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Eligibility Criteriafor the area of

Speech and LanguageImpairments

05-03-02 BASSC Resource Manual Speech Section.doc Speech - Page 2 of 27

Table of ContentsELIGIBILITY CRITERIA FOR SPEECH/LANGUAGE IMPAIRED SERVICES ................................................................. 3

INTRODUCTION........................................................................................................................................................................................3ROLE AND RESPONSIBILITY OF THE SPEECH LANGUAGE PATHOLOGIST...................................................................3

STUDENTS SUSPECTED OF HAVING A SPEECH AND LANGUAGE IMPAIRMENT: THE IDENTIFICATIONPROCESS........................................................................................................................................................................................................ 4

REFERRALS FOR A SPEECH AND LANGUAGE ONLY CASE STUDY EVALUATION ................................................................................4

THE ASSESSMENT PROCESS............................................................................................................................................................... 5

PROCEDURES FOR SPEECH AND LANGUAGE EVALUATIONS..................................................................................................................5EVALUATION.................................................................................................................................................................................................5ELIGIBILITY DETERMINATION ....................................................................................................................................................................5IMPARTIAL DUE PROCESS HEARING ..........................................................................................................................................................6OTHER FACTORS TO CONSIDER WHEN DETERMINING ELIGIBILITY.....................................................................................................6THE SPEECH AND LANGUAGE EVALUATION ............................................................................................................................................6SEVERITY RATING GUIDELINES..................................................................................................................................................................7ARTICULATION/PHONOLOGY ELIGIBILITY ...............................................................................................................................................7ARTICULATION/PHONOLOGY MATRIX......................................................................................................................................................9DEVELOPMENTAL AGES TO PHONEME MASTERY .................................................................................................................................10

Illinois State Board of Education - 1990 Speech and Language Technical Assistance Manual.............................................10POOLE NORMS..................................................................................................................................................................................10Articulation/Phonology Measurement Instruments Commonly Used at BASSC .....................................................................10

LANGUAGE.................................................................................................................................................................................................11

PRAGMATICS................................................................................................................................................................................................11

LANGUAGE ELIGIBILITY MATRIX................................................................................................................................................12

LANGUAGE MEASUREMENTS COMMONLY USED IN BASSC..........................................................................................13

FLUENCY.....................................................................................................................................................................................................13

FLUENCY MATRIX......................................................................................................................................................................................14

CONTINUUM OF DISFLUENT SPEECH BEHAVIOR ................................................................................................................15

VOICE............................................................................................................................................................................................................16

VOICE MATRIX ...........................................................................................................................................................................................16

EXIT CRITERIA.........................................................................................................................................................................................17

SPEECH-LANGUAGE ELIGIBILITY CRITERIA/MATRIX.....................................................................................................18

SERVICE DELIVERY MODELS ..........................................................................................................................................................20

MONITOR .....................................................................................................................................................................................................20INTEGRATED SERVICES..............................................................................................................................................................................20COLLABORATIVE CONSULTATION ...........................................................................................................................................................20THE SPEECH-LANGUAGE PATHOLOGIST FUNCTIONING AS A CONSULTANT :.......................................................................................21

VARIOUS APPROACHES TO COLLABORATIVE CONSULTATION.................................................................................21

TRADITIONAL (PULL-OUT MODEL).........................................................................................................................................................21INSTRUCTIONAL SERVICES........................................................................................................................................................................22REFERENCES................................................................................................................................................................................................22

Definition And Examples Of Adverse Effect ....................................................................................................................................23Cognitive Considerations...................................................................................................................................................................25Functional Language Ability Profile (FLAP)..................................................................................................................................26Pre-Referral/Child Study Team Request for Speech and Language ...........................................................................................27


Eligibility Criteria for Speech/Language Impaired Services

The following guidelines have been developed for determining eligibility for Speech and Language services within theBelleville Area Special Services Cooperative. Significant portions of this document have been taken directly from or closelyalign with the Technical Assistance Manual for Speech-Language published by the Illinois State Board of Education inAugust, 1993.

INTRODUCTION

Eligibility for special education and related services in the area of Speech and Language Impairment is determined throughthe IEP process beginning with the Child Review Team meeting.

Determining the existence of a speech and language impairment is the first step in determination of eligibility for specialeducation under the eligibility of Speech/Language Impaired. Subsequent to identifying an impairment, the adverse impactof the disability on the student's educational performance and the need for special education and related services must bedocumented.

It is very important to note that, although this document provides guidelines, specific circumstances affecting a particularstudent must be taken into consideration. Cultural influences or differences and the primary language of the student must betaken into account prior to test selection and evaluation. Clinical judgment may necessitate modification of these guidelines.

The guidelines described here are designed for a school population 3 to 21 years of age. All evaluation and interview datamust be considered when determining the extent to which these children are adversely affected within their communicationsetting and the impact on future educational performance. Communicatively impaired children could be at risk for futureacademic failure without appropriate intervention and, therefore, may be eligible for speech and language services. Thesestudents are served through the continuum of service delivery models outlined later in this document.

ROLE AND RESPONSIBILITY OF THE SPEECH LANGUAGE PATHOLOGIST

Speech-language pathologists currently trained to work in school programs have a minimum of a masters degree and/or holda Standard Special Certificate, (Type 73 or Type 3 and Type 9), in Speech and Language Impaired. According to 23 IllinoisAdministrative Code Part 226 rules, speech and language services may be made available as:

• Special education related services• Special education resource programs• Special education instructional programs

The scope of practice of the speech-language pathologist includes, but is not limited to:1 Identification and evaluation of students with speech and language impairments2. Participation in the determination of eligibility for special education and related services in the area of speech and

language impairment3. Participation in teacher and parent conferences including multidisciplinary conferences, IEP meetings, and annual

reviews4. Development and implementation of IEPs for all students eligible for special education and related services in the area

of speech and language impairment5. Provision of inservice programs to parents, teachers, students, administrators, and other professionals6. Completion of required documentation and reports7. Participation of child study and teacher assistance teams8. Facilitation of curriculum and instructional modifications9. Supervision of support personnel/CFY's10. Participation in continuing professional education


STUDENTS SUSPECTED OF HAVING A SPEECH AND LANGUAGEIMPAIRMENT: THE IDENTIFICATION PROCESS

A student may be identified as eligible to receive a special education evaluation to determine if he/she has a speech andlanguage impairment through teacher or school-based referral; parent, self or other agency referral; or group screening. Theschool district must publicize its referral procedures. These procedures must also be approved by the Illinois State Board ofEducation.

Referrals for a Speech and Language Only Case Study Evaluation

It is important to document referrals by completing a referral packet (forms A1, A2, A3) which includes:

• The date of referral• The referring agent• The determination of the student's language use pattern and cultural background (this is made by determining the

language(s) spoken in the student's home and the language(s) used most comfortably and frequently by the student); and• The determination of the student's mode of communication (this is made by assessing the extent to which the student uses

expressive language and the use he or she makes of other modes of communication as a substitute for expressivelanguage).

