Speech-Language Intervention in the Schools FINAL color revision

Report
Speech-Language
Intervention in the
Schools
An overview of what to expect from your
child and your school system.
Stephanie Bailey, M.A., CCC-SLP
Stephanie Lucy, M.S., CCC-SLP
Understanding Normal Speech and
Language Development

Parents should discuss early
speech and language
development, as well as
other developmental
concerns, with their child's
doctor at every routine wellchild visit. Developmental
norms help guide parents
and doctors to determine if
speech and language are
developing as expected.
Before 12 months
Cooing
 Babbling
Babies are using their voices to relate to their
environment.
At about 9 months of age, they begin to string
sounds together, incorporate the different tones
of speech, and say words like "mama" and
"dada" (without really understanding what
those words mean).

What if my child doesn’t attend to
sound?


If a baby is attentive to
you but doesn’t seem to
be startled by loud
noises, he may be
demonstrating a hearing
loss.
Hearing screen.
12-15 months




Wide range of speech
sounds in their babbling.
At least one or more true
words.
Nouns are usually first.
Should also be able to
understand and follow
single directions ("Please
give me the toy”)
18-24 months




Vocabulary of about 20 words by 18 months.
50 or more partial words by the time they turn
2.
Combine two words, such as "baby crying" or
"Daddy big."
A 2-year-old should also be able to follow twostep commands (such as "Please pick up the
toy and bring me your cup").
2-3 years of age

An "explosion" in their
child's speech occurs at
this time.

Expressively:
-Large vocabulary
-Routinely combine three
or more words into
sentences.
2-3 years of age
Receptively:
- Should begin to understand what it means to
"put it on the table" or "put it under the bed."
- Should also begin to identify colors and
comprehend descriptive concepts (big versus
little, for example).

Speech sound development
Iowa-Nebraska Articulation Norms
Smit, Hand, Freilinger, Bernthal, and Bird (1990). Journal of Speech and Hearing Disorders, 55, 779-798.

Phoneme
/m/
/n/
/ng/
/h-/
/w-/
/j-/
/p/
/b/
Age of Acquisition Age of Acquisition
Females
Males
3.0
3.0
3.6
3.0
7.0
7.0
3.0
3.0
3.0
3.0
4.0
5.0
3.0
3.0
3.0
3.0
Speech sound development
Iowa-Nebraska Articulation Norms
Smit, Hand, Freilinger, Bernthal, and Bird (1990). Journal of Speech and Hearing Disorders, 55, 779-798.

Phoneme
/t/
/d/
/k/
/g/
/f-/
/-f/
/v/
Voiceless th
Voiced th
Age of Acquisition Age of Acquisition
females
males
4.0
3.6
3.0
3.6
3.6
3.6
3.6
4.0
3.6
3.6
5.6
5.6
5.6
5.6
6.0
8.0
4.6
7.0
Speech sound development
Iowa-Nebraska Articulation Norms
Smit, Hand, Freilinger, Bernthal, and Bird (1990). Journal of Speech and Hearing Disorders, 55, 779-798.

Phoneme
/s/
/z/
/sh/
/ch/
/dg/ (j)
/l-/
/-l/
/r-/
/er/
Age of Acquisition Age of Acquisition
females
males
7.0
7.0
7.0
7.0
6.0
7.0
6.0
7.0
6.0
7.0
5.0
6.0
6.0
7.0
8.0
8.0
8.0
8.0
Speech sound development
Iowa-Nebraska Articulation Norms
Smit, Hand, Freilinger, Bernthal, and Bird (1990). Journal of Speech and Hearing Disorders, 55, 779-798.
Age of Acquisition Age of Acquisition
females
males
/tw kw/
4.0
5.6
/sp st sk/
7.0
7.0
/sm sn/
7.0
7.0
/sw/
7.0
7.0
/sl/
7.0
7.0
/pl bl kl gl fl/
5.6
6.0
/pr br tr dr kr gr fr/
8.0
8.0
/thr/
9.0
9.0
/skw spl/
7.0
7.0
/spr str skr/
9.0
9.0

Phoneme
Mom and Dad’s role in all of
this:
STIMULATE STIMULATE
STIMULATE
TALK TO YOUR CHILD
LABEL OBJECTS AND ACTIONS
READ TO YOUR CHILD
PLAY GAMES WITH YOUR CHILD

