Speech-Language Pathology Services in Schools:: Guidelines For Best Practice

Speech-Language Pathology
Services in Schools:
Guidelines for Best Practice
Revised 2011
Virginia Department of Education, Office of Special Education and Student Services

Speech-Language Pathology Services in Schools: Guidelines for Best Practice
Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Commonly Used Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Overview of School-Based Speech-Language Pathology . . . . . . 4

Role of the School-Based Speech-Language Pathologist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Speech-Language Pathologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Speech-Language Pathology Assistants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Substitutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Supervision and Mentoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Technical Assistance and Professional Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Work Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Recruiting/Retaining Qualified Speech-Language Pathologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Evidence-Based Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Overview of Evidenced-Based Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Documentation and Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Evaluation of Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Assessment and Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Comprehensive Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
School-Based Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Observations of Academic Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Tests and Measures of Academic Achievement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Speech-Language Specific Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Observation and Probes of Speech-Language Specific Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Norm-Referenced Tests and Measures of Speech-Language Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Educational Impact of the Speech-Language Impairment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
The Speech-Language Pathologist’s Evaluation Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Special Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Child Find Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Special Education Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Related Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
IEP Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Transitions from Early Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Private School Students with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Service Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Service Delivery Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Direct Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Indirect Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Other Service Delivery Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Scheduling, Service Delivery, and IEPs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
General Education Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Caseload Establishment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Virginia Department of Education, Office of Special Education and Student Services i

Special Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Literacy Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Autism Spectrum Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Language Diversity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Limited English Proficiency (LEP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Phonological Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Dysphagia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Auditory Processing Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Assistive Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Medicaid/Famis Reimbursement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
References and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Appendices
APPENDIX A: Print and Web Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
APPENDIX B: Assessment Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
APPENDIX C: Speech-Language Sample Screening Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
APPENDIX D: Comprehensive Communication Assessment System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
APPENDIX E: Forms and Checklists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Figures and Tables

Figure 1. Overview of Evidence-Based Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Figure 2. Factors to Consider When Integrating Evidence and Making Decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Figure 3. Aim and Trend Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Figure 4. The Components of Comprehensive Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Figure 5. Comprehensive Assessment of School Communication Abilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Figure 6. Steps in the Special Education Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Figure 7. SLI Criteria Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Figure 8. A sampling of possible communication profiles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Figure 9. Auditory Processing Skills Hierarchy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Table 1. Roles/Responsibilities of School-Based Speech-Language Pathologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Table 2. Responsibilities of Mentors and Newly Hired SLPs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Table 3. Equipment, Materials, and Space for School-Based SLP Use in School Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Table 4. SLP Recruitment Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Table 5. Types of Data Commonly Collected in Education Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Table 6. Advantages and Disadvantages of Common Assessment Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Table 7. Components of Discourse Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Table 8. Checklist for Reviewing Norm-Referenced Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Table 9. Normal Distribution Curve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Table 10. IEP Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Table 11. IEP Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Table 12. Teaching Models for Integrated Therapy in the Classroom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Table 13. Possible Delivery Options for 60 Minutes of Services per Week . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Table 14. Examples of Caseload Reduction Based on Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Table. 15 Common Features of SWE that Overlap with AAE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Table 16. Comparison of Children with Limited English Proficiency with and without Disabilities . . . . . . . . . . . . . . . 58
Table 17. Phonological Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Table 18. Overlap Between Auditory Processing Disorders, Attention Deficit Disorders, and
Speech-Language Impairments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
ii Virginia Department of Education, Office of Special Education and Student Services

Introduction
The development of communication skills is important for all students and can
impact school success. The school-based speech-language pathologist (SLP) plays
an important role in education and may serve on both the special education and
general education teams. SLPs may serve students directly or work with educators
and families to address communication and language needs.
This guidelines document is designed to assist school-based SLPs, administrators,

teachers, and parents as they explore the role of the SLP in the school-based
setting and work together to serve students in Virginia.
The Virginia Department of Education (VDOE) Regulations Governing Special

Education Program for Students with Disabilities and other VDOE guidance
documents should be used in conjunction with this resource.
The VDOE employs staff who provide assistance understanding information

provided in this and other VDOE resources. Additional information may be found
on the VDOE Web site at: www.doe.virginia.gov or by contacting the VDOE at:
Virginia Department of Education

Division of Special Education and Student Services
P.O. Box 2120
Richmond, VA 23218-2120
1-800-422-2083
Virginia Department of Education, Office of Special Education and Student Services 1

Acknowledgements
The Department of Education would like to express its appreciation to the In addition, the following persons at
following people for their work on these guidelines: the Virginia Department of Education
provided valuable assistance in their
Chondra Malson Lisa Disney review of the document:
University of Virginia Chesterfield County Public Schools
Cynthia O’Donoghue, Ph.D. Myra Flint Amy Edwards

James Madison University Virginia Beach City Public Schools Medicaid Specialist
Donna Bryant Marie Ireland Patricia Abrams, Ph.D.

Spotsylvania County Public Schools Virginia Department of Education Director, Special Education Instructional
Services
LaVae Hoffman, Ph.D. Traci Morris
University of Virginia Prince William County Public Schools Phyllis Mondak
Early Childhood Specialist
Lee White Vicki Reed, Ph.D.
Prince William County Public Schools James Madison University Scottie Alley
Complaints Specialist
Lisa Kinton
Chesterfield County Public Schools Vivian Stith-Williams, Ph.D.
Specialist
2 Virginia Department of Education, Office of Special Education and Student Services

Commonly Used Acronyms

AAC Augmentative and DMAS Department of Medical IFSP Infant and Family Service
Alternative Assistance Services Plan (treatment document
Communication (Virginia’s Medicaid agency) for children receiving
services through EI)
APD (Central) Auditory DSM Diagnostic and Statistical
Processing Disorder Manual LEA Local Education Agency
ASD Autism Spectrum Disorders EBP Evidence-Based Practices LEP Limited English Proficiency
ASHA American Speech- EI Early Intervention LRE Least Restrictive

Language-Hearing Environment
Association ESL English as a Second
Language L1 First Language of a child
AT Assistive Technology
FAMIS Family Access to Medical L2 Second Language of a child
BASLP Board of Audiology Insurance Services
and Speech-Language (Virginia’s health insurance MBSS Modified Barium Swallow
Pathology programs for families that Study
do not qualify for Medicaid)
BICS Basic Interpersonal NBPTS National Board for
Communication Skills FAPE Free Appropriate Public Professional Teaching
Education Standards
CALP Cognitive Academic
Language Proficiency FERPA Family Educational Rights NOMS National Outcome
and Privacy Act Measurement System
CCC Certificate of Clinical (developed by ASHA)
Competence granted by FM Frequency Modulated
ASHA PLOP Present Level of Educational
Hz Hertz (measure of a sound’s Performance
CF Clinical Fellowship frequency)
(supervised work POC Plan of Care
experience after ICD-9-CM International Classification
completing Master’s of Diseases, 9th revision, RtI Response to Intervention
degree requirement, Clinical Modification
required for CCC) (standardized listing of SHAV Speech-Language-Hearing
descriptive terms and Association of Virginia
CLD Culturally and linguistically identifying codes for
diverse reporting diagnoses SOL Standards of Learning
and medical services
CMS Centers for Medicare and performed) SRS Severity Rating Scale
Medicaid (the agency
overseeing Medicaid) ID Intellectual Disability TTAC Training and Technical
(formerly Mental Assistance Centers
CFR Code of Federal Retardation)
Regulations USC United States Code
IDEA Individuals with Disabilities
dBHL decibels, measured in Education Act VAC Virginia Administrative
Hearing Level (measure of Code
a sound’s loudness) IEP Individualized Education
Program VDOE Virginia Department of
Education

Overview of School-Based
Speech-Language Pathology
This opening section addresses Regulations Governing Special teacher assistance teams, and child
questions that frequently arise about: Education Programs for Children with study committees). On these teams,
Disabilities in Virginia1(Virginia Special the speech-language pathologist
• The role of the SLP
Education Regulations), 8 VAC 20-80- may conduct observations, complete
• Personnel requirements for 10 et al. defines speech-language assessments, plan with teachers, model
licensure and duties pathology services as: identification interventions, coach teachers, and/
of children with speech-language or gather data, all in the context of
• Supervision
impairments, appraisal and diagnosis general education. Speech-language
• Skill development, and of the impairment, referral for medical pathologists may provide prevention
or other professional attention, and intervention services based on local
• Recruitment and retention of
provision of speech-language services programs and policies.
SLPs.
for prevention or habilitation of
communication impairments, and In the early years of school practice,
Role of the School- counseling and guidance for parents, provision of services focused on
Based Speech- children and teachers regarding speech fluency, voice, and articulation
and/or language impairments. Speech- disorders, with later inclusion of
Language Pathologist language pathology services are language disorders. Although these
both special education and a related areas continue to be included within
The focus of school-based speech- service and may also be provided as the SLP’s roles and responsibilities,
language pathologists is the part of a general education initiative. changing legal mandates and an
communication abilities of students. Table 1 summarizes the roles and expanded scope of practice for SLPs
The school-based speech-language responsibilities of school-based speech- across settings has prompted a
pathologist’s goal is to remediate, language pathologists. redefinition of work in the schools.
improve, or alleviate student Several professional practices
communication and swallowing The school-based speech-language may now be included as part of
problems within the educational pathologist may serve as a member of the SLP’s workload…. These areas
environment. To meet this goal, school- a variety of teams that make decisions include work with students who are
based speech-language pathologists: regarding evaluation, eligibility, medically fragile; work with those
and services. The speech-language with dysphagia; work with reading,
(a) prevent, correct, improve, or pathologist does not make decisions writing, and curriculum; EBP; RtI; and
alleviate articulation, fluency, in isolation regarding the needed telepractice. (ASHA, 2010, page 10)
voice, language, and swallowing evaluation components, the child’s
impairments eligibility for special education and The field of speech-language
related services, or the goals and pathology is dynamic. Research in
(b) reduce the functional objectives of intervention. The needs the field provides new information
consequences of the of students with disabilities are best on assessment and intervention
communication and swallowing addressed in a transdisciplinary manner approaches. Fully qualified speech-
disabilities by promoting the with a team of professionals providing language pathologists possess the
development, improvement, services. foundational knowledge and skills
and use of functional to provide service for all clients. To
communication skills; and Speech-language pathologists may develop specialized skills, speech-
also provide support when students language pathologists and their
(c) provide support in the general are not eligible for speech-language employers must be willing to participate
educational environment to services by participating on various in continuing education to maintain
lessen the handicap (the social prevention/early intervention teams best practice in aspects of the field
consequence of the impairment (e.g., Instructional Support Teams, such as assistive technology, dysphagia
or disability) by facilitating
successful participation,
socialization, and learning
1 Regulations Governing Special Education Programs for Children with Disabilities in Virginia became
(ASHA, 1999).
effective July 7, 2009. These regulations can be found on the Virginia Department of Education Web
site at www.doe.virginia.gov

Table 1. Roles/Responsibilities of School-Based Speech-Language Pathologists
Role Speech-Language Pathologist Responsibilities
Prevention Provides pre-referral consultations and involved in various initiatives including RtI
Identification Conducts speech-language and hearing screenings

Identifies if students failing screening should be referred for evaluation
Evaluation: Determining Need for Serves as member of team for any students with suspected speech-language
Evaluation deficits
Evaluation: Assessment Conducts a comprehensive assessment to determine the existence of a disability
Evaluation: Interpretation of Identifies child’s communication strengths and weaknesses

Assessment Prepares evaluation report
Eligibility Decision Presents speech-language assessment results at team meeting

Describes the student’s functional speech and language skills as they relate to
the student’s ability to access the curriculum and progress
Individualized Drafts parts of present level of performance, IEP goals and objectives/bench-
Education Program Development marks related to speech-language impairment
Intervention Provides intervention appropriate to the age and learning needs of the
individual student
Caseload Management Employs a continuum of service delivery models in the LRE; meets federal and
state mandates as well as local policies in performance of job duties
Data Collection and Analysis Gathers and interprets data for individual students as well as overall program
evaluation
Supervision and Mentorship Supervises university practicum students, clinical fellows, and paraprofessionals
Mentors new SLPs
Documentation Completes progress reports (for special education and Medicaid)

Completes performance appraisals for supervisee
Collaboration SLPs work with individuals and agencies in the community, universities, other
school professionals, families, and students
Unique Contributions Contributes to the literacy achievement of students

Addresses the linguistic and metalinguistic foundations of the curriculum
Professional Development Remains current in all aspects of the profession and supports the use of EBP
Stays abreast of educational issues
Adapted from American Speech-Language-Hearing Association. (2010).

(swallowing), and auditory-oral/ experience (tracking the requirements Speech-Language

auditory-verbal skill development for for the Certificate of Clinical
children with cochlear implants. Competence in Speech-Language Pathology Assistants
Pathology offered by the American
In addition, a speech-language Speech-Language-Hearing Association Some divisions use assistants to support
pathologist should be up-to-date in and consistent with those of the Board the speech-language pathologist. The
his/her knowledge of both general and of Audiology and Speech-Language special education staffing requirements
special education, including education Pathology). (Virginia Special Education Regulations,
standards, curriculum, state and local 8 VAC 20-81-40) do not include a
assessments, parental rights and Some school divisions contract with paraprofessional for speech-language
responsibilities, and special education private agencies or universities to caseloads, as they do for classroom
requirements and procedure. The provide speech-language pathology special education teachers. This does
Virginia Department of Education services. The Code of Virginia requires not prohibit the use of paraprofessionals;
publishes guidance documents on a that any person not employed by a however, they must be used with
number of topics that may be of interest local or state government who provides caution.
to school-based speech-language speech-language pathology services
pathologists. Guidance documents, must hold a license from the Board IDEA specifies that a paraprofessional is
available online at www.doe.virginia.gov, of Audiology and Speech-Language an appropriately trained employee who
address topics such as the evaluation Pathology (BASLP). Therefore, any assists and is supervised by qualified
and eligibility process, specific disability persons providing services through a professional staff. In Virginia, there is
areas such as student with autism contract with an outside agency must no credentialing of assistants, resulting
spectrum disorders or those who are be licensed by the BASLP. in local determination of the nature,
deaf or hard of hearing, and special degree, and quantity of training. The
education topics such as extended IDEA requires that personnel providing Virginia Administrative Code addresses
school year and resolving disputes. services to students with disabilities the use of Speech-Language Pathology
Speech-language pathologists are be qualified and hold the necessary Assistants (SLPAs) and supervisory
encouraged to access VDOE guidance credentials required by the state responsibilities of the licensed SLP (18
documents when appropriate. A listing education agency. In addition, IDEA VAC 30 20 240).
of documents is provided in Appendix A specifies that qualified professionals
of this document. conduct assessments and that the The Virginia Administrative Code (18 VAC
decisions regarding a student’s 30 20 240) states that:
Speech-Language eligibility for special education 1. A licensed audiologist and

include personnel representing the speech language pathologist
Pathologists discipline providing the assessments. shall provide documented
In addition, Virginia Special Education supervision to unlicensed
All students who have IEPs that specify Regulations specify that the special assistants, shall be held
the provision of speech-language education provider on the IEP team fully responsible for their
services must receive those services will be a speech-language pathologist performance and activities, and
by a qualified speech-language for students whose only disability is shall ensure that they perform
pathologist (Virginia Special Education speech-language impairment. only those activities which do
Regulations, 8 VAC 20-81-40). Speech- not constitute the practice of
language pathologists in the schools VDOE licensed speech-language audiology or speech language
must hold a valid license issued by the pathologists may provide supervision pathology and which are
Virginia Board of Education with a valid for speech-language pathology commensurate with their level
speech-language pathologist preK-12 assistants. To provide supervision for of training.
endorsement.2 This endorsement is clinical fellows or university students
based on the Master’s degree in speech- in the school setting, SLPs must have 2. The identity of the unlicensed
language pathology, with clinical national certification through ASHA. assistant shall be disclosed to
the client prior to treatment
2 The specific requirements are reflected in the Board of Education regulations, Licensure Regulations and shall be made a part of the
for School Personnel, found on the VDOE Web site at www.doe.virginia.gov. client’s file.

As a result, the paraprofessional is not S ubs titute s rescheduling, the division must ensure
allowed to practice independently and that the student does not receive any
must be supervised by qualified staff. The U.S. Department of Education’s reduction in the services specified on
Given these restrictions, the following Office of Special Education Programs the IEP.
list reflects those tasks a speech- (OSEP) has addressed the impact of an
language assistant may assume: interruption of services on the student’s For long-term interruption of services,
right to a free and appropriate public the division must inform the parents
• Assisting the speech-language
education (FAPE). In addressing an of students who are not served or
pathologist with screening;
inquiry in this regard, OSEP stated that underserved of the interruption of
• Assisting the speech-language in order to meet its FAPE responsibilities, services. The interruption may be
pathologist with copying, a school division is generally responsible due to a vacancy or medical leave.
distributing, and filing for making alternative arrangements to The parents must be assured that
special education forms, and provide services set out in a student’s once the services resume, the IEP
contacting parents to set up IEP when there is an interruption team will determine if the student is
meetings; of services. This may be due to the entitled to compensatory services. The
absence of the service provider or other compensatory services may be provided
• Preparing materials;
school-related activities. However, the during the summer, during school
• Assisting with transporting school division is not obligated to do breaks, or by providing additional
students to and from services so when the student is unavailable for time during the school year. Division
(within the school); and other reasons, such as absences from speech-language pathologists may
school. provide these services and should be
• Monitoring the student’s
appropriately compensated for working
performance, following the
Given these requirements, school additional hours.
directions provided by the
speech-language pathologist divisions face significant challenges
when they have vacant positions or Nonqualified substitutes shall not
and only after the speech-
temporary absences. Every effort conduct assessments, write evaluation
language pathologist has
should be made to secure a qualified reports, prepare IEPs, represent speech-
verified that the assistant can
speech-language pathologist. School language pathology at meetings,
accurately gather data.
divisions should maintain an open job or teach new skills. These tasks are
announcement for a qualified speech- reserved for qualified speech-language
Speech-language pathology assistants
language pathologist for ongoing pathologists.
may not be used to provide services to
the caseload in the absence of qualified recruitment efforts. The division
speech-language pathologists. A may wish to contract with a private Supervision and
speech-language pathologist with an agency to provide services, assuring
that their personnel hold a license
Mentoring
assistant may serve more students than
the division average, but not higher from the Virginia Board of Audiology
Supervision
than the caseload maximum of 68 (8 and Speech-Language Pathology. In
Speech-language pathologists may
VAC 20-81-340). School divisions may addition, divisions should recruit a pool
be supervised by a variety of persons
consider the addition of a speech- of qualified speech-language pathology
within a school division: principal,
language assistant to facilitate the substitutes to cover caseloads during
special education director, speech-
completion of nonclinical duties and short- or long-term absences. (Retired
language pathology coordinator, or
serve as a recruitment and retention speech-language pathologists may be a
lead speech-language pathologist. The
tool. valuable pool for substitutes or part-
supervisor may not be familiar with the
time personnel.)
field of speech-language pathology and
For further information on using special may come from a different background
education paraprofessionals, see the For short-term absences, speech-
in general or special education.
Virginia Department of Education language pathologists should take
document, The Virginia Paraprofessional advantage of the flexibility written
The speech-language pathologist has
Guide to Supervision and Collaboration: into the IEP for scheduling services to
the responsibility to provide his/her
A Partnership. enable them to reschedule the student
supervisor with sufficient information
at another time. However, when

about the role and responsibilities of the values, beliefs, and practices that support during the early years is a tragic
speech-language pathologists to enable lead to a more productive, efficient, and loss that can be avoided.”
the supervisor to provide effective effective professional. It contributes to
supervision. The supervisor can provide successful retention, career satisfaction, The guidelines identify certain
effective evaluation of the speech- better decision-making, and greater mentoring objectives that are
language pathologist’s teamwork, perceived confidence (Horgan and applicable to new school-based speech-
cooperation, professionalism, and Simeon, 1991). language pathologists. Objectives
ability to be able to complete required include facilitating a seamless transition
special education procedures in a timely School divisions may have procedures into the first year of employment in
fashion. The supervisor may not be in place for a mentoring program; the schools, preventing isolation, and
able to provide evaluative feedback however, there are numerous resources improving skills. Mentoring programs
regarding the speech-language available. The Guidelines for Mentor may be a tool used to retain quality
pathologist’s therapy skills. Speech- Teacher Programs for Beginning and speech-language pathologists.
language pathologists may wish to work Experienced Teachers is available on the Supporting the new SLP and putting
collaboratively to self-evaluate or peer- Virginia Department of Education Web theory into practice are benefits
evaluate their therapy skills. site at www.doe.virginia.gov. These in addition to improving morale,
guidelines point out that “losing a communications, and collegiality.
Speech-language pathologists may also talented teacher because of inadequate
find themselves in supervisory roles for
fellow speech-language pathologists
seeking to complete the clinical
fellowship requirements for ASHA’s Table 2. Responsibilities of Mentors and Newly Hired SLPs
certificate of clinical competence, Requesting assistance proactively related to service delivery, school
Newly
for paraprofessionals, for university and community culture, working with other school personnel,
Hired
practicum students, or for school- and other personal or professional issues,
SLP
approved volunteers. Speech-language
pathologists in such supervisory roles Attending all training sessions and sessions with the mentor
should pursue continuing education to speech-language pathologist,
develop and enhance their supervisory Remaining open and responsive to feedback,
skills. Observing other experienced personnel, including the mentor
speech-language pathologist,
Mentoring
One of the most challenging Conducting self-assessments and using reflective skills to enhance
experiences for a speech-language clinical skills, and
pathologist can be the first year of Participating in the evaluation of the mentoring program.
employment in a public school setting.
Mentoring has proven to be a valuable Providing support and guidance to the newly hired speech-
Mentor
technique to assist new personnel in language pathologist in the areas of planning, assessment,
SLP
their new work situations regardless of working with parents and colleagues, obtaining materials and
their level of professional experience. equipment, cultural sensitivity, school procedures, division
Mentoring is a cooperative arrangement policies, and local special education procedures,
between peers in which an experienced Acclimating the newly hired speech-language pathologist to the
speech-language pathologist provides culture of the school and community,
a newly hired SLP with ongoing support
and assistance. The relationships Observing the newly hired speech-language pathologist as
should be collegial in nature and all appropriate and providing feedback,
experiences should be directed toward Attending all training sessions relevant to mentoring,
the development and refinement of Maintaining a professional and confidential relationship based on
the knowledge and skills necessary respect and trust, and
for effective learning. The goal of
mentoring is to develop knowledge of Participating in the evaluation of the mentoring program.

What Every Special Educator Must professional development opportunities Speech-language pathologists are
Know: Ethics, Standards, and Guidelines, for school speech-language encouraged to work together to share
published by the Council for Exceptional pathologists. Local and regional and discuss current information and
Children, offers suggestions for the roles training events, access to telephone research. Journal discussion groups
and responsibilities of beginning and seminars and collaboration with and distance education opportunities
mentor teachers in special education university training programs provide like ASHA telephone seminar replays
(2008). Both individuals should have opportunities for SLPs to learn about provide opportunities for high-quality
an active role. Responsibilities for each evidence-based practices. Resources professional development. Professional
individual are shown in Table 2. can be found by accessing the state development opportunities through
Web-based community of learning professional associations including the
Technical Assistance online at www.ttaconline.org. On this Speech-Language Hearing Association
Web site free online training modules, of Virginia (SHAV), ASHA, and ASHA
and Professional called ‘webshops’, are available on special interest divisions provide current
Development topics such as phonological processes, evidence-based practices in the field of
data collection, and augmentative speech-language pathology.
The Virginia Department of Education communication. By utilizing
(VDOE) and the VDOE Training and these tools, educators and school
Technical Assistance Centers (TTACs) divisions can access free professional
offer many free resources and low cost development.
Table 3. Equipment, Materials, and Space for School-Based SLP Use in School Setting

Equipment Materials Space
Teacher’s desk and chair; Computer software, including word Location: The room should be located
Student furniture of correct sizes and processing, spreadsheet, database away from noisy activities (gym,
adequate number; and creation software; clinical band room, cafeteria, etc.) and in an
evaluation and instructional area that is readily accessible to non-
File cabinets or drawers with locks; software; assistive technology ambulatory students.
Adequate and secure storage for software; Size: The room should be of an
materials and equipment; Current norm-referenced assessment adequate size to allow for small
Marker or chalk board, bulletin board, tools and protocols; group activities. Generally, 180
mirror; Materials for informal assessment; square feet is recommended if the
Computer, microphone, speakers, room also serves as an office for the
Therapy and instructional materials speech-language pathologist.
printer, and workstation for and supplies;
computer; Climate control: The room should have
Access to instructional materials and adequate ventilation and climate
Clock; and textbooks used in the classrooms; control.
Access to: File folders/pocket folders;
Penlight and otoscope; Recording Lighting: Adequate lighting is
and playback equipment; Disposable gloves (latex-free); and necessary to allow for testing and
Assistive communication Office supplies – stapler/staples, observing.
devices Audiometer (calibrated scissors, pencil sharpener, paper Internet access
annually); Phone for confidential clips, pens/pencils, correction fluid, Wiring: A minimum of two 110-volt
conversations; and Copy machine post-its, hole punch, chalk or dry double outlets
and paper shredder. erase markers.
Availability: To provide privacy for
assessment, conferences and
therapy.
Acoustics: Acceptable acoustics
optimize instruction.

Work Environment Some examples of adjustments to evaluations, services and administrative

working conditions include reducing responsibilities is another option school
Adequate facilities for the many caseloads, paying membership dues divisions may consider when addressing
services provided by speech-language in professional organizations such recruitment issues.
pathologists are necessary to meet as the American Speech-Language-
the IEP requirements of students and Hearing Association (ASHA) or the A number of school divisions have
to meet IDEA and Americans with Speech-Language-Hearing Association determined that the American Speech-
Disabilities Act of 1990 regulations. In of Virginia (SHAV). Additionally, Language-Hearing Association’s
addition, specialized equipment and school-based SLPs report that school certificate of clinical competence is
materials may be required to meet the divisions sometimes provide continuing equally rigorous and comparable to the
goals and objectives of students’ IEPs. education to assist in maintaining ASHA National Board for Professional Teaching
Table 3 contains recommendations to certification, provide laptop computers, Standards (NBPTS) requirements. The
meet the need for adequate facilities and provide volunteer, clerical support NBPTS does not offer certification to
and materials and equipment. or a SLP assistant to assist the SLP as a speech-language pathologists, so the
recruitment or retention incentive. ASHA standard was used as a proxy in
The school division should provide those divisions (ASHA Leader, June 10,
adequate maintenance and prompt Some examples of employment 2003).
repair of any equipment that is needed opportunities include creating part-
to meet the IEP goals of students. As time positions, with benefits, enabling Shortages of school-based speech-
technology advances, equipment job-sharing, and recruiting of retired language pathologists are an ongoing
should be updated. speech-language pathologists for concern for many school divisions.
long-term substitutes or part-time Because speech-language pathologists
Speech-language pathologists should personnel. Financial incentives such are also employed in noneducational
work with building principals and as providing a salary supplement settings, recruiting efforts should
special education administrators to for maintaining national (ASHA) focus on more than traditional teacher
identify appropriate locations and certification (a percentage differential recruitment strategies and be ongoing
to prepare a budget to secure the or lump-sum addition to annual salary) throughout the year. Table 4 provides a
necessary equipment and materials. or for billing Medicaid are also reported. checklist of strategies and recruitment
Speech-language pathologists must Extending contracts to eleven months opportunities that may be used by
remain up-to-date in their knowledge of for certain staff to cover summer school divisions.
appropriate materials and technology.
Table 4. SLP Recruitment Strategies

Recruiting/
Retaining Qualified Participate in local, regional, state and national job fairs (e.g., SHAV and
ASHA),
Speech-Language Post job opportunities on professional Web sites (e.g., ASHA, SHAV, and
Pathologists VDOE sponsored www.teacher-teacher.com),
Obtain mailing lists of local SLPs from professional associations (e.g.,
Recruiting and retaining qualified
SHAV, ASHA) or state agencies (e.g., the Board of Audiology and Speech-
speech-language pathologists for
Language Pathology),
school division’s vacancies is a challenge
for school divisions statewide. A variety Contact state and regional universities with master’s programs in speech-
of creative approaches to enhance language pathology to recruit graduate students,
work conditions or employment Serve as a site for student practicum or internships with state or regional
opportunities can be used to recruit and universities, and
retain qualified staff. Speech-language
Create part-time positions for retirees or SLPs who have left the work
pathologists are encouraged to work
force.
with school leaders to determine
strategies that may assist in recruiting
and retention efforts.

Evidence-Based Practice
The use of ‘scientifically-based research’ that are proven to be beneficial on the Create a PICO Question
and evidence-based practice (EBP) basis of the highest level of scientific Evidence-based practice begins
is indicated by the Elementary and research-evidence available. with clarifying the specific issue or
Secondary Education Act (ESEA), and decision that must be addressed. The
state and local policies and procedures. Evidence-based practice includes a clarification of an issue forms a “PICO”
EBP is a term that describes a model sequence of steps as shown in Figure 1 question. Thoughtful development of
for professional work and also a way of below. A tutorial detailing specific steps this clear and specific question allows
working that increases accountability in making evidence-based practice the gathering of relevant research
and student outcomes. This section (EBP) clinical decisions when serving findings and lays the foundation for
includes: children was recently published in the the EBP decision-making process.
American Journal of Speech-Language A well-formed PICO question has
• an overview of evidence-based
Pathology (Johnson, 2006). In addition, four components that are stated in
practice,
several articles in peer-reviewed terms that are as specific as possible:
• information on documentation journals have addressed issues that are the patient or population (P), the
and data collection, and particularly relevant to the application intervention (I), the comparison (C),
of EBP in public school systems (e.g., and the desired outcome (O). The more
• evaluation of outcomes.
Justice & Fey, 2004; Meline & Paradiso, specific each component of the PICO
2003). SLPs should understand the question, the more relevant will be the
Overview of steps for gathering and reviewing evidence that results from the search
Evidence-Based external evidence and the issues to of the published literature. Searches
consider when using evidence to based on generic questions often
Practice make decisions regarding treatment in result in too little relevant information.
schools. SLPs are encouraged to use An example of a well-formed PICO
Speech-language pathologists who research and be aware of factors that question might be, “Do preschool
serve students in Virginia public schools impact school-based EBP services for children with expressive language
should implement service delivery students. deficits (P) demonstrate improved word
models and treatment approaches decoding skills (O) following one-on-
one literacy intervention using print-
referencing strategies (I) in comparison
Figure 1. Overview of to classroom-based instruction (C)?”
Evidence-Based
Practice Find and Examine the
Create a Evidence
After the PICO question has been
Evaluate PICO
defined, a search of the published
Outcomes Question research literature should be conducted
by accessing electronic professional
databases, such as the American
Psychological Association’s PsycINFO
Intervention (www.apa.org), the Education
Documentation Find and Resources Information Center’s (ERIC)
public database (www.eric.ed.gov), or
and Data Examine PubMed’s Medline (www.ncbi.nlm.nih.
Evidence gov/pubmed), and entering keywords
to identify potentially relevant research
Integrate
publications. Additionally, ASHA
Evidence members have access to an online
Make Decision search engine that will identify and
deliver full-text versions of articles
published in all ASHA journals (www.
asha.org/publications). Publications that

appear to address the PICO question Integrate Evidence and Make Intervention Documentation
must be obtained and reviewed in Decisions and Data
order to complete the next step of the In their recent description regarding After the evidence has been evaluated
process: evaluating the evidence. use of EBP to make clinical decisions and the intervention has been selected
about language intervention for and implemented, it is necessary to
Several resources are available to guide children in schools, Gillam and Gillam document the intervention and gather
practitioners through the important (2006) summarize critical questions data. This data will be used to document
step of evaluating the level of evidence, to consider when comparing research student progress and is vital for the next
validity, and importance of the studies. Of particular interest for step of evaluating outcomes. Data must
published research data that address school SLPs may be the assertion that be gathered throughout the process
the PICO question. Speech-language in addition to assessing the published to determine whether the intervention
pathologists should be familiar with research (external) evidence, school is effective. Additional information on
basic EBP search procedures. In practitioners should also consider the documentation and data collection is
addition, SLPs must be able to search relevant internal evidence (student- provided in the following section of this
the professional literatures regarding parent and clinician-agency factors) chapter and online at www.ttaconline.
an array of disorders as well as evidence that contribute to school-based clinical org.
specific to the practice of speech- decisions. Student-parent factors are
language pathology. described as the cultural values, interest, Evaluate Outcomes
engagement, activities, and opinions of Professionals cannot claim to use EBP
Once the relevant research is identified, the family. if they do not evaluate intervention
readers should be able to review outcomes. During this critical phase,
the work with attention to the study the SLP reviews documentation and
design, measurement methods data collected to determine if the
used, and possible biases. Resources
Stu
student is making progress. At a

es
include publications from the medical

nc
minimum, SLPs should use data and

de
rie
profession that explain EBP in depth, documentation of efforts to evaluate

nt/
pe
such as the book Evidence-Based outcomes during naturally occurring

Fa
Ex
Medicine: How to Practice and Teach points in the educational cycle such as
ily
al
EBM (Sackett, Straus, Richardson, the annual IEP and progress reporting
nic
Va
Rosenberg, & Haynes, 2000), online periods.