In addition, it is important to note that the date of the decision to refer a student is the actual referral date. This date beginsthe 60-school-day timeline during which the IEP process (referral, evaluation and placement) must be completed.

After a referral has been initiated, the review team determines whether the referral is appropriate (i.e., whether or not toconduct an assessment). Parental consent must be obtained for an individual screening. Parental consent is not necessarywhen the speech-language pathologist does not have direct individual contact with the student (i.e., observations, teacherinterviews, record reviews and student interviews).

The building team decides whether or not the assessment is warranted and the parent receives written notice of this decision.If an assessment is warranted, the IEP team confers and agrees on what types of assessments are necessary. The parent orlegal guardian must sign consent for the designated evaluations to be completed. A copy of the “Explanation of ProceduralSafeguards for Parents of Students with Disabilities” must be explained and provided to the parent at that time.


THE ASSESSMENT PROCESS

Procedures for Speech and Language Evaluations

Federal and state regulations require that the eligibility determination be multidisciplinary. This necessitates the involvementof at least three professional disciplines in determining eligibility. It also requires that the IEP and placement decisions bemade at the conference at which at least three professional disciplines are represented. If following the initial conference it isdetermined that speech testing is the only domain requiring assessment, the Speech/Language Pathologist becomes thefacilitator for the assessment process.

The assessment should include vision an hearing screenings completed within the last six months, as well as the othercomponents identified by the team at the Child Review Team meeting.

Evaluation

After parental consent has been obtained, the Speech/Language Pathologist is responsible for assuring necessary evaluationsare completed:

Eligibility Determination

After the evaluation components are completed, the Speech/Language Pathologist sends ISBE form 34-57E “Parent/GuardianNotification of Conference” to the parent. This form invites the parent to the conference which will be held to review theirchild's case study and determine eligibility for special education and related services. This form must be sent to the parents atleast 10 calendar days before the conference. It must contain information regarding where the conference will be held, thepurpose of the meeting, who will be invited to attend the meeting and who should be contacted for more information.Individuals who are required to participate in the conference include a local education agency (LEA) representative, a regulareducation teacher, and those who have conducted assessments with the student.

During the conference, team members interpret evaluation data and make an eligibility determination. The team must arriveat a consensus regarding the student's eligibility for special education and related services. According to IDEA 1997regulations, a student is eligible for special education and related services when and only when it is determined that adisability exists, that the disability has an adverse effect on the student's educational performance and that the need forspecialized services to address the adverse effect(s) is present and documented.

For example, speech and language impairments may affect the student's educational performance in the classroom and withpeers. Articulation, fluency or voice disorders can create negative self-esteem that inhibits a student's performance in theclassroom. Students with language disorders lack a strong language base that is the foundation necessary for learning tooccur within the academic curriculum. They often lack proficiency in language arts that is central to the curriculum across allgrade levels. These factors frequently mask the true ability level and actual proficiency of the student and can limitparticipation in the classroom exchanges and discussions.

On the other hand, a student may have an articulation, fluency or voice disorder that does not create negative self-esteem,does not receive negative reactions to the disorder from the student and/or other students and does not inhibit the student'sperformance in the classroom. In this case, the disorder does not interfere with the student's ability to benefit from education.Therefore, no adverse effect on the student's educational performance can be documented, and the student is not eligible forspecial education and related services. For more examples and a definition of adverse effect, see examples in the Appendix.

If, according to IDEA 1997, a student is determined eligible for special education and related services, an IEP must bedeveloped for the child. It must be noted that the educational placement decision is made after the entire IEP is developed.

*NOTE: The IEP meeting must also be conducted within 60 school days of the referral to be in compliance.

Individuals who are required to participate in the IEP meeting include an LEA representative, the child's teacher and, forinitial placement, a person knowledgeable about the evaluation procedures utilized in this assessment and the results. If theparent(s) does not attend the meeting, documentation of three attempts to arrange a mutually agreed upon time and place forthe meeting needs to be in the student's temporary record.


Impartial Due Process Hearing

A parent or a school district may initiate a Level I due process hearing regarding the district's proposal or refusal to initiate orchange the identification, evaluation, or educational placement of the student or the provision of a free, appropriate publiceducation to the student.

Other Factors to Consider When Determining Eligibility

Several other factors need to be taken into account along with the state-recommended eligibility criteria when determiningeligibility for special education and related services in the area of speech and language impairment. A student may be foundnot eligible for special education and related services in the area of speech and language impaired if his/her languagefunctioning is commensurate with overall cognitive ability. Guidelines outlining procedures for determining if languagescores are commensurate with cognitive potential can be found in the Appendix under “Cognitive Considerations.”

This statement reflects the cognitive hypothesis, which claims that cognition is a prerequisite for language development, andtherefore language depends upon and cannot develop beyond a student's underlying cognitive limits (Casby, 1992). Manyspeech-language pathologists recognize that there is a relationship between cognition and language; however, theseprofessionals do not uphold the idea that language cannot develop beyond a student's underlying cognitive limits. Theybelieve factors other than cognition can influence language development, and development in cognition (Casby, 1992).Therefore, these professionals recommend that, in addition to standardized testing results, the assessment team consider thefollowing questions when determining eligibility for special education and related services in the area of speech and languageimpairment:

• Do the student's communication skills meet his/her needs in current environments (i.e., if the student communicatedbetter, would it make a significant difference )?

• Would working with this student significantly change his/her ability to communicate?

Other factors to consider when determining eligibility (i.e., existing disability, adverse effect and the need for specializedservices) include:

1. Does the identified speech and language impairment interfere with the student's educational, social, or emotionalprogress so as to consider it a disabling condition?

2. Is the student's level of language functional for his/her level of adaptive behavior?3. Is a physiological factor such as an unrepaired cleft palate, enlarged adenoids, or orthodontia an interference?

A subjective rating scale such as the Functional Language Ability Profile (see Appendix for copy) may be used to addresssome of these areas and aid in eligibility determinations.

As always, the assessment team must document the adverse effect on the student's educational performance and the need forspecialized services to address the adverse effect(s) if it is determined that a disability exists. The Illinois State Board ofEducation supports this approach to eligibility determinations.

The Speech and Language Evaluation

The purpose of the speech and language evaluation is to determine the degree and extent of oral language usage, receptivelyand expressively, and language processing abilities. Those areas of language competencies examined need to include rhythm(or fluency), voice, articulation, and language.*

Language is the ability to use the symbols of language through proper use and understanding of words and meanings(semantics), appropriate grammatical patterns (syntax), and correct usage and understanding of meaningful word markers orelements (morphology). Areas usually assessed are receptive and expressive language and pragmatics.