Mom and Dad’s role in all of
this:


Consistency is key—read the same books over and
over, play with the same toys and use the same words
or phrases over and over. This will help your child to
know the “routine.”
Once the child knows the routine, then you can leave
out the word that goes with a particular action. The
goal is for the child to begin to add to the activity by
saying a word or by participating in the activity at a
different level—adding to an activity or expanding on
an activity.
What Are Some Warning Signs of a Possible
Problem?
An infant who isn't responding to sound or
who isn't vocalizing is of particular concern.
Between 12 and 24 months, reasons for
concern include a child who:
-isn't using gestures, such as pointing or waving
bye-bye by 12 months
-prefers gestures over vocalizations to
communicate by 18 months
-has trouble imitating sounds by 18 months

For the child over 2 years, you should seek an
evaluation if he or she:






Doesn't produce words or phrases spontaneously – only imitates.
Only certain sounds or words repeatedly.
Can't use oral language to communicate more than his or her immediate
needs
Can't follow simple directions
Has an unusual tone of voice (such as raspy or nasal sounding)
Is more difficult to understand than expected for his or her age.
Parents and regular caregivers should understand about half of your child's
speech at 2 years and about three quarters of your child's speech at 3 years.
By 4 years old, your child should be mostly understood, even by people
whom your child doesn't know.
What if I suspect difficulties in
speech or language?





Anyone can refer a child for speech and
language services:
Parents
Teachers
Speech Pathologist
Other supporting staff
Screening process



All children are screened at the Pre-K or
Kindergarten level for speech and language
development.
This can be done by the teachers or the school speech
pathologist.
A child who does not “pass” the screen may be
referred for evaluation or another course of action
may be pursued (i.e., offer guidance to parents or
refer to teacher assistance team).
Referral

Designee – records the date, reason for
referral, and name of person making referral.
Procedural safeguards notice
Confidentiality

Child Study Team meets.


Child Study

Child Study team members:




Parent
Speech Pathologist
Classroom teacher
Designee (principal, asst principal, other)
Reviews information the school already has:
classroom test scores, observations by school staff,
previous evaluation reports, classroom performance as
reported by teacher, etc.
TIMELINE

Evaluation must be completed and the child’s
eligibility determine within 65 business days of the
date the referral is received.
Evaluation Report



Analysis of child’s strengths and weaknesses.
Assessment results fully explained.
Indicates the existing and predicted impact of
any speech-language impairment on the child’s
ability to access and progress in the general
educational curriculum.
ELIGIBILITY




Based on the presence of a disability that
results in the child’s need for special education
and related services,
Not the potential benefit from speech-language
services.
The team must be able to document the
adverse educational impact of a student’s
speech and language skills on performance.
Is there a need for specially designed services
The bottom line…
A student can demonstrate communication
differences, delays, or even impairments,
without demonstrating an adverse affect on
educational performance.
Virginia Dept of Education (2005). Speech Language Pathology Services in Schools:
Guidelines for Best Practice, p.15.
Educational Impact Of a SpeechLanguage Impairment




How does the disability affect the progress and
involvement of the student in the general
curriculum; for preschoolers, the effect on their
ability to participate in appropriate activities.
Academic
Social
Vocational
Academic





Reading
Math
Language Arts
Difficulty with language-based activities
Difficulty comprehending orally presented
information and/or difficulty conveying
information orally.
Social




Interference with the ability of others to
understand the student
Peers teasing the student about his/her speechlanguage disability
The student having difficulty maintaining and
terminating verbal interactions
The student demonstrating embarrassment
and/or frustration regarding his speechlanguage skills.
Vocational

Job-related skills that the student cannot
demonstrate due to speech-language
impairment



Inability to understand/follow oral directions
Inappropriate responses to coworkers’ or
supervisors’ comments
Inability to answer and ask questions in a coherent
and concise manner
Children not eligible for Special
Education

“The Virginia Special Education Regulations
require whenever a child is found ineligible for
services, the eligibility committee should
prepare useful information for the classroom
teacher and the parent about steps they can
take to facilitate the child’s development.”
Virginia Dept of Education (2005). Speech Language Pathology Services in Schools:
Guidelines for Best Practice, p.18.
When a child is found eligible