Cli
lu
portals such as the Cochrane

es
Collaboration (www.cochrane.org), and Current

Curr
Cu rre
ent
nt Be
Best
st Pr
Prac
Practices
acti
tiic
icees Additional information about the
resources specific to speech-language process for evaluating treatment
pathology such as the ASHA technical outcomes is available through other
report on EBP (American Speech- Figure 2. Factors to Consider When published resources such as the article
Language-Hearing Association, 2004). Integrating Evidence and Making “Making Evidence-Based Decisions
Decisions about Child Language Intervention in
An additional source of information Schools” (Gillam and Gillam 2006) or
that may be of particular help to busy Agency and clinician factors include the “Guide to Evidence-Based Practice”
practitioners are published meta- training, theoretical orientation, agency available online at www.linguisystems.
analyses and systematic reviews that policies and resources, as well as com/pdf/EBPguide.pdf.
address clinical issues in speech- intervention data. Figure 2 illustrates
language pathology (e.g., Cirrin & the balance of factors that should be
Gillam, 2008; Law, Garrett, & Nye, 2004; considered when making evidence-
McCauley, Strand, Lof, Schooling, & based treatment decisions.
Frymark, 2009). A Compendium of EBP
Guidelines and Systematic Reviews is
available from the ASHA Web site.

Documentation and toward all annual goals will be Intervention Documentation

measured. There are many different and Data
Data kinds of data that can be collected in
the school environment. Data can be Effective data collection requires more
An essential part of the job for every qualitative or quantitative. than simply recording student responses
SLP is maintaining appropriate and behavior. The reason for the data
documentation and data collection Quantitative data collection measures collection, the type of data collected,
systems. Documentation includes behaviors that are observed and by whom, and how often it is recorded
recording dates (mm/dd/yyyy) services counted. It is typically considered to should be considered. Different types of
were provided and what goals were be objective data, meaning that the data may be collected to:
addressed. If scheduled services were behavior can be defined well enough
not provided, the reason for missed • demonstrate a student’s ability
that different people could observe and
services should be documented to perform a task or skill,
count the same behavior. Quantitative
and compensatory service offered if data includes measures of correct or • assess the level of support that
appropriate. Documentation provides incorrect (e.g., production of initial /k/ in is needed, or
a record of IEP service implementation words), present or not present (e.g., the
and information for progress reports • measure progress over time.
use of –ing verb form) and appropriate
and parent/teacher conferences. or inappropriate (e.g., means of gaining
Documentation should also include Examples of data types are listed in Table
attention). Most data taken will
the evidence used when selecting 5. Data collection forms designed to
measure the frequency of a behavior,
interventions in accordance with EBP. It match the type of data being collected
but it could also record duration cues
is recommended that documentation can make the collection, summary, and
used.
be maintained for five to seven years. analysis easier. For example, the data
form used to record the number of times
Qualitative data involves describing
Data is information about student a student initiates communication would
and reflecting on what has been
performance that is recorded and be different than the data form used to
observed. It is considered subjective
can be used to guide instruction, gather information on what happens
data because it depends upon the
communicate with parents, develop an immediately before and after a behavior
perspective of the person doing
IEP, or demonstrate progress. Specific (i.e., frequency count table to tally
the observing. Qualitative data
uses of data include: occurrences vs. antecedent, behavior,
acknowledges that communication
consequence [ABC] log). Appendix F
• To inform the evidence-based does not occur in a vacuum, making
contains sample data collection forms.
decision-making cycle the environment and perspectives of
Training on data collection for SLPs is
communication partners important
• To identify current skills available on www.ttaconline.org and
in measuring the success or failure of
levels or present levels of provides additional information on data
treatment. Qualitative data includes
performance collection, sample forms for assessment,
descriptive observations and interviews
and data collection during intervention.
• To evaluate outcomes and with parents, teachers or students.
determine mastery of goals (Olswang & Bain, 1994)
Data must provide accurate information
• To document progress and regarding a student’s performance. To
Educators should use a data collection
develop future goals have accurate information, the recording
system that is consistent, considers
of data must be consistent. If, for
• To measure progress over time the type of data being collected,
example, only 30 out of 50 responses are
and accurately measures progress.
• To provide a record for the IEP recorded, randomly missing 20, those
The VDOE Training and Technical
team and educators. 20 missed responses could significantly
Assistance Center (TTAC) Web site www.
change the percentage of correct/
ttaconline.org includes free training
Data should be collected and reviewed incorrect responses and views of student
on data collection and data-based
regularly. IDEA (2007) requires a performance.
decision-making for speech-language
student’s individualized education pathologists.
program (IEP) include a statement
regarding how the child’s progress

Table 5. Types of Data Commonly Collected in Education Settings
Data Type Description Example
Cue Recording This data notes visual, verbal or physical cues Recording which student responses were
given prior to a student response. preceded by a visual cue for sound
placement.
Duration Recording Data records the length of time a student is Recording the length of time a student
engaged in a specific, discrete behavior. demonstrates joint attention during a
Any recorded behavior should have a clear structured task.
beginning and ending, so that stop and start
times are consistent.
Frequency Counts Data is collected on the frequency of a skill or Recording the number of times a student
occurrence of a behavior. correctly produces a target sound or uses
pronouns correctly when telling a story.
Language/ Written record of student’s expressive output. A list of all utterances a student says when
Narrative Samples telling a story based on a wordless picture
book.
Latency Recording Data measures the amount of time between Recording the amount of time between the
instruction or a prompt and the initiation of a delivery of a carrier phrase and the student’s
student’s behavior. response.
Pre-test/Post-test This method involves testing a student on Scoring a student’s narrative of a wordless
specific material before an intervention, and picture book before and after intervention.
giving a test on the same material after a
chosen intervention has been implemented.
Rating Scales Rating scales can be used to quantify The classroom teacher describes a student’s
descriptions or observations of behavior. overall use of a target sound on a 5-point
rating scale.
Observations Notes may detail descriptions of events or a Observer provides a description of classroom
student’s performance in a class. This data events surrounding a communication
can be combined with other data, such as breakdown.
frequency counts or duration recordings.
Work Products Collection includes any student-completed Self-corrections made to a student essay
work that reflects targeted skills (e.g., tests, following instruction on combining
quizzes, writing samples). sentences.

Recording the amount and types of Graphs of data provide a picture of Figure 3. Aim and Trend Line
cueing during intervention is essential progress and can be used effectively
Target
to maintain an accurate record of with students and parents to discuss
student performance. Cueing data changes in performance for specific
should include the type of cue provided, skills or show change over time. When
how often the cue was needed, a clear target is set for a skill, this can be
and how the cue impacted student included on the graph as the target or
performance. This information informs goal.
the amount and type of support needed
and, therefore, the student’s level of Plotting features such as aim lines
independence with a targeted skill. and trend lines provide a visual of the
Changes in the amount or types of target and performance trends. Trend
cueing required may reveal changes lines also may provide an estimate of
in a student’s level of independence. future performance and help the team
Baseline
Student independence is one factor predict targets for future IEP goals. It
used to measure progress. is important to review and summarize Aim Line
data periodically to ensure that students Trend Line
As part of data collection planning, the are making progress and assist in
This trend line shows student not
SLP should consider continuous and determining the need for any changes
progressing at a rate that will meet the
interval data collection. Continuous to the intervention.
target or goal within the time period.
data collection would involve recording
each response for an entire session An aim line connects the baseline point
or activity. Interval data collection and target and provides a clear picture to ensure that students are making
involves recording all responses within of the progress needed to meet the progress and consider instructional
a specified time frame (e.g., three five- goal. A trend line shows the average changes.
minute samples) or for a certain number student performance, even if daily or
of responses (e.g., the first 20 and the weekly performance varies. A sample When interventions are successful,
last 20 trials). Pre- and post-testing is of an aim line and trend line graph is documentation should show student
also a form of interval data. Planning pictured in Figure 3. Instructions for progress that exceeds the normal
ahead ensures that data collected will creating this type of graph are provided developmental trajectory. In other
be an appropriate measure of student in Appendix E. words, the student should learn more
performance. than they would have without the
Reviewing the purpose of the graph intervention or services. The amount
Evaluation of and its specific features, such as an aim of extra progress depends on a variety
line and a trend line, will help parents of factors including the severity of the
Outcomes and other team members see student disability, amount of home practice or
progress. Data also can show how support, and student motivation. If
Data collected should be reviewed by changes in instruction have affected a student is not progressing at a rate
speech-language pathologists at regular the student’s progress. The graph greater than their nondisabled peers, a
intervals and analyzed to determine should be labeled and contain enough review of the intervention and amount
outcomes. The review of data at descriptive information for it to be or type of services should be completed.
naturally occurring times (progress easily understood. It is important to
reporting and annual IEP) also informs review and summarize data periodically
SLPs and IEP teams if adjustments to the
program should be considered.

Assessment and Evaluation

The purpose of a special education multifaceted and include multiple data During a speech-language assessment,
evaluation is to determine whether the sources (teachers, parents, students, all procedures, tests, and materials must
student has one or more disabilities; other service providers), types of data meet specific conditions (Virginia Special
the present level of performance and (quantitative and qualitative), a variety Education Regulations, 8 VAC 20-81-
educational needs of the student; of types of measures and procedures 70 C). Examples of these conditions
whether the student needs special (authentic assessment strategies, include:
education and related services; and criterion-referenced measures, norm-
• Assessment measures must
whether any additions or modifications referenced tests, dynamic assessment
be provided in the student’s
to the special education and related procedures, etc.), and several
native language or other mode
services are needed to enable the environments (classroom, playground,
of communication unless it is
student to meet the measurable annual home) as appropriate for each child. As
clearly not feasible to do so.
goals in the IEP and participate, as a result of the evaluation, the eligibility
appropriate, in the general education team will have a complete picture of the • A variety of assessment
curriculum (Virginia Special Education student’s communication abilities and tools and strategies should
Regulations, 8 VAC 20-81-70). The VDOE needs. The resulting speech-language be used to gather relevant
publication, Guidance for Evaluation evaluation report should: functional and developmental
and Eligibility for the Special Education information on a student;
• provide a comprehensive
Process, provides specific information this must include information
assessment of the student’s
on referral, assessment, and eligibility related to enabling a student
communication skills,
decision-making. to be involved in and progress
• identify strengths and in the general education
Upon referral for evaluation, a team, weaknesses, and curriculum, or, in the case of a
having the same composition as the IEP preschooler, to participate in
• present information for
team and other qualified individuals as developmentally appropriate
determining whether the
appropriate, reviews existing data and activities. The evaluation
student has a speech-
determines whether additional data materials, including, but not
language impairment that
are needed to determine eligibility. limited to, any norm-referenced
adversely affects educational
The team reviews: evaluations and tests that were administered,
performance.
information provided by the parents should assist in determining
of the student; current classroom- whether the student has a
Speech-language pathologists have
based and state assessments, and disability and, if eligible, the
expertise in language and should
observations; and observations contents of the IEP.
ensure that all components of
by teachers and related services
the evaluation consider language • The assessment instruments
personnel (Virginia Special Education
differences and dialect use. Evaluation must be validated for the
Regulations, 8 VAC 20-81-70 B). If the
data that provides evidence of purpose for which they
team decides that additional data
dialect use or language difference are used and administered
are needed to determine whether a
should be documented and may not by trained personnel
student is eligible for special education
be considered a disability. When in accordance with the
and related services due to a possible
language differences or dialects are instructions provided by their
communication disorder, a full and
inappropriately viewed as errors, producer and should be able to
complete assessment of communication
students may be inappropriately provide evidence of adequate
abilities may be conducted by the
identified as having a disability. Virginia sensitivity and specificity.
SLP. Other professionals in the
regulations clearly state that “tests and
school division or in the local medical • Any measure (norm-referenced,
other evaluation materials used to assess
community may complete other criterion-referenced, or
a student must not be discriminatory on a
assessments as requested by the team. systematic observation),
racial or cultural basis.” (8VAC 20-81-70)
administered by qualified
Additional information on language
The evaluation of a student to personnel, may be used to
diversity is provided in the special topics
determine whether he/she has a assist in determining whether
section.
speech-language impairment should be the student meets the criteria
to determine that a student

has a disability and, if so, the Figure 4. The

contents of the student’s IEP. Components of Speech-
• Any deviation in administration
Comprehensive Academic Language
of a standardized, norm-
Assessment Activities Pathology
referenced test or criterion- Probes
environment and
referenced measure must be
how their speech and
described in the evaluation
language abilities
report.
impact educational Contextual Decontextual
• The assessment tools and achievement. For Tests - Tests - that parse
strategies must provide relevant preschool-age children that reflect components of
information that directly who do not participate communicaion speech &
abilites language skills
assists persons in determining in a formal school
the educational needs of the program, these data
student. will be gathered with
parents and caregivers.
• No single procedure can be
Preschool data should
used as the sole criterion for and/or vocational program, and to
focus on participation in the home
determining an appropriate progress in the educational setting. It
and community and developmentally
educational program for a does not rely solely, or even primarily,
appropriate activities.
student. on norm-referenced assessment
instruments to determine a student’s
The remaining two assessment sources,
Comprehensive communication abilities. Spaulding,
SLP probes and decontextualized
Plante, and Farinella report, “The practice
Assessment tests, are specific to the field of
of applying an arbitrary low cut-off score
speech-language pathology. Within
for diagnosing language impairments is
A thorough and balanced assessment the category of school-based data
frequently unsupported by the evidence
is mandated by special education sources, half of the assessment
that is available….(2006)”
regulation. This process is critical to information will be gathered through
determining the existence of a disability systematic observations in a variety Instead, a variety of data sources
and necessary for educational planning of settings, while the remaining should be used to gather valuable
for the student. “Assessment” refers half will be gathered by examining
information about the student’s use of
to data collection and the gathering measures of academic achievement
his/her communication skills in school.
of evidence, whereas the term that are common to all children as
A comprehensive speech-language
“evaluation” refers to the process of part of the education system. Within
assessment includes performance
interpreting assessment evidence and the category of speech-language
sampling across multiple skills, with
determining the presence or absence pathology specific data sources, half
multiple people using different
of an impairment to inform eligibility of the assessment information should
procedures from varied contexts. It is
decisions. come from systematic observations
essentially developing a database of
of communication functions, while
a student’s abilities across tasks and
A comprehensive assessment requires the remaining half may be comprised
settings (Secord, 2002) to examine a
four sources of information as shown in of tests of specific speech-language student’s communicative functioning in
Figure 4. Two sources, academic activities skills. The use of both observation and an educational program. Therefore, it is
and contextual tests, provide information measurement for the four data sources the responsibility of the school-based
that is available through every student’s is shown in Figure 5. Gathering data speech-language pathologist to assess
general school experiences. These from each of these four sources will be
the student using a variety of methods
school-based sources document how a described further in the next sections.
completed in a variety of contexts.
child communicates in the school For preschool through high school
A comprehensive assessment provides
students, a comprehensive assessment
a picture of a student’s functional
should include evaluation of discourse
speech and language skills in relation
skills through one or more of the
to the ability to access the academic

following: 1) language sampling, 2) A comprehensive speech-language • What is the functional result

narrative sampling, and 3) assessment of assessment is student-centered, of the student’s current
students’ metalinguistic/metacognitive descriptive, and functional. It should speech-language difficulties as
skills. Methods of assessment for answer the following questions: demonstrated by performance
each of these three elements include in classroom activities and
• What is the student’s current
criterion-based and norm-referenced assignments, curriculum
level of communication
measurements, observations, benchmarks, and academic
development?
including in the classroom, and artifact testing?
analysis such as class worksheets • Is there evidence of a language
• What language skills does the
and students’ assignments. These difference or dialect?
student need to be successful
assessment elements provide a
• What can the student do in his/her educational setting?
baseline of performance, contribute
without supportive prompts
critical information to how a student’s • What challenges does the
and what can the student do
communication skills affect his/her student have in the educational
with appropriate support and
access to learning and the curriculum environment? In what
scaffolding? That is, what is
across the grades, and provide a means situations do they occur?
the student’s ability to learn
to document qualitative changes in the
speech and/or language, learn • How do the speech-language
student’s communication skills over
to communicate effectively skills adversely affect the
time. Because learning in school is a
for needs within an academic student’s educational
highly metalinguistic and metacognitive
environment, and use speech performance?
environment, a student’s ability with
and/or language effectively
metalinguistic and metacognitive • What strategies are in place to
to access curriculum content
tasks should be assessed as part of a assist the student to develop
across all grades in an
comprehensive assessment. Additional his/her speech-language
educational environment?
information on meta skills is provided skills? How does use of these
on pages 24-25. strategies affect the student’s
academic performance?
Figure 5. Comprehensive Assessment of School Communication Abilities
Systematic Observation
School-Based Speech-
SLP Specific
Data Academic Language Data
Observations and Activities Pathology Observations and
measures that are Probes measures that are
elicited from the child elicited by the SLP with
by others as part of Contextual Decontextual the child individually
Tests - Tests - that parse
the general education that reflect components of to examine specific
experience communicaion speech & components of
abilites language skills
communications
Measurement

School-Based Data variety of activities, including review samples can confirm the functional
of student work (artifact analysis), can impact of language deficits or reveal
Collection be used to obtain the information language areas that may need further
for curriculum-based assessment, to assessment.
A comprehensive and authentic evaluate phonology, morphology,
assessment with a school-age child syntax, semantics, pragmatics, Curriculum-based assessment uses the
requires substantial use of school-based sequencing and attention in functional student’s educational curriculum as
information. This type of information settings. For example, if student work the framework for the collection and
includes documents, work products, reveals difficulty with use of prefixes, analysis of student work, and focuses
and testing data that result from the suffixes, and morphemes (e.g., past on what the student knows and is able
student’s participation in educational tense ‘ed’, plural ‘s’, etc.) the SLP should to do. It takes place in the student’s
activities. These artifacts are the note if this is also present during SLP natural educational environment and
result of the student’s interactions probes. The SLP’s analysis of the speech- provides meaningful information to the
with teachers and peers (not the SLP) language components of school-based family and teacher. Curriculum-based
and provide data about the child’s information reveals the educational assessment for a student with a speech-
functional communication abilities in impact of a communication deficit. language impairment will investigate
the educational environment. School- the student’s communication skills and
based data are collected through Examining a collection of student work weaknesses within the context of the
both systematic observation and samples that document a student’s language and communication demands
measurement. achievement in specified areas is of the curriculum and education
sometimes called artifact analysis. environment. A curriculum-based
Observations of Student data may include classroom assessment conducted by a speech-
observations, anecdotal records, language pathologist addresses the
Academic Activities photographs, drawings, and/or work following areas:
samples. Student data are not designed
Systematic observations of school • the speech-language skills
to compare a student to others but
performance includes reviewing and strategies needed by the
instead to document an individual
educational records, collecting student to participate in the
student’s current level of functioning
evidence of academic performance general curriculum,
and progress over time. Documentation
(including documents from class
of the information gathered via artifact • strategies the student currently
assignments, independent and group
analysis must clearly identify the tasks, uses,
work, homework, class tests, and
the student’s performance, and the
portfolios of class performance), and • skills, strategies, or
student’s communication strengths
completing observations across a compensatory techniques that
and deficits. Student work may be
variety of educational contexts (classes, the student must acquire, and
used to document progress or as a tool
playground, extra-curricular activities,
for students to assess their own work. • classroom instruction
lunch, etc.). These observations provide
Language Disorders from Infancy Through accommodations and
insight into the student’s speech-
Adolescence: Assessment and Intervention modifications that will provide
language performance during real
(2006), by Rhea Paul provides detailed the student with greater
communication tasks.
information about use of student work opportunities for success.
in assessment.
The purpose of systematic observations
of school performance is to gather Tests and Measures
It may be particularly useful to review
evidence about the student’s functional of Academic
samples of a student’s written language.
communication skills. Systematic
observations that reveal students’
Unedited writing samples can be helpful Achievement
in identifying inadequate or limited
abilities to use speech and/or language
syntactic structures, morphological Contextual measures of school
to meet their academic and social
errors, semantic misunderstandings, performance and academic
needs may take many forms including
and phonological misperceptions (as achievement are an integral part
published or locally-developed
found in spelling errors). Information of educational process for almost
classroom observation checklists. A
gathered from written language all students. Norm-referenced

tests are regularly or periodically Using the Standards of provide important and educationally
administered to almost all students Learning Assessments relevant expectations to be used while
to systematically evaluate students’ In order for the speech-language developing IEPs for students.
academic achievement in comparison pathologist to adequately identify
to their peers. In addition, students are the effect of any speech-language Speech-Language
regularly assessed on their academic impairment on the student’s academic
skills through the Virginia Standards performance, the speech-language Specific Data
of Learning. Sometimes these forms pathologist must have a thorough
of measurement are referred to as understanding of the general education In addition to school-based information
“high-stakes testing” or “curriculum curriculum. The Standards of Learning that reveals the student’s functional
benchmarks.” These types of testing are (SOL) in Virginia are the framework for communication abilities and the
not part of an individualized assessment the curriculum taught in each general educational impact of communication
for special education. Instead these education classroom in Virginia. These deficits, a comprehensive assessment
tests are completed by all students standards clearly demonstrate the need also requires in-depth analysis
within the context of participating in for effective communication skills, as of specific speech and language
the education system. These measures illustrated by: skills. Like school-based data, SLP-
are administered to groups of students specific evidence is also gathered
• the phonological and through systematic observations and
by teachers (not SLPs) to assess all
phonological awareness measurement. However, the purpose of
students’ general academic progress.
requirements of English in these data is to identify if the student
The results of these tests become part
primary grades, exhibits any variations in language
of each student’s educational record.
Completing these measures requires • the mastery of syntax and use (dialect), the type and degree of
students to actively use their oral and morphology required for speech-language impairment, and to
written language abilities including oral and written language inform the development of appropriate
vocabulary, semantic, syntactic, throughout the grades in recommendations. Cumulatively, the
morphological, metalinguistic, and English and other content data collected through systematic
literacy skills. As such, these measures areas, observation and measurement
do not directly assess components of of specific speech-language skills
• the mastery of semantics, supports a determination as to
speech language ability but, instead,
syntax, and morphology whether or not a student has a speech-
reflect student’s ability to activate
required for understanding language impairment, and developing
their language skills to support
mathematical terms and recommendations accordingly. Table 6
their academic performance. These
problems, provides a summary of the advantages
contextualized tests and measures can
be important sources of information • the ability to use pragmatic and limitations of various assessment
about a student’s academic skills and skills to make a persuasive procedures.
progress. As part of a comprehensive presentation in any content
assessment, the SLP can analyze these area, and Observation and
data to document a student’s use
of speech-language abilities during
• the mastery of semantics in the Probes of Speech-
acquisition of content-specific
testing completed by others (not the
vocabulary in all areas.
Language Specific
SLP) which supports the evaluation of Skills
functional communication abilities and
A copy of the Standards of Learning can
helps to document the educational School SLPs complete a variety of
be found on the Virginia Department
impact of a speech-language systematic observations or standardized
of Education Web site. Speech-
impairment. probes across an array of specific
language pathologists should become
familiar with the grade-level curricula speech-language skills. These probes
developed and used within their allow the SLP to fully examine a
division to have a full understanding of student’s current level of performance
the general curriculum requirements in the areas of speech, language form-
each student will be facing. These content-use (phonology, morphology,

Table 6. Advantages and Disadvantages of Common Assessment Procedures
Method Advantages Disadvantages

Checklists, Information from multiple perspectives and environments Limited ability to compare with grade-
observations, and (parent, teacher, student); or age-level peers;
interviews Easy to administer; Can be standardized but may or may
Information can relate directly to general curriculum not be norm-referenced

Criterion-referenced Designed for use in natural environments such as for Rarely can statistical comparison with
measures preschoolers’ interactions with parent, and in academic grade or age-level peers be made;
environments; Fewer measures available;
Can include clinician-developed probes;
Can be standardized but may or may
Useful for: analysis of quality of responses, documentation
not be norm-referenced
of progress over time, and developing intervention plans;
Essential for determining a student’s ability/inability to learn
language at the same rate and “teaching” or intervention
effort as same-age peers
Development scales Designed for natural environments; Fewer measures available;

and play-based Identifies strengths and weaknesses; Can be standardized but may or may
assessments Easily interpreted not be norm-referenced
Dynamic assessment Systematic assessment of a student’s ability to improve No statistical comparison with grade- or
speech-language performance as a result of mediated age-level peers;
learning; Limited availability of standardized data
Provides evidence to distinguish speech-language collection formats
impairments from speech-language differences (ESL/ELL,
nonmainstream dialect, at-risk populations);
Yield data-based recommendations for use in classrooms
and intervention plans
Language sampling Measures communication skills during functional use Can be standardized but may or may not
and speech Based on natural situations or educationally relevant be norm-referenced;
intelligibility scenarios such as narrative production or expository Only a few language sample analysis
measures discourse; procedures provide norm-referenced
Norm-referenced data for comparison to age- or grade- data for comparison with age-level
level peers available through approaches such as peers (e.g., SALT, DSS);
Systematic Analysis of Language Transcripts (SALT)
Often time-consuming
and Developmental Sentence Scoring (DSS) database
comparisons
Assessment is in nonrealistic, 1:1 situation;
Norm-referenced tests Objective comparison with age- and grade-level peers;
Limited normative population;
Generally reliable and valid measures for students who
Sensitivity and specificity may be
match the normative sample;
unacceptably low for some tests ;
Widely available;
Inappropriate for planning intervention;
Measurable range of average performance
Inappropriate for documentation of
progress;
Inappropriate for linking to general
education requirements
Limited ability to compare with grade- or

Portfolio review and Documentation of student performance in the general
age-level peers;
review of student file curriculum on an ongoing basis;
Limited validity
Documentation of historical information about the student

semantics, syntax, pragmatics), hearing, skills in various environments. Student • involves several professionals
voice, and fluency. These probes are interviews, when appropriate, can so the student’s skills and
completed by the SLP, who elicits and disclose the student’s perception of his/ deficits are viewed as a
documents performance in specific her communication skills and his/her complex whole and not in
facets of communication as part of motivation to address these skills. isolated, individual segments,
a full and complete individualized
• identifies service needs, assists
assessment for which parents must Play-based assessment is a student-
in developing educational
provide written permission. The centered method for revealing a young
plans, and evaluates progress,
purpose of these probes is to provide child’s communication skills in a natural
a clear and complete picture of the environment. It is designed for children • permits a student to
student’s communication strengths and functioning between infancy and six demonstrate what is known
weaknesses. This information assists years of age. A transdisciplinary play- and eliminates the biases of
the team in determining eligibility and based assessment permits an integrated norm-referenced tests that can
for those students, who are eligible, approach to assessing multiple areas penalize students with physical
inform the development of IEP goals. of development. Together, parents and and other impairments,
However, these procedures cannot professionals interact with the young
• provides a picture of a student’s
replace observations of the student’s child to examine a variety of skills (such
learning style and strengths
interactions with peers and teachers as talking, eating, drawing, counting,
and weaknesses, and
in real educational settings because, walking, jumping, etc.) at the same time.
to some degree, interacting with The transdisciplinary team members • is flexible and adaptive.
an SLP to probe skills is always an often include speech-language
artificial communication task. SLPs are pathologists, occupational therapists, Developmental scales are particularly
extensively trained in the administration physical therapists, psychologists, and useful with preschool children, students
and interpretation of these highly special educators. A transdisciplinary, with significant developmental
specialized assessment strategies play-based observation supports delays, and students with cognitive
which include collecting case histories, efficient and concurrent analyses of the impairments. There are a number of
conducting interviews, completing student’s developmental level, learning valid and reliable published scales that
play-based assessments, administering style, and interaction patterns across can be used.
developmental scales or criterion- multiple developmental domains. A
referenced measures, conducting play-based assessment includes the Criterion-referenced measures compare
discourse assessments, completing following advantages when conducting a student’s performance on a specific
dynamic assessment procedures, an assessment with very young children: skill, grammatical structure, or linguistic
and/or assessing metalinguistic and concept to predetermined criteria.
• is conducted in a natural,
metacognitive abilities. These measures permit assessment of
nonthreatening environment,
communication skills in a social context.
A case history is essential for gathering • generally involves parents, Criterion-referenced measures can
information on the development of
a student’s speech-language skills,
significant birth and medical, academic, Table 7. Components of Discourse Analysis
and social-emotional functioning.
Additionally, it provides information Category Examples of Features
about language models and language
use in the community. Interviews Macrostructural Elements character, setting, initiating events; number of story
with parents, service providers, propositions and episodes; informativeness
teachers, and the student provide
valuable information about a student’s Microstructural Elements pronominal reference, cohesive devices; tense
effectiveness in communication. This appropriateness
information can provide insight into
how the student’s speaking, listening, Language Productivity overall length; length per unit – MLU, C-units,
writing, and reading skills are impacted T-units; syntactic complexity; elaboration;
by the student’s speech and language morphological adequacy; lexical diversity

have standardized or nonstandardized and yes/no questions. When success. Narrative sampling
administration procedures. Criterion- children are prompted to is a good way to introduce
referenced measures are dependent converse through frequent appropriate challenge to a
on the use of well-documented and what-where-which-or-when student’s language performance.
validated developmental data (Laing & questions, the resulting It also provides information
Kamhi, 2003). language data (including MLU) about a student’s narrative
is often skewed and yields structure and story grammar
Each assessment method provides invalid findings. Alternative (see next page).
advantages and disadvantages. A conversational prompts,
• Speech-language pathologists
summary for some assessment methods including modeling and “I
should audio and/or video
is provided in Table 6. wonder about…” statements are
record the sample for later
preferable.
orthographic transcription and
Discourse Assessments
• Each sample should consist analysis. There is limited research
These probes of language skills assess
of between 50 and 100 that suggests that in very
ability beyond the single sentence level.
consecutive utterances in one limited circumstances it may be
Discourse assessments allow analysis of
sampling context. possible to complete real-time
comprehension and expression across
transcription (i.e., transcribing as
sequences of multiple utterances. These • Sampling in more than one
the sample is being elicited) with
types of assessments include oral and context and using more than
acceptable accuracy, for example
written language samples, conversations, one sample elicitation task
when the sample is from a child
narrative samples (storytelling), and (e.g., free play, conversation,
who is not very talkative, has
analysis of expository text (formal writing narrative) is important since
quite low-level language (e.g.,
samples). a sampling context itself
short MLU consisting of 2-4 word
constrains the characteristics of
utterances), and the transcriber
Discourse can be analyzed for features the language that a student will
is not the same person who
such as: use (Miller, et al. 2005; Nippold,
is eliciting the sample (Klee,
Hesketh, Duthie, & Mansfield,
• knowledge of macrostructural Membrino, & May, 1991).
2005). In order to use any of the
elements However, trying to use real-time
several normed databases for
transcription in more typical
• evidence of microstructural comparing a student’s language
school situations is likely to lead
elements sample performance to peers,
to an inaccurate and incomplete
it is essential that speech-
• general language productivity transcription resulting in
language pathologists use
measures unreliable and invalid data on
that same elicitation tasks and
which to base evaluation. “There
contexts as those on which the
Examples of the various features for each is not a strong evidence base
norms were developed.
category are included in Table 7 with to the practice of transcribing
additional explanation in Appendix B. • At some point in the language samples in real time.” (Heilmann,
sampling process the 2010, p. 7)
Language Samples speech-language pathologist
The professional literature in speech must create for the student Whatever practices speech-language
language pathology provides several sampling situations that pathologists use for language sampling,
best practices guidelines with regard to stress and challenge the they should be able to explain in their
obtaining and analyzing valid language student’s language use and reports and during eligibility meetings
sampling procedures (for example, Evans language system (Lahey, 1990). their decisions based on best practices
& Craig, 1992; Miller, 1996) to use as a Informal play, interview, or and evidence from the literature.
basis for eligibility decisions: conversational situations may
not be fully and sufficiently
• To obtain a valid sample for
challenging to identify
analysis, elliptical responses
language performance that
should be minimized by
interferes with academic
avoiding wh-question prompts