Articulation is the accuracy and precision of speech sound selection and usage and the rules that govern their production(phonology).

Rhythm or Fluency is the flow of speech. It covers breaks or interruptions, repetitions, or prolongations in that flow. Usuallythe number and type of disfluencies are quantified based on conversational samples obtained under a variety ofcircumstances.


Voice is the use of the voice and its observable characteristics including pitch, resonance, quality and volume. Thesecharacteristics are usually evaluated during a sample of conversational speech. A medical evaluation may be indicated undercertain circumstances.

*Cultural influences, differences, and the primary language of the student must be taken into account prior to test selectionand evaluation.

Severity Rating Guidelines

A severity rating helps to determine the scope of intervention required to meet the needs of students with speech andlanguage impairments who are eligible for special education and related services. Speech and language assessment data, casestudy conclusions and criteria on the Eligibility Criteria/Matrix should be utilized to determine the severity of theimpairment. No attempt should be made to determine severity based on the eligibility matrix until an IEP is developed by theappropriate team and placement is subsequently determined. The IEP must be the foundation for the placementdetermination, not a severity rating.

The severity ratings are divided into four categories - mild, moderate, severe, and extreme - each of which is given a pointvalue on the basis of standardized test results, observations and clinical judgments. The amount of speech and languageservice a student receives may be proportional to the severity of his/her impairment and is in relation to the nature of theintervention model(s) and the goals and objectives determined by the IEP conference participants.

It is understood that students frequently exhibit multiple types of speech and language impairment. In these situations, thespeech-language pathologist may need to modify the amount of and the options for service delivery. For example, theservice delivery models for a language and articulation impaired student may be a combination of integrative and pull-out.

The following severity classifications apply to all disorder areas:

MILD: Impairment minimally affects the individual's ability to communicate in school learning and other socialsituations as noted by at least one other familiar listener, such as teacher, parent, sibling, or peer.

MODERATE: Impairment interferes with the individual's ability to communicate in school learningand/or other social situations as noted by at least one other familiar listener.

SEVERE: Impairment limits the individual's ability to communicate appropriately and respond in school learningand/or social situations. Environmental and/or student concern is evident and documented.

EXTREME: Impairment prevents the individual from communicating appropriately in school and/or social situations.

This severity rating scale takes into account many viable service delivery models and is not intended to be used solely withthe traditional group and individual options. Times listed reflect direct service, but not necessarily a pull-out model. A rangeof service delivery options should be utilized with these severity and time guidelines.

The IEP must include a specific number of minutes per week, not a range of minutes per week. The number listed on the IEPshould be considered the minimum number of minutes a student will receive in a week.

Articulation/Phonology Eligibility

The student with an articulation/phonological impairment is unable to produce sounds correctly in conversational speech.This impairment is typically characterized by the omission, distortion, substitution, addition, and/or inaccurate sequencing ofspeech sounds. Errors are not related to cultural or dialectical differences.

A student is not eligible for special education related services in the area of speech and language(articulation/phonological) impairment when:

1. Sound errors are consistent with developmental age or are within normal articulation development.*2. Articulation differences are due primarily to unfamiliarity with the English language, dialectal differences, temporary

physical disabilities or environmental, cultural or economic factors.*3. The articulation errors do not interfere with the student's ability to benefit from education.

*Adapted from: The Michigan Speech-Language-Hearing Association (1990) Speech and Language Services in Michigan:Suggestions for Identification, Delivery of Service and Exit Criteria.


At times referrals may be made from physicians or dentists regarding tongue thrust or reverse swallow in students. Tonguethrust is not an articulation disorder in itself, although it is often found in tandem with interdentalization of /s/, /z/, and mayresult in interference with other speech sounds. Therefore, the speech therapist in the school setting does not specificallyenroll students to eliminate tongue thrust or correct deviant swallow patterns that do not interfere with nutrition, but mayenroll this student if the resulting articulation disorder meets the eligibility criteria. No goals should specifically address theswallow, but rather only the articulation disorder.

Some students may demonstrate significant swallowing disorders including developmentally delayed or disordered patternsor loss of swallowing function due to brain injury or other circumstances. The decision to enroll a child for swallowingtherapy should be made by all parties including the caregivers, teachers, school nurse, and occupational therapist as well asthe speech pathologist. A feeding evaluation, feeding plan, and therapy plan may be established, if appropriate.

Students may be candidates for augmentative communication if, after a significant period of intervention, it is determinedthat the student lacks an appropriate modality to communicate expressively. A “Request for Student Assistance” can be sentto the BASSC office for consultative services. If an evaluation appears appropriate, the child’s IEP team will need toconvene a Child Review Team meeting to document the need for the augmentative communication evaluation and any otherassessments that may be pertinent.


Articulation/Phonology Matrix

Severity Rating Behavioral Descriptions Recommended MinimumService Minutes Per Week

No Problems No errors No eligibilityMinimal Student exhibits developmentally Consultative services to teacher

appropriate speech skills in thetherapy room setting, but may require 30 minutes or less directmonitoring for successful contact with student eachgeneralization of skills. Month.

Speech is generally intelligible; priorintervention has eliminated all butdevelopmental sound errors forwhich the student is not yetstimulable.

Mild Intelligible over 80% of the time in 20 minutesconnected speech.

No more than two speech sounderrors outside developmentalguidelines. Students may bestimulable for error sounds.

Moderate Intelligible 50-80% of the time in 30 minutesconnected speech.

Substitutions, distortions and someomissions may be present. There islimited stimulability for the errorphonemes.

Severe Intelligible 20-49% of the time in 60 minutesconnected speech.

Deviation may range from extensivesubstitutions and many omissions toextensive omissions. A limitednumber of phoneme classes areevidenced in a speech-languagesample. Consonant sequencing isgenerally lacking.

Augmentative CommunicationSystem may be warranted.

Extreme Speech is unintelligible without 90 minutesgestures and cues and/or knowledgeof the context. Usually there areadditional pathological orphysiological problems such asneuro-motor deficits or structuraldeviations. Augmentativecommunication systems may bewarranted.


Developmental Ages to Phoneme Mastery

Current research continues to demonstrate discrepancies in ages of speech sound acquisition. This dilemma is characterizedby the findings of the 'Iowa Articulation Norms Project and Its Nebraska Replication' (Smith, Hand, Freilinger, Bernthal,Bird, 1990). These findings suggest 'that ages of acquisition for most of the tested consonant singles have either remainedconstant or have moved to slightly later ages.' These researchers also found that 'demographic variables that might have beenexpected to influence the outcome failed to do so, although sex of the child was a significant factor in the preschool years.'

