Collaborating with Educational Diagnosticians in the Referral and Evaluation Process

Trends in Education

Learner Objectives

Participants will be able to list, discuss, describe:

▫ Similarities and differences between the roles of Diagnosticians/LSSPs and SLPs

▫ The objectives of each profession’s evaluation process

▫ Creating a framework for evaluating referral packets

▫ How to improve the quality of referrals received for testing for special education

Two sides to the same

house

Exploring the differences between Speech and Academic Special Education

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Professional Responsibilities

SPEECH & LANGUAGE ACADEMIC

• SLPs perform

▫ Evaluations

▫ Intervention

▫ Dismissals

• Diagnostic Staff perform

▫ Evaluations

▫ Dismissals

• Special Education Teachers perform

▫ Intervention

Focus of Evaluation


Fluency

Voice

Intelligibility

Social appropriateness

Expressive language

Receptive language

Written expression

Basic reading

Reading comprehension

Reading fluency

Math reasoning

Math calculation

Oral expression

Listening comprehension

We will discuss the similarities and differences of the last two

items.

Qualification Guidelines


• Grammaticality

• Accuracy of word meanings

• Percent unintelligible

• Mean length of utterance

• 1.5 standard deviation below the mean

• Local norms (in-class tests, benchmarks, universal screenings)

• Grade averages over time

• Norm-referenced tests, criterion-referenced tests

• Statewide assessments

• Response to research based interventions targeting the student’s area of need

Age of Students Tested


• Greatest number in pre-k and kindergarten

• Initial evaluations taper off by 3rd -5th grade

• Initial evaluations can be less common in kindergarten and in first grade

0

5

10

15

Speech-language

Academic

Age of Students Tested – Why?


• Differences at a young age are more apparent

• Communication deficits neutralize themselves with years of exposure to language

• In order for a learning disability to be identified, a child has to have had educational opportunity.

• Standardized testing compares students to national norms.

• In districts using response to intervention, child has to have had research-based interventions targeting their area of need

Referral Concerns

SPEECH & LANGUAGE

• Can’t follow directions

• Unorganized

• Not completing assignments

• Does not understand what is read to him

• Writes/speaks in short utterances

• Confusing

• Cannot answer questions

• Frustrated

• Does not retain from day to day

Referral Concerns



• Unorganized




• Confusing


• Frustrated



• Unorganized




• Confusing


• Frustrated


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The evaluation process

for Diagnosticians/LSSPs

What is the focus of their evaluation?How do they determine eligibility?How do they take into account cultural differences?What about their testing might indicate a need for speech-language testing?

Learning disability?

• Child does not make sufficient progress in RTI

• Child meets criteria under pattern of strengths and weaknesses

• Child has had appropriate exposure to instruction

• Not due to exclusionary factors

Cognitive Testing

1. Crystallized knowledge

2. Fluid Reasoning

3. Long-term retrieval

4. Short-term memory

5. Visual processing

6. Auditory processing

7. Processing speed

Cognitive Testing

1. Crystallized knowledge (Gc)

2. Fluid Reasoning (Gf)

3. Long-term retrieval (Glr)

4. Short-term memory (Gsm)

5. Visual processing (Gv)

6. Auditory processing (Ga)

7. Processing speed (Gs)

g = general intelligence

G= followed by smaller letter related to a specific area

Gc and Gf

• Gc - Crystallized knowledge is the fund of information a person has acquired. This includes general information and verbal communication.

• Gf – Fluid intelligence is the ability to engage in mental operations when faced with a non-automatic novel task.

Glr and Gsm

• Glr - Long-term retrieval is the ability to store and retrieve information fluently

• Gsm - Short-term retrieval is the ability to capture and hold information in awareness, and use it within a few seconds

Ga, Gv, and Gs

• Ga – Auditory processing is processing auditory stimuli

• Gv – Visual processing is processing visual stimuli

• Gs – Processing speed is the ability to perform cognitive tasks automatically and fluently

Cultural Differences

• Exclusionary factors include limited English proficiency, cultural differences, and economic disadvantage/environmental differences

• Results must be interpreted in light of the child’s experience/exposure. Certain scores may be more heavily affected by those differences, such as Gc.

Language-related

• Cognitive – Gc, crystallized knowledge

• Cognitive – Ga, auditory processing

• Achievement – Oral expression

• Achievement – Listening Comprehension

Speech and

Language

Receptive

LanguageExpressive

Language

Communication Process vs.

Learning Process

Academic

Speech and

Language

Receptive

LanguageExpressive

Language

Use of Cognitive

Processes

Communication Process vs.

Learning Process

How to reduce the number of evaluations that we

undertake that result in DNQs.