Narrative Sampling Sometimes a procedural explanation American), may have more linear,
“Narratives are stories about real or task (such as explaining how to play topic-centered structures, whereas
imagined events that are constructed Monopoly or baseball) is included narratives of other cultures, such as
by weaving together sentences about as one aspect of narrative sampling; Asian-influenced narratives or those
situational contexts, characters, such a task taps a student’s ability with Native American influences may
actions, motivations, emotions, to sequence steps and organize be more topic-associated and have
and outcomes.” (Petersen, Gillam, language but does not tap a student’s more circular or winding structures
& Gillam, 2008, p. 115) Difficulties knowledge of story grammar. As with (Paul, 2007; Westby & Rouse, 1985).
with narrative comprehension and language sampling procedures, the Therefore, to judge the adequacy of a
production may have serious negative selection of specific elicitation tasks student’s narrative structure a speech-
effects on students’ educational and depends on the purposes that a language pathologist must take into
social achievement (Nation, Clarke, & speech-language pathologist wishes consideration the student’s cultural and
Marshall, 2004). Narratives are sensitive to accomplish and the information linguistic background and understand
indicators of language impairment in about a student’s abilities that he/ the nature of narratives produced
students; children and adolescents with she wants to know. Resources such within the culture. The second caution
compromised language skills typically as the “Guide to Narrative Language” is that in some cultures, children are
produce shorter, less complete, and less (Hughes, McGillivray, & Schmidek, 1997) not encouraged or permitted to tell
elaborate narratives than their same- summarize many of the pros and cons stories because narration is a privilege
age, typical peers. Therefore, assessment of different elicitation tasks. and responsibility reserved for adults.
of students’ narrative abilities is an Consequently, some students may not
essential part of a comprehensive Types of narrative tasks with different have experience in storytelling or may
speech-language assessment and elicitation methods can be norm- be uncomfortable and even reluctant
results should regularly be reported as referenced or standardized criterion- to engage in storytelling if asked.
part of eligibility meetings. based. Examples include “Bus Story” Dynamic assessment and observation
(Cowley & Glasgow, 1994), The Test of approaches are particularly important
There are several tasks that speech- Narrative Language (Gillam, & Pearson, with these children to determine if a
language pathologists use to elicit 2004), Systematic Analysis of Language student’s different narrative structure is
narratives from students, and each Transcripts-Narrative Sample Scoring a result of cultural-linguistic differences,
has its strengths and weaknesses and (Miller & Chapman, 2004). As with language impairment, or both.
affects the characteristics of narratives conversational language sampling, in
students produce. Examples of these order to use any of the norm-referenced There is no one “correct” way to
include: or criterion-referenced databases, complete narrative sampling and
it is essential that speech-language analysis. But, as with language
1) generating a new, creative
pathologists use the standardized sampling, whatever practices speech-
story,
procedures. language pathologists use, they need
2) retelling a familiar child’s story to be able to explain in their reports
(with or without the book), a Additional information on narrative and during eligibility meetings their
favorite movie, analysis can be found in Appendix B and decisions based on best practices
The Guide to Narrative Language (1997) and evidence from the literature. The
3) recounting some experience
by Hughes, McGillivray and Schmidek. references cited in the discussion
such as a trip to a circus,
Table 7 includes features for narrative provide sources for speech-language
4) telling a story from a sequence analysis. pathologists to decide on their
of pictures with or without procedures and support their decisions.
printed words associated with With regard to narrative structure
the pictures (e.g., “Frog Where such as story grammar or structure, Assessment for the Metas
are You?” Mayer, 1969), and two particular cautions are needed. For students, everything about
One is that what is considered typical school and learning involves one or
5) telling a story from a single
story structure/grammar of narratives more of the “metas”: metacognition,
picture (Hughes, Ratcliff, &
has a strong cultural base. Some metalinguistics, or metapragmatics.
Lehman, 1998).
cultures, such as those with strong When we combine this prefix with
European influences (e.g., white Anglo- another word, it means being able to

think explicitly about that word or skill. abilities (Nippold, Hegel, Uhden, Norm-Referenced
Metalinguistics “refers to the ability to & Bustamante, 1998). Classrooms
use language to communicate or talk (including teachers’ oral language, Tests and Measures
about and to analyze language” and written language, and textbooks) of Speech-Language
“involves thinking about language, from kindergarten through secondary
seeing it as an entity separate from its school are filled with frequent instances
Skills
function as a way of communicating.” of figurative language, in particular
Decontextual measures of speech-
(Reed, 2005, p. 5-6) Most children and idioms (Lazar, Warr-Leeper, Nicholson,
language specific skills, are the
adolescents who do not have issues & Johnson, 1989). Another common
traditional form of speech-language
with their metacognitive or executive weakness for children and adolescents
assessment where the SLP administers
functioning abilities use language with language impairments involves
norm-referenced tests to an individual
(metalinguistic abilities) to plan their their difficulties with social skills when
student.
learning approaches, solve problems, interacting with both adults and peers.
and/or plan their actions. Adults may These students are often weak in
Norm-referenced measures usually
coach students to “talk it through.” The their metapragmatic skills. Students
cannot distinguish between
idea of “talking something through” who have language impairments
communication disorders and
involves both metalinguistic and commonly struggle with metalinguistic,
communication differences due to
metacognitive skills. Students who metacognitive, and/or metapragmatic
instructional, cultural or dialectal
have academic difficulties are often tasks.
experience. Norm-referenced tests are
described as having weak executive
not aligned with the curriculum and
functioning abilities or problems with In light of the pervasiveness of
do not take into account how prior
metalinguistics and metacognition. metalinguistic, metacognitive,
knowledge and experience impact
Individuals use metalinguistic skills to and other meta tasks in education,
performance. The speech-language
judge the correctness of language and assessment of these abilities as a
pathologist should keep in mind
to control how we use it differently with standard part of a comprehensive
that norm-referenced tests are not
particular people, such as teachers or assessment is important. There are
contextually based and will provide
peers. Learning to read (i.e., associating several norm-referenced tests that
an incomplete picture of the student’s
speech sounds with printed symbols, include subtests that tap language
skills. These measures are not sufficient
recognizing that a printed word is areas related to metalinguistic abilities.
sources of data for determining
a word already known and used in These are subtests that deal with
eligibility for special education or
speech, sounding out a word) and figurative language, idiomatic language,
the educational impact of a speech-
reading to learn (i.e., gleaning meaning ambiguous expressions and multiple
language impairment. In addition, SLPs
from a series of printed sentences or meanings, inferences, and verbal humor.
should carefully consider statistical
extended text that occurs in school
properties of norm-referenced tests
books) are among the metalinguistic Dynamic assessment processes can
with regard to their ability to correctly
tasks students encounter in school. also be used to assess students’ meta-
identify students with speech-language
Spelling, learning new vocabulary in abilities. Test-teach-retest strategies
impairments (Spaulding 2006).
vocabulary lessons, using the dictionary, and a variety of mediated learning
and deciphering mathematics symbols experiences, such as explaining to a
These instruments are designed to
to put them into words are other student the patterns in forming adverbs
parse speech-language abilities into
examples of metalinguistic tasks. from adjectives and then following up
discrete skills according to a particular
Language arts lessons that involve with additional probes, are excellent
theoretical framework. These discrete
using prefixes and suffixes to extend tasks to explore a student’s analysis
skills are then measured through formal
vocabulary and derive new words from of language-based tasks. Classroom
testing procedures which is an artificial
known roots are classic metalinguistic activities, homework assignments, and
communication task. Therefore, these
tasks encountered in school. Research worksheets teachers use also provide
assessment procedures are referred to
has also established that success in rich opportunities to assess students’
as decontextualized tests of speech-
school is associated with students’ levels meta-abilities and document the
language abilities. The purpose of these
of skill with interpreting and using ways in which a particular student’s
tests is to produce standard scores that
various aspects of figurative language, weaknesses have an educational
allow a student’s performance on that
which require good metalinguistic impact.

particular test to be compared to that guided learning to determine the school settings. Dynamic assessment
of their typically developing peers. student’s potential for change. is particularly useful for students from
How well a student performs after culturally and linguistically diverse
Performance on norm-referenced tests assistance is critical information when backgrounds. After guided practice,
can reveal areas of communication using dynamic assessment methods. students who do not have speech and/
that should be assessed further Essentially, dynamic assessment or language impairments often show
through systematic observation and procedures evaluate a student’s marked improvement in performance.
standard probes of speech-language learning processes and ability to In other words, students who initially
skills. However, performance on benefit from instruction. As such, the performed poorly on tests due to
norm-referenced tests does not test-teach-retest paradigm can be a limited opportunity to learn often
document functional performance highly informative assessment strategy benefit from supportive teaching
in educational settings. A balanced that is particularly relevant for use in and then perform better when tested
and comprehensive assessment will
include data from all four sources of
information, with only a limited amount Table 8. Checklist for Reviewing Norm-Referenced Tests
of data in the form of norm-referenced
measures of speech-language skills. Name of Test _________________________________ Edition _________________
A comprehensive assessment does
not rely extensively or solely upon Reviewer ____________________________________ Date ___________________
decontextualized tests.
Present? Criteria
Norm-referenced tests are standardized Yes No Does the normative sample represent the most recent census
assessment tools that can be used data?
to compare a student’s performance
with that of age or grade-level peers. Yes No Is the normative sample large enough?
Caution must be taken that the Yes No Does the normative sample include representative samples of all
student matches the population used populations that the test states it measures?
for establishing norms, as described
in the test manual. In addition, the Yes No Does the test meet sensitivity standard of at least .80?
test must be administered exactly Yes No Does the test meet specificity standard of at least .80?
as prescribed in the test manual. If
not, then the statistical scores are not Yes No Does the normative sample represent the target students in
valid and should not be included in terms of racial-ethnic and geographic status?
the evaluation report or used in the Yes No Does the test meet reliability standards of at least .80?
determination of eligibility for special
education services. Yes No Is it a valid measure for the planned assessment? (Does the
theoretical model upon which the test is based represent
Norm-referenced tests assess a student’s currently accepted research?)

current level of performance in a Yes No Does the test have test-retest validity?
particular task or discrete skill. Poor
performance on norm-referenced Yes No Does the test have predictive validity? Is the predictive validity
measures could be due to a disability relevant to the purpose of the planned assessment?
or to a lack of experience or limited Yes No Do the test items or scoring procedures penalize students who
opportunity to learn the particular are not speakers of Standard American English?
skills that are measured on the test.
In contrast, dynamic assessment Yes No Does the test manual provide cautions in the use of age-
focuses on the ability of the student equivalent scores?
to respond to learning experiences. Yes No Does the test provide valuable assistance in analyzing a student’s
Dynamic assessment includes a test- communication skills?
teach-test approach and mediated
learning experiences that examine Yes No Is this the most recent version of the test?

again. Responsive instruction and Spaulding, Plante, & Farinella, 2006). referenced tests, review them before
Response to Intervention (RtI) are Sensitivity means the rate at which using with a student, and be able to
instructional approaches that also utilize a test can correctly identify students support the decision to use specific
intervention data to inform decision- with language impairments as having tests as part of the eligibility or dismissal
making. Students who have speech a significant deficit. Specificity refers process. These considerations must be
and/or language skills that are readily to the rate at which students who have a critical part of any comprehensive
modifiable in a dynamic assessment typically developing language abilities assessment.
or RtI process are less likely to have are found by that test to have adequate
impairments. language performance. Sensitivity and Reliability refers to the consistency of
specificity are also referred to as type measurement. It indicates whether an
Selection and Use of I and type II errors. For more than a instrument is stable and repeatable
Norm-referenced Tests decade researchers have suggested that -- the probability that the instrument
One challenge for the speech- norm-referenced measures should have would produce similar results if re-
language pathologist is to determine at least 80% accuracy in discriminating administered to the same student
which assessment instruments can language abilities (Plante & Vance, 1994, under the same conditions by the same
be used to accurately characterize a Spaulding, Plante, & Farinella 2006). tester or by several different testers. It is
student’s communication skills and Practitioners are encouraged to review important to consider reliability of the
assist in determining if a speech or the technical manuals of published tests whole test and each subtest. A review
language impairment is present. Tests to ensure that publishers have reported of the test manual should provide
must be able to correctly identify sensitivity and specificity data for norm- information on the following types of
children with language impairment referenced tests. When these data have reliability:
as ‘impaired’ and those with normal not been included by the publisher,
• test-retest (data that show that
language as ‘normal’ as well as meet clinicians should calculate sensitivity
the test scores are dependable
the psychometric properties of and specificity using reported norming
and stable across repeated
statistical reliability and validity. Table data within the test manual or contact
administrations),
8 provides a list of factors to consider the test publisher for the necessary
and may help SLPs review tests for information. • inter-rater (data that show
possible use. The speech-language that scoring is objective and
pathologist must be cautious in Another resource that can be used to consistent across examiners),
deciding which assessment instruments analyze a norm-referenced assessment
• alternate form (different
to use. Neither the reputation of is Mental Measurements Yearbooks,
forms of the same test show
the producer of the test nor the fact published by the Buros Institute of
consistency of performance),
that an earlier version of a test met Mental Measurements.3 Publications by
and
specific psychometric standards is a the Buros Institute provide information
guarantee that the measure meets the on tests in print, mental measurement • internal consistency (assumes
standards. Articles in peer-reviewed yearbooks, and access to current all of the items are measuring
journals that “assess the assessments” commercially produced tests. The the same thing) (Sattler, 1988).
provide research-based comparisons yearbooks provide in-depth evaluations
and provide information about the of norm-referenced tests by assessing The minimum acceptable reliability is
relative performances of tests in terms their reliability, validity, norming 0.80 (Sattler, 1988). Local standards
of validity, reliability, sensitivity, and sample, and relationship to other norm- will determine the acceptable period
specificity. referenced tests. of time between administrations of the
same test, based on the population. For
Current best practices in speech- In order to have confidence in the example, the locality may determine
language pathology include outcomes of an assessment process, that a year is an acceptable standard
consideration of the sensitivity and the speech-language pathologist for students and that six months is the
specificity of published assessment must consider carefully all of the standard for preschoolers. A measure’s
instruments (Dollaghan, 2004; psychometric properties of norm- validity informs the user as to whether
test measures what it purports to
3 The Mental Measurements Yearbooks can be located in public libraries and at the Buros Institute’s Web
measure. The test manual should
site: www.unl.edu/buros. provide detailed information as to the

validity evidence that supports the test’s Scoring procedures should be Norm-referenced tests are designed
interpretations and uses. Sources of analyzed to determine whether for screening and assessment,
validity evidence (Sattler, 1988) include: correct answers are based on use of not to select goals or determine
Standard American English, which progress. Therefore, norm-referenced
• content validity (adequate
will potentially penalize students who tests should not be used to write IEP
sampling of the content areas
use other dialects or languages. This goals and objectives/benchmarks or
and if the content areas are
information is particularly critical when to determine whether a student has
generally accepted as the
using norm-referenced tests with met his or her IEP goals and objectives/
proposed construct),
students who come from culturally and benchmarks. Norm-referenced tests
• concurrent validity (test scores linguistically diverse backgrounds. In are used as only one component to
are related to some currently such situations, norm-referenced tests determine the possible presence of an
available criterion measure), that do not represent diverse groups in impairment and are not achievement
the norming sample must be replaced tests. Using norm-referenced tests for
• predictive validity (obtained
with other assessment procedures to selecting goals or determining progress
score is an accurate predictor
avoid inaccurate results for students is not a valid practice. Likewise, norm-
of future performance on the
from culturally-linguistically diverse referenced tests should not be used
criterion), and
populations. to determine whether a student has
• construct validity (how the test met the functional communication
items relate to the theoretical Prior to test administration, the outcomes written in the IEP. Systematic
construct of the test). speech-language pathologist should observations and functional
thoroughly review the test manual. assessments provide the critical
The normative sample for every This includes analyzing the norming information regarding the changing
assessment should be reviewed for information and test administration nature of a student’s impairment and its
several factors. It should be based on guidelines. Failure to comply with the impact on the student’s ability to access
the most recent national census data strict, standardized administration the educational curriculum.
and include representative samples procedures of a norm-referenced test
of all populations that the test states invalidates the test results. The standard A very important caution must be noted
that it measures, including gender, scores, percentile ranks, and stanines regarding age-equivalency scores. An
ethnicity, race, native language, age, from nonstandard administrations of age-equivalent score indicates the
and primary caregiver education level. norm-referenced tests must not be age at which a certain raw score is
There is disagreement as to whether or included in evaluation reports. Standard mathematically average. Describing
not the normative sample should also scores are equal interval units and a student’s performance as equal
include persons with disabilities (Peña, provide statistically valid information to that of a student of a certain age
Spaulding, & Plante, 2006). The sample about test performance only when is statistically incorrect. It does
should include a variety of geographical resulting from a standard administration not consider a range of normalcy as
locations (e.g., urban, rural, and with a student for whom the norming is provided by the standard error of
suburban). Prior to administration, it sample is representative. One way to measurement (SEM) for standard scores
is important to review the normative report the results of a nonstandard on a norm-referenced test. Therefore,
sample information to determine administration would be to describe age-equivalent scores imply a false
whether it is an appropriate fit for the percentage of items correct and standard of performance. Many
the student being assessed. Testing a the type(s) of errors made on particular teachers and parents erroneously
student who represents a population tests or the age ranges in which most assume that an age-equivalent score
not fairly represented in the norming correct responses fell. If standard can reflect a student’s standing within a
sample would produce invalid results. administration procedures are altered, group of same age-peers. Because the
Best practice is to administer the most the evaluation report should indicate age equivalent score is the obtained
recent version of a test because it that the test was administered only for or estimated average score for that
represents the most current census informational purposes. Best practices particular age, simple arithmetic shows
data and follows updated research on within the profession require that the that for any group of students of a
validity and reliability (Jakubowitz and speech-language pathologist practice given age, about half will be expected
Schill, 2008) administering a measure at least once to achieve a lower raw score, and
prior to testing a student. about half will achieve a higher raw

score, giving a broad range of normal focus on norm-referenced tests, it is the assessment session, interruptions
performance. Consequently age- possible to inappropriately identify a to the testing session, additional time
equivalent scores should not be used student with a cultural or language required because of physical limitations,
when determining whether the student difference as having a speech and/or or use of positive reinforcement. Any
has a speech-language impairment or language impairment. The team should variation must be documented as a
to demonstrate change. Best practice is consider many sources of information nonstandard administration according
not to report age-equivalency scores and discuss cultural and linguistic bias to Virginia and federal regulations.
on a norm-referenced assessment. before determining that a student is Students with behavior or sensory
eligible for special education. needs and some disabilities may require
Students with cultural or linguistic supports including providing breaks
differences, such as speakers of African- On some occasions, the SLP may not or reinforcements, enlarging the text
American English, may encounter be able to follow the administration or pictures, transferring the test to an
content and/or linguistic bias when protocol because of a particular alternate input device, and using sign
they are administered many norm- situation or a student’s particular needs. language to present material and to
referenced tests. When eligibility teams Examples include a fire drill during provide responses. The same situation
Table 9. Normal Distribution Curve
After norms have been established, an individual’s raw score can be converted to “derived scores” which
communicate that individual’s performance to the standardization sample. This chart shows the relationship
of derived scores in a normal distribution.

applies when administering a norm- Interpretation of School- in ASHA’s technical report Access to
referenced test to a student older than Based and SLP-Specific Communication Services and Supports:
the test norms. Any deviation from Data Concerns Regarding the Application of
the standard administration or use of When the data collection (assessment) Restrictive “Eligibility” Policies (2002).
a test not normed on the appropriate is completed, then the information
population for the specific student must must be interpreted and reviewed The practice of cognitive referencing
be reported in the evaluation report. by the team. Interpretation of the assumes that the psychometric
The speech-language pathologist assessment components requires properties of each of the standardized
should contact the publisher of the careful review of norms on norm- assessment instruments used to assess
test for guidance regarding acceptable referenced assessments and integrating language and cognitive abilities are
adaptations within the guidelines additional data, including systematic similar. This is not true since each
for standard administration. In such observations and contextualized measure has different theoretical
situations, the test may be used only to assessments, to create a complete bases and different standardization
provide descriptive information as the picture of a student’s communication samples. Additionally, intelligence
deviation from standard administration skills. It is critical that there not be measures cannot be assumed to be
invalidates the scoring. an over reliance on any one piece of a meaningful predictor of a student’s
information or assessment source. response to intervention. Students with
Speech-language pathologists must Assessment data should represent all significant impairments of intellect
review carefully the norm-referenced four sources of information: 1) school- may respond well to speech-language
tests they use. Use of multiple norm- based observation 2) contextual interventions, therefore improving
referenced tests will be only as measures of academic performance and their ability to succeed academically
accurate as the results of the least achievement, 3) systematic observation and in the community. Cognitive
accurate test selected. It is better and probes of specific speech-language referencing uses the question “Who has
to use a single, well-validated, and skills, and 4) decontextual measures language skills significantly lower than
reliable measure, that is normed on a of specific speech-language skills. their nonverbal cognitive skills?” when
population comparable to that of the Standard scores from norm-referenced identifying candidates for intervention.
target student, than to use a variety speech-language tests should be only Instead, we should be asking “Who has
of norm-referenced measures that a small part of the assessment picture. language and communication skills that
are poorly constructed or that used The strengths and needs of the student are insufficient to support them in the
a normative sample that does not must be considered within the context important context of school?” (Nelson,
represent the target student. See Table of the school, home, and community. 1995)
8 for a checklist that can be used when
reviewing norm-referenced tests. Cognitive Referencing Educational Impact
Table 9 is a normal distribution curve, Cognitive referencing refers to the
with percentile rank and standard score practice of finding students not eligible of the Speech-
information, and guidance for using test for special education or for related Language Impairment
scores. This diagram may be useful in services when their language skills
explaining test results to parents. are deemed to be commensurate Virginia eligibility criteria require that
with their cognitive or intellectual determination of a speech-language
Table 9 is a normal distribution curve, abilities. IDEA does not require a impairment include documentation
with percentile rank and standard score significant discrepancy between of the educational impact - how the
information, and guidance for using test intellectual ability and achievement disability affects the progress and
scores. This diagram may be useful in for a student to be found eligible for involvement of the student in the
explaining test results to parents. speech-language services. The use general curriculum or for preschoolers,
of cognitive referencing within an the effect on their ability to participate
organization to determine eligibility in appropriate activities. Consideration
for speech-language services is should be given to the academic,
inconsistent with IDEA’s requirement to vocational, and social-emotional
determine services based on individual aspects of the speech-language
needs. Additional information on impairment. Academic areas include
cognitive referencing can be obtained reading, mathematics, and language

arts with the impact determined by The Speech- communication. These forms are designed
grades, difficulty with language-based to describe a student’s speech-language
activities, difficulty comprehending Language , impairment, based on assessment using
orally presented information, and/or Pathologist s multiple sources of data and considering
difficulty conveying information orally. multiple aspects of communication.
Social areas impacted by a speech-
Evaluation Report This system provides valuable tools
language impairment include the for describing the student’s speech-
The speech language pathology
communication problem interfering language impairment, communicating
evaluation report should identify
with the ability of others to understand with eligibility and IEP team members,
the student’s preferred mode of
the student, peers teasing the student and providing consistency among
communication (oral, sign, augmenta-
about his/her speech-language speech-language pathologists. There is no
tive communication). It should
impairment, the student having requirement to use the comprehensive
include an analysis of strengths and
difficulty maintaining and terminating assessment system; each division will set
weaknesses in the areas assessed.
verbal interactions, and/or the student its own policy regarding its use. Appendix
Assessment results should be fully
demonstrating embarrassment and/ D includes summary forms for speech
explained. The report should indicate
or frustration regarding his speech- production, language, voice, fluency, and
the existing and predicted impact
language skills. Vocational areas include functional communication.
of any speech-language impairment
job-related skills that the student
on the student’s ability to access and
cannot demonstrate due to the speech- Attainment of a certain level of impact
progress in the general educational
language impairment. These include on a summary form does not guarantee
curriculum. Emerging abilities may serve
the inability to understand/follow oral eligibility for special education;
as prognostic indicators in determining
directions, inappropriate responses to rather, it describes the results of the
his/her potential for improvement. The
coworkers’ or supervisors’ comments, comprehensive speech-language
evaluation report should reflect the
and/or the inability to answer and ask assessment in consistent terms. The
interrelationship of a variety of factors
questions in a coherent and concise eligibility committee considers the
that impact communication. These
manner. summary of data in conjunction with
include the student’s age, attention
Virginia eligibility criteria and other
skills, auditory processing skills, cultural/
Educational impact may be determined information as the team determines
linguistic background, sensory deficits
using information from school-based eligibility.
(hearing/vision), and other health factors.
data including contextualized tests
and systematic observations. It is also A particular level of impact does not
All speech-language assessment reports
possible to assess the educational specify or predict a certain level of service.
should be written in easily understood
impact of a speech-language The level of service is determined by the
language without extensive use of
impairment through the use of teacher/ goals and any objectives or benchmarks
professional jargon. The goal of the
parent/student interview checklists. specified by the IEP team.
assessment report is to communicate
These would enable a comparison of
valuable findings to enable all team
the student’s speech-language skills The Comprehensive Assessment System
members, including the parents,
and needs in his/her two most natural emphasizes the use of academic activities
to meaningfully participate in the
environments: home and school (see and measures along with SLP probes and
eligibility discussion. When professional
Appendix E for sample checklists). The norm-referenced tools to describe the
terminology is used, it should be clearly
Functional Communication Assessment communication disorder. Accordingly,
defined (e.g., “phoneme” could be
Summary included in Appendix D no reference is made to cognitive or
defined with the layperson’s phrase
may also provide documentation for intellectual functioning. Decisions to
“speech sound”).
educational impact. Statements made provide services and decisions concerning
by the classroom teacher on the teacher severity are made solely on observations
Comprehensive Assessment
checklist provide contextually-based of the student’s performance on
System
information on the student’s speech- assessments of language in conjunction
This document includes a
language skills and needs in the general with observations concerning the
Comprehensive Assessment System and
curriculum program. student’s performance on functional
summary forms in speech production,
language tasks. See Appendix D for the
language, fluency, voice, and functional
Comprehensive Assessment System.

