|About the presenter: Kathleen Whitmire is Director of School Services for the American Speech-Language-Hearing Association (ASHA). Prior to joining the ASHA staff, she served as a school-based clinician for fourteen years, and held positions as a clinic supervisor and lecturer at Syracuse University and as Assistant Professor and Chair of the Communication Disorders Department at The College of Saint Rose. She has served in a variety of capacities for regional and state professional associations and boards, for which she has received two Distinguished Service awards, and currently sits on the editorial board of Topics in Language Disorders. She has written and presented extensively at the state and national levels on issues related to the academic and social implications of communication disorders in school-age children and adolescents, with particular interests in language learning disabilities, stuttering and deafness. Dr. Whitmire received her MA, MS, and PhD from the University of Rochester.|
In the United States, children with communication disorders are eligible to be served by speech-language pathologists in their school setting, if they "qualify for services." Every day in the United States, speech-language pathologists (SLPs) are faced with decisions regarding the students they serve in the school system and the manner in which they provide those services. Deciding which students will be eligible for services in the schools can be the most challenging decision to make, with the interplay of pressures from struggling children, large caseloads, budget constraints, and concerned parents. The situation may be further complicated for certain disability groups such as children with fluency disorders, when it is unclear if the school is responsible for providing services to a child who may not be getting failing grades. It is essential that clinicians and parents become informed about the federal mandates for services in the schools for children with special needs, in order to make appropriate decisions. This article discusses the main premises of those mandates and the implications for services to children with fluency disorders in the schools in the United States. A discussion about how children are served in other countries is welcome as well.
Public Law 94-142, the Education for All Handicapped Children Act, was enacted by Congress in 1975 to guarantee a free, appropriate public education for children with disabilities. That act has undergone three major statutory reauthorizations, the latest of which was the Individuals with Disabilities Education Act amendments of 1997 or IDEA '97. The purpose of IDEA '97 is to establish an educational planning process that promotes meaningful access to the general curriculum for all students. The goals of IDEA '97 are to help each child:
There are several interdependent components to the planning process as defined by IDEA '97. First, the child is referred to a building-level team for discussion and consideration. In some cases, the team may decide to institute some instructional modifications, consultation, and/or short-term intervention to determine if the child's needs can be met outside of the special education arena. Other times, the team will decide that an assessment is appropriate to determine if special education services are needed. In that case, the second step is that various members of the team will conduct their respective parts of the assessment, and then come together to review those results and decide if special education services are needed. If so, the third step is that the assessment findings will be used as the basis for developing the Individualized Education Program (IEP), that is, the plan for intervention. Implementation of the IEP constitutes the fourth step, intervention. When viewed this way, it becomes apparent that the IEP should emerge from the assessment findings and in turn should direct the intervention process, creating a cohesive picture of the child's needs and the best way to meet those needs in the school setting. The following sections highlight strategies and approaches that contribute to successful interdependence of these components, particularly for children with fluency disorders.
The assessment should be designed to answer three questions:
According to IDEA '97, no single procedure is used as the sole criterion for determining an appropriate educational program for the child. Rather, a variety of assessment tools and strategies should be used to gather relevant functional and developmental information, including information provided by the parent. The information should relate to enabling the child to be involved in and progress in the general curriculum, and should assist in determining the content of the IEP. In other words, the assessment must be contextually based. This requires information regarding the child's ability to function in educational settings and, as such, cannot rest solely on standardized test results. Rather, multiple forms of assessment (and not multiple norm-reference tests) are needed. These may include:
For over twenty years, there has been debate about the determination of the "adverse affect" of a communication disorder upon a child's educational performance. Some school districts deny special education services to children with an obvious speech or language impairment who do not have an associated discrepancy in age/grade performance in one or more academic subject-matter areas that can be directly attributed to their speech or language impairment. This narrow interpretation of "adverse affect" requires academic failure before a child can receive special education services. This requirement is especially exclusive for children with fluency problems who are doing well academically. In 1980, ASHA sought and received clarification on this policy interpretation from the US Department of Education. Following are highlights from the official policy interpretation. (Information in brackets provides current terminology as included in IDEA '97.)
...It is clear that, in establishing the existence of a speech [or language] impairment that is [a disability]...a professional judgment is required. The basis for that judgment is the child's performance on formal and/or informal measures of linguistic competence and performance rather than heavy reliance on the results of academic achievement testing. The impact of the child's communicative status on academic performance is not deemed the sole or even the primary determinant of the child's need for special educational services. It is the communicative status -- and professional judgments made in regard to assessments of communicative abilities -- which has overriding significance. In the event the speech [-language] pathologist establishes through appropriate appraisal procedures the existence of a speech [or language] impairment, the determination of the child's status as a [child with a disability] cannot be conditioned on a requirement that there must be a concurrent deficiency in academic performance."
Once it has been determined that the child is eligible for special education services, the next step in the planning process is the development of the IEP by a team of educators and the parent. Information from the assessment regarding the child's performance in educational contexts academic, nonacademic, and extracurricular now serves as the basis for the focus of intervention as defined in the IEP. As outlined earlier in this article, that plan should address the child's involvement in the general curriculum, participation in extracurricular and other nonacademic activities, and participation with other children with disabilities and nondisabled children. In other words, the intervention plan must be educationally relevant. It is not adequate to just report test scores or to establish an annual goal of "will increase fluent speech." The plan must be more reflective of the child's performance in the school setting at large.
Components of the IEP that are particularly relevant to this discussion include present levels of performance, annual goals, supports for school personnel, and service delivery. Present levels of performance describe how the child's disability affects involvement and progress in the general curriculum, broadly defined as academic, nonacademic, and/or extracurricular. This component of the IEP provides information on the child's educational strengths and weaknesses, including an understanding of the unique educational needs that result from the child's disability. Following is an example of a statement of present levels of performance that is useful as the basis for intervention planning:
When developing the intervention plan, the team should take into consideration the full spectrum of service delivery options when deciding which options are appropriate for meeting the individual needs of the child. It may be appropriate to provide a mix of options, e.g., classroom-based, individual pull-out, and consultation, to help the child establish basic speech-language skills, examine attitudes and beliefs, and apply skills in various contexts. In addition, these options should be reviewed and changed over time as needed, as the child's needs change.
Being informed about the federal mandates of IDEA '97 is the best way to ensure that children with fluency disorders are receiving the services to which they are entitled in our schools. Using this law as guidance in decision-making will help to bring fairness and consensus to the process, resulting in appropriate support to these children and their families.
American Speech-Language-Hearing Association. (1999). IDEA and your caseload: A template for eligibility and dismissal criteria for students ages 3 to 21. Rockville, MD: Author.
Council for Exceptional Children. (2000). Developing educationally relevant IEPs: A technical assistance document for speech-language pathologists. Reston, VA: Author.
Dublinske, S. (2002). "Adversely affects educational performance" policy 1980-2002: Nothing has changed. Perspectives on School-Based Issues, 3(2), 3-7.
U.S. Congress. (1997). Individuals with Disabilities Education Act amendments of 1997. Washington, DC: U.S. Government Printing Office.