The following are collected developmental norms:

Illinois State Board of Education - 1990 Speech and Language Technical Assistance Manual

AGE Sound

3 b, p, m, n, w, b, vowels, diphthongs (such as “oy”)

4 k, g, t, d, ng, y

5 f6 v, th (voiceless), I

7 s, z, sh, ch, j, zh, r, hw, th (voiced)

POOLE NORMS

AGE Sound

3.5 years b, m, h, p, w4.5 years d, n, , t, j, g, k5.5 years f6.5 years l, , , , v7.5 years r,s, , z

Information prepared from Poole, I., (1934). The genetic development of consonant sounds in speech. Elementary EnglishReview, 11, 159-61.

Articulation/Phonology Measurement Instruments Commonly Used at BASSC

AAPS Arizona Articulation Proficiency ScaleAPP-R Hodson Assessment of Phonological Processes-RevisedG-F Goldman-Fristoe Test of ArticulationSPAT Structured Photographic Articulation Test (featuring Dudsberry) Conversational Speech Sampling


Language

The student with a language impairment demonstrates impairment and/or deviant development of comprehension and/or useof a spoken symbol system. This may include:

1. Language form - the portion of language that refers to the utterance/sentence structure of what is said (phonology,morphology, syntax)

2. Language content - the portion of language that refers to meanings of words and sentences including abstract conceptsof language (semantics)

3. Language use - the context in which language can be used and the purpose of communication (pragmatics). Individualswith pragmatic problems demonstrate difficulty in communicating effectively although form and content may be intact

In some situations, severity of the disabling condition caused by a language impairment may need to be determined by factorsother than standardized tests. In these cases, eligibility and severity would need to be determined by the impact of thelanguage impairment on the student's communicative, academic and social competence, thereby adversely impactingeducational performance. Clinical observations, language samples, and consultation with other school personnel areimportant components in determining eligibility of language impaired students (Casby, 1992).

PragmaticsSpeech-language pathologists take into consideration the student's use of pragmatics along with other case study assessmentinformation obtained to determine eligibility for services.

Pragmatics include:

1. The ability to use verbal labels to name objects, actions or attributes appropriately.2. The ability to use language to request objects or information or to fulfill needs.3. The ability to use language to relate previous incidents.4. The ability to use language to relate original ideas.5. The ability to use language to express emotions and moods.6. Adherence to the basic rules of conversation, including imitating, turn taking, and staying on topic.7. Adherence to the social rules of conversation such as maintenance of personal space, eye contact, posture and volume.8. The ability to determine listener’s reception and interpretations.9. The ability to react to various speech setting appropriately.10. The ability to understand and react appropriately to idioms, figures of speech, inferences and humor.

A student is not eligible for special education and related services in the area of speech and language impairmentwhen:

1. Language differences are primarily due to environmental, cultural, or economic factors includingnon-standard English and regional dialect;

2. Language performance does not interfere with the student's ability to benefit from education.

It is very important to note that the criteria should be interpreted as guidelines and may vary with specific circumstancesaffecting a particular student.


Language Eligibility MatrixRecommended Minimum

Severity Criteria Service Minutes per Week

Mild The student demonstrates a deficit in receptive, 30 Minutesexpressive or pragmatic language as measured bytwo or more diagnostic procedures/standardizedtests. Performance falls from 1 - 1.5 standarddeviations below the mean standard score, generallystandard scores between 85 -78.

Moderate The student demonstrates a deficit in receptive, 40 Minutesexpressive or pragmatic language as measured bytwo or more diagnostic procedures/standardizedtests. Performance falls from 1.5 to 2.0 standarddeviations below the mean standard score, generallystandard scores between 78-70.

Severe The student demonstrates a deficit in receptive, 60 Minutesexpressive or pragmatic language as measured bytwo or more diagnostic procedures/standardized tests(if standardized tests can be administered).Performance is between 2.0 to 2.5 standarddeviations below the mean standard score, generallystandard scores between 70 - 62.Augmentative communication systems may bewarranted.

Extreme The student demonstrates a deficit in receptive, 90 Minutesexpressive or pragmatic language which preventsappropriate communication in school and/or socialsituations. Performance on standardized tests (ifstandardized tests can be administered) is greaterthan 2.5 standard deviations below the meanstandard score, generally standard scores below 62.Augmentative Communication systems may bewarranted.

*Adapted from The Michigan Speech-Language-Hearing Association (1990). Speech and LanguageServices in Michigan: Suggestions for Identification, Delivery of Service and Exit Criteria .


Language Measurements Commonly Used In Bassc

ASSETBankson Language TestBracken Basic Concepts Scale(BBCS)Boehm Test of Basic Concepts(BTBC)Clinical Evaluation of Language Fundamentals-Preschool (CELF-PS)Clinical Evaluation of Language Fundamentals-3rd edition (CELF-3)Developmental Sentence Analysis (Laura Lee)Expressive One-Word Picture Vocabulary Test-Revised (EOWPVT-R)Expressive One-Word Picture Vocabulary Test-Upper Extension (EOWPVT-UE)Functional Communication Profile (FCP)Functional Language Ability Profile (FLAP)Language Processing Test (LPT)Preschool Language Scale-3 (PLS-3)Peabody Picture Vocabulary Test-Revised (PPVT-R)Receptive One-Word Picture Vocabulary Test-Revised (ROWPVT-R)Screening Test for Auditory Processing Disorders (SCAN)Structured Photographic Expressive Language Test-2nd Edition(SPELT 11)Test for Auditory Comprehension of Language-Revised (TACL-R)Test of Early Language Development (TELD)Test of Language Development-intermediate (TOLD-1)Test of Language Development Primary -2nd Edition (TOLD:P-2)Test of Pragmatic Language (TOPL)Test of Problem Solving (TOPS)Test of Word Knowledge (TOWK)The Listening TestThe WORD Test

Fluency

A fluency impairment is defined as the abnormal flow of verbal expression. It is characterized by impaired rate and rhythmof connected speech and may be accompanied by struggle behavior.

Consideration must be given to the student's chronological age and perception of the problem by the student and parents, thecontextual situations in which the student functions and the overall impact on educational performance.

A student is not eligible for special education and related services in the area of speech and language (fluency)impairment when disfluencies:

1. Are part of normal speech development2. Do not cause the speaker to modify behavior3. Do not interfere with the student's ability to benefit from education

A tape-recorded sample of a minimum of 100 words or 200 syllables from 2 different situations (reading, monologue orconnected speech) is recommended to determine eligibility and severity. The sample should be taken from a variety ofcircumstances and/or settings.


Fluency Matrix

Recommended Minimum ServiceSeverity Behavioral Description Minutes Per WeekMild 2-4% atypical disfluencies Recommended consultative services

within a speech to teacher(s).sample of at least 100words.No tensionto minimal tension.

Rate and/or Prosody:Minimal interferencewith communication.

Moderate 5-8% atypical disfluencies 40 minuteswithin a speech sampleof at least 100 words.Noticeable tensionand/or secondarycharacteristicsare present.

Rate and/or Prosody: Limitscommunication.