Special Education
In Virginia, educators and families Child Find Screening the target screening population. Items
must follow specific steps in the that are unfamiliar to the general student
special education process required by As part of the child find requirements population, that require knowledge or
federal law, Virginia special education of special education and public health experience with mainstream culture,
regulations, and local policies and policy, screenings are conducted in or that have a high level of language
procedures. The VDOE publication, public schools to identify students who proficiency associated with them may
Guidance on Evaluation and Eligibility for may need a special education evaluation result in more student failures during
the Special Education Process, provides or a referral to medical personnel. In screening.
information on each step in the special 2009, changes were made to Virginia
education process, documentation Screenings may be completed through
special education regulations including
requirements, and additional information collaboration with classroom teachers,
changes to the screening requirements.
on other factors to consider. To assist Information about these current who are an excellent source of data
parents in understanding this process, requirements is available in the VDOEregarding the status of their students’
the Parent’s Guide to Special Education, communication skills. An efficient
publication Resource Document for Local
published by the VDOE, provides Screening Requirements in Virginia’s and accurate method of screening
information on the special education Public Schools. is to capture the classroom teacher’s
process and specific information for information as the initial screening.
parents. The Virginia Special Education Regulations For example, teachers can complete a
do not specify the qualification 10-item screening questionnaire about
The following sections provide requirements of personnel who provide each student’s communication skills
information on steps of the special screenings. The school division is (see Appendix E). If no concerns are
education process including: responsible for assigning personnel who noted on the teacher’s screening, the
are appropriately qualified to ensure student is considered to pass the speech-
• Student screening
that the results are valid and reliable. language screening. Students may also
• The special education process The School Health Guidelines, jointly be screened by trained volunteers. Any
from referral to eligibility prepared by the Virginia Departments of student with one or more errors may
Education and Health, include detailed be rescreened by the speech-language
• Related services
information about mass screenings, pathologist.
• IEP development, and including recommended screening
protocols, can be found at the Virginia If the original screening is conducted
• Students in private schools.
Department of Education Web site. by a teacher or volunteer, students who
fail the screening are often rescreened
When appropriate, specific information
Speech, voice, and language screenings by the speech-language pathologist for
pertaining to students with speech-
speech-language screenings and the
language impairments and the role of the are completed according to locally
audiologist, school nurse, or speech-
speech-language pathologist is provided. developed procedures and timelines.
The qualifications for the individuals language pathologist for hearing
For general information on special
providing the screening are also locally screenings. The regulations specify
education, the steps in the process,
that students “may be rescreened if the
timelines, regulatory and documentation developed. School speech-language
requirements access the VDOE Web site pathologists are encouraged to become original results are not considered valid.”
(www.doe.virginia.gov), the Parent’s Guide familiar with school divisions procedures,
When a student fails a screening, the
to Special Education, or the Guidance on timelines, and screening instruments and
provide input to ensure screening tools individual conducting the screening
Evaluation and Eligibility for the Special
align with current evidence for speech must determine if there is a suspicion
Education Process.
sound and language development. of a disability or another reason for the
failure, such as a lack of experience in
Students that receive speech-language
Speech-language screenings should be a structured setting, limited English
services in Virginia public schools have
proficiency, etc. Parents must be
been found eligible using the criteria for conducted using screening tools that
notified of screening results and the
speech-language impairment or their IEP meet the needs of the target population.
Commercially available screening action that will be taken. Actions may
team has determined that they require
instruments should be reviewed to include no further action, referral to a
speech-language services as a related
ensure their reliability and validity with school team or other agency for follow
service.

up, or referral for special education Referral for Special Evaluation and Eligibility
evaluation. Education Evaluation for Special Education and
When parents, school staff, or outside Related Services
Special Education sources, suspect a disability because a Whenever a student is being evaluated
student is having difficulty in speech for speech-language concerns, one team
Overview and/or language skill development, member must be a speech-language
they may express their concerns to pathologist. After review of existing
The special education process school personnel. The concerns do not information if additional information
is governed by federal and state need to be in writing. After the school is needed, the team will identify the
regulations and local policies. There is alerted to the concern, the special needed information and obtain parental
are documentation requirements for education administrator, or designee, consent to conduct the evaluation.
each step of the process. SLPs are records the date, reason for referral, and The team may decide it has sufficient
encouraged to attend local trainings on name of the person making the referral, information to make the necessary
special education matters and become provides the parent with a procedural decisions. If so, the team’s review of
familiar with steps in the process and safeguards notice, and ensures that data is considered the evaluation and
requirements. Additional information on confidentiality of information is no further testing is required prior to
the special education process is available maintained. Comprehensive information meeting to determine eligibility.
online at www.doe.virginia.gov and in on the referral process is available in
documents including the Regulations Guidance on Evaluation and Eligibility for Eligibility for services is based on
Governing Special Education Programs the Special Education Process. the presence of a disability that
for Students with Disabilities (2010) and
results in the student’s need for
A Parent’s Guide To Special Education.
special education and related
Figure 6 illustrates the steps in the
services, not on the possible benefit
special education process.
from speech-language services.
The speech-language pathologist
and team members must be able to
document the student meets criteria
for the disability category of Speech-
Language Impairment including
Figure 6. Steps in the Special Education Process
the adverse educational impact of
a student’s speech and language
Referral for skills on performance. A student can
Suspected Disability demonstrate communication differences,
delays, or even impairments, without
demonstrating an adverse affect on
educational performance. Specific
Review of Existing Data criteria for speech-language impairment
Determination of Any Needed must be met before a child can be found
Data eligible as a child with a disability with
a speech-language impairment (8 VAC
20-81-80 U). The sample form, that
uses Virginia criteria for determination
Eligibility Determination of a speech-language impairment, is
shown in Figure 7. When a student
does not meet the criteria for eligibility
as a student with a speech language
impairment, the IEP team may determine
that speech or language therapy is
Development of IEP Recommendations to School required as a related service.
Team or Staff

Figure 7. SLI Criteria Worksheet
Speech-Language Impairment Worksheet
Name: __________________ School: __________________________________ Meeting Date: ____________________
Student ID: ______________ D.O.B. ___________________________________ Age: _________ Grade: ____________
In application of the Virginia Department of Education’s Regulations Governing Special Education Programs for Children
with Disabilities in Virginia, this worksheet may assist the eligibility group in applying criteria for students who are
being considered for eligibility under the category of Speech-Language Impairment. Review the definition, consider
the items below, and note any additional information. Attach this worksheet to the Eligibility Summary Form and
include any necessary documentation.
STEP 1. DEFINITION: “Speech-Language Impairment” means a communication disorder, such as dysfluency

(stuttering), impaired articulation, expressive or receptive language impairment or a voice impairment
that adversely affects a child’s educational performance.

STEP 2. There is documentation of a significant discrepancy from typical communication skills in one of the areas
below (check all that apply):
q Fluency
q Receptive or expressive language
q Articulation
q Voice
List and/or describe: _______________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
AND
STEP 3. The student does not demonstrate Limited English Proficiency (LEP) and/or is not a speaker of a
sociocultural dialect that is the primary reason for the speech-language impairment.

AND
STEP 4. There is documentation of an adverse effect on educational performance due to one or more
documented characteristics of Speech-Language Impairment.
List and/or describe: _______________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

AND
STEP 5. Due to the identified Speech-Language Impairment, the student needs specially designed instruction.


The evaluation must be completed and It is not necessary to reconvene the eligibility. The purpose of an IEP is to
the student’s eligibility determined eligibility committee, unless required by describe the special education and
within 65 business days of the date local procedures. related services that are necessary to
the referral is received (8VAC20-81- meet the unique educational needs of
80). Comprehensive information Students Not Eligible For the student, as identified by the
on the review of existing data and Special Education and assessment. The IEP should address
determination of needed data is Related Services where the student is currently
available in Guidance on Evaluation Students who do not meet the criteria functioning, what the goals are for the
and Eligibility for the Special Education for speech-language impairment are student, and what services and supports
Process. not eligible for special education with will be provided to reach the target.
an identification of speech-language
Related Services impairment (SLI). The Virginia Special The IEP team is a multidisciplinary team
Education Regulations require whenever that includes the parents. The speech-
A student must be found eligible for a student is found ineligible for services, language pathologist must be a member
special education to receive related the eligibility committee should prepare of the team for any student with a
services. Speech-language pathology useful information for the classroom speech-language impairment. IEPs are
services are considered both special teacher and the parent about steps developed using local forms that contain
education and a related service in they can take to facilitate the student’s all components required by regulations.
Virginia. When determining the need development. In Virginia, parental consent must be
for a related service, it is important to secured prior to implementing any
remember that the federal definition of Students with another disability proposed IEP.
related service means a service required identification, such as autism or hearing
to assist a child with a disability to impairment, may receive speech services Sample state forms are available online
benefit from special education (34 CFR as a related service if determined at www.doe.virginia.gov. A sample
300.24). For example, it is not likely necessary by the IEP team. checklist including components of
that a student with a speech-language the IEP are provided in Table 10. This
impairment will need physical therapy When the speech-language pathologist, checklist may be useful at staff in-service
as a related service to work on balance or anyone with a legitimate educational meetings, when reviewing IEPs, and for
when the student is receiving therapy interest in the student, perceives that identifying methods for improving the
for articulation issues. Local procedures the student no longer requires speech- quality of the IEP.
may provide additional information or language services to benefit from special
requirements for IEP teams. or general education programs, the The IEP team considers the following
IEP team must reconvene to discuss factors: the strengths of the child; the
A student may be found eligible for the possible change in eligibility. If concerns of the parents for enhancing
special education in another disability speech-language services are provided their child’s education; the results of
area and may receive speech and as a related service and SLI is not an the most recent evaluations; and the
language services as a related service. identified disability area, the IEP team child’s performance on any state or
For example, a student with intellectual can determine if continued services are divisionwide assessments. The IEP team
disabilities may not meet the Virginia required. must also consider:
eligibility criteria for SLI due to the • the results of the evaluation,
communication difficulties being an I E P Development strengths of the student, and
inherent component of the primary academic, developmental, and
disability. However, this same student When the eligibility committee functional needs;
may still require speech-language as a determines that a student has a speech-
related service to address documented language impairment (SLI) that requires • the concerns of the parent;
needs in order to benefit from their intervention as a primary special • the student’s communication
special education program. When a education or related service, an needs and assistive technology
student is eligible for special education, individualized education program (IEP) device(s) and service(s) needs;
the IEP team may make decisions must be developed within 30 calendar
regarding the need for related services. days of the date of the student’s • the need for short-term
objectives and benchmarks;

Table 10. I E P Components
I E P Component Description Sources of information
Present Level of Academic How the student’s disability affects his/her Performance on assessments of academic
Achievement and involvement and progress in the general and functional performance, parent
Functional Performance curriculum and in the areas of need. input and student input
Strengths and weaknesses of the student For students 14 years of age and older,
should contain the preferences and
needs of the individual as well as age
appropriate transition assessments
Goals and Short-Term A measureable description of what we want Developed from the information in the
Objectives or Benchmarks the student to be able to do in a year PLOP (Present Level of Performance)
Accommodations Supports used in instruction and assessment Present Level of Performance

that do not change the learning expectations
Assessment A description of the student’s participation in Based on IEP student performance

Virginia’s statewide assessment program and participation criteria for state
assessments
Modifications Supports that change learning expectations Based on IEP, student’s needs, and
supports
Placement Where the student will be educated (LRE) Based on IEP, student’s needs, and
supports
Postsecondary Goals Measurable postsecondary goals describing Age appropriate transition assessments
what the student is planning to do beyond
school.
Must address at least one goal in the areas
involved in postsecondary employment:
training, education, living and community
participation.
Transition Plan Should be considered for all students 14 years Postsecondary Goals, plus age appropriate
of age or younger if appropriate. transition assessments
Should include statements regarding: transition
service needs that focus on the child’s high
school course of study and for the student
to achieve employment, postsecondary
training, education or independent living
goals.
Services Written after the goals are established Assessments regarding the needs of
May include related services, supplementary the child in relation to participation
aids and services, program modifications, in the general education curriculum,
and accommodations and modifications in extracurricular and nonacademic
instruction and assessment. activities and to be educated and
participate with children without
disabilities.

• for a student whose behavior avoid or explain professional jargon) Goals should be realistic and prioritized,
impedes his or her learning and in objective terms. Test scores, if and written in measurable terms that
or that of others, when appropriate, should be self-explanatory clearly state the skill or behavior to be
appropriate, strategies or an explanation should be included. achieved, the level of independence
including positive behavioral For preschool students, the present and or accuracy, and the time frame for
interventions, strategies, level of educational and functional meeting the goal. It is also important to
and support to address that performance should include how the include information on how the skill or
behavior; student’s disability affects his/her behavior will be measured, under what
participation in activities appropriate for circumstances or where the student will
• for a student with limited
preschoolers. See Table 11 for a checklist use the behavior.
English proficiency, the
of components of a present level of
language needs of the student
educational and functional performance. Benchmarks are considered milestones
as they relate to the student’s
to the annual goal that are set at regular
IEP;
Sources of information should include increments of time during the year,
• for a student who is blind or has data from all four assessment areas. providing a marker to gauge student
a visual impairment, instruction Data from formal tests, informal tests, progress. Short-term objectives are
in Braille and the use of Braille;observations, anecdotal reports, intermediate steps to achieving the
curriculum-based assessments, annual goal and are sequentially
• the language and
interviews, and checklists may be arranged along a continuum of difficulty
communication needs for a
included. It is also helpful to consider designed to move the student toward
student who is deaf or hard of
the future, specifically, the student’s mastery of the annual goal. Benchmarks
hearing, including opportunities
aspirations in one year, three years, or objectives are required for students
for direct communication
or a longer period of time. The use who will be assessed using alternate
with peers and professional
of teacher/parent/student checklists achievement standards (The Virginia
personnel in the student’s
is recommended to ensure that all Alternate Assessment Program [VAAP]).
language and communication
perspectives are included. Sample forms Benchmarks or objectives are not
mode and the need for direct
can be found in Appendix E. required for students not participating
instruction in the student’s
in the VAAP, but may be required by
language or communication
The present level of educational and divisions.
mode.
functional performance serves as the
foundation for the rest of the IEP. There Accommodations,
Present Level of Educational
should be a direct relationship between Modifications, and Supports
and Functional Performance
the information in this section and the for School Personnel
The present level of educational and
goals, any short-term objectives or Accommodations are supports that
functional performance serves to identify
benchmarks, and the accommodations provide equitable instructional and
the student’s current level of functioning,
or modifications in the rest of the IEP. assessment access for students
discusses strengths and weaknesses,
with disabilities. Accommodations
and may include information provided
Annual Measureable Goals are generally provided in the areas
by parents or the student. This section
Annual measurable goals to be of presentation of instruction, the
of the IEP describes how the student’s
addressed for the duration of the IEP equipment and materials needed by the
disability affects his/her involvement and
must be developed from the information student, the way in which the student will
progress in the general curriculum and in
reported in the present level of respond, the setting in which instruction
the area(s) of need. This will include the
educational and functional performance. or learning will take place, and the time
student’s performance in academic areas
Goals are designed to meet each of the it will take. Modifications are supports
(e.g., reading, mathematics, science,
student’s disability-related needs and that change, reduce, or raise learning or
social studies) and functional areas (e.g.,
to enable the student to progress in the assessment expectations. Supports for
communication, behavior, social skills,
general curriculum (or in age appropriate school personnel may be used to describe
self-determination). The present level of
activities for preschool children). The the supports provided to school staff
educational and functional performance
goal should be written to answer the which are required for the student to be
should be written in language
question: What do we want the student provided FAPE. Examples of supports for
understandable to all participants (i.e.,
to be able to do in a year? school personnel may include training

Table 11. IEP Checklist
Present Level of Performance

Yes No Does the present level of performance statement identify the child’s strengths, especially in each problem
area (i.e., what the student is able to do)?
Yes No Does it address the child’s needs/weaknesses in each area of need (i.e., what the student is not able to do)?
Yes No Is it based on the most recent information gathered from comprehensive assessment (school-based and SLP
specific data gathered through systematic observation and measurement)?
Yes No Are the sources of data identified, including dates and methods?
Yes No Does it document the child’s performance in the general curriculum?
Yes No Does it document the child’s communication needs?
Yes No Are instructional needs identified?
Yes No For a child whose behavior impedes his/her or other’s learning, does it address behavior?
Yes No For a child with limited English proficiency, does it consider the child’s language needs?
Yes No Is it written using language that can be understood by both professionals and parents?
Annual Goals and Benchmarks or Short-Term Objectives
Yes No Are the goals relevant to the student’s academic, social, and vocational needs?
Yes No Are the goals practical considering the student’s age and remaining years in school?
Yes No Is there at least one goal for each area of need identified in the Present Level of Performance?
Yes No Are the goals stated using positive terms and indicate what the student will achieve?
Yes No Does it identify who will achieve?
Yes No Does it identify what skill or behavior is to be achieved?
Yes No Does it identify how or in what manner or at what level the skill or behavior is to be achieved?
Yes No Does it identify where, in what setting, or under what conditions the skill or behavior will be achieved?
Yes No Does it identify when or by what time, the skill or behavior will be achieved? Should be no longer than
1 year.
Yes No Is educational jargon avoided?
Accommodations, Modifications and Supports for School Personnel
Yes No Are accommodations and modifications related to the needs identified in the present level of performance?
Yes No Are any needed supports for school personnel listed (e.g., training on AAC equipment, consultation with
teachers, etc.)?
State Assessments, Transition, and Diploma Status
Yes No Are assessment and diploma options coordinated with course of study?
Yes No Are postsecondary goals included for education, training, employment, and independent living?
Yes No If appropriate, are outside agency service providers involved?
Services
Yes No Are services based on needs documented in the present level of educational performance and goals
written for the student?
Yes No Are services written to permit changes in setting or session length (e.g., 2 hours /month instead of
30 minutes per week)?

on specific disability characteristics, independent living. These goals with Disabilities upon Reaching the
in-service on use of assistive technology are based upon appropriate Age of Majority in Virginia” and other
or student equipment, or ongoing assessments and take into information on secondary transition is
consultation with teachers. consideration the student’s available on the Virginia Department of
strengths, preferences, and Education Web site at www.doe.virginia.
IEP teams should carefully consider interests. gov.
adding supports that may reduce
2) Transition services, including
the rigor of the student’s educational Postsecondary Outcomes
the courses of study needed to
program and potentially cause an The very first step in purposeful planning
assist the student in reaching
adverse effect on learning. These for positive postsecondary outcomes is
his or her stated postsecondary
supports must be directly related to the helping the family and student create
goals. Services are based on the
student’s disability and can be provided a vision for life after high school. This
student’s needs.
in the general and special education vision is defined or described through
setting. the postsecondary goals which are
Beginning not later than the first IEP to
based upon age appropriate transition
be in effect when the student turns 16,
Participation in State assessments. The planned supports,
or younger if determined appropriate
Assessments activities, services, and agency linkages
by the IEP team, the IEP must include a
The section of the IEP addressing are written into the transition IEP to
statement of interagency responsibilities
state assessments shall be completed facilitate the student’s movement to his/
or any linkages.
for all students enrolled in a grade her post-graduation goals. Effective
level requiring an assessment. Any transition planning will lead to maximum
For a student pursuing a modified
accommodations used on state independence and positive post-
standard diploma, the IEP team
assessments must be the same as those graduation outcomes when planning
must consider the student’s need for
used in instruction and assessment and services delivery are viewed as a
occupational readiness upon school
during the year. These accommodations shared responsibility among all involved
completion, including consideration
should reflect the student’s disabilities including the student, school, family and
of courses to prepare the student as a
and needs to access the general community agencies.
career and technical education program
curriculum. See the Virginia Department
completer.
of Education Web page on Testing and Transition to Post High
Standards of Learning Participation School
At least one year prior to the student
and Inclusion for documents such as If a student is graduating with a standard
reaching the age of majority (age 18),
Guidelines for Participation of Students or advanced studies diploma, the parent
the students and parent(s) or guardian(s)
with Disabilities in the Assessment must receive prior written notice of the
must be informed of the rights that will
Component of the State’s Accountability change in placement (i.e., the end of
transfer to the student when he/she
System for more information about services per the IEP due to graduation).
reaches eighteen. The adult student
the state assessment system and If the student is receiving a modified
is presumed, under Virginia law, to be
the standard and nonstandard diploma, the option for extended services
capable of making his/her own decisions,
accommodations that can be used. (through to age 21) under Part B of IDEA
including educational decisions. Only if
is available. When deemed appropriate
it is proven that the adult student is not
Transition and Diploma per the IEP team, a student may qualify
capable of providing informed consent
Status for school-based special education
when making decisions can another
Prior to a student entering secondary services through age 21.
person be appointed to make decisions
school, but not later than the first IEP to
for the adult student. Most students
be in effect when the student turns 14, Services
will be part of the decision making
or younger if determined appropriate by The IEP team’s discussion of supports and
process and seek guidance from their
the IEP team, the IEP must include: services should be completed after the
parent(s)/guardian(s). Ideally, planning
goals are written. Services are selected
1) Measureable postsecondary and decision making are collaborative
based on the needs of the student and
goals related to education, and involve all parties regardless of the
the educational support needed for him
training, employment, student’s age. VDOE’s technical assistance
or her to: meet annual goals, be involved
and where appropriate, document “Transfer of Rights for Students

in and progress in the general curriculum, valuable in demonstrating progress. performance data collected over the
participate in extracurricular and reporting period. Parents may request
nonacademic activities, and be educated If a standardized assessment will be an explanation of the data used to
and participate with students without used to measure progress and it was document progress, or the lack thereof
disabilities. The services section may not specifically referenced on the IEP, (e.g., a percentage of accuracy).
include related services; supplementary parental consent must be secured to Some children demonstrate little if
aids and services for the student, or those complete the evaluation. any progress for a period of time,
provided to school personnel on behalf prompting educators to consider
of the student; program modifications; IEP revisions may include changes to dismissing the child from services due
and accommodations and modifications the special education services, the to lack of progress. IDEA requires that
in instruction and assessment. The related services, the goals, any short- whenever there is a lack of progress,
services section shall include beginning term objectives or benchmarks, the the IEP team must review the child’s
and ending dates for all services; the accommodations or modifications, IEP to determine whether the annual
frequency, location, and duration of and supplementary aids and services. goals are being achieved and revise the
services; and the extent of participation In addition, the IEP team may add or IEP as appropriate to address any lack
with students without disabilities in terminate a related service. of progress. Any decision to dismiss a
general education class(es), as well child who continues to have a speech-
as extracurricular and nonacademic Reporting Progress language impairment and who is not
activities. Services should be provided IDEA requires IEPs to contain a statement making progress must occur after an IEP
in the least restrictive environment. regarding how the student’s progress team has reviewed the child’s progress
Prescriptions and reports from outside toward annual goals will be measured and pursued a variety of options for
providers must be considered by the IEP and when periodic reports on progress achieving progress. Those options
team, but are not required to be followed. will be provided. Speech-language should include working with other
pathologists follow local procedures special and general education teachers
The speech-language pathologist and timelines for reporting progress. to incorporate the communication
and other staff may develop a draft Progress must be reported for each goals into their classrooms. This may
IEP. For specific details on this process, annual goal indicated in the student’s be especially effective for children
the speech-language pathologist IEP. “Norm-referenced tests do not with other disabilities (e.g., intellectual
must consult the local procedures for lend themselves to use in monitoring disabilities). Some children lack
developing IEPs, convening IEP meetings, an individual’s performance over time. motivation to continue to work on
and implementing IEPs. When the IEP Their use can engender inflated illusions improving their speech-language
has been written and parental consent of success or unwarranted delusions of skills. The IEP team should consider the
has been obtained for implementation, failure and can invalidate their future use cause(s) of the motivation problem and
the speech-language pathologist must as tests of skill.” (McCauley 1984, p 346) may develop a joint effort to address
initiate services by the beginning date The use of norm-referenced tests to motivation (e.g., working with the school
noted in the IEP. report progress is discouraged. social worker, guidance counselors, or
teachers).
Each IEP must be reviewed and revised If services have been provided to
at least annually. During this review, the address a particular IEP goal during the If the lack of progress is not related to
IEP team addresses the student’s progress reporting period, but the student has any of the above, the IEP team should
(or lack of progress) toward meeting not made progress, the IEP committee consider whether further evaluation
the annual goals, the results of any re- must reconvene. The IEP committee may be needed to understand the
evaluation, information provided by the must determine if the goal needs to be lack of progress. This evaluation may
parents, the student’s anticipated needs, modified or if other aspects of the special be conducted by a school-based
and any other matters. The IEP team education and related services need to speech-language pathologist, an
must look at a variety of data sources, be changed to facilitate the student’s outside speech-language pathologist
including data gathered by the speech- mastery of the current goal for which with specialized skills, another school
language pathologist regarding student there has been “no progress.” Methods professional, or outside professionals.
performance; assessments completed; of measuring progress are noted in
and teacher, student, or parent checklists. the student’s IEP and all notations of
Audio and video recordings may be progress should be based on actual

Re-evaluation child does not need specially recommendation, other courses of

If the student is identified with a speech- designed instruction; or action must be considered. Further
language impairment, regulations require discussions with the IEP team, mediation,
• The IEP team determines
school divisions conduct an evaluation at or a due process hearing may become
the child no longer needs
least once every three years to determine appropriate depending on the individual
speech-language related
if the student continues to be “a child case. The speech-language pathologist
services to benefit from special
with a disability.” This evaluation includes must refer to their school division’s local
education. For example, the
a review of existing data and may include policies. However, the speech-language
child’s communication needs
additional information if determined services must not be discontinued
can be met through the
necessary by the team. Reviews may be until parental consent is obtained or
communication goals worked
conducted more frequently if requested the matter has been resolved by other
on in the regular or special
by the team. If the student is receiving means.
education classroom.
speech language services as a related
service, determinations for continued Transitions from
The student’s daily performance on
need for services may be made by the
activities associated with IEP goals, Early Intervention
IEP team. Evaluation is not required
performance on class assignments,
before termination of eligibility due to
small- or large-group interactions, Children from birth to three years of age
graduation with a standard or advanced
parental reports of performance outside may qualify for Early Intervention (EI)
studies high school diploma or before
the school environment, or student self- services. In Virginia, the Infant & Toddler
reaching the age of 22.
reporting should be considered. Audio Connection provides these services
or video recordings may be valuable in different regions across the state.
The decision to dismiss is based on the
ways to demonstrate student progress. Specific information regarding these
same criteria as the decision to find the
If additional information is required, services and the specific service areas
child eligible. The team should be able to
parental consent for testing must be can be found online at www.infantva.
answer yes to the following questions for
obtained prior to administration of org/. A child is determined eligible for EI
a child to remain eligible:
the assessment unless that particular services when he/she meets at least one
• Does the child have a speech- instrument was already noted in the of the following criteria:
language impairment? student’s IEP as a means of measuring
progress. The Comprehensive • developmental delay – a
• Is there an adverse educational documented 25% or greater
Assessment System tools, included
impact? delay in functioning in at least
in Appendix D, may also be helpful in
• As a result, does the child need determining progress. one area of development
special education? • atypical development
Review of Need for
A student may be found no longer Related Services • a diagnosed physical or mental
eligible for services in the following When the IEP team convenes to discuss condition that has a high
situations: the need for continued services for a probability of resulting in a
student receiving speech-language as a developmental delay
• The child no longer has a
related service, all evaluation information
speech-language impairment; EI services typically follow a coaching
should be reviewed. The IEP team then
• The child continues to have a determines if the information is sufficient style model; this evidence-based
speech-language impairment, to find the student in need of continued approach fully involves the family and
but it no longer affects his/her speech-language services. caregivers within the home environment
educational performance; and/or community, empowering them
Termination of Services to utilize appropriate strategies to assist
• The child continues to have a with improving the child’s skills within
If an IEP or eligibility team decides
speech-language impairment his/her daily routines. The Infant and
that the related service is no longer
that affects his/her educational Family Service Plan (IFSP) is the guiding
needed, the division must secure
performance, but the eligibility treatment document in EI. Similar to
parental consent to terminate services.
committee determines the an IEP, the IFSP outlines the following
If the parent does not agree with the

information: child and family activities Private School To maintain best practice, the Virginia
and daily routines; family identified Department of Education recommends
resources, priorities and concerns; a Students with that, once a parentally-placed private
social assessment which reviews the Disabilities school student has been found eligible
child’s present level of functioning; for special education and related
a narrative of the team evaluation; The reauthorization of IDEA in 1997 services, the school division of residence
specific long-term and short-term goals; and 2004 significantly altered the rights develops and proposes an IEP. The
suggested learning opportunities and of children placed in private schools proposed IEP provides documentation
activities for the family; information by their parents when there is no that the school division stands ready,
regarding the provider, type and disagreement about special education willing and available to provide a free
frequency of service; and early transition services. These are students whose appropriate public education if the
planning. EI services cannot persist parents prefer private education to parent elects to enroll the student in the
beyond the child’s third birthday. public education, often placing their public school. In any case, a parentally-
children in parochial or other private placed private school student may be
When a child moves from early schools. In Virginia, children who are entitled to receive certain services under
intervention (EI) to school-based home-schooled are treated as children an “Individualized Services Plan” or “ISP.”
services, he/she shifts from Part C to who attend private schools.
Part B of IDEA. In Virginia, this transition However, the rights of these children
process can occur as early as two years (This section does not address children to receive special education services
of age, as long as the child is two on or placed in private schools by the school are limited. Each school division must
before September 30th of that school division or children placed there by their develop a plan for how it will serve these
year. If the family chooses to pursue parents when they disagree with the children according to a federal funding
school-based services prior to the school division about the provision of formula. This plan will address the
child’s third birthday, once he/she is a free appropriate public education for type of service, location of the service,
determined eligible for treatment, the their children. The speech-language and transportation (if applicable) the
home-based EI services must end prior pathologist should refer to school school division will provide the student.
to implementation of an IEP. division policies for addressing such Regardless of the type of service needs
situations.) that are identified by the evaluation, the
When a child is transitioning from EI to child is only entitled to receive those
the public schools, the first step is to The Regulations Governing Special services identified in the school division’s
refer the child to the school division to Education Programs for Children with plan, meaning that the child does not
determine if the child is eligible using Disabilities in Virginia require each have an entitlement to a free appropriate
Virginia’s criteria and eligibility process. school division to locate, identify, and public education.
If the child is found to be eligible for evaluate all private school children
special education and related services, enrolled in private schools (including The ISP does not require the same
then the IEP team must consider the preschools) located in the division, as amount or type of services provided to
content of the IFSP. The IEP team is well as home-schooled children residing public school students. It may exclude
not obligated to replicate the IFSP and in the division. Upon completion of the those sections that are not relevant
should specify services and supports evaluation, the eligibility committee based on the division’s plan for serving
for the child that will provide a free determines whether the child is a child private school children. For example,
and appropriate public education. It is with a disability. If the determination is if the division plan does not include
also suggested that the school team made that the student has a disability a particular related service, such as
consult with the EI service providers to and requires special education, the occupational therapy, the division is
communicate regarding present level of student may be entitled to receive not obligated to include that particular
performance and functional needs. The certain services from the school division.4 service in the student’s ISP.
child’s parent has the right to request
that the Part C service coordinator, as 4 Students in certain schools (those that are “for profit” or do not meet the definition of “elementary”
well as other professionals involved or “secondary” school under the Virginia Regulations may not be eligible for services under the
in treatment, be invited to the initial applicable regulations. This issue is complex and beyond the scope of this document. SLPs should
consult with LEA staff to determine how these rules apply to a specific student’s situation.
meetings (e.g., referral, eligibility, IEP).