IEP (individualized education program)
Within 30 calendar days of the eligibility date.
Describes the services necessary to meet the unique
educational needs of the child, as identified by the
assessment.
Consider: strengths, parental concerns, results of most
recent evaluations, performance on any state or
division-wide assessments.
Addresses 3 questions:



Where are we now?
Where are we going?
How will we get there?
PLOP

Present Level of Performance

What would I want to know about this student
if he or she were going to be in my classroom
next year?
(Virginia Institute for Developmental Disabilities, 2001)
Annual Measurable Goals




What do we want the child to be able to do in a
year?
Be realistic
Prioritize
Measurable terms:

Who will achieve?
-- What is the skill or
behavior to be achieved?
 How can the skill be
-- Where will the student
measured?
use the behavior?
-- When will the skill be used or goal be accomplished?
Service Delivery


Direct services
When speech and language services are
indicated, the service delivery and clinical
methods must focus on achieving the goals in
the child’s IEP.

Pull-out therapy (individual or small group)

provided in an individual or small group setting (speech
therapy room, classroom, cafeteria, or other school
setting)
Service Delivery

Integrated Therapy


Individualized service in a least restrictive setting and does not
remove the child from the general or special ed. Classroom.
Direct services while continuing to receive classroom instruction.
Classroom teachers are an integral part of the process.
Collaborative effort.







Paraphrases information,
creates graphic organizers,
teaches strategies for vocabulary learning,
teaches strategies for sequencing,
teaches strategies for developing a narrative,
cues and prompt the student,
modifies the language level of instruction to meet students’ needs.
Indirect Services





Consultative
Specifies support for school personnel as a part of the
accommodations, modifications, or supplemental
support services provided to a teacher on behalf of
the student.
Include providing information and demonstrating
effective instructional and facilitation procedures.
SLP monitors student’s progress.
Appropriate for students nearing dismissal from
speech-language services or students whose teachers
require additional support to create materials,
implement specific communication strategies, or
modify AAC equipment.
Indirect Services continued

Indirect services include:



Providing information and demonstrating effective
instructional materials and facilitative procedures.
While providing consultative services on behalf of
a child, the speech-language pathologist will
monitor the student’s progress.
Consultative services usually do not involve the
direct provision of therapy to the student.
Services Available at School



Effective service delivery is dynamic and
changes with the needs of the student.
Services may be provided directly to the
student or indirectly through consultation with
educators and families.
Decisions are based upon the child’s present
level of performance, progress made in
services received to date, assessment results,
IEP goals, and any objectives/benchmarks.
Speech Language Intervention
includes:

Articulation / phonology



Increase Intelligibility of child’s speech.
Reduce use of phonological processes.
Stimulability of sound production.
Speech Language Intervention
includes:

Expressive and Receptive Language








Syntax
Morphology
Organization
Vocabulary
Pragmatics
Semantics
Verbal comprehension
Figurative Language skills
Speech Language Intervention
includes:

Fluency



Repetitions (sounds, syllables, part words, whole
words, phrases)
Pauses
Prolongations
Differ in number and severity from those of
normally fluent individuals.
Speech Language Intervention
includes:

Voice



Pitch
Loudness
Quality
Calls attention to itself rather than to what the speaker is
saying.
Before a child may be found eligible for services for a voice
impairment, the child should receive a medical examination
from an otolaryngologist (ENT), clearing the child for
intervention.
What Can Parents Do at Home?

For mild developmental errors try these:


Repeat the sound slowly and correctly over and
over in lots of natural conversations while facing
your child directly.
Work on one sound at a time for no more than 15
minutes at least three times a week.



Five trials at a time. Parent model and child tries to
match it. Give praise – positive reinforcement.
Make it a game, color something together.
Stickers!
Quick Communications, P.O. Box 27891, St.Louis, MO 63146
Suggestions that Parents Can Do at
Home.

For mild developmental errors try these:




Model proper grammar during conversation
Correct a child’s grammar during spontaneous speech no
more than once a day. We want enthusiasm for natural
speech.
Respond with lots of encouragement and praise for trying.
Refer your child to the word in which he can produce the
sound correctly. (i.e., I like your /r/ in ‘run’.)
Quick Communications, P.O. Box 27891, St.Louis, MO 63146
Suggestions that Parents Can Do at
Home.

Aiding your child’s language development.


