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Collaboration with Diagnosticians & LSSPs in the Referral and Evaluation Process
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Collaboration with Diagnosticians & LSSPs in the Referral and Evaluation Process


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  • Introduction of Sherry and explanation of today. I have taught bilingual functional academics, bilingual resource, and bilingual PPCD. For the last 5 years, I have worked as a bilingual educational diagnostician.
  • Basically we are the two halves of special education. While it might seem that our differences are obtuse, it is actually a great plan to round out the needs of a student. Our two professions in many instances are mirror opposites but it covers all the bases for assessment and provision of services.
  • What are the referral statements that get LSSPs referrals versus us
  • Want to talk here about the differences between qualification criteria and the differences of abilities versus being low on language scores
  • Want to talk here about the accuracy of different measures based on the different ages. For academic – 1. child needs to be exposed to learning in order to be learning disabled
  • Want to talk here about the accuracy of different measures based on the different ages. For academic – 1. child needs to be exposed to learning in order to be learning disabled
  • Some districts will require both RTI and the pattern of strengths and weaknesses, as current best practice support this.
  • So what was it with the two qualifications that caused them to qualify. It should be noted that a DNQ doesn’t necessarily equal a bad referral. Some were good referrals that just didn’t qualify. We should expect this but we would like less of them.
  • Once you see this list it seems like a no-brainer. Of course we would want to see concerns in these areas before referring for an evaluation. However, there is something about the RTI process, the amount of time the child has spent “in RTI” that makes it seem as though a process of some sort is continuing and that the initial information is already there.
  • Transcript

    • 1. Sherry Niccolai, M.A. Diagnostician Scott Prath, M.A. Speech Pathologist December 13 th , 2010 Bilingual SLP Leadership Group
    • 2. Learner Objectives
        • Understand similarities and differences between the roles of Diagnosticians/LSSPs and SLPs
        • Describe the objectives of each profession’s evaluation process
        • Apply a framework for evaluating referral packets
        • Improve the likelihood that a referral will result in qualification rather than a DNQ
    • 3. Two sides to the same house Exploring the differences between Speech and Academic Special Education
    • 4. Professional Responsibilities
      • ACADEMIC
      • SLPs perform
        • Evaluations
        • Intervention
        • Dismissals
      • Diagnostic Staff perform
        • Evaluations
        • Dismissals
      • Special Education Teachers perform
        • Intervention
    • 5. Focus of Evaluation
      • ACADEMIC
      • 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.
    • 6. Qualification Guidelines
      • ACADEMIC
      • 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
    • 7. Age of Students Tested
      • ACADEMIC
      • Greatest number in pre-k and kindergarten
      • Initial evaluations taper off by 3 rd -5 th grade
      • Initial evaluations can be less common in kindergarten in first grade
    • 8. Age of Students Tested – Why?
      • ACADEMIC
      • 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
    • 9. Referral Concerns
      • ACADEMIC
      • 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
      • 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
    • 10. 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?
    • 11. 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
    • 12. Cognitive Testing
      • Crystallized knowledge
      • Fluid Reasoning
      • Long-term retrieval
      • Short-term memory
      • Visual processing
      • Auditory processing
      • Processing speed
    • 13. 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.
    • 14. 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
    • 15. 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
    • 16. 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 difference such as Gc.
    • 17. Language-related
      • Cognitive – Gc, crystallized knowledge
      • Cognitive – Ga, auditory processing
      • Achievement – Oral expression
      • Achievement – Listening Comprehension
    • 18. Activity
      • Case study of Evie
      • 5 th grade bilingual female
      • Age 11;1
      • Prior speech services for articulation, dismissed
      • Initial referral for academic difficulties and reassessment of speech and language abilities
    • 19.  
    • 20. 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.
    • 21. Current State
      • Evaluations of 3 rd – 5 th 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
    • 22. Where do the referrals begin?
      • ACADEMIC
      • “ During my testing, the teacher said that he is having difficulty with writing/reading/math. We don’t do that . 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.”
    • 23. 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?
    • 24. 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
        • 3 rd – 5 th graders
        • Bilingual* (not limited to bilingual)
        • Male and female
        • Initial Referrals for Academic Concerns, referred on to Speech
    • 25. Population Pool Name Grade Age Gender Speech Results AR 5 th 9:0 Male DNQ JD 5 th 12;2 Male DNQ MA 4 th 9:11 Female DNQ HG 4 th 10;9 Male DNQ ES 5 th 11;1 Female DNQ DR 3 rd 10;10 Female Q WS 4 th 10:7 Male Q BS 4 th 10:7 Male DNQ JG 4 th 9:11 Male DNQ
    • 26. Research Methods
      • Data Collection
        • Referral Packets
        • Academic Testing
        • Speech-Language Testing
        • CUM folder
      • Documents were searched for concerns that related to poor academic performance.
      • Data was accepted from entire academic career.
    • 27. 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.
    • 28. Research Methods
      • Results
      • 7 areas of concern that create the greatest predictive value for proper evaluation
        • Prior academic history
        • Current academic history
        • Current speech/language concerns
        • Teacher Concerns
        • Parent Concern
        • Medical History (to include hearing data)
        • Oral Language Achievement Scores
    • 29. 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
    • 30. 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?
    • 31. 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.
    • 32. 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.
    • 33. Predictive Value
      • 5. Parent Concerns
        • Are there any?
        • Is there a family history?
        • Can the parent understand the student?
      • 6. Medical History (including hearing status)
        • Are there medical issues or other diagnoses?
        • Has the child passed the hearing and vision screening?
    • 34. 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)
    • 35. Research Methods
      • Results
        • 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
    • 36. Case Studies Using Referral Information to increase the predictive value of our potential evaluations
    • 37. Group Referral Information Activity
      • 5 students were tested for a learning disability.
      • Speech-language testing was requested following the evaluation due to concerns including “low language.”
      • Were these good referrals?
      • Break up into 5 groups and analyze a folder
    • 38. Case Study Results
      • Wilber
      • Hugo
      • Debbie
      • Bryan
      • Joshua
      • Jeffrey
    • 39. More Great Resources on Cultural and Linguistic Diversity
    • 40. Thank you!