Service Delivery
Students eligible for special education services within the educational and amount of direct and indirect
and related services should receive setting through their collaborative services the student will receive in the
intervention from school-based speech- consultation with the teachers and least restrictive setting. Decisions are
language pathologists that is: classroom-based services as part of based upon the child’s present level
the service delivery continuum. The of performance, progress made in
• curriculum-based,
focus on performance in the general services received to date, assessment
• outcome-oriented, curriculum requires a team approach, results, IEP goals, and any objectives/
with specific responsibilities shared by benchmarks. In addition, the IEP team
• integrated with educational
various professionals. Reliance on the should consider the advantages and
activities,
traditional approach of pull-out therapy, disadvantages of specific settings and
• diagnostic in nature, focusing solely on discrete speech or the necessity for repeated practice in
language skills, is no longer sufficient a controlled environment. No single
• dynamic, changing as the
for all students. service delivery model can be used
child’s needs change,
exclusively for all students. Multiple
• based on research-proven Speech-language pathologists must perspectives are needed for students
strategies, and use evidence-based practice in their as their needs change. When speech
service delivery. Evidenced-based and language services are indicated, the
• designed to ensure access
practice incorporates specific steps service delivery and clinical methods
to the general curriculum so
such as: identification of clinical issues, must focus on achieving the goals in the
the child can be successful in
review of existing research, definition of student’s IEP. Regardless of the service
mastering the Standards of
expected outcomes, and evaluation of delivery model used, it is essential
Learning.
clinical practice. For more information that time be scheduled for regular
on evidence-based practices see collaboration with parents, general
IDEA 2004 directed educators to focus
the section titled Evidence-Based educators, special educators, and other
on access to the general curriculum for
Practices. Any use of a practice that is service providers.
all students. SLPs should select a service
not research-based should be used on a
delivery approach for each student, and
trial basis, with pre- and post-testing to Direct Services
may use a combination of approaches
determine the outcome of that practice
for the student during the intervention
for that particular student (Meline and The IEP team may determine that the
process. A comprehensive intervention
Paradiso, 2003). When services are student’s goals and objectives will be
program that supports students’
based on research-proven strategies, met most effectively through direct
involvement in academic, nonacademic,
there is improved accountability for services. Direct services may be offered
and extracurricular programs is
students, schools, and families. in a variety of settings (the classroom,
necessary to meet students’ needs.
Regardless of approach(es), intervention the cafeteria, the intervention room
that utilizes curricular materials or Service Delivery or other school settings). The type,
activities facilitate the language abilities Methods location, and amount of services
of students, including promotion of are adjusted to meet the needs of
metalinguistic and metacognitive Effective service delivery is dynamic the student. Whenever possible,
skills essential to academic success. and changes with the needs of the intervention should be provided in the
This may be effectively provided in students. Service delivery approaches least restrictive setting and result in
classroom settings, frequently working are selected on the basis of the needs the least amount of disruption to the
alongside the classroom teacher (or of a specific student and include student’s academic day.
sometimes a resource room teacher) a variety of methods at different
in collaborative or co-teaching roles. times, including those that may be Integrated or Push-In
Although speech-language pathologists provided directly to the student in Therapy
will maintain a therapeutic focus in their the classroom or less frequently on a Therapy integrated into the classroom
use of curricular materials, activities, short-term basis in pull-out setting or provides individualized service in a less
and classroom-based interventions, indirectly through consultation with restrictive setting and does not remove
they can ensure effective integration educators and families. The IEP team the student from the general or special
of speech-language pathology makes the decisions about the type education classroom. This service
delivery method allows the student to

receive direct therapy from a speech- demonstrated, or monitor students Therapy provided in the classroom
language pathologist while continuing for use of a particular skill. This type provides many benefits for students
to receive classroom instruction. of information is especially helpful in and staff. Because of the SLP’s unique
Classroom teachers become an integral determining the educational impact of a professional preparation in the area of
part of the process as they learn to speech or language impairment. language development and language
reinforce speech-language goals, assess impairment, the SLP may be able to
student progress, and learn specific While in the classroom, the speech- review the language of instruction and
techniques that will benefit the studentslanguage pathologist and classroom provide helpful feedback to classroom
with speech-language impairment as teacher may present instructional teachers. This includes the language
well as general education students. This materials collaboratively. With the levels of texts, the impact of readability,
incidental benefit to regular education speech-language pathologist’s worksheets and exercises, test formats
students is a naturally occurring assistance, these instructional materials and question wording, and language
outcome of collaborative service and activities can focus on the speech- levels used in lectures.
delivery. This is often the appropriate language objectives of the students
approach for school students struggling receiving speech-language services. Collaboration and consultation with
with acquisition of content because of The speech-language pathologist may teachers can provide opportunities
their language difficulties. use this as an opportunity to provide for the students with language
reinforcement for specific objectives in a difficulties to take better advantage
The speech-language pathologist has more natural setting (the classroom) or of the curriculum. Such collaboration
exposure to classroom communication gather data on the child’s performance and consultation has the potential for
including: levels of adult and child in the classroom setting without direct generalized benefits to the whole class.
communication (rate, volume, instruction. The speech-language
complexity of language), daily routines, pathologist may work with individual Pull-Out Therapy
the language of the curriculum, students, small groups, or with the Sometimes the nature and severity of
vocabulary demands, and the student’s entire class. Table 12 provides examples the speech-language impairment may
coping strategies. Using this model, the of teaching models for integrated necessitate service delivery in a pull-out
general or special education teacher therapy. This method also enables situation. Therapy services provided
and speech-language pathologist jointly the speech-language pathologist to in an individual or small group setting,
plan, teach, and assess the student’s observe the student in a more natural with intensive specialized instruction in
progress within the classroom setting. setting and gather data on his/her use specific skills or strategies, are typically
Integrated therapy can involve several of skills learned in pull-out therapy. It is referred to as pull-out therapy. This
approaches to sharing instruction. important to note that only time spent service delivery model generally
Throughout the academic week, the providing direct service to the students focuses on remediation of articulation,
teacher may then choose to employ with speech-language impairment can language, voice, fluency, or swallowing
strategies learned, use prompts or cues be counted toward the frequency and deficits.
the speech-language pathologist has duration of services required on the IEP.
Table 12. Teaching Models for Integrated Therapy in the Classroom
Team Teaching Small Group Instruction

The speech-language pathologist: The speech-language pathologist:
• paraphrases information • works in small group instruction with targeted
• creates graphic organizers students, reviewing academic material
• teaches strategies for vocabulary learning • presents the academic material with a focus
• teaches strategies for sequencing on enabling the student to generalize his/her
• teaches strategies for developing a narrative communication skills
• cues and prompts the students
• modifies the language level of instruction to meet
students’ needs.

Indirect Services Information, home programs, and American Speech-Language-Hearing

demonstration that can positively Association.
Indirect services, or consultative impact communication development or
services, are provided when a maintenance skills may be offered. This Community-Based Instruction
student’s IEP specifies support for type of support is especially valuable Many school divisions offer community-
school personnel as a part of the for families and teachers when there is based instruction for students with
accommodations, modifications, or concern about the child’s development. disabilities. Providing instruction
supplemental support services provided and experiences in the community
to a teacher on behalf of the student. Other Service facilitates the development of skills
These services include providing that are required for success in life.
information and demonstrating
Delivery Methods Opportunities are provided to practice
effective instructional and facilitation daily living or work skills during
Combined Direct and Indirect community trips with monitoring
procedures. The speech-language
Services Using a 3:1 Model and support provided by teachers
pathologist may provide support for
The 3:1 model combines three weeks of and other staff. The speech-language
staff or analyze, adapt, modify, and
direct intervention with students and pathologist may participate in these
create instructional materials and
one week of indirect services. With this outings if the functional setting
assistive technology for targeted
model, three weeks out of each month provides opportunities to monitor
students. While providing consultative
are designated for direct intervention the generalization of skills or provides
services on behalf of a child, the speech-
with students, and one week for indirect opportunities for structured practice.
language pathologist will monitor
services, such as meeting with teachers, The speech-language pathologist may
the student’s progress. Consultative
parents, and other specialists; and also provide consultation services to the
services may also be characterized as
developing treatment materials. teachers who are providing community-
indirect services on the student’s IEP.
based instruction.
During the time designated for indirect
This model is appropriate for students
intervention for students, the SLP Intervention for the Metas
who are nearing dismissal from
provides services that address individual One way to ensure that metalinguistic
speech-language services or students
student needs. These services may skills are embedded in and promoted
whose teachers require additional
include: during language-learning activities
support to create materials, implement
specific communication strategies, • Conducting and attending is to explain the reason and rationale
or modify augmentative/alternative meetings behind the activity to students.
communication (AAC) equipment. Asking students to paraphrase the
• Performing evaluations reasons and explanations aids them
The classroom teachers may request
assistance as they plan, monitor student • Conducting training and in understanding and applying
progress, or make decisions regarding consultations with staff and the rationale. Paraphrasing is one
the presentation or selection of parents metastrategy that can often be an
materials. intervention activity aimed at improving
• Visiting classrooms and a student’s metaskills. Engaging
conducting systematic students as young as five years of age in
Consultative services may be provided
observations making plans, writing (or drawing) the
to family members. Such consultation
can include information on speech- • Developing and adapting steps in the plan, and then executing
language development and facilitation, classroom and intervention the plan are strategies to address both
home programs, recommended materials metacognition and metalinguistic
environmental changes, or parent- abilites and strengthen executive
support groups. This level of service The 3:1 model provides opportunities functioning skills. Plans can become
may be provided to a family member for SLPs to consult with teachers about more complex as students progress
of a child who is receiving services or students’ needs in the classroom, in the grades. Wiig’s (1989), “Steps to
a child who is not eligible for services address curriculum pacing, and Language Competence: Developing
to support recommendations by the integrate speech-language goals and Metalinguistic Strategies” includes
eligibility group. classroom curriculum. This service numerous examples and lists of plans
delivery model is supported by the and activities designed to foster

students’ meta-abilities. An important Communication Skills to five students with similar speech
aspect of working with students with Secondary Course and language needs are grouped in
meta weaknesses is to encourage Some school divisions have found one teacher’s classroom, the speech
them to take time to think through and it beneficial to offer a course on pathologist can work with the teacher
plan their responses. Students with communication skills. These are most to provide services integrated within
learning disabilities, who likely also have often offered at the middle or secondary the classroom or can select a time for
language impairment, have typically level as an elective class. They may be pull-out services that limit disruption
been conditioned by the educational semester or yearlong classes. These to the classroom. By working with
environment to respond quickly, which classes offer direct instruction to general one or two teachers per grade level,
is the opposite of what is needed to education, as well as special education speech-language pathologists can
engage metalinguistic or metacognitive students, addressing communication efficiently provide services. This can
strategies (Reed, 2005). skills in home, school, community reduce planning time by addressing
and work settings. Topics generally concerns for multiple students and
Services in the Middle and include rate, volume, eye contact, classroom activities in fewer sessions.
High Schools social communication skills, topic, This scenario also decreases the need
The language levels of the curriculum maintenance, and code-switching skills. for individual students to be pulled
escalate in middle school so that the Promoting and strengthening students’ from different classrooms causing a
transition into the middle school metalinguistic and metacognitive skills disruption in multiple locations for a
learning environment can present are typically an area of focus. single therapy session. This practice is
challenges for students with language becoming increasingly important with
impairment that the students may have Although the speech-language the higher academic expectations of
been able to manage in the elementary pathologist may be a natural choice to the general curriculum and No Child
grades. Middle school curriculum and teach this class, other special or general Left Behind’s (NCLB) requirements for
its curriculum delivery model (e.g., educators may also have the necessary minimum amount of instructional time
multiple subjects, different teachers skills to serve as the instructor. In in the content area for certain students.
with different language styles, content other situations, the speech-language
specific vocabulary, an emphasis on pathologists may co-teach this class or Speech-language pathologists will have
reading and writing to learn versus consult with the teacher. If the speech- greater control over their own schedules
learning to read and write, different language pathologist is the instructor, if a flexible approach to service delivery
schedules requiring good executive his/her caseload should be adjusted is maintained. When IEPs are written
functioning skills, demand for high accordingly. appropriately, frequency, duration, and
level metalinguistic and metacognitive setting can provide built-in flexibility
abilities) may require the IEP team to for a speech-language pathologist.
conduct a thorough evaluation and
Scheduling, Service Frequency and duration of services,
consider whether a termination of Delivery, and IEPs setting, and method of service delivery
services is warranted. may vary, depending on the needs
Speech-language pathologists can of the child. Provision of the same
Various service delivery options, often increase the effectiveness of their frequency and duration to each
those in which the SLP works with the treatment if a flexible approach to student violates the requirement that
students in their middle school classes scheduling and service delivery services be individualized and leaves
and/or alongside the content teachers is adopted. Working with school little room for flexibility and creativity
may be important in supporting these administrators is a strategy often within a speech-language pathologist’s
students. The same is true with regard used by veteran special educators schedule. This allows speech-language
to students’ transition into high school and speech-language pathologists. pathologists to adjust the delivery of
where the language demands of the This can enable the speech-language services a child receives at a particular
educational environment again increase pathologist to group students in one period to capitalize on the benefits of
dramatically. class, enhancing the opportunity to increased therapy (ASHA, 2004).
collaborate with the teacher, decreasing
the disruption to classrooms, and Flexibility in service delivery can be
limiting the amount of time students built into IEPs and the speech-language
are pulled from a classroom. If three pathologist’s schedule in a variety

of ways. Rather than consistently A third option may be to schedule the special education should work together
scheduling two sessions per week for student on a monthly basis. This may to discuss new scheduling formats prior
30 minutes each, schedule 60 minutes be most useful for students who are to implementation.
per week or 120 minutes per two-weeks monitoring their own performance
period, when appropriate for student and need periodic opportunities to The student’s IEP should also specify
needs. In addition to accommodating check in with the speech-language where services will be provided – in the
student and classroom needs, this pathologist to gauge their progress. speech-language pathologist’s room; in
offers the speech-language pathologist It is not uncommon for this level the general, special, or career-technical
greater flexibility when providing of service delivery to be provided education classroom; on the playground
services. The speech-language immediately prior to a determination or in the cafeteria (or other school
pathologist is better able to capitalize by the eligibility committee that locations); in the community; or other
on opportunities to integrate services the student no longer has a speech- specific location. The identification of
in the classroom or during school language impairment that adversely location may be flexible, recognizing
events and to reschedule sessions to affects his/her educational performance that there may be a valuable
accommodate absences. This type and therefore no longer needs special opportunity to practice a newly
of frequency and duration statement education and related services. acquired skill in a classroom setting or
allows the speech-language pathologist that a child may need a few sessions
a myriad of scheduling options that can Speech-language pathologists must of direct pull-out therapy to work on
change to meet the students’ needs always provide the total amount of a specific strategy before returning to
(see Table 13). Another option is the service written in the IEP, regardless classroom-based intervention. When
provision of intense services early in the of the wording of the frequency and specifying location on the IEP, it may
year, with the amount of time reduced duration statement. Use of a range be appropriate to identify multiple
later in the year (e.g., 30 minutes daily (i.e., 30 – 40 minutes) is typically not locations for services, as follows:
for the first quarter; no services for the considered acceptable because the
second quarter; 30 minutes once a week service provider and the parents may Johanna will receive 60 minutes of
for the third and fourth quarters). This view the expected time requirements services/week in the classroom, in the
approach can be used to teach a new differently. Unfortunately, this type of cafeteria or playground and/or the
skill and give the child time to practice it ambiguity may result in a complaint or speech-language pathologist’s room.
or to accommodate particular curricula due process hearing. Speech-language
and/or classroom demands. pathologists and their administrators of
Table 13. Possible Delivery Options for 60 Minutes of Services per Week
Delivery Options Representative Students
10 minutes, 6 times/week Students with articulation, fluency or voice goals, who are
or generalizing skills, or
15 minutes, 4 times/week Students who benefit from short, intense therapy sessions on a
or frequent basis (e.g., students with apraxia), or
20 minutes, 3 times/week Students needing frequent review of specific strategies or devices
or (e.g., alternative/augmentative communication) out of the
classroom setting.
30 minutes, 2 times/week Students who are learning skills such as articulator placement and
fluency strategies in a therapy room.
60 minutes, once a week Students with language or pragmatic needs who receive therapy in a
or classroom setting
45 minutes + 15 minutes once a week (Note: some students will benefit from an additional 15 minutes for
pull-out sessions to reinforce a particular skill or strategy)

If local IEP forms require specific settings Content Literacy Continuum® is to address prevention and early
to be listed, it may be useful to specify (CLC) and Strategic intervention prior to the point of special
that the child will receive services in a Instruction Model® (SIM) education evaluation and service. This
variety of settings including individually, The Content Literacy Continuum® is a does involve a decrease in the amount
in a group, or in a classroom. This Virginia demonstration project funded of time spent providing more traditional
provides flexibility for the SLP to work by the State Personnel Development and direct special education and related
with the child one-on-one to establish Grant from the U.S. Department of services. SLP’s workload will need to
skills, in small groups to practice Education. The CLC® is a schoolwide take into consideration the time needed
them in a structured setting, and in framework designed to address the for indirect services and support
the classroom to use them in a more content literacy needs of middle and activities.
natural environment without having to high school students in the areas of
schedule an IEP meeting for each step listening, speaking, reading, and writing. Additional resources for RtI can be
of the process. CLC® involves provision of services at found on both the Virginia Department
various levels. Strategic Instruction of Education’s (VDOE) Web site and The
Whatever the type of scheduling option Model® (SIM) strategies are used by American Speech-Language-Hearing
used, it should be clearly documented all school staff. The SLP is particularly Association’s (ASHA) Web site:
in the student’s IEP and include dates, well trained to address all levels of www.doe.virginia.gov/instruction/
frequency, and duration statements. intervention and may play a pivotal role response_intervention/
If the student’s speech or language across all levels of CLC® implementation. www.asha.org/slp/schools/prof-consult/
needs change, the IEP team needs Additional information about CLC® is RtoI.htm
to reconvene to make appropriate available online at www.doe.virginia.
adjustments. gov/ and through the University of Caseload
Kansas Center for Research on Learning
http://www.kucrl.org. Establishment
General Education
Initiatives Response to Intervention The speech-language pathologist’s
(RtI) caseload includes all students eligible
SLPs may be involved in a variety of Response to Intervention (RtI) process is for special education and related
initiatives outside special education a multi-tiered intervention model used services. In addition, all students
such as Response to Intervention to identify and serve struggling learners eligible for services under 504 should
(RtI), literacy development, pyramids at increasing levels of intensity prior to be counted. Federal law does not
of intervention, Content Literacy referral for special education. According mandate caseload size. Each state
Continuum® (CLC), etc. The SLP’s to ASHA, SLPs may play numerous sets its own caseload caps. Virginia’s
caseload/workload must take into roles within the RtI framework such current cap on the caseload for full-
consideration the amount of time as collaboration, program design and time speech-language pathologists is
the SLP assists with and/or performs direct intervention. The goal of RtI 68. The average caseload in Virginia,
nonspecial education tasks.
Table 14. Examples of Caseload Reduction Based on Schedule

Speech-Language Pathologist Schedule Caseload Maximum
Part-time employee example: 2 days/week or .4 FTE providing speech-language 27 (.4 FTE x 68)
services
Department chair/lead teacher example: 3 administration periods out of a 6 period day 34 (.5 FTE x 68)
or 3/6 time (.5 FTE) providing speech-language services
Provides phonological example: 1 hour/day providing phonological awareness 56 (.82 FTE x 68)
awareness remediation out of a 5½ hr day or 4½ hours (.82 FTE) providing
speech-language services

between 50 and 55, is lower than the • regular meetings to review has an augmentative device and is
state maximum. caseload size and severity to physically and cognitively impaired. To
make adjustments as needed, count these two students equally on a
The caseload maximum is lower for and caseload does not reflect the amount
part-time personnel or persons assigned of time involved in addressing each
• review of student data to
other responsibilities in proportion to student’s needs. The scenario above
determine if children have
the amount of time spent as a service may be reversed if the student has a
met their goals and should
provider (8 VAC 20-81-40). Table 14 severe intelligibility problem, requiring
be referred to the IEP team to
shows how an SLP’s caseload would intensive therapy, versus a student with
determine if they are no longer
be reduced depending upon the time significant disabilities who is a proficient
eligible (Power-deFur, 2001a;
assigned to provide services. augmentative communication user, and
American Speech-Language-
only requires consultation to monitor
Hearing Association, 2002).
Speech-language pathologists in the equipment. SLPs advocating for
schools are encouraged to be actively changes may find documentation of
Weighted Caseload
involved in seeking strategies to caseload or workload responsibilities
Distribution
manage their caseload (Power-deFur, helpful. Consideration of student needs
When managing multiple speech-
2001b). Strategies include: is important to caseload distribution
language pathologists within a school
and management.
• prevention activities at the division, characteristics of students,
school site, such as the age and the severity of
their needs can also be considered.
• collaboration with teachers and
For example, a student who is enrolled
administrators,
in speech-language services for an
• strategic scheduling and articulation error may require less
groups, service time, paperwork, consultation
or preparation than a student who
• participation in problem
solving,
• effective utilization of
paraprofessionals,

Special Topics
be familiar with the language master. The VDOE Web page also
Literacy expectations of the SOL in all content provides a blueprint of those skills
Development areas. Proficiency in the five aspects
of language (i.e., semantics, syntax,
measured on each SOL assessment.
A review of the blueprint will assist
The speech-language pathologist’s morphology, phonology, and in determining those skills that must
background in language is a valuable pragmatics) is necessary in all areas be acquired by a certain grade level.
asset to educators when addressing and across all grade levels. The oral Further, the VDOE Web page provides
strategies to enhance literacy. The language component of the English test items from past years. These
speech-language pathologist may serve Standards of Learning has an obvious can provide direction for the written
as a member of a team developing relationship to speech-language language skills and test formats with
strategies to enhance literacy of pathology services. However, other which students will need to be familiar.
all students, provide services in content areas require language Speech-language pathologists can
collaboration with other educators, or proficiency as well. For example, use this information to ensure that the
provide direct services to children with morphological skills are necessary stimulus materials they use provide
oral language deficits that limit their to master fractions (e.g., one-tenth), students with the same format they
access to literacy. When collaborating pragmatic skills are necessary to debate will need to master in their classroom
with teachers in a classroom, the a topic, and syntactic skills are necessary and on the general curriculum (SOL)
speech-language pathologist may to understand written directions assessments.
target the students with speech- in all content areas. Furthermore,
language impairments who have oral metalinguistic skills (i.e., the ability to The American Speech-Language-
and/or written language deficits. This use language to reflect on language) are Hearing Association (ASHA) takes the
collaboration may provide an incidental necessary for higher order thinking in all position that the speech-language
benefit to all students in the classroom content areas. pathologist plays a critical and direct
(Virginia Special Education Regulations, 8 role in the development of literacy
VAC 20-81-40). for children and adolescents with
Rather than teaching the communication disorders. There is a
Special education law defines special curriculum, speech-language well-established connection between
education, as specially designed pathologists use the curriculum spoken and written language. Spoken
instruction, which is further defined, as as a source of stimulus materials language provides the foundation for
adapting, as appropriate, the content, for the children they serve. This the development of reading and writing
methodology or delivery of instruction, practice will give the children and there is a reciprocal relationship in
to address the unique needs of the child more exposure to the general that each builds on the other, resulting
that result from the child’s disability curriculum and enhance their in general language and literacy
and to ensure access to the general ability to generalize their skills. competence. This relationship between
curriculum, so that the child can meet spoken language and literacy begins
the educational standards that apply to early in a child’s life and continues
all children (Virginia Special Education The Virginia Department of Education through adulthood. Persons with
Regulations, 8 VAC 20-81-10). To ensure (VDOE) Web page www.doe.virginia. spoken language difficulties will have
access to the general curriculum, gov has numerous resources that are challenges with reading and writing
speech-language pathologists must useful for understanding the general and those having difficulties with
integrate their services with the general curriculum. Teacher resource guides, reading and writing will have challenges
education curriculum. Instructional enhanced scope and sequence guides, with spoken language. There is also
materials used by the student in the and links to instructional materials a connection between reading and
primary educational placement provide can be useful for speech-language writing and using language strategically
the best source of materials for school- pathologists as they improve their for effective communication, thinking
based speech-language pathologists. understanding of the language and learning.
expectations in the curriculum across
In Virginia, the general education different grade levels. In addition, a
curriculum is based on the Virginia review of the Standards of Learning
Standards of Learning (SOL). Speech- assessments can assist in identifying
language pathologists should those language skills a student must

and assistive technology supports to in students with ASD (Bellini,

Autism improve performance of students with 2006).
Spectrum ASD. Knowing the student’s individual
strengths and weaknesses will better Behavioral supports such as
Disorders enable the speech-language pathologist posted rules, consistent
to design a functional approach to meet classroom routines, systematic
The term autism spectrum disorder that student’s communicative needs. reinforcement systems, tangible
(ASD) includes Pervasive Developmental The following supports are examples and nontangible reinforcers,
Disorders, also referenced as autism of individual student supports that self-monitoring scales, a quiet
spectrum disorder, Autistic Disorder, address features of autism and may be retreat area, periodic breaks, and
Asperger’s Disorder, Rett’s Disorder, provided to students in any classroom. showcasing student interests
Childhood Disintegrative Disorder, or and passions can increase the
Pervasive Developmental Disorder – Visual supports such as individual display of positive behaviors
Not Otherwise Specified, and Atypical schedules, task lists, task in students with ASD (Janzen,
Autism. Students with a medical organizers, templates, clearly 2003).
diagnosis of autism spectrum disorders defined physical boundaries
must be found eligible for special within the classroom, visual Assistive technology supports
education and related services using timers, cue cards, picture ranging from low tech, (such
Virginia’s eligibility criteria (8 VAC 20-81- prompts, picture symbols, as dry erase boards, clipboards,
80 J) before an Individualized Education or any visual representation 3-ring binders, photo albums.
Program (IEP) is developed. The Virginia of messages can enhance or highlight tape), to mid tech,
Department of Education has published student performance in (such as recording devices,
a guidance document, Guidelines instruction, communication, timers, calculators), to high
for Educating Students with Autism socialization, behavior and tech, (such as computers,
Spectrum Disorder, which provides transitions. Students with ASD video cameras, personal digital
additional information and is available often demonstrate greater assistant (PDA), or complex
online at www.doe.virginia.gov. understanding when shown, voice output devices), can
rather than told, what to do increase positive outcomes for
Students with ASD frequently have (Hodgdon, 1999). students with ASD (WATI, 2003).
communication challenges and may
receive services from an SLP. Common Communication supports such Sensory supports, such as the on-
characteristics of autism spectrum as real objects, pictures, going provision of materials and
disorders include: symbols, photographs, written activities for students with ASD
words, increased wait time, to modulate sensory responses,
• Social differences: might have voice meters, visual pragmatic (compression items, music,
difficulty understanding the cues and augmentative headphones, calming area,
perspective of others communication devices can rocking chair, opportunities
• Communication differences: all enhance both receptive for rhythmic sustained
might have difficulty and expressive language for movement, oral stimulation
understanding nonverbal (non- students with ASD (Mirenda, opportunities, personal fan, seat
spoken) communication and 2009). cushions) and environmental
literal vs. figurative language accommodations, such as the
Social supports such as visual use of natural light, lower levels
• Repetitive behaviors or prompt cards, social stories©, of lighting, incandescent rather
obsessive interests: might have scripts, rehearsals, peer than fluorescent bulbs, or seat
strong need for predictability partners, and video modeling placement by a window, can
or a passionate interest in one when implemented as part increase student self-regulation,
topic of systematic social skills decrease display of challenging
instruction can improve behaviors, and maximize
SLPs may collaborate with other demonstration and engagement in instruction
educators to develop visual, social, generalization of social skills (Miller, 2006).
communication, behavioral, sensory

Service delivery models should Some school divisions have established assistance centers also provide training
provide for multiple communication school autism teams that provide and materials to assist those working
opportunities in naturally occurring opportunities for staff to support and with students with ASD. For more
settings. Pull-out services may be train each other as new developments information on training and materials
considered by the IEP team for teaching in the field arise across disciplines. visit www.ttaconline.org.
specific skills, however, therapy in the The VDOE training and technical
classroom or any teaching environment
where the skill will naturally be used
should be part of the student’s overall
communication plan. For more information see the following references:
Virginia Autism Council
For many students with ASD, verbal
www.autismtrainingva.org/
skills may be limited or nonexistent.
The Virginia Autism Council is a state-supported council of autism experts
SLPs should work with IEP teams
seeking to define needed skill competencies and to advance higher
to determine if there is a need to
education, training and educational opportunities for personnel and
augment expressive communication.
caregivers supporting individuals with autism.
As with other disabilities, this may be
accomplished through the use of: Autism E-News
www.doe.virginia.gov/special_ed/disabilities/autism/enews/index.shtml
• Sign language or an agreed
VDOE’s Training and Technical Assistance Centers (T-TACs) publish an
upon set of physical gestures
e-newsletter with information on the education of students with autism.
• Picture or text communication Archive copies and free subscription information is available from this link.
system
Evidence Maps Autism Spectrum Disorders
• A speech generating device www.ncepmaps.org/Autism-Spectrum-Disorders.php
Comprehensive set of research on autism spectrum disorders. Information
• A combination of any of the
on Clinical Expertise and Client/Patient Perspectives is also provided.
above
Ohio Center for Autism and Low Incidence
As the number of children identified www.ocali.org/
with this disability continues to rise, Education materials, research, Web site links, and online training
continued education and training
First 100 Day Kit
is important; this applies to the SLP,
www.autismspeaks.org/community/family_services/100_day_kit.php
school, community, and the families
The Autism Speaks 100 Day Kit and the Asperger Syndrome and High
involved. A public school SLP has
Functioning Autism Tool Kit are intended for newly diagnosed families
the responsibility to support the
to make the best possible use of the 100 days following their child’s
student’s communication needs in his
diagnosis of autism or AS/HFA.
or her educational setting. Educating
other professionals, as well as family National Professional Development Center on Autism Spectrum Disorders
members, is an important component autismpdc.fpg.unc.edu/
of the speech-language program A multi-university center to promote the use of evidence-based practice
for students with ASD. This can be for children and adolescents with autism spectrum disorders.
achieved by attending trainings, staying
School Community Tool Kit Modules
current with the research, and sharing
www.autismspeaks.org/community/family_services/school_kit.php
the newly acquired knowledge with the
Includes information on support for school staff who interact with
school staff and community; in this way,
students with autism in various capacities. It provides valuable
the SLP is acting as both the trainee and
information and resources that can be employed by special education
trainer.
and administrative staff in their efforts to plan for and support students
in general education environments and involvement in the school
community as a whole.

spoken languages and should not Teams that ignore cultural or

Language be considered a speech or language linguistic differences demonstrate
Diversity disorder. Additionally, educators
must acknowledge that students
cultural incapacity, a stage in the
development of cultural competence
The overrepresentation of racially, using dialects are speaking or writing in which cultural differences are
culturally, ethnically and linguistically following the language patterns of neither punished nor supported (FOR
diverse students in special education their community to avoid making CULTURAL COMPETENCE: Knowledge,
is well documented and continues inappropriate determinations. Skills, and Dispositions Needed to
to be an area of emphasis for the U.S. Embrace Diversity, 2007). When
Department of Education and the Office Cultural sensitivity and competence students are evaluated using a ‘culture
of Special Education Programs (OSEP). are a necessity for educators given the neutral lens’ or when differences
As required, the Virginia Department of increasingly diverse populations served are viewed as inconsequential it is
Education (VDOE) gathers and examines in schools. When there is evidence of referred to as cultural blindness. Such
school divisions’ data to determine if cultural or linguistic diversity, teams cultural blindness can be evident in
disproportionate representation due must ensure that assessment and assessments. Test items that require a
to inappropriate identification of racial classroom teaching strategies are high level of knowledge and experience
and/or ethnic groups exists. culturally and linguistically responsive with mainstream culture are considered
and that teachers have the linguistic to have a high ‘cultural load.’ Test items
To help prevent overrepresentation, training required to build on the that require a high level of proficiency
SLPs and school teams should language skills of students from with English are considered to have
ensure that their structures, policies, dialectally diverse backgrounds. a high ‘language load.’ Researchers
and routines account for language
diversity and cultural differences. The Figure 8. A sampling of possible communication profiles.
term language diversity describes
the wide variation in communication
form, function, and use. For example, SLI WNL SLI
variations in vocabulary, morphology, WNL
syntax, and phonology may be noted
in individuals who communicate in SLI WNL
English using regional dialects. Non-
native English speakers may exhibit
SLI
Dialec
communication differences because of WNL

BICS
language differences, accents or cultural SA

variations.5 E LP
t
CA
The evaluation process, and any
pre-referral interventions, should first
examine whether an area of concern
Native
results from a cultural or language Speakers of
Native English
difference, and/or economic disparity. Another
Local community dialectal and cultural
Speakers Language
variations that exist within the school
division should be examined by the
team and documented efforts should SAE = Standard American English
be made to ensure that student BICS = Basic Interpersonal Communication Skills
performance is viewed using culturally CALP = Cognitive Academic Language Proficiency
and linguistically sensitive measures. WNL = Within Normal Limits
Educators should use the student’s SLI = Speech Language Impaired
community language, not race, when
considering dialect use and recognize 5 Additional information on language acquisition is provided in the section on English Language
that accents are a natural part of Learners.