Severe 9-12% atypical disfluencies 60 minuteswithin a speech sample ofat least 100 words.Excessive tension and/orsecondary characteristicsare present.

Rate and/or Prosody:Interferes withcommunication.

Extreme More than 12% atypical 90 minutesdisfluencies withina speech sample of atleast 100 words.Excessive tension and/or secondarycharacteristics are present.

Rate and/or Prosody: Preventscommunication.


Continuum of Disfluent Speech Behavior

More Usual Typical DisfluenciesHesitations (silent pauses)Interjection of sounds, syllables or wordsRevisions of phrases or sentences

Phrase repetitions

One syllable word repetitions cr

Two or fewer repetitions per instance, oeven stress, no tension s

sov

Part-word syllable repetitions eTwo or fewer repetitions per instance reven stress, no tension

B Stutteringe Atypical Disfluenciesha One syllable word repetitions.v Three or more repetitions peri instance or uneven stress.or Part-word syllable repetition.s Three or more repetitions per

instance or uneven stress.

- --- --- - - -Sound repetitions

Prolongations

BlocksIncreased tension noted, e.g.,tremor of lips or jaw or vocaltension.

More Unusual

Developed by:Hugo Gregory, Ph.D., ProfessorJune Campbell, M.A., Clinical SupervisorDiane Hill, M.A., Clinical Supervisor Northwestern University

Department of Communication Sciences and Disorders


Voice

A voice impairment is defined as any deviation in pitch, intensity, quality, or other attribute which consistently interfereswith communication; draws unfavorable attention; adversely affects the speaker or the listener; or is inappropriate to the age,sex or culture of the individual. Voice quality may be affected by either organic or functional factors.

Consideration must be given to age, sex, environment, and perception of the problem by the student, parents, speech-language pathologist, and other school personnel or medical specialists.

A student is not eligible for special education and related services in the area of speech and language (voice)impairment when vocal characteristics:

1. Are the result of temporary physical factors such as allergies, colds, abnormal tonsils or adenoids,short-term vocal abuse or misuse

2. Are the result of regional, dialectic or cultural differences3. Do not interfere with the student's ability to benefit from education

A tape-recorded speech sample of a minimum of 100 words of connected speech is recommended to determine eligibility andseverity.

Voice Matrix

Severity Behavioral Description Recommended Minimum ServiceMinutes Per Week

Mild Voice difference including Consultative services to teacherhoarseness, nasality, and parentdenasality, pitch or intensityinappropriate for the student'sage; disorder is of minimalconcern to parent, teacher,student or physician.

Medical referral may be indicated.

Moderate Voice difference is of concern 30 minutes per week to parent, teacher, student orphysician. Voice is notappropriate for age and sex ofthe student.

Medical referral may beindicated.

Severe Voice difference is of concern 60 minutesto parent, teacher, student orphysician. Voice is distinctlyabnormal for age and sex of thestudent.

Medical referral is indicated.

Extreme Speech is largely unintelligible 90 minutesDue to aphonia or severehypemasality. Extremeeffort is apparent inproduction of speech.

Medical referral is indicated.


Exit Criteria(Eligibility vs. Non-eligibility)

Exit decisions must be individualized, based on developmental norms and the current best practices, as determined by theappropriate team. A student is no longer eligible for special education services and related services for speech languageservices when it is determined that:

1. The need for specialized services to address the adverse effect(s) on educational performance is no longer present

2. The disability no longer has an adverse effect on the student's educational performance

3. The disability no longer exists

4. The student is not motivated to attend to and/or participate in speech-language services (this must be documented)

5. Further improvement is precluded by interference of physiological factors

6. Maximum gains have been achieved from therapeutic intervention as evidenced by lack of further progress

This determination of eligibility or noneligibility is made at the IEP meeting on the basis of the data collected or otheravailable assessment information.


Speech-Language Eligibility Criteria/Matrix

CLINICAL JUDGMENT MAY NECESSITATE MODIFICATION OF THESE GUIDELINES.

Mild Moderate

Severity of Impairment minimally affects Impairment interferesDisorder the individual's ability to with the individual’s ability

communicate in school learning to communicate in schooland/or other social situations as learning and/or other socialnoted by at least one other situations as noted by at leastfamiliar listener, such as teacher, one other familiar listener.parent, sibling, or peer.

Articulation/ Intelligible over 80% of the time Intelligible 50-80% of the timePhonology in connected speech. in connected speech.

No more than 2 speech sounds Substitutions and distortionserrors outside developmental and some omissions may beguidelines. Students may be present. There is limitedstimulable for error sounds. stimulability for error

phonemes.

Language The student demonstrates a The student demonstrates adeficit in receptive, expressive or deficit in receptive, expressive,pragmatic language as measured or pragmatic language asby two or more diagnostic measured by two or moreprocedures/standardized tests. diagnostic procedures/Performance falls from 1 to 1.5 standardized tests.standard deviations below the Performance falls from 1.5 tomean standard score. Generally 2.0 standard deviations belowstandard scores between 85-78. the mean standard score.

Generally standard scoresBetween 78-70.

Fluency 2-4% atypical disfluencies within 5-8% atypical disfluencies a speech sample of at least 100 within a speech sample of atwords. No tension to minimal least 100 words. Noticeabletension. Tension and/or secondary

characteristics are present.Recommend consultation toteacher(s). Rate and or ProsodyRate and/or Prosody Limits communication.Minimal interference withcommunication.

Voice Voice difference including Voice difference is of concernhoarseness, nasality, denasality, to parent, teacher, student orpitch, or intensity inappropriate physician. Voice is notfor the student's age is of appropriate for age and sex ofminimal concern to parent, the student.teacher, student or physician.Medical referral may be indicated. Medical referral may be indicated.

BY THE AGE OF 7 YEARS, THE STUDENT'S PHONETIC INVENTORY IS COMPLETED AND STABILIZED(HODSON, 1991 ASHA CONVENTION)

ADVERSE IMPACT ON THE STUDENT'S EDUCATIONAL PERFORMANCE MUST BE DOCUMENTED.


Speech-Language Eligibility Criteria/Matrix, Cont.

CLINICAL JUDGMENT MAY NECESSITATE MODIFICATION OF THESE GUIDELINES

Severe Extreme

Impairment limits the individual's ability to Impairment prevents the individualcommunicate appropriately and respond from communicating appropriately inin school learning and/or social situations. school and/or social situations.Environmental and/or student concern isevident and documented.

Intelligible 20-49% of the time in connected Speech is unintelligible without gesturesspeech. Deviations may range from extensive and cues and/or knowledge of thesubstitutions and many omissions to extensive context. Usually there are additionalomissions. A limited number of phoneme classes pathological or physiological problems,are evidenced in a speech-language sample. such as neuro-motor deficits orConsonant sequencing is generally lacking. structural deviations.

Augmentative communication system may Augumentative communication systemsbe warranted. may be warranted.

