt, S. Sopris West, 2006.

SLP Lens Spelling

• Provide professional development regarding evidence based spelling instruction

• Help a teacher design effective spelling interventions for her entire class

• Provide spelling interventions for struggling students

How can SLP’s benefit from working on language through reading?

• Comprehension increases as reading fluency increases

• As reading fluency increases students are able to focus on vocabulary

• Collaborating with teachers now reduces your referrals later for

• Phonological Awareness• Vocabulary• Comprehension• Spelling• Writing

Why RTI?

• Look at priorities in the school, district, state• Look at test scores and AYP

– Weak areas of school• Talk and collaborate with teachers

– Prioritize areas of need– Start with one area and expand– Share with others the work you have done

(OSDE 2007, Anita Marcott)

Evidence Based Intervention Sources

• Phonological Awareness– Sounds Abound-Linguisystems– Sound Effects-Thinking Publications– The Phonological Awareness Test-2-Linguisystems

• Comprehension– The Learning Ladder-Thinking Publications– The Narrative Toolbox-Thinking Publications

• Vocabulary– The Bridge of Vocabulary-Pearson Assessments– Bringing Words to Life: Robust Vocabulary Instruction. Isabel Beck, et

al. Guilford Press, 2002.• Spelling/Writing

– SPELL-Learning by Design– Storybuilding-Thinking Publications– Narrative Toolbox-Thinking Publications

RTI can take your expertiseFrom 1 Child To ALL Children

References

• Montgomery, J.K., & Moore-Brown, B.J. (2006). Students Are Responding To Intervention (START-IN) : A Response to Intervention (RTI) Program for Reading. Greenville, SC: Super Duper Publications.

• Moore, B.J., & Montgomery J. (2008). Making a Difference for America’s Children. Thinking Publications.

• Staskowski, M. (2007, November). Language Expertise: A Key Component for Problem Solving in RTI. Presented at the American Speech-Language-Hearing Association Annual Convention, Boston, MA.

• Ukrainetz, T. A. (2006). The Implications of RTI and EBP for SLPs: Commentary on L.M. Justice. Language, Speech and Hearing Services in Schools, 37, 298-303.

• Ukrainetz, T.A. , & Justice, L.M. (2006, November). Response to Intervention: Challenges and Opportunities for SLPs. Presented at the American Speech-Language-Hearing Association Annual Convention, Miami, FL.

Thanks for Listening!

• Nicole Power, CCC-SLP• Bethany Schools• RTI Coordinator• 405-499-4618• npower@bps.k12.ok.us

• Kim Kysar, CCC-SLP• Yukon Schools• RTI Coordinator• 405-354-2501• Kimberly.kysar@yukonps.com

Coming SoonCheck out the September 23, 2008 ASHA Leader

Response to Intervention: Oklahoma SLPs Expand Role in LiteracyBy

Nicole Power and Kim Kysar