(Ortiz and Ochoa, 2005) report that

Table. 15 Common Features of SWE
students with cultural and linguistic
that Overlap with AAE
differences may score substantially
lower (up to 35 points) than peers due Feature Example
to language and cultural differences.
Assessments requiring Standard Irregular Past / Zero past tense – “After he open(ed) his
American English (SAE) may result in Variable use of –ed to mark past tense mouth, he eat the
an underrepresentation of ability or and present tense forms of irregular cookie.”
achievement when assessing students verbs used
using a dialect such as Southern White
English (SWE) or African American Invariant be - Infinitival be coding “and we be cold.”
English (AAE) or those whose native habitual actions or states
language is not English.
Completive done - Done used to “He done finished his
A lack of cultural sensitivity may result emphasize completed actions homework.”
in inadvertent overidentification of
language learning impairments by Zero-marked be - Variable use of copula “My dog (is) young and (will)
identifying dialectally and culturally and auxiliary forms of be verbs. have to go to the park
acceptable productions as inadequate to play.”
relative to Standard American
English. Likewise, underidentification Subject – verb agreement - Subjects and “My mom like_ to go
of language learning impairments verbs differ in marking and number shopping.”
may occur by mistakenly attributing
deficient language abilities to the Multiple negation - Use of two or more “It’s not cold no more.”
presence of dialectal or cultural factors. negatives in a clause
A critical factor in determining language
difference versus disorder is comparison Auxiliary ain’t - Used in place of negative “I ain’t got homework.”
of the student’s language abilities auxiliary have+not, do+not, are+not,
relative to the expectations of their and is+not.
dialectal and/or cultural peer group,
which may be substantially different Zero-marked plurals - Variable inclusion “She likes those five toy_.”
from SAE expectations. of –s to mark plurals
Native English Speakers Undifferentiated pronoun case or “Them chasing them.”

Using a Dialect Pronoun substitution - Pronoun “Her fell.”
When examining a student’s language cases used interchangeably
use, the SLP must first assess the
student’s linguistic background Existential it/they - It or they used “I saw it’s a girl or boy
and determine whether a dialect or in place of there to indicate the running.”
accent is possibly being used. This existence of a referent without adding
initial determination prevents the meaning
misidentification of phonological or
morpho-syntactic dialect patterns as Appositive pronoun - Both a noun and “The other dogs they barked.”
evidence of a language disorder. pronoun or two pronouns used to
signify the same referent
Information about dialect density or
variations in pattern use based on
context is also important. Oetting
and McDonald (2002) describe three
possible methods for characterizing
dialect usage: listener judgment, type

based, and token based. SLPs using Phonological features additional information on working with
the listener judgment method must Differences in the phonological students who are learning English, visit
be familiar with dialect patterns and system, impacting the production the VDOE Web site www.doe.virginia.gov
current research. Once the linguistic of sounds and words, are another and the special topics section English
background and dialect usage of the area for consideration. Dialectically Language Learners in this publication.
student is determined, the SLP should acceptable substitutions of sounds, SLPs should also consider that lack of
share this information with other cluster reduction, and consonant familiarity with English may result in
educators and those conducting any reduction (dropping of a sound) are hesitations, false starts, pauses, that
assessments to ensure an unbiased documented in professional literature. may not be indications of dysfluent
examination of student performance. These dialectical differences should behavior. Loudness, pitch, prosodic
Since many dialect patterns may be not be coded as errors, but differences and suprasegmental features may also
considered errors in Standard American when evaluating a student’s speech be impacted by the student’s native
English (SAE), it is important to provide production. language.
examples of the specific dialect features
used to ensure the student’s language Native Speakers of Another SLPs can support classroom teachers
difference is not considered a disorder. Language and the evaluation team by providing
When students speak more than one information on cultural norms and
Some students who use a dialect language, it is important to examine evidence-based patterns of dialect
may also have a language disorder. the rules of both languages, since or other languages that should be
The SLP should be able to identify one language may impact the use of considered when evaluating student
and distinguish contrastive features another. When working with native performance. It is important to
(features unique to the dialect) versus speakers of another language, the remember that students who use
noncontrastive features (features shared SLP should examine the student’s dialect patterns or features of a native
with SAE) in order to differentiate a proficiency in English and consider language in spoken or written language
language disorder from a language the phonemic, allophonic, syntactic, exhibit a language difference, not a
difference (Bland-Stewart, 2005). For morphological, semantic, lexical, disorder. These language differences
example, if a first-grade student who and pragmatic characteristics of the should be addressed outside of special
uses a dialect does not appropriately student’s other language. education.
use pronouns, articles, demonstratives,
or complex sentences, the SLP may A comparison of the phonemic
suspect a language disorder in addition inventory (sounds used in a language)
to the documented dialect use. of English and the native language
will help the SLP to identify sounds
Morphological and Syntactic features in the native language that may not
Educators who are familiar with exist in English or identify sounds in
common dialect features should identify English that do not exist in the native
dialectical differences when reviewing language. Additionally, sounds may not
language or writing samples. There is be used the same way or in the same
significant overlap in morpho-syntactic combinations in both languages. For
dialect patterns for Southern White example, in some languages a sound
English (SWE) and African American may only be used at the end of words
English (AAE) documented in the and not as a word-initial sound. ASHA
research (Oetting, Cantrell, Horohov, provides phonemic inventories for many
1999; Craig et al., 2003). Table 15 languages online at www.asha.org/
includes some features of SWE that are practice/multicultural. Resources such
also among the most common features as Multicultural Students with Special
of AAE. Language Needs - New 3rd Edition by
Celeste Roseberry-McKibbin can also
provide features of various languages
and phonemic inventories. For

For more information see the following references:

Adger, C. T., Wolfram, W., & Christian, D. (Eds.). (2007). Dialects in schools and
communities. Mahwah, NJ: Erlbaum.
Bland-Stewart, L. M. (2005, May 03). Difference or Deficit in Speakers of African
American English? : What Every Clinician Should Know…and Do. The
ASHA Leader.
Cazden, C. B. (2001). Classroom discourse: The language of teaching and
learning (2nd ed.). Portsmouth, NH: Heinemann.
Craig, H. et al., (2003) Phonological Features of Child African American English,
JSLHR, v 46 623-635
Godley, A., Sweetland, J., Wheeler, S., Minnici, A., & Carpenter, B. (2006).
Preparing teachers for dialectally diverse classrooms. Educational
Researcher, 35(8), 30–37.
Hudley, A. & Mallinson, C (2011) Understanding English Language Variation in
U.S. Schools. New York, NY: Teachers College Press.
Oetting, J. & McDonald, J. (2002) , Methods for Characterizing Participants’
Nonmainstream Dialect Use in Child Language Research, JSLHR, v 45. 505-
518
Oetting, J., Cantrell, J., and Horohov, J. (1999) A Study in Specific Language
Impairment (SLI) in the Context of Non-standard Dialect, Clinical
Linguistics and Phonetics, v 13, 25-44
Spaulding,T., Plante, E., and Farinella, K. (2006) Eligibility Criteria for Language
Impairment - Is the Low End of Normal Always Appropriate? Language,
Speech, and Hearing Services in Schools Vol. 37 61-72 January
Tabbert, Russell, (1994) Linguistic Diversity in America: Will We All Speak
“General American?” www.eric.ed.gov/ERICWebPortal/search/detailmini.
jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED374658&ERICExtSear
ch_SearchType_0=no&accno=ED374658
Virginia Department of Education (2007) FOR CULTURAL COMPETENCE:
Knowledge, Skills, and Dispositions Needed to Embrace Diversity.
Richmond, VA: Author
Wheeler, R., Swords, R. (2006) Code-switching: Teaching Standard English in
Urban Classrooms (Theory & Research Into Practice) National Council of

The students are making needed

Limited English Second Language Acquisition
Speech and language pathologists connections between the first language
Proficiency must understand the first as well
as the second language acquisition
and their new language. Conversational
proficiency is the ability to use language
(LEP) process. They must be familiar with in face-to-face communication. It
current information available on the is important to remember that oral
There has been a significant increase in morphological, semantic, syntactic, proficiency does not constitute second
the number of students from culturally pragmatic, and phonological language proficiency. Oral proficiency is
and linguistically diverse populations development of children from a non- not sufficient for the increased language
who are developing English proficiency English language background to be demands required for academic
in Virginia (VDOE data). The increasing able to distinguish a communication competence.
numbers of linguistically and culturally difference from a communication
diverse students present a unique disorder in bilingual children. The acquisition of first and second
challenge to school divisions because languages shares many similarities.
these students often demonstrate The primary goal for most second The field of bilingual education has
communication behaviors similar language learners is to function as adopted a model of second language
to those exhibited by students with proficient learners in the classroom. (L2) acquisition that is based on Basic
language disorders. The speech- Literacy skills will transfer from the Interpersonal Communication Skills
language pathologist is challenged first language (L1) to the developing (BICS or social language) and Cognitive
to differentiate language differences second language (L2) if the student has Academic Language Proficiency (CALP
from language disorders. The VDOE learned the academic skills (reading, or academic language) (Roninson,
Handbook for Educators of Students writing, organization of information) 2003). After one to two years of
Who Are English Language Learners in the “home” or first language. Most exposure to L2, an average child usually
with Suspected Disabilities, provides language learners experience a time acquires BICS. At this level the child
assistance as teams identify and assess when they acquire receptive language socializes with peers and participates
students who are ELLs for possible skills before they are able to use the in everyday interactions. Achieving
eligibility for special education and language expressively. They listen but the CALP requires at least five to seven
related services. do not speak. This silent period parallels years of L2 exposure. This time period
the stage in first language acquisition is comparable to the period needed
The speech-language pathologist will when the children are internalizing for a monolingual child to learn the
be part of an interdisciplinary team the vocabulary and rules of the new formal aspects of the linguistic code.
that may include English as a Second language. CALP development may be longer (up
Language (ESL) teachers, bilingual to 10 years) for students. Individual
professionals, qualified interpreters and differences in prior knowledge, learning
translators, in addition to the traditional Speech-language pathologists styles, previous academic and abilities
members of special education teams. should become familiar with the will determine how quickly a student
This team will ensure that the relevant culture and communication style will progress through the various stages.
information is compiled, including (e.g., independent research and
immigration background and personal consultation with knowledgeable The student’s social-emotional
life such as separation from family, individuals) of the student being characteristics can also influence
trauma or exposure to war or other assessed. the rate of L2 learning. The student’s
conflicts, length of time the student has personality (extrovert vs. introvert, low
been learning the English language, vs. high self-esteem, shy vs. assertive),
and the type of instruction and informal Students with Limited English home culture’s attitudes toward L2 and
learning opportunities. The team will Proficiency (LEP) may be more cultural adjustment, and socioeconomic
gather this information by interviewing comfortable speaking with other status can be factors that will alter the
the parents or family members, by second language learners in a social time for L2 acquisition (Roninson, 2003).
reviewing records, or by contacting staff setting yet remain silent in the general Brice (2002) identifies a number of
from the agencies or organizations that education classroom. The silent commonly held myths about students
may be working with the immigrant period is part of the learning process. with limited English proficiency that can
family.

Table 16. Comparison of Children with Limited English Proficiency

with and without Disabilities
Characteristics Child with limited Child with limited English proficiency

English proficiency and a disability
Communication Typical language learning potential. May exhibit speech and language disorders in
Skills Communicative use of English is reduced the areas of articulation (atypical phonology
and easily noted by native English or prosody), voice, fluency, or receptive and
speakers. English phonological errors expressive language; may not always achieve
common to culture. No fluency or voice communicative competence in either first or
impairment. Can be communicatively second language. May exhibit communication
proficient to function in society. behaviors that call attention to himself/herself
in L1.
Language L1 skills are appropriate for age level May have deficits in vocabulary and word finding,
Skills prior to exposure to L2. The nonverbal following directions, sentence formulation,
communication skills are culturally and pragmatics in L1 and L2. Atypical syntactic
appropriate for age level (e.g., eye contact, and morphological errors. Persistent errors in
response to speaker, clarification of L2. Low mean length of utterance (MLU) and
response, turn-taking). Vocabulary deficit difficulties in first language and English cannot
and word-finding difficulties in L2 only. be attributed to length of time in English-
Student may go through a silent period. speaking schools. Stronger performance on
Code switching common. tests assessing single word vocabulary than on
tests assessing understanding of sentences or
paragraphs.
Academic Typical language learning potential. May observe limited progress in second language
Functioning Apparent problems due to culturally acquisition, difficulty retaining academic
determined learning style, different information, difficulty in schoolwork of home
perceptual strategies, or lack of schooling country, or difficulty in acquiring the first
in home country. language.
Progress Progress in home language is contingent May show less than expected progress in English
upon adequacy and continuation of first acquisition and development of academic skills.
language instruction. Academic progress May show a marked or extreme discrepancy
in English should be steady, but will between different areas (e.g., oral skills and
depend on the quality and quantity of writing skills) that cannot be attributed to lack
English instruction. of sufficient time or appropriate interventions.
Social No social problems in L1. May have some May exhibit persistent social and behavioral
Abilities social problems due to lack of familiarity problems that are in L1 and his/her native
with American customs, language, culture and not attributable to adjustment and
expected behaviors, etc. Student may acculturation.
experience social isolation and may be
likely to be a follower rather than a leader
in a group of English speakers.
Adapted from Handbook for Educators of Students Who Are English Language Learners with
Suspected Disabilities (2009), Virginia Department of Education

impede educators’ or speech-language The speech-language pathologist L2, a disorder would not be indicated,
pathologists’ ability to understand should become familiar with the but rather a characteristic of second
the difference between a language student’s cultural communication language acquisition.
impairment and language difference. norms. Analysis of the English errors
of phonology, morphology or syntax Working With Foreign
Eligibility for special education with should consider the phonology, Language Interpreters and
a speech-language impairment must morphology, syntax, semantics and Translators
be based on the presence of a speech- pragmatics of the student’s native Interpreters can be used when there
language impairment in L1, not the language (Derr, 2003). are no available speech-language
child’s limited English proficiency. Care pathologists fluent in the language of
must be given to determine the cause At any point in the process of acquiring the child. The interpreter functions as a
of the communication skill deficits. second language proficiency, a student link between the school culture and the
Table 16 contrasts the characteristics may appear to have language delays or culture of the student’s family. The use
of students with limited English even language disorders as observed of a trained interpreter is preferable to
proficiency alone and limited English in the classroom. Making a differential the use of a family member. The speech-
proficiency in conjunction with a diagnosis is challenging for both the language pathologist should meet with
communication impairment. bilingual and monolingual speech- the interpreter to explain the purpose
language pathologist. However, if and protocols for the assessment,
When a child with limited English the speech-language pathologist’s provide descriptions of English
proficiency is referred for an evaluation analysis shows that English errors are terminology, and stress confidentiality.
for special education the following due to interference caused by learning
practices should guide the evaluation:
• Use trained interpreters
when interviewing the family
or talking to the child in a
language other than English. Artiles, A. & Ortiz, A. (Eds.). (2002). English language learners with special
education needs: Identification, assessment, and instruction. Washington,
• Interview the family (or staff D.C.: Center for Applied Linguistics.
from agencies involved with
the child) regarding the Collier, C. (2000). “Separating Difference from Disability.” Cross Cultural
child’s communication skills Developmental Education Services. Ferndale, WA.
in comparison with those of
peers, siblings, and parents. Cummins, J. (1981). “Four misconceptions about language learning proficiency
in bilingual education.” NABE Journal, 5, 3-35.
• Parental concerns about L1
communication skills. Guitierrez-Clellen, V. & Peña, E. (2001). Dynamic assessment of diverse children:
A tutorial. Language, Speech, and Hearing Services in Schools, 32, 212-224.
• ESL teacher reports slower than
typical acquisition of English. Hamayan, E.V. & J.S. Damico (1991). “Limiting bias in the assessment of
bilingual students.” Austin, TX: Pro-Ed.
Use standardized tests with caution. If
the normative sample for the test did Rhodes, R. L; Ochoa, S.H., & Ortiz, S.O. (2005). Assessing culturally and
not include a comparable group or if linguistically diverse students. New York, New York: Guilford Press.
the testing procedure was modified,
scores should not be reported. Review Roseberry-McKibbin, C. (1994). “Assessment and intervention for children with
the child’s written work to identify any limited English proficiency and language disorders.” American Journal
language patterns. Complete an MLU of Speech-Language Pathology, 3 Willig, A. (1992). In Ortiz, A.: “Assessing
assessment in both languages. appropriate and inappropriate referral systems for LEP”.

Web sites:
Handbook for Educators of Students Who Are English Language Learners with
Suspected Disabilities (2009, Virginia Department of Education
www.doe.virginia.gov/instruction/esl/standards_resources/resources/
handbook_educators.pdf
Virginia Department of Education Instructional Resources for English as a

Second Language
www.doe.virginia.gov/instruction/esl/standards_resources/index.shtml
The Council for Exceptional Children (CEC) Professional Practice Topics and
Information on Cultural & Linguistic Diversity
www.cec.sped.org/AM/Template.cfm?Section=Cultural_and_
Linguistic_Diversity&Template=/TaggedPage/TaggedPageDisplay.
cfm&TPLID=36&ContentID=5541
National Association for Bilingual Education (NABE)
www.nabe.org
Culturally Competent Assessment of English Language Learners for Special

Education Services www.nasponline.org/publications/cq/pdf/V38N7_
CulturallyCompetentAssessment.pdf
English Language Learners: An Introductory Guide for Educators
www.nasponline.org/resources/culturalcompetence/ell_educators.pdf
National Clearinghouse for English Language Acquisition & Language

Instruction Educational Programs (NCELA)
www.ncela.gwu.edu

The types of phonological processes Most processes fade by age five. While
Phonological (See Table 17) fall into three general this normative information should
Processes categories: be considered as a factor during
an evaluation, determinations of
• Whole Word/Syllable Processes
A phonological process is a systematic whether or not a student’s speech
change to a class or group of sounds • Substitution Processes production is disordered and eligible
that simplifies production for the for special education also should
• Assimilation Processes
child as a part of normal or disordered include consideration of intelligibility,
development. Phonological processes consistency of productions, and
Whole Word/Syllable processes
are a researched-based means of stimulability (Bernthal & Bankson, 1998).
change the syllables structure by
analyzing, describing and treating either taking away a sound(s), adding
speech production in children. While Although articulation and phonology
a sound(s), moving a sound, or a
age-norms are useful when only a few are both terms used when describing
combination of these. Final Consonant
sounds are in error, when multiple speech sound production, they are not
Deletion would be an example of a
sounds are in error phonological interchangeable. Articulation can best
process that would fall in this category.
processes provide an alternative way to be described as the movement of the
Substitution processes replace
examine and treat those errors. articulators when producing a sound,
one sound with another, changing
while phonology is a component of
something in the manner, place or
When multiple sounds are in error, language that controls the patterning
voicing of the sound. Stopping and
students may be very difficult to of speech sounds. When describing
Fronting are both types of substitution
understand. This is referred to as speech processes. Assimilation processes are speech sound production errors in
intelligibility. In the schools, speech terms of articulation, the assumption
also known as harmony processes, as
intelligibility is important because it is that there is a problem with the
one sound changes to become more
indicates how much the phonological movement of the articulators which
like (or exactly like) another sound in
processes present are affecting the needs to be corrected on a sound-by-
the word. For example, when a sound
student’s communication ability. A sound basis. When describing speech
at the beginning of a word changes one
study by Overby, Carrell, and Bernthal sound production errors in terms of
at the end, it is described as Progressive
(2007) found that speech intelligibility phonology, the assumption is that
Assimilation. A more detailed list of
was a variable that influenced teachers’ processes, assessment and remediation there is a problem with the patterning
perceptions of a student’s academic, of the sounds and it is connected to
techniques are available in the online
social, and behavioral performance in the meaning of language. In that case,
training modules at www.ttaconline.org.
school. When discussing presence of remediation should focus on changing
an impairment and possible educational The use of phonological processes the patterns of sound production in
impact, it is important to consider groups, and emphasizing the impact of
appears to be part of normal
speech intelligibility and phonological the change on meaning.
development at very young ages.
processes. Children’s use of phonological processes
should decrease steadily as they get
Phonological analysis is especially older. One study documented that a
helpful when developing treatment group of children ages 18 months to 21
for children with multiple sound months had a 55 percent occurrence of
errors and/or unintelligible speech phonological processes, while a group
(Hodson, 1992). By addressing the of children age 26 months to 29 months
production of multiple sounds within a were found to have only a 22 percent
pattern simultaneously, phonological occurrence (Preisser, Hodson, Paden,
remediation has been shown to be both 1988). Researchers’ data on specific age
effective and efficient in improving norms for phonological processes vary.
sound production and increasing Some processes, such as reduplication,
speech intelligibility (Klein, 1996). typically disappear before age three, but
others, such as gliding of liquids, tend to
persist up to age five.

Table 17. Phonological Processes
Phonological Process Description Example

Consonant Cluster a consonant cluster is simplified, changed, or ‘star’ becomes ‘tar’ or ‘dar’
Whole Word/Syllable
Simplification (reduction) eliminated ‘must’ becomes ‘mu’

Final Consonant Deletion the final consonant of a word is deleted ‘cup’ becomes ‘cu’
Reduplication a syllable is repeated often making CVCV word ‘wagon’ becomes ‘wawa’
Processes
Unstressed (weak) Syllable an unstressed syllable of a word is deleted ‘banana’ becomes ‘nana’
Deletion
Coalescence features of two adjacent sounds are combined ‘crying’ becomes ‘bying’
into one sound
‘plane’ becomes ‘palane’
Epenthesis a segment is added
Metathesis two sounds or segments are transposed ‘cinnamon’ becomes
‘cimmanin’
Affrication a fricative becomes an affricate ‘sheep’ becomes ‘cheep’

Backing a sound is replaced by a sound made further ‘too’ becomes ‘koo’
back in the mouth
Substitution Processes
Deaffrication an affricate becomes a fricative ‘chair’ becomes ‘shair’

Denasalization a nasal sound becomes a stop ‘no’ becomes ‘do’
Devoicing of Final a voiced final sound is devoiced ‘bad’ becomes ‘bat’
Consonants
Gliding of Liquids prevocalic liquids become glides ‘light’ becomes ‘wight’
Glottal Replacement a final or intervocalic sound is replaced by a ‘wagon’ becomes ‘wa?on’
glottal stop
Prevocalic Voicing a prevocalic voiceless sound is voiced ‘too’ becomes ‘doo’
Stopping a fricative or affricate becomes a stop ‘sheep’ becomes ‘teep’
Velar Fronting a sound is replaced by a sound made further ‘cup’ becomes ‘tup’
forward in mouth
Vocalization a liquid or nasal becomes a vowel ‘over’ becomes ‘ova’
Labial Assimilation a nonlabial consonant becomes a labial in the ‘bad’ becomes ‘bab’
Assimilation
Processes*
presence of a labial
Nasal Assimilation a nonnasal consonant becomes a nasal in the ‘can’ becomes ‘nan’
presence of a nasal
Velar Assimilation a nonvelar consonant becomes a velar in the ‘dog’ becomes ‘gog’
presence of a velar
* May be progressive - a sound at the beginning of a word changes one at the end or regressive - a sound at
the end of a word changes one at the beginning. Adapted from Bernthal and Bankson, 1998


Bernthal, J. E., & Bankson, N. W. (1998). Articulation and phonological disorders
(4th ed.). Boston, MA: Allyn and Bacon.
Hodson, B. W. (1992). Applied phonology: constructs, contributions, and
issues. Language, Speech, and Hearing Services in Schools.23(3), 247-252.
Khan, L. (1982). A Review of 16 Major Phonological Processes Language,
Speech, and Hearing Services in Schools Vol.13 77-85
Klein, E. S. (1996). Phonological/traditional approaches to articulation therapy:
a retrospective group comparison. Language, Speech, and Hearing Services
in Schools. 27(4), 314-323.
Overby, M., Carrell, T. & Bernthal, J. (2007). Teachers’ perceptions of students
with speech sound disorders: a quantitative and qualitative analysis.
Language, Speech, and Hearing Services in Schools. 38(4), 327-341.
Priesser, D. A. , Hodson, B. W., Paden, E. P. (1988). Developmental phonology:
18-29 months. Journal of Speech and Hearing Disorders. 53(2), 125-130.
Web sites:
Phonological Processes (three online training modules)
www.ttaconline.org
Overview of Phonological Processes
www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm

As with other areas of speech-language, • frequent, prolonged absences

Dysphagia the American Speech-Language- due to health issues; and
Hearing Association (ASHA) states that
Dysphagia is a disorder in swallowing, • limited social interaction and
only persons possessing a “competent
resulting in difficulty moving food communication during meals
level of education, training, and
through the mouth and into the or snack time.
experience” should conduct assessment
stomach. The number of children
and intervention (ASHA, 2003).
requiring management for dysphagia Any school staff member or parent
Staying abreast of new developments
within the school setting is growing. with concerns about the child’s
in the field is the responsibility of
In the school setting, it is important feeding and swallowing should make
the individual speech-language
that teams be established to address a referral to the dysphagia team. The
pathologist. Any speech-language
the needs of children with swallowing team should complete observations
pathologist should ensure that his/her
disorders. Ideally, there will be a team in and the dysphagia checklist and
skills are current. Ideally, the speech-
each school where there is a child with assign a dysphagia case manager.
language pathologist will spend some
dysphagia. School divisions may want The dysphagia case manager should
time shadowing or being coached
to begin by creating a divisionwide ensure the parents are informed of
by a speech-language pathologist
dysphagia team. The team should be swallowing concerns from school
with significant experience in this
comprised of the following individuals: and are interviewed regarding their
area (Power-deFur, 2000). In some
observations and concerns in the home.
• speech-language pathologist, circumstances, a consultation with a
In addition, the case manager will
person outside the school division may
• occupational therapist, observe the student eating in a natural
be required.
• school nurse, setting, determine if further assessment
is necessary, determine if there is a need
• child’s teacher, Symptoms and Support at
for a medical referral such as a modified
School
• school nutrition director, barium swallow study, or if there is a
Speech-language pathologists,
need for positioning or diet changes.
• cafeteria manager, and occupational therapists, nurses,
teachers, parents, and paraprofessionals
• the child’s parent. An Individualized Health Care Plan
should be observant of the following
shall be developed to gather the child’s
symptoms of dysphagia:
NOTE: Most schools have a list of medical history, discuss the need for
Cardiopulmonary Resuscitation (CPR) • overt signs of aspiration, such a possible modified barium swallow
trained staff within their schools. as coughing, choking or a study, devise a feeding and swallowing
It is important to ascertain where runny nose; plan for school, and develop an in-
trained staff members are in school emergence plan. If a modified
• difficulty chewing and moving
relationship to the children with diet is required for the student, the
the food from the front to the
dysphagia. school nutrition director will need a
back of the mouth, pocketing,
doctor’s order to modify the food items
food falling from the mouth;
This team should stay in close contact offered or the texture of food offered
with the child’s parent and physician, • complaints of food “getting as part of a school meal. Appendix F
in addition to educating the staff on stuck in the throat”; includes a checklist that may be used by
the symptoms and support available a school-based swallowing team.
• recurrent aspiration
within the school. The team will be
pneumonia;
responsible for educating other school The Individualized Health Care Plan
staff (principals, teachers, central office • significant weight loss with may be attached to the child’s IEP. In
administrators) about dysphagia (its resulting fragility; some cases, the child will need direct
definition, treatment, and educational intervention to develop his/her feeding
• reduced alertness and
relevance). skills. In such a situation, an IEP meeting
attention in the classroom;
will also be held to develop the goals
• reduced strength and vitality; and objectives of intervention. Sample
IEP statements are shown below.
• weakened health status;

• Present Level of Educational

and Functional Performance
Maria has low lip tone resulting
in excessive drooling and American Speech-Language-Hearing Association. (2002). Roles of Speech-
spillage when eating and Language Pathologists in Swallowing and Feeding Disorders [Position
drinking. Maria needs to be Statement]. Available from www.asha.org/policy
visually cued to close her lips.
American Speech-Language-Hearing Association. (2002). Knowledge and Skills
Needed by Speech-Language Pathologists Providing Services to Individuals
• Goals and Objectives
With Swallowing and/or Feeding Disorders [Knowledge and Skills]. Available
Maria will improve her ability to
from www.asha.org/policy
eat independently, increasing
the number of different foods, Power-deFur, L. (2000). Serving Students with Dysphagia in the Schools?
textures, and temperatures Educational Preparation is Essential! Language, Speech and Hearing
she eats during lunch without Services in Schools. 31, 76 – 78.
assistance.
Web sites:
• Services
VDOE’s Training and Technical Assistance Centers
The amount and frequency of
www.ttaconline.org
direct intervention should be
Four free online training modules that provide a basic overview of
listed. The service provider may
how school-aged children typically swallow, screening tools, case
be any member of the team
management, and overall management of students requiring dysphagia
with the appropriate skills.
intervention and management.
• Services ASHA Swallowing and Feeding Disorders
The dysphagia team member www.asha.org/slp/clinical/dysphagia/
will train the paraprofessional, This Web site contains professional policy documents and special issues
classroom teachers, and other such as assessment, treatment, special populations, and additional
staff, as appropriate, in safe resources.
feeding techniques.
If the parents refuse swallowing

intervention plans (as is their right
through the 1990 Patient Self-
Determination Act), after informed
discussions with the dysphagia team,
then it is strongly recommended to
request their refusal in writing. This
request should acknowledge receipt
of the dysphagia report, consequent
treatment discussion, and desire for
continued unaltered feedings at school.