The student demonstrates a deficit in receptive, The student demonstrates a deficit inexpressive or pragmatic language as measured receptive, expressive or pragmaticby two or more diagnostic procedures/standardized language which prevents appropriatetests (if standardized tests can be administered). Communication in school and/or socialPerformance is between 2.0 to 2.5 standard deviations situations. With measured performancebelow the mean standard score with standard scores (if standardized tests can begenerally between 70-62. Augmentative communication administered) falling greater than 2.5 stsystems may be warranted. standard scores generally less than 62.

Augmentative communication systemsMay be warranted.

9-12% atypical disfluencies within a speech sample More than 12% atypical disfluenciesat least 100 words. Excessive tension and/or within a speech sample of at least 100secondary characteristics are present. Words. Excessive tension and/orRate and/or Prosody secondary characteristics are present.Interferes with communication. Rate and/or Prosody

Prevents communication.

Voice difference is of concern to parent, teacher, Speech is largely unintelligible due tostudent or physician. Voice is distinctly abnormal aphonia or severe hypernasality.for age and sex of the student. Extreme effort is apparent in production

of speech.

Medical referral is indicated. Medical referral is indicated.


Service Delivery Models

Students who have been identified as speech and language impaired have traditionally been served through a pull-out model.There are numerous reasons for the speech-language pathologist to consider alternative service delivery modes, including:

• To provide a range of services appropriate to the needs of each student• To provide a more natural communication environment• To promote generalization from the therapy environment to other communication settings• To provide an opportunity for interprofessional training• To provide an opportunity for peer modeling and reinforcement• To more effectively integrate the student’s communicative goals into the educational program• To provide for a better understanding of overall student achievement• To provide for more teacher involvement in specific communication skills development; and• To reinforce and supplement clinical activities

These issues, the necessity for a multidisciplinary approach and the least restrictive environment, have made it necessary toinvestigate alternate service delivery models.

Monitor

IEP’s are developed for students in this group. A student who has not exhibited carryover or generalization of skills maybenefit from this service delivery option. This model is structured to provide feedback in the classroom from the teacher,consultation between the teacher and the speech-language pathologist and/or intermittent intervention with the pathologist.

This model achieves these goals:

1. To establish carryover of therapy gains to the instructional setting,2. To provide feedback to the student from peers and other adults,3. To enhance generalization of skills acquired.

Integrated Services

In an integrated-service delivery model, the speech-language pathologist provides direct services to students with speechand language impairments across educational activities/settings in cooperation with other education professionals. Thismodel addresses one of the most consistent problems when providing therapeutic services: carryover or generalization ofskills. In order to facilitate the student's use of emerging or acquired speech and/or language skills, the speech-languagepathologist works with the student in a variety of settings: classrooms, community, and/or social. By working with thevarious service deliverers (teacher, occupational therapist, physical therapist, etc.) in multiple educational environments, thespeech-language pathologist maximizes opportunities for the student to achieve the stated goals on the individualizededucation program (IEP). The ability to provide ongoing assessment, to modify therapeutic techniques, to teach strategiesand to relay feedback to the student are enhanced when the speech-language pathologist can observe, treat and gather datain multiple settings with the input of additional professionals. This model is also referred to as the transdisciplinary ormultidisciplinary team approach.

This model achieves these goals:1. To provide therapy in a natural setting;2. To involve the classroom teacher and other education professionals in the therapeutic process (Knowledge and skills

are shared between the speech-language pathologist, the classroom teacher and other educational professionals.);3. To promote the generalization of skills.

Collaborative Consultation

According to Idol, Paolucci-Whitcomb and Nevin (1986), 'Collaborative consultation is an interactive process that enablespeople with diverse expertise to generate creative solutions to mutually defined problems. The outcome is enhanced,altered, and produces solutions that are different from those that the individual team members would produceindependently. The major outcome of collaborative consultation is to provide comprehensive and effective programs forstudents with special needs within the most appropriate context, thereby enabling them to achieve maximum constructiveinteraction with their nondisabled peers. Collaborative consultation is a viable service delivery model using the classroomas a more natural environment and giving communication development more meaningful contexts.”


The speech-language pathologist functioning as a consultant:

1. Demonstrates teaching of alternative instructional approaches

2. Co-teaches lessons based on the learning styles of students3. Instructs groups for the purpose of reteaching abstract course material4. Provides direct study skill instruction and materials based on curricular content developed in conjunction with the

classroom teacher5. Adapts instructional materials based on classroom teacher-defined curricular objectives6. Recommends and provides supplemental materials to reinforce and explain course content7. Prepares and/or adapts test materials specific to needs of students8. Observes and/or charts behavior and performance of students with disabilities9. Facilitates socialization goals10. Makes recommendations to regular/special instructional staff regarding instruction of students11. with disabilities based on observations12. Communicates with education staff and parents regarding progress13. Provides ongoing inservice to parents and teachers on special education techniques

Various Approaches to Collaborative Consultation

Ongoing Direct Intervention is defined as the combined use of direct therapy and collaborative consultation where theconsultation is based on ongoing direct contact with the student. The teacher and consultant jointly devise activities designedto follow up on therapy goals. The teacher implements and monitors programs in the classroom. Students being served bythis model must have an evaluation and IEP.

Intermittent Intervention is defined as consultation regarding a student or group of student following a diagnosticevaluation. Consultation is based on periodic intervention with the student by the speech pathologist. The teacher andconsultant devise a program which is implemented in the classroom by the teacher. Students being served by this modelmust have an evaluation and an IEP.

No Direct Intervention involves consultation regarding a specific student or group of students where the consultant has nodirect contact with the student. This type of consultation would occur for students perceived to have special needs as well asthose who are not eligible for special education and related services. These students would not necessarily have an IEP.

This model achieves the following goals:1. To facilitate the integration of speech and language goals into the curricular goals and objectives of the student2. To provide increased opportunities for carryover of speech and language goals through additional reinforcement and

practice within the classroom3. To coordinate adaptation of curriculum, instructional materials, test materials and supplemental materials needed to

permit the speech-language impaired student to benefit from the classroom4. To increase the positive communicative interactions of students within the classroom

Traditional (Pull-Out Model)The traditional model has been the most frequently utilized service delivery model in the area of speech and languageimpairment. By utilizing this model, students with all types of impairments and varying degrees of severity are treated by aspeech-language pathologist in the following manner: Students are seen individually, or in small groups, during specifiedblocks of time throughout the school day in a room specifically designed for this purpose. The traditional service deliverymodel can be used in combination with other therapy models.