How to improve the caliber of information shared with

Special Education Professionals.

Current State

• Evaluations of 3rd – 5th graders are time intensive

• Evaluations suggested by special education professionals result in a high number of DNQs

• The process can pin Diagnosticians against SLPs in the eyes of the administration

• Team relationships are strained when testing timelines and support is compromised

Where do the referrals begin?

SPEECH AND LANGUAGE ACADEMIC

• “During my testing, the teacher said that he is having difficulty with writing/reading/math. Let’s refer him for academic testing.”

• “During my testing, she scored in the 60s on oral expression and comprehension. Let’s sign consent to rule out speech.”

Research Study on referrals

from LD to Speech

• Question #1:

▫ Can we reduce the number of evaluations that result in DNQs?

• Question #2:

▫ What do previous evaluations tell us about the nature of the process?

Research Methods

• Population Identification

▫ Mined academic and speech-language evaluations from the 09-10 school year to identify the greatest area of overlap (LD & SL) and concern

• Population Pool

▫ 3rd – 5th graders

▫ Bilingual* (not limited to bilingual)

▫ Male and female

▫ Initial Referrals for Academic Concerns, referred on to Speech

Population Pool

Name Grade Age Gender Speech Results

AR 5th 9:0 Male DNQ

JD 5th 12;2 Male DNQ

MA 4th 9:11 Female DNQ

HG 4th 10;9 Male DNQ

ES 5th 11;1 Female DNQ

DR 3rd 10;10 Female Q

WS 4th 10:7 Male Q

BS 4th 10:7 Male DNQ

JG 4th 9:11 Male DNQ

Research Methods

• Data Collection

▫ Referral Packets

▫ Academic Testing

▫ Speech-Language Testing

▫ Cumulative folder

• Documents were searched for concerns that related to poor academic performance.

• Data was accepted from entire academic career.

Research Methods

• Results

▫ Referrals were made largely based on Oral Language and Achievement Scores

Oral Expression

Listening Comprehension

▫ These formal scores carried the most weight but were the worst predictor for qualification (2/8)

▫ 6 other areas of information, when combined, provided the greatest predictor for accurate diagnosis.

Research Methods

Results

• 7 areas of concern that create the greatest predictive value for proper referral

1. Prior academic history

2. Current academic history

3. Current speech/language concerns

4. Teacher Concerns

5. Parent Concern

6. Medical History (to include hearing data)

7. Oral Language Achievement Scores

Predictive Value

1. Prior academic history

▫ PPCD?

▫ How many schools were attended?

▫ Was the student retained?

▫ Were notes passed between grades in the CUM folder

Predictive Value

2. Current academic history

▫ Where is she struggling?

▫ Is she receiving resource?

▫ How long has she been in the RTI process?

▫ What are they targeting?

Predictive Value

3. Current speech/language concerns?

▫ Is there ANY mention of communication?

▫ There was a big difference between when a professional was asked if they wanted speech/language testing and if any anecdotal or direct reference to communicative difficulties were made in any of the referral paperwork.

Predictive Value

4. Teacher Concerns

▫ A teacher’s informal or formal description of a child’s performance in class was highly predictive.

▫ It was the truest measure against the child’s peers.

▫ Teachers possess data charts on TAKS, TAKS benchmarks and reading. These give you a general trend of academic growth.

Predictive Value

5. Parent Concerns

▫ Are there any?

▫ Is there a family history?

▫ Can the parent understand the student?

Predictive Value

6. Medical History (including hearing status)

▫ Are there medical issues or other diagnoses?

▫ Has the child passed the hearing and vision screening?

Predictive Value

7. Oral Language Achievement Scores

▫ The child has low oral expression and/or low comprehension .

▫ This is measured by: The Woodcock Johnson III (Spanish)

Habits and work-culture beliefs

that make the process difficult

Habit #1RTI is thought to be a one time process. It is not begun

anew with secondary or tertiary concerns.

Habit #2Initial referrals result in a DNQ:• The administration says: “Well since they didn’t

qualify for A, let’s try B”• Even though there was never any concern in the

initial packet

Research Methods

• Results of evaluations have 3 possibilities

▫ Good referral – Qualified

▫ Good referral – Did not qualify (DNQ)

▫ Bad referral – Did not qualify(DNQ)

• Results of the study▫ A student did not need ALL 7 areas to be considered to be a

good referral.

▫ On average, the students who qualified had information in 5/7 areas.

▫ The students that were DNQs had 1-2 of the 7 areas.

▫ All had low formal Oral Expression /Comprehension Scores

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Collaborating with Educational Diagnosticians in the Referral and Evaluation Process

Education

Transcript of Collaborating with Educational Diagnosticians in the Referral and Evaluation Process