Auditory
cohesion
• auditory discrimination –
Auditory the ability to hear differences
Processing between sounds (speech or
nonspeech),
Auditory
figure-ground
Disorders
• auditory figure - ground
The central auditory nervous system problems – the ability to Auditory Auditory
develops and matures at least through attend to the primary memory discrimination
age 12. In theory, persons with auditory auditory message
processing disorders generally develop in the presence
symptoms at an early age and may of competing
continue to experience difficulty with auditory Auditory attention
auditory tasks as they mature. Auditory signals (e.g.,
skills build on one another, as shown in background
Figure 9. Auditory processing disorder noise,
is not one of the 14 federal disability other
Figure 9. Auditory Processing Skills Hierarchy
categories outlined in IDEA. To qualify speakers),
as a “child with a disability,” the student and
• Review developmental and
must have the characteristics of one • auditory cohesion – is the student records. Identify onset
of the existing 14 disability categories, ability to integrate information of symptoms, developmental
demonstrate an educational impact gathered auditorily. characteristics, and educational
as a result of the disability, and require
background. Review current
specialized instruction. Evaluation medications and possible
When a child is referred for an evaluation effects on performance.
Some researchers claim that auditory to determine special education eligibility
processing is a neural process. It due to a diagnosis of auditory processing • Use questionnaires, checklists,
is important to note that auditory disorder or a potential disorder, and the and interviews to gather input
processing is separate from language special education director or designee from teachers and parents
comprehension and is not a hearing decides to move forward with an regarding student performance,
acuity impairment. Children who have evaluation, the team should consider distractibility, attentiveness,
an impairment in auditory processing certain assessment measures and and compensatory strategies in
may have a diagnosis of Auditory medical information about the child. both quiet and noisy settings.
Processing Disorder.6 Students with
• Complete multiple classroom
auditory processing disorders may The following procedures are offered observations with special
have an underlying receptive language as a best practice approach to attention to the following areas:
disorder and abnormal language scores. completing an assessment of a child classroom noise (i.e., in-class,
suspected of having an auditory outside-class reverberation),
A student with a potential auditory processing disorder. proximity to teacher, and
processing disorder may have difficulty
• An audiological evaluation comparison with other students
in one or more of the following areas:
should be conducted in the class.
• auditory attention - the ability following a referral for auditory • Gather sufficient assessment
to focus on an auditory signal processing. A licensed data to allow for analysis of
(speech or nonspeech), audiologist with experience all auditory skills (attention,
• auditory memory - the ability working with school-age memory, discrimination, figure-
to remember information children with auditory ground, and cohesion).
presented auditorily, either processing disorders should
immediately or after a delay, conduct the evaluation. The student must meet the Virginia
eligibility criteria for one or more of the
6 Auditory Processing Disorder may also be termed Central Auditory Processing Disorders (CAPD). disability areas in order to be eligible for
special education and related services.

Table 18. Overlap Between Auditory Processing

Disorders, Attention Deficit Disorders, and Management
Speech-Language Impairments Regardless of the eligibility
determination, students with an
Auditory Speech- auditory processing disorder will benefit
Behavior Processing ADD/ Language from a multidisciplinary team approach
Disorder ADHD Impairment to management. The team may include
the classroom teacher, speech-language
Attention Concerns pathologist, school psychologist,
educational diagnostician, audiologist,
Distractibility X X X parent, and special education teacher
Difficulty listening X X X if appropriate (often the teacher of
Difficulty understanding verbal information X X students with learning disabilities).
Poor attention to auditory detail X X X Team members should recognize the
Poor attention to visual detail X significant overlap in the presenting
Forgetfulness of routines X characteristics of attention deficit
Short attention span X disorder (with or without hyperactivity),
Need for repetition of information X X X speech-language impairment, and
Appears to ‘daydream’ X X auditory processing disorders. It is
Appears to lack motivation X X important to address and rule out other
Delayed response to verbal requests X X X common disabilities that may impact
Frequently says, “Huh?” or “What?” X X X student performance (see Table 18).
Often misunderstands what is said X X X
Poor short-term memory X X Children with auditory processing
disorders will benefit most from
Hyperactivity, Impulsivity and Emotional Concerns management of three aspects of the
Fidgety - active hands and feet X following factors: environmental
Often leaves seat X modifications, development of
Excessive movement X compensatory strategies, and direct
Difficulty playing quietly X treatment for specific deficits. The
Talks excessively X following summarizes some key
Blurts out answers X management strategies that may be
Restlessness X X implemented for students in general or
Irritability X special education programs:
Poor social interactions X X • Place the child away from noise
Difficulty awaiting turn X sources and within 6 – 8 feet of
Interrupts or intrudes with others X X the speaker.
Academic Achievement • Work one-on-one or in small

groups.
Difficulty following verbal instructions X X X
Difficulty identifying, blending, and • Reduce or eliminate
manipulating sounds X X background noises (e.g.,
Poor receptive and expressive language skills X X audiovisual equipment).
Deficits in reading, writing, or comprehension X X X • Keep doors and windows
Decreased performance in noisy environments X X X closed to reduce outside and
Difficulty completing work X hall noise; place windows and
Worry about academic performance X X doors to the child’s back to put
Frequently looses or misplaces items X the noise behind the child.
Poor organizational skills X

Adapted from Chesterfield County Public Schools, 2000.

Environmental modifications • Teach auditory discrimination • Teach mnemonic strategies.

Environmental modifications may be skills through examples
provided to students in general and of curriculum and/or age These strategies may be provided
special education programs. One appropriate vocabulary. to students regardless of their
common example of environmental special education status and may be
• Teach auditory memory
modification is the use of sound implemented by the classroom teacher
enhancement activities (e.g.,
absorbers in the classroom to reduce (especially environmental strategies)
imagery and drawing).
sound reverberation (e.g., curtains at or the speech-language pathologist.
the windows, acoustical tile ceiling, • Use of phonemic awareness, Strategies should be addressed, as
carpeting or pads/tennis balls on chair sequencing training, and appropriate in the child’s IEP or 504
legs for noncarpeted floors, sound- language building exercises. plan.
absorbing room dividers and bulletin
boards).
Strategies
There are a variety of strategies that Bellis, T.J. (2003). Assessment and management of central auditory processing
may be implemented to assist a student disorders in the educational setting: From science to practice, second edition.
in compensating for or improving skills Clifton Park, NY: Delmar Learning.
related to the auditory skill weakness.
(Central) Auditory Processing Disorders (2005) American Speech-Language-
Examples of strategies include:
Hearing Association www.asha.org/docs/html/TR2005-00043.html
• Develop habit of previewing
Chermak, G. D., & Musiek, F. E. (Eds.) (2007). Handbook of (central) auditory
(announcing content), stating
processing disorder: Comprehensive intervention – Volume II. San Diego, CA:
(presenting content), and
Plural Publishing.
reviewing (summarizing
content). DeBonis, D, Moncrieff, D. (2008). Auditory Processing Disorders: An Update for
Speech-Language Pathologists American Journal of Speech-Language
• Teach the child how to manage
Pathology Vol.17 4-18
his/her placement within the
classroom to reduce the impact Colorado Department of Education (Central) Auditory Processing Deficits:
of noise. A Team Approach to Screening, Assessment, and Intervention Practices
(2008) www.cde.state.co.us/cdesped/download/pdf/APDGuidelines2008.pdf
• Teach the child how to
maximize his/her visual
Web sites:
strengths to compensate for
auditory weaknesses. ASHA Web article Understanding Auditory Processing Disorders in Children
www.asha.org/public/hearing/disorders/understand-apd-child.htm
• Consider the use of a personal
Overview of terminology, diagnosis, and treatment for auditory
or classroom FM auditory
processing disorders.
trainer (best used on a trial
basis with pre- and post-testing National Institute on Deafness and Other Communication Disorders
to determine the effectiveness). National Institutes of Health
www.nidcd.nih.gov/health/voice/auditory.html
• Teach the child to ask for
Overview of auditory processing disorder causes, diagnosis, and
clarification; to get organized
treatment.
and maintain a neat desk and
calendar; to study aloud (when Colorado Department of Education (Central) Auditory Processing
not interfering with others); Deficits: A Team Approach to Screening, Assessment & Intervention
to repeat what was said; to Practices (Revised 2008) www.cde.state.co.us/cdesped/download/pdf/
take accurate notes, using key APDGuidelines2008.pdf
words/concepts; and to note Guidelines for the screening, assessment, and intervention of (central)
communication clues (teacher’s auditory processing deficits were developed by the Task Force on Auditory
voice, time of day, setting). Processing, facilitated by the Colorado Department of Education.

student with a disability. The term physical therapist, special education

Assistive does not include a medical device teacher, regular education teacher, and
Technology that is surgically implanted, or the
replacement of that device.”
assistive technology specialist. Those
knowledgeable in assistive technology
The increase in the availability of should participate in the evaluation,
technology in general education, in and assistive technology services as: eligibility (of the service), and IEP teams
conjunction with IDEA’s delineation of whenever AT for the student is being
the school’s responsibility to provide “… any service that directly assists discussed.
assistive technology (AT) in the an individual with a disability
educational setting, had a significant in the selection, acquisition, or Assessment
impact for students with disabilities. use of an assistive technology The following series of questions can
It has increased the availability of device….” (Virginia Special Education guide the assessment and IEP teams as
appropriate AT services and devices Regulations, 8 VAC 20-81-10) they consider the need and type of AT:
for these students to ensure their • Does the student have any
participation in both academic and These definitions are general and allow
existing AT? If so, are the
social communities. The use of AT can IEP teams the flexibility that they need to
devices being used to their
enable a student to: make decisions about appropriate AT for
maximum benefit?
individual students. These technology
• increase his/her access to and solutions include a wide range of • What are the functional and
participation in the general no-tech, low-tech, mid-tech, and academic areas of concern
education curriculum, high-tech devices, hardware, software, and what tasks is the student
• increase productivity, and other instructional technology expected to complete (consider
tools that the student’s IEP team may communication, instruction,
• expand his/her educational/ identify as necessary for the provision participation, independence,
vocational options, of FAPE. The team’s considerations productivity, and environmental
• improve communication should not be limited to the devices control)?
opportunities and effectiveness, and services currently available within • What should the student be
the division. The Virginia Assistive
• reduce the amount of support able to do that is difficult or
Technology Resource Guide maintains
services needed, and impossible to do at this time?
a comprehensive list of AT strategies,
• increase his/her levels of modifications, accommodations of tasks, • What are the environments
independence. and assistive technology solutions for the student will be in (e.g.,
specific academic and communication classroom, lunchroom,
Assistive Technology and the areas. Up-to-date information on playground, gym, home)?
Special Education Process assistive technology can be found at
• What type of AT would be
Every IEP team must consider whether The Family Center on Technology and
appropriate for the student?
the student requires AT devices and Disability Web site www.fctd.info or from
services and that such devices and the Virginia Department of Education’s • Are additional AT services
services will be provided as needed. Training and Technical Assistance needed to enable the student
(Virginia Special Education Regulations Centers at www.ttaconline.org. to use the device? (Customizing
8 VAC 20-81-110 F (34 CFR 300.324[a]). and maintaining devices,
The Virginia Special Education Regulations Assistive Technology Teams coordinating services, and
define an assistive technology device as: The scope of knowledge and training the student, family or
amount of service that is required educational personnel should
“… any item, piece of equipment or for the successful consideration, be considered.)
product system, whether acquired assessment, and implementation of
• What is the schedule for
commercially off the shelf, modified, AT services is so broad and intensive reviewing progress toward
or customized, that is used to that it requires a collaborative team
the goals and objectives that
increase, maintain, or improve approach. Potential members of an
involve AT?
the functional capabilities of a AT team include the speech-language
pathologist, occupational therapist,

Within an IEP, AT may be: through participation in regional, state, Effective transition planning involves
or national training opportunities; a collaborative effort that involves the
• listed in the accommodations or
distance education, including Web- participation of the student, parents,
services section of the IEP. An
based training; or self-study. and professionals from the educational
accommodation refers to the
setting and community agencies
necessity to modify a task or an
When a student with disabilities uses working together to ensure that the AT
assignment so that the student
AT to perform either in the classroom needs of the student are addressed so
may compensate for the skills
setting, community-based instruction, that the student’s level of independence
that he/she does not have. For
or to accomplish activities of daily and function is maintained in the post-
example, a student may retell
living, the IEP team should consider school setting.
stories, but will tell them using a
the use of AT in transition planning.
communication device.
• a supplementary aid if its
presence (with other necessary
aids) supports the student For more information see the following references:
sufficiently to maintain the VDOE (2010) INFUSING ASSISTIVE TECHNOLOGY FOR LEARNING: Assuring Access
placement, and its absence for all Students—A companion document of the Educational Technology Plan
would require the student to for Virginia: 2010-15. Retrieved August 2010
be placed in a more restrictive www.doe.virginia.gov/support/technology/edtech_plan/assistive_technology.
setting. pdf
• a related service, just like Blackhurst, A. E. (2001). A Functional Approach to the Delivery of Assistive
physical therapy, or speech- Technology Services. Lexington, KY: University of Kentucky, National
language services, if the services Assistive Technology Research Institute.
are necessary for the student to
benefit from his or her special Chambers, A. C. (1997). Has Technology Been Considered? A Guide for IEP Teams.
education. For a student to be Reston, VA.: Council of Administrators of Special Education and Technology
successful in using AT, he or and Media Division of Council for Exceptional Children. [Available full text
she must be trained in its use. from ERIC - www.eric.ed.gov/ERICWebPortal/recordDetail?accno=ED439561]
Training to use a computer or an
augmentative communication Web sites:
device, or other similar devices VDOE’s Training and Technical Assistance Online Web Site
can occur as a related service www.ttaconline.com
that supports the student’s All information services, resources, and online training opportunities are
educational program. available free of charge online.
Periodic Review Virginia Assistive State Directed Project

To ensure there is no device vaatpp.org
“abandonment” the following The Assistive Technology project addresses priorities of VDOE with
questions can serve as reminders of the centralized dissemination of information about the laws which define AT
importance of AT for the student. Is the devices and services, the process of consideration of AT by Individualized
AT device and/or service: Education Program (IEP) teams, and AT assessment and resources.
• effective in its purpose? AIM-VA Accessible Instructional Materials Center of Virginia

aimva.org
• being utilized as planned? The Virginia Accessible Instructional Materials Center (AIM-VA) will produce
• in need of re-evaluation of and deliver accessible instructional materials for Local Educational Agencies
appropriateness? (LEAs) in Virginia who have students with an IEP indicating a need for
alternate formats of printed materials.
The AT team members will also need Assistive Technology at Virginia Commonwealth University TTAC
training to keep their knowledge and www.vcu.edu/ttac/assistive_technology/
skills current. This may be provided

office function. In addition, the division Coordination of Services: Medicaid

Medicaid/Famis must submit each service provider’s requires that when two or more
Reimbursement qualification with the Department
of Education. Since Medicaid is a
rehabilitation providers are providing
services to a child that those services
In 1988 the Supreme Court upheld a health care program, the qualification are coordinated (i.e., school and after
Massachusetts ruling, which clearly requirements vary from those required school therapies). Coordination of
established that health services by the Board of Education. services allows two treatment therapists
provided as part of a child’s IEP cannot to assure that maximum benefit of
be denied Medicaid reimbursement When any speech-language pathologist services is achieved for the child based
merely because they are in an IEP. Also, not meeting DMAS requirements on the treatment goals per the plan of
in 1988, the Medicare Catastrophic provides treatment, there must be a care (POC). Coordination of services may
Coverage Act was signed into law. supervisory 30-day on-site review. This prevent duplication (e.g., when a school
The act amended Title XIX to prohibit must be documented in the monthly speech-language pathologist and
the restriction of Medicaid funds from progress notes section. community-based speech-language
reimbursement for services provided to pathologist have identical treatment
a child with a disability because services DMAS requires a periodic review of the plans and provide identical services.)
were outlined in the IEP. The Conference child’s progress and revising or deleting Documentation of coordination should
Committee Report specified that goals as needed. This review allows for be recorded in the therapist’s progress
while the state education agencies are determining if the child has reached notes.
financially responsible for educational a plateau, regressed, or progressed as
services, in the case of a Medicaid- anticipated. Administrative Claiming
eligible child with a disability, state Administrative expenses in support of
Medicaid agencies remain responsible It should be noted that DMAS will the Medicaid program may be claimed.
for the “related services” identified in the only reimburse services that result in Activities include outreach, translation,
child’s IEP if they are covered under the significant and practical improvement coordination of services, and referrals.
state’s Medicaid plan. in the child’s level of functioning
within a reasonable period of time Use of Funds
There are two facets to the Medicaid (Improvement of Function). DMAS Federal requirements state that federal
program in schools. Special will not reimburse for services that funds must be used to supplement,
education billing, billing Medicaid do not result in significant practical not supplant, other appropriations (20
for services specified on the IEP that improvement, or the skills of a licensed U.S.C. Sec. 613 [a][9]). This means that
can be considered medical as well as therapist are not required in carrying Medicaid revenue may not be used to
educational (e.g., speech-language out the treatment to maintain function replace IDEA funds. There is no other
services, occupational therapy, nursing) (e.g., “maintenance therapy” or federal or state requirement regarding
has been in place in Virginia since “monitoring”). the use of Medicaid revenue.
1991. Administrative claiming, claiming
expenses that support the Medicaid Whenever the eligibility committee School divisions are encouraged to
program, was initiated in 2003. finds a child is no longer eligible for use the funds for special education
special education and related services or health-related services. Some
The Department of Medical Assistance or the IEP determines that a specific funding may be used to provide
(DMAS) provides information about related service should be terminated support to those employees who are
Medicaid billing on their Web site and in Medicaid may no longer be billed completing the additional requirements
their provider manual. All materials are for services. Additionally, Medicaid- to generate the funds. Potential
available online at www.dmas.virginia. reimbursed rehabilitation services will uses include: supplement salaries,
gov. be terminated when further progress pay workshop and conference fees;
toward the established goals is purchase augmentative/alternative
Special Education Billing unlikely and/or the family or caretaker communication devices or other
School divisions must have an active can provide the services (i.e., home assistive technology; pay fees to secure
provider agreement with DMAS for program) and the skills of a qualified the license needed to bill Medicaid; or
both special education billing and therapist are no longer required. purchase computer software, supplies,
administrative claiming. This is a central materials, equipment. Some localities

have used Medicaid revenue to fund

additional staff, lowering caseloads for
all speech-language pathologists in the
division. Centers for Medicare and Medicaid Services
www.cms.gov/
Regulations, provider manuals, information about state plans.
Medicaid School Provider Manual for Virginia
dmasva.dmas.virginia.gov/Content_pgs/mch-home.aspx

References and Resources

Annett, M. (June 10, 2003). Arizona, Virginia School Districts Recognize Values
of CCCs. ASHA Leader.
American Speech-Language-Hearing Association. (2004) K-6 Schools.
National Outcomes Measurement System. Rockville, MD: Author.
American Speech-Language-Hearing Association. (2002). Technical Report:
Appropriate school facilities for students with speech-language-hearing
disorders: Technical report. ASHA Supplement 23.
American Speech-Language-Hearing Association. (2002). A workload analysis
approach for establishing speech-language caseload standards in schools:
Guidelines. Rockville, MD: Author.
American Speech-Language-Hearing Association. (2000). IDEA and Your
Caseload: A Template for Eligibility and Dismissal Criteria for Students
Ages 3 – 21. Rockville, MD: Author.
American Speech-Language-Hearing Association. (1999). Guidelines for the
Roles and Responsibilities of the School-Based Speech-Language Pathologist.
Rockville, MD: Author.
Board of Audiology and Speech-Language Pathology. (2004). Regulations
Governing the Practice of Audiology and Speech-Language Pathology.
Richmond, VA: Author.
Brice, A. (2002). Guidelines for English-speaking SLPs in Treating Bilingual
Patients. Available at asha.ucf.edu/ASHA2002.html.
Chesterfield County Public Schools. (2001). Auditory Processing: Best Practice
Guide. Richmond, VA: Author.
Connecticut State Department of Education. (1999). Guidelines for Speech and
Language Programs. Vol. II: Determining Eligibility for Special Education
Speech and Language Services. Hartford, CT: Author.
Council for Exceptional Children. (2003). Mentoring Induction Principles and
Guidelines. Reston, VA: Author.
Derr, A. (July 2003). Growing Diversity in Our Schools-Roles and
Responsibilities of Speech-Language Pathologists. Special Interest Division
11 Perspectives on Language Learning and Education. Rockville, MD:
American Speech-Language-Hearing Association.
Fairfax County Public Schools. (2003). Culturally and Linguistically Diverse
Exceptional Students (CLiDES) Handbook. Fairfax, VA: Author.
Homer, E.M. (October 10, 2002). Dysphagia Teams in School Settings. ASHA
Telephone Seminar.
Horgan, D & Simeon, R.J. (1991). The Downside of Marketing, Performance,
and Instruction, 30(1) 34-36
Jakubowitz,M and Schill, M.J. (2008) Ethical Implications of Using Outdated
Standardized Tests School-Based Issues 9: 79-83
Kentucky Department of Education. (2002). Kentucky Eligibility Guidelines for
Students with Speech or Language Impairment. Frankfort, KY: Author

Laing, S. & Kamhi, A. (2003). Alternative assessment of language and literacy

in culturally and linguistically diverse populations. Language, Speech and
Hearing Services in Schools. 34.
Meline, T. & Paradiso, T. (2003). Evidence-based practice in schools: Evaluating
research and reducing barriers. Language, Speech, and Hearing Services
in Schools. 34. 273-283.
Miccio, A.W. (2002). Clinical problem solving: Assessment of phonological
disorders. American Journal of Speech-Language Pathology. 8, 347-363.
Moore-Brown, B. & Montgomery, J. (2001). Making a Difference for America’s
Children. Speech-Language Pathologists in the Public Schools. Eau Clair,
WI: Thinking Publications.
Nelson, N. (1996). Opening remarks: Are we asking the wrong question?
Division 1 Newsletter. (April 1996). American Speech-Language-Hearing
Association.
Plake, L., Impara, J. & Spies, R. (Eds.) (2003). The Fifteenth Mental
Measurements Yearbook. Buros Center for Testing.
Power-deFur, L. (March 20, 2001). Reducing Caseloads: A Potpourri of Ideas.
ASHA Leader.
Power-deFur, L. (April 2001). Making changes: Advocacy suggestions for
reducing caseloads. Special Interest Division 16 School-Based Issues.
Rockville, MD: American Speech-Language-Hearing Association.
Power-deFur, L. (2000). Serving Students with Dysphagia in the Schools?
Educational Preparation is Essential! Language, Speech and Hearing
Services in Schools. 31, 76 – 78.
QIAT Consortium. (August 2003). Quality Indicators for Assistive Technology
Services in Schools. www.qiat.org.
Rehabilitation Act of 1973. 34 CFR § 104.
Roninson, O. (April, 2003). But they don’t speak English!: Bilingual students
and speech-language services in the public school. Special Interest
Division 16. School-Based Issues. Rockville, MD: American Speech-
Language-Hearing Association.
Runyan, C. (January, 2004). Personal communication.
Sattler, J.M. (1988). Assessment of Children. (3rd edition). San Diego, CA:
Jerome M. Sattler Publisher.
Secord, W. (March 22, 2002). Classroom Performance Assessment: Where
Meaningful Access Begins! Presentation to Speech-Language-Hearing
Association of Virginia.
Shriberg, L. & Kwiatkowski, J. (1982). Phonological disorders III: A procedure
for assessing severity of involvement. Journal of Speech and Hearing
Disorders. 47. 256-270.

Smit, A., Hand, L., Freilinger, J., Bernthal, J., & Bird, A. (1990). The Iowa
Articulation Norms Project and its Nebraska Replication. Journal of
Speech and Hearing Disorders. 55. 779 – 798.
Virginia Board of Education. (2010). Regulations Governing Special Education
Programs for Children With Disabilities In Virginia. Richmond, VA: Author.
Virginia Board of Education. (2000). Guidelines for Mentor Teacher Programs for
Beginning and Experienced Teachers. Richmond, VA: Author.
Virginia Board of Education. (1998). Licensure Regulations for School
Personnel. Richmond, VA: Author.
Virginia Department of Education. (2002). Guidelines for Participation of
Students with Disabilities in the Assessment Component of the State’s
Accountability System. Richmond, VA: Author.
Virginia Department of Health. (1999). Virginia School Health Guidelines.
Richmond, VA: Author.
Virginia Institute for Developmental Disabilities. (2001). Creating collaborative
IEPs: A handbook. Richmond, VA: Virginia Commonwealth University.
Weiss, C. (1980). Weiss Comprehensive Articulation Test. Austin: Pro-Ed.

Notes

Speech-Language Pathology Services in Schools: Guidelines for Best Practices - APPENDICES
APPENDIX A:
Print and Web Resources
The following Web resources may be useful to speech-language pathologists, as well as those
interested in learning more about the services speech-language pathologists provide. It is not
an exhaustive list of useful Web sites. Further, inclusion in this list does not constitute
endorsement of the site.
Virginia Resources
www.doe.virginia.gov Main Web site of the Virginia Department of Education.
www.ttaconline.org Main Web site for the VDOE Training and Technical Assistance Centers or
T/TAC.
www.infantva.org Main Web site for the Infant & Toddler Connection of Virginia.
www.shav.org Main Web site for the Speech-Language-Hearing Association of Virginia (SHAV).
www.dhp.state.va.us/aud/default.htm Main Web site for the Virginia Board of Audiology and
Speech-Language Pathology.
www.vats.org Main Web site for the Virginia Assistive Technology System (VATS).
www.vddhh.org Main Web site for the Virginia Department for the Deaf and Hard of Hearing.
www.dmas.virginia.gov Main Web site for the Virginia Department for Medical Assistance
Services (Medicaid).
National Resources
www.asha.org Main Web site of the American Speech-Language-Hearing Association (ASHA).
www.tesol.org Main Web site of the Teachers of English to Speakers of Other Languages, Inc.
(TESOL).
www.ed.gov Main Web site for the United States Department of Education.
www.cal.org Main Web site for the Center for Applied Linguistics (CAL).
The following sites would be useful when conducting research searches to assist with ensuring
use of evidence-based practices (EBP):
American Psychological Association’s PsycINFO
www.apa.org
Education Resources Information Center’s (ERIC) public database

www.eric.ed.gov
PubMed’s Medline
www.ncbi.nlm.nih.gov/pubmed

77
Cochrane Collaboration
www.cochrane.org
ASHA journals
www.asha.org/publications
Virginia Department of Education Technical Assistance and Guidance Documents

The following technical assistance and guidance documents are available from the Virginia
Department of Education Web site, www.doe.virginia.gov.
VDOE’s Division of Special Education and Student Services has revised or developed, or is in the
process of revising or developing, the following technical assistance documents on matters related
to implementing the Virginia special education regulations. These documents are, or will be
posted, to VDOE’s Web site at www.doe.virginia.gov/VDOE/SESS
• Educational Interpreter Qualifications in Virginia Public Schools, Frequently Asked Questions
• Revised VDOE Model IEP Form, Standards-based IEP form, Secondary Transition IEP form
• Revised VDOE’s Model Procedural Safeguards Document
• Model Policies and Procedures Document for LEAs and SOPs
• Guidance Document for Local Screening Requirements in Virginia’s Public Schools
• Technical Assistance Document on Matters Related to Residency and FAPE Responsibilities for
Virginia’s Public Schools
• Revised Technical Assistance Document on Discipline Requirements
• Revised VDOE Complaint Resolution Procedures
• Revised Complaint Appeal Procedures
• Fact Sheets for Parents:
− Change in category name from MR to ID; Emotional Disturbance to Emotional
Disability
− Phasing out of the SD category
− Explanation for the age change to the DD category
− Parent Notification of RtI

APPENDIX B:
Assessment Terms
The following Assessment terms are important for comprehensive assessment in the field of
speech-language pathology.
Artifact Analysis: A review of student work to provide information on use of skills in the
educational setting. Artifacts may include homework, journal entries, essays, or other forms of
student work. Items may be analyzed for specific information or to highlight strengths, weaknesses,
and provide a comparison to peers.
Expository Text: Nonfiction work intended to inform or explain. Some common formats of
expository writing include descriptions, persuasion, analysis, and comparison.
Elliptical Productions: Productions omit repeated information during a conversation.

For example
Person 1: “What are you doing after school today?”
Person 2: “Getting a snack.” (after school today is omitted)
Language Productivity: Includes overall length, length per unit, mean length of utterance (MLU),
communication units (C-units), terminal unit (T-units), syntactic complexity; elaboration;
morphological adequacy; lexical diversity.
Language Sample Analysis: A process that consists of four parts: the student’s language sample,
transcription of sample, analysis, and interpretation. Analysis includes factors such as mean length
of utterance (MLU), number of different words (NDW), total number of words (TNW), mazes,
utterances per turn, repairs, and revisions.
Macrostructural Elements: Includes higher order hierarchical organization that typically focuses
on children's inclusion of story grammar components (e.g., description of situation, evolution of a
problem, attempts to resolve, and consequences) and their complexity. Features such as character,
setting, initiating events, number of story propositions and episodes, and informativeness are
important. Norm-referenced and criterion-referenced tools are available.
Mean Length Utterance (MLU): The mean number of morphemes produces calculated by dividing
the total number of morphemes in a language sample by the number of utterances.
Microstructural Elements: Include embedded structures used within the narrative and features of
construction, such as conjunctions, noun phrases, and dependent clauses, pronominal reference,
cohesive devices, and tense appropriateness.
Narrative Text: A fictional or nonfictional story, in oral or written form, that describes a series of
events. May be analyzed for micro or macro structural elements.

79
Definitions and examples of T-units, C-units, fragments, and clauses (Nippold, 2005):
T-Unit: A T-unit contains one independent (main) clause and any dependent (subordinate)
clauses or nonclausal structures that are attached to it or embedded within it (Hunt, 1970).
For example, the utterance ‘‘Bill bought a new bicycle before he went to Europe’’ is one T-
unit that contains an independent clause (‘‘Bill bought a new bicycle’’) and a dependent
clause (‘‘before he went to Europe’’). In contrast, the utterance ‘‘Bill went to France and then
he went to Italy’’ consists of two T-units because it contains two independent clauses joined
by the coordinating conjunction ‘‘and.’’ Whenever a coordinating conjunction (e.g., ‘‘and,’’
‘‘but,’’ ‘‘so’’) initiates an independent clause, that clause is considered to be a new T-unit.
C-Unit: A C-unit is identical to a T-unit but includes responses that lack an independent
clause when answering a question (Loban, 1976). For example,
the response ‘‘yes’’ to the question ‘‘Did Jack drive?’’ is one C-unit.
Fragment: A fragment is an utterance that lacks a main verb and/or a subject; therefore, it is
not an independent clause (Crews, 1977). It does not answer a question. For example, the
following utterances are fragments: ‘‘going down the road,’’ ‘‘the other day,’’ ‘‘2 weeks later.’’
Independent (Main) Clause: An independent clause contains a subject and a main verb and
makes a complete statement (Crews, 1977). For example, the following are both
independent clauses: ‘‘Mother rode her bicycle to work today,’’ and ‘‘It started to rain late
last night.’’
Dependent (Subordinate) Clauses: A dependent clause contains a subject and a main verb
but does not make a complete statement; therefore, it cannot stand alone. There are three
main types of dependent clauses: relative, adverbial, and nominal (Crews, 1977; Quirk &
Greenbaum, 1973):
1. A relative clause (i.e., adjective clause) acts like an adjective and modifies the
noun that precedes it: for example, ‘‘The cat that was sleeping on the couch was
content.’’
2. An adverbial clause acts like an adverb and modifies a verb. It often describes a
condition or cause and begins with a subordinate conjunction: for example,
‘‘Unless we can reach Los Angeles by eight o’clock, we’ll miss the concert.’’
3. A nominal clause is a noun-like element that can serve as either the subject of a
sentence (e.g., ‘‘Whatever she told you about the wedding was a great
exaggeration’’) or its object (e.g., ‘‘I told her what she needed to hear’’). Nominal
clauses often begin with wh-words: For example, ‘‘I never know where I should
park. ’’; ‘‘My desire to become a nurse is why I study so hard ’’; ‘‘Checkmate is
when your opponent’s king cannot escape.’’