Read longer and longer stories and see if he/she
can remember what happened first, second, third,
etc. Have him tell the story back to you. This
promotes memory improvement.
Make category scrapbooks – select categories for
each page. Have child find and glue magazine
pictures for each category. This promotes logic
and logical language.
Quick Communications, P.O. Box 27891, St.Louis, MO 63146
Suggestions that Parents Can Do at
Home.

Aiding your child’s language development.


Encourage complete sentences. When your child
uses just a few words, repeat them and put them
into a short sentence. Provide sentences with
additional phrases as your child grows older.
This expands sentence length naturally.
Embrace opportunities to incorporate language
concepts: descriptive (big); spatial (under) ,etc..
Quick Communications, P.O. Box 27891, St.Louis, MO 63146
Suggestions that Parents Can Do at
Home.

Aiding your child’s language development.

Play “what if-” games:
“What if we ran out of gas, what would you do?”
 Ask questions of why, what, how & where.
 Use riddles.
This promotes problem solving skills.

Quick Communications, P.O. Box 27891, St.Louis, MO 63146
Suggestions that Parents Can Do at
Home.



Language is best learned while doing, so let
your child participate in household and
neighborhood routines whenever possible.
Describe what you are doing and what will
happen next.
Give him/her a chance to ask questions.
Quick Communications, P.O. Box 27891, St.Louis, MO 63146
Suggestions that Parents Can Do at
Home.

What if my child stutters?
 Start with improving your own listening skills.
What is your child really trying to tell you?

Provide an appropriate speech model for you child.




Make efforts to talk a little more slowly.
Try using simpler and shorter sentences at times.
Give your child time to talk without interruption.
Act and speak patiently.
Adapted from If Your Child Stutters: A Guide for Parents; The Speech Foundation of America
Suggestions that Parents Can Do at
Home.

What if my child stutters?

Provide pleasurable and rewarding speech
experiences.

Singing
Word games
Teach riddles and jokes
Read or tell stories

Speech is not always for scolding and reprimanding.



Adapted from If Your Child Stutters: A Guide for Parents; The Speech Foundation of America
Suggestions that Parents Can Do at
Home.

What if my child stutters?

Help him/her to express feelings verbally.



Model verbalizing and showing love.
Talk about things that are funny and make him/her
laugh. The child should also learn that something that
harms others is not funny.
Talk about what is making him/her angry. Talk about
ways he/she could express their feelings.
Adapted from If Your Child Stutters: A Guide for Parents; The Speech Foundation of America
Suggestions that Parents Can Do at
Home.

What if my child stutters?

Accept the Disfluencies
Express acceptance


It may help you to remember that he/she is doing the best
he can at the moment he speaks. If you react emotionally,
you make him struggle harder to stop, avoid, or conceal
what he is doing to distort his speech.
Adapted from If Your Child Stutters: A Guide for Parents; The Speech Foundation of America
Suggestions that Parents Can Do at
Home.

What if my child stutters?

Talk to him about his stuttering – Sometimes we all get
tangled up or stuck. Some of us do it more than others.
Describe to him what he doing and that it’s alright to talk
this way as long as he has to do so.


Tell him to talk as easily as he can at the moment. – One parent
taught this by showing the child what he meant: He squeezed his
fist and gradually relaxed it while he let a sound “leak out.”
Let him know he can take all the time he needs.
Adapted from If Your Child Stutters: A Guide for Parents; The Speech Foundation of America
Suggestions that Parents Can Do at
Home.

What if my child stutters?

Reduce fears, anxieties and frustrations about speech.




Encourage him to talk about his fears, anxieties and frustrations and
accept what he says without criticism or disapproval.
Do not attempt to overprotect (i.e., don’t try to arrange his life so he
doesn’t have to talk.)
“Successive approximation” process- Encourage him to overcome his
barriers and fears gradually.
Help him to release the destructive feelings of frustration. (i.e.,
encourage him to hit a stuffed animal or clown as hard as he can until he
feels better; allow the child to have a period of saying anything he wants
without disapproval, only assurance that that you understand his
feelings; have child to talk into a wastebasket and throw out the
metaphoric poison, outdoor exercise-take a long walk.)
Adapted from If Your Child Stutters: A Guide for Parents; The Speech Foundation of America
Speech and Language Development
is a journey we all make together.
The world cannot function without communication. We
make bridges with our ability to communicate.

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