This model achieves these goals:1. To provide therapy in an intensive manner without intrusions or distractions to the student2. To teach new skills


Instructional ServicesStudents whose primary disability is speech and language and whose needs are so great that they cannot be achievedsatisfactorily in regular classes with the use of appropriate supplementary aids and services have the option of being placed inan instructional (self-contained) special education class for students with speech and language impairments. The followingshould be considered when determining a student's placement in this program:

1. Documentation of severe speech and language delays/impairments, academic delays, social/emotional delays, andaverage cognitive potential

2. Documentation of academic failure, low motivation, high frustration, and poor self-image and interpersonalrelationships

3. Documentation that previous educational programming made little impact and progress was virtually at a standstill

If placement is to be made in a regular education building that is not the student's home school, the student's IEP mustidentify reasons that make this placement determination appropriate.

The appropriately certified provider for such a service is the individual holding a Type 10, or Type 3 and Type 9 SpecialCertificate endorsed for Speech and Language Impaired. The teacher is responsible for the students' total academiccurriculum. Curriculum is adapted as needed to meet the specific speech-language goals of each student.

This model achieves these goals:1. To provide a modified or an alternative curriculum for a student2. To provide language learning in a structured, yet natural environment3. To enhance pragmatic language learning and usage

References

Casby, Michael W. (1992). The Cognitive Hypothesis and Its Influence on Speech-Language Services in Schools.Language, Speech, and Hearing Services in Schools, 23, 198-202.

Gregory, Hugo; Campbell, June; & Hill, Diane. Continuum of Disfluent Speech Behavior. Northwestern University.

Idol, Loma; Paolucci-Whitcomb, P.; & Nevin, A. (1986). Collaborative Consultation. Aspen Publication: Rockville,Maryland.

The Michigan Speech-Language Hearing Association. (1 990). Speech and Language Services in Michigan: Suggestions forIdentification, Delivery of Service and Exit Criteria.

Smith, A.B.; Hand, L.; Freilinger, J.J.; Bernthal, J.E.; Bird, A. (1990). The Iowa Articulation Norms Project and ItsNebraska Replication. Journal of Speech and Hoofing Disorders, 56, 779-798.

Resources Included:

A. Definition and Examples of Adverse Effect

B. Cognitive Considerations

C. Functional Language Ability Profile (FLAP)

D. Pre-Referral/Child Study Team Request for Speech and Language


APPENDIX A

Definition And Examples Of Adverse Effect

The term adverse effect is taken from the federal regulations for Part B of the Individuals with Disabilities Education Act(IDEA), the federal law that mandates educational services for students with disabilities. Under Section 300.5 of thoseregulations, the definitions of the impairments covered by the law include adverse effect as one of the components thatmust be demonstrated in a student's disability in order for that student to be eligible for the entitlements of the law.

For example, the term deaf is defined as a hearing impairment “....which is so severe that the child is impaired in processinglinguistic information through hearing, with or without amplification, which adversely affects educational performance.”

In Illinois, adverse effect has been defined as problems resulting from the manifested characteristics of the student'sdisability which interfere with learning and educational performance in school. This means that the effect of theimpairment on the students is such that they are not able to benefit from the regular instructional program offered to othersof their age group. The adverse effect is not the actual impairment, but rather the impact of that impairment on the student'sability to learn without specially designed instruction.

(Note: Due to the individual nature of each student's impairment and its impact on their learning and educational progress,it is difficult to give examples of adverse effect without reinforcing general concepts that may not be appropriate for aspecific student. Please keep this in mind when reviewing the following examples of adverse effect on educationalperformance.)

Two issues pertaining to communication in educational settings should be considered in attempting to determine if acommunication problem is an educationally disabling condition. The first involves the fact that language is the primarymedium of education. To the extent that a student has not mastered the skills necessary to understand, express and uselanguage, the student's access to the primary medium of education is limited. The second is that communication is theprocess through which education takes place. To the extent that a speech and language impairment affects the student'sability to participate in active, interactive communication with others in the educational setting (including peers as well asadults), the student is prevented from participating in the process of education. Keeping in mind the interaction of thespeech and language problems with the medium and process of education will facilitate the consideration of an adverseeffect on educational performance.

Several misconceptions regarding the adverse effect on educational performance must be addressed. The first involves arestriction of the definition of educational performance. The definition of educational performance must not be limitedsolely to consideration of academic performance. The student does not need to be below grade level or failing in anacademic area to be eligible as speech and language impaired. Examples of students who may be succeeding academicallybut are still eligible as speech and language impaired include the following:

• A bright student who is disfluent and has related problems contributing to class discussions, giving book reports, andanswering questions orally

• A first grader who is ahead of peers in many areas, but has non-developmental articulation errors that affect intelligibilityduring “show and tell”, phonics instruction, and other educational activities requiring oral responses

• A third grader who is an above average reader, but whose voice disorder inhibits his classroom verbal interactions,resulting in reluctance to give book reports, do oral reading and join in class discussion

Another misconception is that any deviance in communication constitutes a disability. A speech or language deviation doesnot necessarily constitute an adverse effect on the student's ability to function in the educational setting any more thandeviations like mild muscle incoordination or poor eyesight necessarily interfere with educational functioning. Studentshaving muscle incoordination or poor eyesight are not automatically determined to be PH/C or VI. The deviation infunctioning must be shown to interfere with the student's ability to perform successfully in the educational setting. Similarly,the speech and language deviation must be shown to interfere with the student's ability to perform in the educational settingbefore Speech and Language Impaired eligibility is determined.

The effect of the speech and language deviation on social/emotional development also must be carefully considered. The keyissue to be addressed is whether the deviation interferes with the student's ability to establish and maintain socialrelationships and experience sound emotional development. Self consciousness about a speech or language deviation orteasing by peers does not by itself necessarily constitute an impediment to social relationships and emotional development.Careful documentation of limitations of social relationships and sound emotional development must be directly linked withthe speech and language deviation to establish the existence of an adverse effect on educational performance.


The documentation of effect on educational performance must clearly indicate two things: the manner in which the student'scommunication deficit affects his performance in the educational setting, and the adverse nature of the effect. Also, inconsidering the effect on educational performance, the student's present educational setting must be the point of reference.The idea that while a student's communication deviance is not currently causing an adverse effect but may cause an adversevocational effect in the future does not allow us to determine that he is disabled now.

Documentation of the effect on educational performance can be obtained by having the regular education teacher complete achecklist detailing behaviors of the student in the classroom which may indicate an adverse effect on educationalperformance. Checklists might include specific questions such as: “Does the student participate in class discussion?”, “Doesthe student understand verbal directions?”, “Does the student make errors in spelling on the same sounds he misarticulates?”Responses on the checklist must be related to the speech and language impairment and judged to be indicative of a significantproblem.

As stated earlier, adverse effect is only one of the components required to determine a student's eligibility for specialeducation services. The four components are:

• Completion of a regulatorily correct assessment• Existence of an impairment as identified by the evaluation• Adverse effect of the impairment on learning and educational performance• The need for specially designed instruction as a result of the impairment and its adverse effect

The cycle of eligibility determination is completed when an IEP is developed which specifies the services that will beprovided to address, and as much as possible, remediate the adverse effect. The goals and short-term objectives of the IEPmust be directed to the reduction or remediation of the specific adverse effect for that student and not the generalcharacteristics of the impairment, e.g., students with language development problems should not automatically receivearticulation therapy because they are identified under the speech-impaired category.

Sources:Illinois State Board of Education, Department of Special Education StaffThe Michigan Speech-Language-Hearing Association (1990). Speech and Language Services inMichigan: Suggestions for Identification, Delivery of Service and Exit Criteria.


Appendix B

Cognitive Considerations

The purpose of the cognitive considerations form is to compare the student's standard language scores to standard scores inother ability areas. This process helps differentiate the ”slow learner” who is functioning in language at the expected level,from the student who is truly language disordered and is functioning below the expected level.

Examples of these types of situations may include:

1. The student demonstrates a 15 point (or greater) discrepancy between WISC-III performance score (or a similar IQperformance score from another test) and language skills as judged by the results of language testing. Student showssignificant discrepancy between ability and language performance and demonstrates deficits on one or more descriptivemeasures. Student may be eligible for speech-language services if he/she meets other eligibility requirements (adverseeffect, etc.).

Example: WISC-III Performance IQ 98 Verbal IQ 76CELF-3 Receptive 81

Expressive 76

Has difficulty completing assignments in class; seldom speaks in full sentences; seems to lose his train of thought oftenand will change topics without completing a thought or answering the questions asked of him.

2. If a student demonstrates no discrepancy between WISC-III performance score and languageabilities as judged by the results of language testing, the student's language appears to becommensurate with abilities. Student shows no difficulty in functional communication as judged bythe speech-language evaluation. Since language skills are measured to be commensurate withcognitive abilities, language therapy services are not indicated.

Example: WISC-III Performance IQ 75 Verbal IQ 72CELF-3 Receptive 72Expressive 72

This student has difficulty keeping up with the class and it takes several repetitions to assure that he has grasped newconcepts presented. He socializes well and speaks easily with his friends. He can make his wants and needs knowneffectively in the classroom situation.

3. The student demonstrates no discrepancy between WISC-111 performance score and the language testing results.However, two descriptive language measures indicate that the student has difficulty communicating and that thisdifficulty causes an adverse educational effect and therefore, the student may be eligible for speech/language services toaddress functional communication skills.

Example: WISC-III Performance IQ 81 Verbal IQ 79CELF-3 Receptive 84

Expressive 81

This student does well in communicating in guided, structured tasks, however, in the classroom he has difficulty attendingand completing tasks assigned. He has difficulty following directions. Results of the Functional Language AssessmentProfile indicate he has skills below those of his classroom peers and significant weaknesses are noted in the pragmatic areasof topic maintenance, turn taking, transitions, and conversational initiation skills.

*Adapted from the Anchorage School District Speech-Language Services Manual, June, 1990.


Appendix CFunctional Language Ability Profile (FLAP)

(FLAP to be completed by SLP. SLP may elicit input from teacher and/or parent.)Student: ObserverTotal Points: Average Score:Age: Date: Informants:

Key: 1,2 = Below average 3,4,5 =Average 6, 7 = Above AverageStudent compare to peers in ______Regular Education ______Special Education classroom

1. Auditory Attention Inattentive; easilydistracted.

1234567 Attentive: good listening skills

2. Vocabularycomprehension

Comprehension ofwords/concepts issignificantly delayed.

1234567 Understands words/concepts expectedcompared to peers

3. Sentencecomprehension

Does not comprehendlonger, more complexunits of information.

1234567 Follows complex directions; followssequence of a story

4. Consideration oflistener needs

No awareness of listener;speaks without any effortto evoke understandingfrom others; egocentriccomments.

1234567 Monitors effectiveness ofcommunication; provides sufficientinformation; provides sufficientinformation based on listener need.

5. Organization, purpose,and control

Rambles: no sense oforder or of getting to thepoint; rattles on withoutpurpose; cannot tell a storyin proper sequence.

1234567 Gets to the point; controls language;organizes and coherently presents ideas

6. Vocabulary Expressive vocabulary issignificantly delayed; hasword-finding difficulty;uses non-specific sequence

1234567 Uses flexible and precise vocabulary

7. Use of language todescribe

Includes few details;listener has visualizingwhat is being described

1234567 Provides complete description ofsituation or object that features somedetails and subordinates others

8. Use of language toquestion

Has difficulty askingquestions; asksinappropriate questions

1234567 Obtains information or assistance byasking appropriate questions

9. Use of language toexplain

Instructions are confusing,out of sequence; directionsare non-specific

1234567 Gives specific, sequential directions tolocation; gives complete explanation on“How to” tasks

10. Quality of structure Omissions of structuralelements, including wordendings; uses only simple,active, declarativesentences; word orderdifficulties in questionformations.

1234567 Includes all structural elements; maturesentence patterns; maintains constanttense reference within a paragraph orstory; mature use of phrases.


Appendix D

Pre-Referral/Child Study Team Request for Speech and Language

Student Birthdate Age Grade

Name of person making request Date

Teacher information is required in order to determine if there is a need for a referral to special education for diagnosticevaluations of speech and language skills. Please answer the questions and return the form to your school Speech Therapist.He/she will contact you to discuss your concerns.

Yes No1. Does this student avoid speaking in class? To others?2. Does he/she communicate with a lot of gestures instead of speech?3. Does this student seem frustrated when trying to speak?4. Do peers tease this student about his/her communication problems?5. Is this student's auditory discrimination adequate for sounds and words?6. Does he/she make errors in writing on the same symbols that he/she

makes errors on in articulation? (example: spelling)7. Do most of his/her mispronunciations during oral reading occur on the

articulation error sounds?8. Is this student's grammar (syntax) adequate for his/her age?9. Do you feel comfortable when you try to communicate with this student?10. Does this student's voice quality make it difficult to understand the content11. of his/her verbal message?12. Does this student lose his/her voice during or by the end of the day?13. Is this student able to project loudly enough to be adequately heard in

the classroom during recitation?14. Does the student have difficulty with the fluency or flow of his/her

speech? (Are there hesitations or prolongations?)15. Does this student appear to always turn the same ear toward the teacher

or other source of sound?16. Does this student appear to have more difficulty in understanding material

that is presented auditodly than visually?17. Does this student leave out words when asked to repeat several words or sentences?18. Does this student appear to concentrate on the speaker's lips when listening?19. Is this student aware of his/her communication problem?20. What is your major concern about this student?21. Are parents aware of your concern?

Disposition: _____Suggestions provided _____ Checked Status _____Special Education Referral

Adapted from: The Michigan Speech-Language Hearing Association (1990). Speech and Language Services in Michigan:Suggestions for Identification, Delivery of Service and Exit Criteria.

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