For additional information on assessment terms and techniques please access the following
resources:
Nippold, M., Hesketh, J., Duthie, J., and Mansfield, T. Conversational Versus Expository
Discourse: A Study of Syntactic Development in Children, Adolescents, and Adults. Journal
of Speech and Hearing Research 2005; 48;1048-1064
Hughes, D., McGillivray, L., & Schmidek, M. (1997). Guide to narrative language: Procedures
for assessment. Eau Claire, WI: Thinking Publications.
Gillam, R.B. & Gillam, S. (2006) Making Evidence-Based Decisions about Child Language
Intervention in Schools, Language Speech and Hearing Services in Schools, Vol.37 304-315
Gillam, R. B., & Johnston, J. R. (1992). Spoken and written language relationships in
language/learning-impaired and normally achieving school-age children. Journal of Speech
and Hearing Research, 35, 1303–1315.[Web of Science][Medline]
Gillam, R. B., & Pearson, N. (2004). Test of Narrative Language. Austin, TX: Pro-Ed.
Leadholm, Barbara J.; Miller, Jon F. (1994) Language Sample Analysis: The Wisconsin Guide.
Bulletin 92424. www.eric.ed.gov/PDFS/ED371528.pdf Wisconsin State Department of
Public Instruction, Madison.
Paul, R. (2001). Language disorders from infancy to adolescence: Assessment and

intervention. (2nd ed.) St. Louis, MO: Mosby.

81
APPENDIX C:
Speech-Language Sample Screening Forms
These screening instruments are designed for the classroom teacher to administer. Teachers
may “pass” students who demonstrate no speech-language-voice problems on this checklist.
Any student who does not “pass” should be referred to the speech-language pathologist who
will conduct a second screening.
Completed forms shall be forwarded promptly to the designated person in the school division.
The speech-language pathologist may be notified to conduct the rescreening for any student
who does not “pass.” The rescreening must be completed within the 60- business day time
frame.
If results indicate a suspicion of a disability, the student shall be referred to the special
education administrator. Some screening situations may result in a child failing the screening
without a suspicion of a disability. Some examples of this include when a student speaks
another language fluently, has a medical condition that results in variation in voice quality, or
refuses to participate in screening. The individual conducting the screening should determine
if the results warrant a referral for evaluation due to a suspicion of a disability.

Sample New Student Speech, Language and

Voice Screening Instrument: K-3
Check observed behaviors. A student passes if “never” is checked for all behaviors.
Student: ______________________________________________ Screening Date: __________________
Grade: ______ Teacher: ______________________________________________ Date: _______________
Does the child have limited English proficiency? ___Yes___ NO

In comparison with his/her peers: NEVER SOMETIMES ALWAYS
1 The child is difficult to understand.
The child has a hoarse and/or nasal voice that does

2
not seem related to a cold or allergies.
The child has difficulty with phonological awareness

3 activities (e.g., rhyming, sound blending, syllable
segmentation).
The child has difficulty following directions and/or
4
responding to questions.
The child has difficulty making his/her wants and

5
needs known.
The child has difficulty using complete sentences or

6
correct grammar.
7 The child has limited vocabulary.

The child has difficulty expressing an idea or event
8
(e.g., what he did over the weekend).
9 The child appears frustrated when speaking.
The child exhibits part-word or word repetitions,

10 sound blockages, or excess facial or neck movement
when speaking (i.e., stuttering).
Other communication concerns:

83
Sample Communication Screening Checklist Grades 6-12
Student: _______________________________________________ Date: ________________________

DOB: ___ / ___ / ___ Age: ____ School: _________________________________________________
Student’s Counselor: _____________________________________________ ID#: ________________
Homeroom Teacher: ____________________________________ Date Entered School: _________
This checklist is to be completed for every student who is new to this school by the student’s
Language Arts teacher.
Answer each below question using the following codes

F=Frequently O=Occasionally N=Not at all N.O.=Not Observed
 Yes  No The student is an English language learner or uses a socio-cultural dialect.

 F  0  N  N.0. This student avoids talking in class.
 F  0  N  N.0. This student appears frustrated when trying to talk.
 F  0  N  N.0. This student avoids talking to peers/adults.
 F  0  N  N.0. This student seems concerned about his/her speech.
 F  0  N  N.0. This student withdraws from group activities.

 F  0  N  N.0. I feel uncomfortable when trying to communicate with this student.
This student is experiencing difficulties with: (check all that apply)
 Listening skills  Concept work  Following directions  Oral reading
 Reading comprehension  Other (Describe any items checked)
Observations about student’s communication (include comments for any items checked):
Voice Quality
Stuttering
Intelligibility
Articulation
Return this screening form to: ___________________________________________________________________

Sample Speech-Language Screening Checklist

Student: ______________________________________________________________ Grade: _________
Teacher: ______________________________________________________________ Date: ___________
Communication Skills: Please compare the student’s performance to that of his/her classmates.
Please answer all questions.
 Yes No  Sometimes Do you have difficulty understanding this student?

 Yes No  Sometimes Does the student avoid speaking in class?
Does the student have difficulty understanding curriculum
 Yes No  Sometimes
vocabulary and/or concepts?
Does the student require excessive “wait time” to either
comprehend or respond?
Does the student have difficulty expressing ideas in an
organized and coherent manner?
Does the student exhibit noticeable hesitations,

repetitions and/or tension?
Does the student’s voice sound unusual (e.g., hoarse, nasal,

high-pitched)?
Does the student’s speech rate/volume interfere with your

ability to understand him/her?
Does the student mispronounce sounds or words? Please

provide examples:
Have the parents expressed concerns regarding

communication?
Do you feel the student’s speech and language skills

negatively affect his/her academic performance?
Does the student appear to be upset or have concerns

about communicating?
 Yes No  Sometimes Does the student have difficulty following directions?
Does the student have difficulty using complete sentences
or correct grammar?
Please describe any items marked ‘Yes’ and attach to this form.
Please return this form to: ____________________________________ by: _____________________

85
APPENDIX D:
Comprehensive Communication Assessment System
The following comprehensive assessment tools are used to summarize and describe a student’s speech-
language performance, communicate with team members during eligibility and IEP decisions, and
assure consistency among speech-language pathologists across Virginia. After review of all assessment
data, the team should complete the appropriate Assessment Summary forms. Data from four
assessment sources 1) academic activities, 2) academic tests and measures, 3) SLP probes, and 4) SLP
tests and measures, should be included in a comprehensive assessment. For each column, circle the box
that best represents the student’s documented performance. The resulting descriptors will provide an
overview of the student’s communication skills. A visual pattern of strengths and weaknesses will be
apparent once all areas of assessment are documented on the summary sheet.
When a valid comparison to a normative sample cannot be made or a student has significant
impairments, teams should consider completion of the Functional Communication Summary form. This
tool provides an opportunity to document communication skills that cannot be represented using
typical norm-referenced measures for students who cannot be compared to a normative sample such as
those who are English Language Learners, those with intellectual disabilities, and those who use
alternative forms of communication.
The eligibility committee will consider the comprehensive assessment data, in conjunction with
criteria in Virginia regulations for eligibility as a student with a speech-language impairment and other
information, to determine eligibility. Eligibility team members should note that Eligibility is based
on:
(1) the presence of a speech-language impairment,
(2) an adverse educational impact, and
(3) the need for special education (specialized instruction) and related services
(services to benefit from special education).
The documentation of a level of impact does not guarantee eligibility. Instead; the Assessment
Summary forms describe speech-language assessment findings in consistent terms across all areas of a
comprehensive assessment. See the eligibility section of these guidelines for further information on
Virginia’s eligibility regulations.
Levels of impact must not be used to predict or specify a level of service. The services provided in the
IEP are determined after the IEP team considers the present level of educational and functional
performance and the student’s goals. Service recommendations are not based on the levels of impact
and IEP teams should not add or average levels of impact. See the IEP section of this manual for further
information on IEP development and decision-making.

Speech Production Assessment Summary
An articulation/phonological impairment is characterized by an inability to use speech sounds that are

appropriate for a person’s age and linguistic dialect. Such errors in sound productions may interfere
with intelligibility, social communication, and/or academic and vocational achievement.
Students cannot be considered to have an articulation/phonological impairment based on

characteristics that are consistent with cultural and/or linguistic diversity. Students who use American
Sign Language or other alternate forms of communication (e.g., augmentative/alternative
communication) should be assessed in their primary mode of communication.
Children who evidence problems with hearing, structure and function of the speech mechanism (e.g.,
cleft palate), or motor speech difficulty (e.g., apraxia) should be viewed differently than those with more
common developmental speech sound disorders. The presence of such etiological variables would
suggest a high priority for intervention. After intervention, when the child has reached a plateau in
his/her motor skills and has mastered compensatory strategies, the child may no longer be eligible for
services.
This speech production assessment summary form represents research in the area of articulation and
phonology. The tool provides an opportunity to review data from SLP probes and measures as well as
observation and data from academic settings. The team should review all data and circle the cell that
describes the student’s performance for each of the factors listed. This summary of the assessment data
may also be used to document the educational impact and educational needs of the student.
NOTE: The presence of an articulation/phonological impairment does not guarantee the student’s
eligibility for special education. Virginia criteria, including educational impact caused by the
impairment and need for specially designed instruction, must be met in order for a student to be
eligible for special education and related services.
Articulation/Phonological Considerations
Some areas of assessment may require additional consideration depending on the age of the student.
The following guidelines may be helpful when:
Ages 3-5: Intelligibility, phonological process usage, and stimulability are usually more
important than social and vocational considerations.
Ages 6-9: Speech sound production norms and stimulability are the typical focus. Social and
academic variables should be given stronger consideration.
Ages 9 and up: Stimulability and social and academic/vocational considerations are of high
importance for this age group.

87
Evaluation Data
Evaluation data should be gathered from four areas for comprehensive assessment: Academic
activities, academic tests and measures, SLP probes, and SLP test and measures. Virginia
regulations require multiple sources of information be used to determine eligibility. Teacher,
child, and parent reports, interviews, norm-referenced tests, or checklists are not sufficient
evidence by themselves and must be supported with additional data.
Comprehensive Assessment Data Sources
Academic Activities, Tests and Measures

Data sources include classwork, homework, and observations of oral, written and pragmatic
language in school settings. Intelligibility should be assessed in multiple settings by at least one
familiar listener. Data from achievement tests, PALS assessments, SOL, benchmark tests, pre-
referral intervention data should also be reviewed. Any speech production errors evident in
written work samples or artifacts should be noted.
In addition to providing valuable insight into the student’s abilities, this data also provides
support for determination of educational impact which is required by Virginia regulation.
Intelligibility:
Teachers play an important role in documenting intelligibility in the education setting.

“Children above the age of 4 with intelligibility percentages below 66 percent may be
“at risk.” The children farther along the continuum toward unintelligible speech would
be of greatest concern not only for communication success, but also potentially for
problems in developing literacy skills.” (Gordon-Brannan & Hodson, 2000) Additionally,
research shows that teachers academic, social, and behavioral expectations of students
who are moderately to severely unintelligible are statistically different from normally
intelligible students1 (Overby et al, 2007).
Ratings of intelligiblity should be made using connected speech . For young students
who are highly unintelligible, Gordon-Brannan and Hodson2 (2000) suggest an
alternative measure of intelligiblity using imitated sentences. Some advantages of the
imitated sentence measure are: (a) suprasegmental features and some
syntactic/morphological and contextual cues are available, (b) it takes less time to
administer and score than the continuous-speech procedure, and (c) the child’s
intended utterance is known by the examiner. Intelligibility percentages for imitated
sentences tended to be somewhat lower than for continuous speech in which the
context was known.
1
Overby, M. Carrell, T , Bernthal, J (2007)Teachers' Perceptions of Students With Speech Sound Disorders: A Quantitative and
Qualitative Analysis University of Nebraska–Lincoln Language, Speech, and Hearing Services in Schools Vol.38 327-341 October 2007
2
Gordon-Brannan, M. and Hodson, B.W. (2000) Intelligibility/Severity Measurements of Prekindergarten Children’s Speech American
Journal of Speech-Language Pathology, 9, 141-150

Speech-Language Pathology Probes, Norm-Referenced Tests and Measurements
Data sources include speech sound production or phonological processes data, stimulability
and percentage of consonants correct. Oral motor examination should be completed to ensure
that an underlying physical structure or motor issue is not interfering with speech production.
Use of the Iowa-Nebraska Norms is recommended.
Data from pre-referral interventions and dynamic assessment activities should be included in
this section.
Speech Sound (segmental) Production:

This factor should be rated if phonological processes are not present. Determine
developmental appropriateness of sound errors by using the Iowa-Nebraska (I-N) norms
(Smit, et al, 1990). These norms were originally published in a Journal of Speech and
Hearing Disorders article and reflect the most recent and comprehensive normative
study that has been reported. While results are comparable to those of Templin (1957),
the I-N norms represent a larger normative sample.
Noted Exceptions: For students producing lateralized sibilants, using norms to
determine if therapy is warranted is not best practice because self-correction does not
usually occur with lateralization. There is literature to support not using
developmental norms to determine when to provide therapy for lateral /s/.
The literature also supports provision of therapy for developmental errors /r/ and /s/ at
or around age eight. There is no support for the idea that error production becomes
more resistant to correction and should be treated at a younger age.
Phonological Processes:
When multiple sounds are in error, phonological processes provide a way to examine
patterns of sound errors. Phonological processes go beyond individual phonemes to
changes that occur regularly for entire classes or groups of sounds. Processes can be
divided into three categories:
1. Whole Word/Syllable Processes change the syllable structure of the word by
either taking away a sound(s), adding a sound(s), moving a sound, or a
combination of these.
2. Substitution Processes substitute one sound for another, changing something
in the manner, place or voicing of the sound.
3. Assimilation Processes are also known as harmony processes as one sound
changes to become more like (or exactly like) another sound in the word.
Phonological processes simplify the production of speech and can be part of normal
development. When processes continue beyond a developmental stage they may
impact intelligibility. Some processes have been shown to have a greater relative
effect on intelligibility than others. For example, research shows that final consonant
deletion and stopping have a greater impact on intelligibility than velar fronting.3
3
Klein, E., Flint, C. (2006) Measurement of Intelligibility in Disordered Speech Language, Speech, and Hearing Services in Schools
Vol.37 191-199 July 2006

89
Processes like unstressed syllable deletion, reduplication, and assimilation often

disappear before age 3, while cluster simplification, gliding of liquids, vocalization and
stopping tend to persist the longest, up to age 5 and beyond. Only processes that are
not developmental and occur in 40 percent or more opportunities should be noted on
the assessment summary form. However, when there is evidence of at least one process
that meets the 40 percent criterion, it is important to document any additional
processes used more than 15 percent.
Descriptions and examples of phonological processes are provided in the special topics
section of this document. Free online training modules on Phonological Processes are
available from www.ttaconline.org.
Stimulability:
Stimulability is an important factor when determining the level of impairment and
when documenting the need for specially designed instruction. Data suggests that lack
of stimulability for a misarticulated sound is a good indicator of an appropriate target
for therapy, since ability to produce a sound is essential before children begin to
acquire a sound or otherwise generalize from one context to another.
Students who are stimulable would not need specially designed instruction to produce
sounds correctly and may benefit from a home practice program or follow-up by
classroom teachers.
Determine stimulability using the Miccio Probe (Miccio, A.W., 2002). Stimulability is
determined for all error sounds, regardless of age appropriateness. Use of the Miccio
Probe is best described in Miccio’s article in the American Journal of Speech-Language
Pathology.4 The following is a summary of the process:
1. Only sounds absent from the inventory are tested. The student is asked to
imitate these specific consonants in isolation or nonsense syllables. Those
sounds imitated correctly some of the time (at least 30 percent of possible
opportunities) are presumed to be stimulable.
2. Provide the student 10 opportunities to produce a sound: in isolation and in
three word positions in three vowel contexts, [i], [u], and [a]. The corner vowel
contexts: a high (or close) unround front vowel, a high round back vowel, and a
low unround vowel usually reveal any consonant-vowel dependencies.
3. If multiple sounds are absent from the inventory, the probe may be shortened
by administering only one vowel context during the initial assessment.
Percentage of Consonants Correct:
Percentage of Consonants Correct (PCC) yields severity ratings on a 4-level scale and has
been accepted as a valid index of severity in the field of speech-language pathology. A
study by Johnson, Weston, and Bain found that an imitative sentence procedure
provided PCC scores that compared favorably to those derived from spontaneous
speech, and the imitative procedure was significantly faster than sampling spontaneous
4
Clinical Problem Solving: Assessment of Phonological Disorders. Volume 11, Issue 3. Pages 221 - 229. August 2002

speech.5 These results indicate that either imitative or spontaneous speech samples
may be used when calculating PCC.
The abbreviated procedures below are based on the recommendations of Johnson,
Weston, and Bain (2004) and Shriberg and Kwiatkowski (1982):
1. Obtain a tape-recorded speech sample:
a. Imitative samples of 36 sentences with appropriate mean length utterance
(MLU) for the student’s age should be used. Present sentences using a
conversational tone without exaggerated prosodic cues (Weston and Bain
2004).
b. Spontaneous samples should include 90 different words – usually a sample
of around 225 total words is sufficient. If the child is so unintelligible that it
is impossible to identify this number of different words, then a single word
assessment tool can be used to gather productions for analysis.
2. Only consonants are scored, not vowels (i.e., only the consonantal /r/ is scored).
3. Score only the first production of a consonant if a syllable is repeated (e.g., ba-
balloon. Score only the first production of /b/).
4. Do not score consonants if a word is unintelligible or only partially intelligible.
5. Errors include substitutions, deletions, distortions, and additions. Voicing errors
are only scored for consonants in the initial position of words.
6. If /ng/ is replaced with /n/ at the end of a word, do not score it as an error.
Likewise, minor sound changes due to informal speech and/or selection of sounds
in unstressed syllables are not scored as errors (e.g.,/fider/ for “feed her,” /dono/
for “don’t know”).
7. Dialectal variations are not scored as errors.
8. To determine the PCC value use the following formula:
Number of Correct Consonants X 100 = PCC

Total Number of Consonants
5
Johnson, C., Weston, A, Bain, B. (2004) An Objective and Time-Efficient Method for Determining Severity of Childhood Speech
Delay American Journal of Speech-Language Pathology • Vol. 13 • 55–65

91
Iowa - Nebraska Articulation Norms6

Listed below are the recommended ages of acquisition for phonemes and clusters, based generally
on the age at which 90 percent of the children correctly produced the sound.
Age of Age of Age of Age of

Word-Initial
Phoneme Acquisition Acquisition Acquisition Acquisition
Clusters
(Females) (Males) (Females) (Males)
/m/ 3;0 3;0

/tw kw/ 4;0 5;6
/n/ 3;6 3;0
/ŋ/ 7;0 7;0
/sp st sk/ 7;0 7;0
/h-/ 3;0 3;0
/w-/ 3;0 3;0
/sm sn/ 7;0 7;0
/j-/ 4;0 5;0
/p/ 3;0 3;0
/sw/ 7;0 7;0
/b/ 3;0 3;0
/t/ 4;0 3;6
/sl/ 7;0 7;0
/d/ 3;0 3;6
/k/ 3;6 3;6
/pl bl kl gl fl/ 5;6 6;0
/g/ 3;6 4;0
/f-/ 3;6 3;6
/pr br tr dr kr
/-f/ 5;6 5;6 8;0 8;0
gr fr/
/v/ 5;6 5;6
/θ/ 6;0 8;0
/θr/ 9;0 9;0
/ð/ 4;6 7;0
/s/ 7;0 7;0
/skw/ 7;0 7;0
/z/ 7;0 7;0
/ʃ/ 6;0 7;0
/spl/ 7;0 7;0
/tʃ/ 6;0 7;0
/dʒ/ 6;0 7;0
/l-/ 5;0 6;0
/-l/ 6;0 7;0 /spr str skr/ 9;0 9;0
/r- 8;0 8;0
/ɚ/ 8;0 8;0
Note regarding phoneme positions:
/m/ refers to prevocalic and postvocalic positions

/h-/ refers to prevocalic positions
/-f/ refers to postvocalic positions
6
Smit, Hand, Freilinger, Bernthal, and Bird (1990). Journal of Speech and Hearing Disorders, 55, 779-798.

Miccio Stimulability Probe
Name:
Transcriber:
Date:
Prompt: “Look at me, listen, and say what I say.”
Sound Isolation __i i_i i__ __a a_a a_ __u u_u u_ % Correct
p
b
t
d
k
g
θ
ð
f
v
s
z
ʃ
ʒ
tʃ
dʒ
m
n
ŋ
w
j
h
l
r

93
Percentage Consonants Correct (PCC)

Child: ______________________________________________________ Date of Birth: ___________
PCC Scoring Date: _________ Speech-Language Pathologist: ____________________________
Number of
Consonant Consonant Total No.
Initial Medial Final Consonants
Class Sound Consonants
Correct
Correct
/m/
Nasal /n/
/ŋ/
/w/
Glides
/j/
/p/
/b/
/t/
Stops
/d/
/k/
/g/
/f/
/v/
/ʃ/
/ʒ/
/s/
Fricatives/
/z/
Affricates
/j/
/θ/
/ð/
/dʒ/
/h/
Liquids /l/
/r/
TOTALS
Number of Correct Consonants
X 100 = PCC
Total Number of Consonants

Speech Production Assessment Summary

Name: ______________________________________________________________ Date: ____________
Review all assessment data prior to completing this form. For each assessment area column,
circle the item that best represents the student’s performance. When a valid comparison to a
normative sample cannot be made or a student has significant impairments, consider
completion of the Functional Communication Summary form.
Academic Activities,
SLP Probes, Tests and Measures
Tests, and Measures
Data sources Speech Sound Production
include 1. Speech 2. Phonological Percentage
classwork and Intelligibility sound Processes (Check Stimulability
of
observations in connected segmental only those not (Miccio
Consonants
of oral, & speech production developmentally Probe)
written across Correct (PCC)
use Iowa appropriate that
language in settings Imitative or
Nebraska occur in 40
school Spontaneous
Norms percent or more
settings opportunities)
Performs Meets norms
No Age 3: >75% Error sounds PCC value
similarly to for acquisition No significant
Apparent Age 4: >85% are 90% more than
peers in of phonemes error processes.
Impact Age 5+:>90% stimulable 95%
most areas and clusters
Evidence of
Age 3: 1 – 2 sounds 1 or more occur:
struggles
65–75% do not meet  Gliding
with one or Error sounds
Minimal Age 4: norms for  CR with /s/ PCC value of
more areas are 60 – 89%
Impact 75 – 85% acquisition of  Vowelization 85 – 94%
when stimulable
Age 5+ : phonemes and post-vocalic
compared to
81-90% clusters /r/ or / l/
peers
Age 3: 1 or more occur:
Evidence of 3 – 4 sounds
50 – 64%  WSD
struggles in do not meet
Age 4:  DEP initial Error sounds
Moderate most areas norms for PCC value of
65 – 74%  CR /l/, /r/, /w/ are 50 - 59%
Impact when acquisition of 50 – 84%
Age 5 and  Velar fronting stimulable
compared to phonemes and
up:
peers clusters
70 – 80%
1 or more occur:
5 or more
 ICD
Evidence of Age 3: <50% sounds do not Error sounds
 FCD
Substantial very limited Age 4: <65% meet norms are less than PCC value
 Stopping
Impact ability in Age 5+ : for acquisition 50% less than 50%
 DEP final
most areas <70% of phonemes stimulable
and clusters
Phonological Process Abbreviations:
CR – cluster reduction FR – Fronting DEP- depalitization of singletons

WSD – Weak syllable deletion Gliding- Gliding of liquids FCD- final consonant deletion
ICD- initial consonant deletion

95
Language Assessment Summary
A language impairment is defined as the inadequate or inappropriate acquisition, comprehension or

expression of language. Students who have Limited English Proficiency (LEP) or those students who are
not speakers of Standard American English due to sociocultural dialects are not automatically
considered to be students with a speech-language impairment. The presence of a language
impairment does not guarantee the child’s eligibility for special education.
Evaluation Data
Evaluation data should be gathered from four areas for comprehensive assessment: academic activities,
academic tests and measures, SLP probes, and SLP test and measures. Virginia regulations require that
multiple sources of information be used to determine eligibility. Teacher, child, and parent reports,
interviews, norm-referenced tests, or checklists are not sufficient evidence by themselves and must be
supported with additional data.
When completing the summary, data should be based on the child’s performance in his/her preferred
mode of communication (e.g., American Sign Language, augmentative/alternative communication).
This should be documented in the evaluation report, eligibility minutes, and IEP. On occasion, it may be
valuable to document performance without the preferred mode of communication to contrast the
difference in the child’s skills between the preferred mode of communication and standard oral communication.
Academic Activities
Data sources include classwork, homework, and observations of oral, written and
pragmatic language use in school settings. Samples of student work (artifacts) provide
meaningful opportunities to evaluate language ability in the context of the educational
setting. Observations and evidence of the student’s meta cognitive, meta linguistic,
and meta pragmatic skills should be included as part of this data source.
In addition to providing valuable insight into the student’s abilities, this data also
provides support for determination of educational impact which is required by Virginia
regulation.
Academic Tests and Measurements

Data sources include norm-referenced achievement tests, SOL, benchmark tests, and
pre-referral intervention data. In addition to providing valuable insight into the
student’s abilities, this data also provides support for determination of educational
impact which is required by Virginia regulation.
Speech-Language Pathology Probes

Multiple data sources should be gathered to complete this portion of a comprehensive
assessment. Data should include oral language samples, narrative samples, probes of
written language, interviews with students, parents and teachers, dynamic assessment
findings, and case history information. Data from pre-referral interventions may also be
included in this section.

Oral and written language and/or discourse samples and probes should examine
pragmatic, semantic, syntax, morphological, and phonological skills. Additionally, data
on meta-linguistic, meta-cognitive, and meta-pragmatic skills should be gathered
through interviews and systematic observations.
Speech-Language Pathology Norm-Referenced Tests and Measurements

Data sources include multiple norm-referenced tests with appropriate sensitivity and
specificity (Spaulding 2006). Only composite scores may be considered for use on the
summary form. Subtests and partial test administrations are not valid for comparison to
peers or eligibility decision-making.
Norm-referenced tests must be administered in a standardized manner and norming

populations must match the student being evaluated. Any variation from standard
administration procedures (e.g., repetition, cues, additional time, etc.) invalidates
scoring and results in a nonstandard administration. Virginia regulations require
information about nonstandard administrations be described in the evaluator’s report.
The findings of strengths and weaknesses can be described, but no score should be
reported.

97
Language Assessment Summary

Name: ________________________________________________________________ Date: ______________________
Review all assessment data prior to completing this form. For each assessment area column, circle the item that best
represents the student’s performance. When a valid comparison to a normative sample cannot be made or a student has
significant impairments, consider completion of the Functional Communication Summary form.
Academic Activities Academic Tests Speech-Language Speech-Language

and Pathology Probes Pathology Norm-
Data sources include Measurements Referenced Tests
classwork, Data sources include and Measurements
homework, and Data sources language samples,
observations of oral, include interviews, case history and Data sources
written and achievement tests, dynamic assessment data include multiple
pragmatic language SOL, benchmark norm-referenced
in school settings tests, and pre- tests with
referral appropriate
intervention data sensitivity and
specificity
May indicate differences 2 or more composite

from Standard American scores* at or
No Performs similarly to
Performs similarly to English above:
Apparent peers in most
peers in most areas Demonstrates • mean to -1 SD
Impact areas
improvements during • > 85 SS #
dynamic assessment • >17th %ile
May indicate differences

Evidence of struggle from Standard American
with one or more Evidence of English 2 or more composite
areas when struggle with Demonstrates scores*
Minimal compared to peers one or more improvements during documenting:
Impact areas when dynamic assessment • -1 to -1.5SD
Evidence of occasional compared to Occasional difficulty with • 84 to 77 SS #
difficulty with ‘meta’ peers pragmatic, semantic or • 16th-7th %ile
skills syntax- morphological
skills
Demonstrates limited
Evidence of struggle 2 or more composite
Evidence of improvement during
in most areas when scores*
struggle in most dynamic assessment
Moderate compared to peers documenting:
areas when Frequent difficulty with
Impact • -1.5 to -2 SD
compared to pragmatic, semantic or
Evidence of difficulty • 76-70 SS #
peers syntax- morphological
with ‘meta’ skills • 6th -3rd %ile
skills
Demonstrates very limited

Evidence of very 2 or more composite
improvement during
limited ability in most scores*
Evidence of very dynamic assessment
Substantial areas documenting:
limited ability in Extensive difficulty with
Impact Evidence limited or • -2 or greater SD
most areas pragmatic, semantic or
absence of ‘meta’ • 69 or below SS #
syntax- morphological
skills • below 3rd %ile
skills
*These scores should be composite scores from the full battery of subtests, not individual subtest scores.
#
This example assumes a mean of 100 and standard deviation of 15 points. See page 29.

Fluency Assessment Summary
A fluency disorder is primarily characterized by repetitions (sounds, syllables, part words, whole
words, phrases), pauses, and prolongations that differ in number and severity from those of
normally fluent individuals. The onset usually occurs during the time that language skills are
developing, and onset is generally gradual in nature. Secondary characteristics are frequently
evident, and these vary in type and severity from individual to individual. The dysfluencies may
interfere with intelligibility, social communication, and/or academic and vocational
achievement.

Assessment data should be gathered from four areas for comprehensive assessment: academic
regulations require that multiple sources of information be used to determine eligibility.
Teacher, child, and parent reports, interviews, norm-referenced tests, or checklists are not
sufficient evidence by themselves and must be supported with additional data.

Data sources include classwork, homework, and observations in school settings. Data from
achievement tests, SOL, benchmark tests, and pre-referral intervention data should also be
reviewed. An observation of student’s speech and language during oral language activities in
the classroom/school environment should provide information on frequency and type of
dysfluencies as well as any nonvocal behaviors and avoidance.
Speech-Language Pathology Probes, Norm-Referenced Tests & Measurements
Data should include frequency of dysfluency, description of dysfluency, associated non-vocal

behaviors, and avoidance . Data from pre-referral interventions and dynamic assessment
activities should also be included in this section. The speech-language pathologist should
complete the attached form and provide a description of the student’s communication skills
including information from each of the factors listed in the assessment summary form.
The SLP should also gather data on:
• background information: a history of the development of the student’s stuttering,

family history of stuttering, etc.
• communication abilities: a report of his/her skills in the five parameters of
communication – stuttering, articulation, voice, language, and hearing.
• oral-peripheral examination: a description of any atypical structures and the functional
abilities of the oral mechanism.

99
When considering a preschool-age child who is exhibiting dysfluent behavior, research

indicates that the chances of success are greater the sooner a problem and its contributing
factors are identified. When a preschool-aged child exhibits the following chronic non-fluent
behaviors, it is likely the child will benefit from early intervention: the insertion of the schwa,
uneven stress and rhythm, difficulty initiating and sustaining airflow, body tension and struggle
behavior during speech, and the presence of significant predictors such as family history
(Runyan, 2004).
For preschool children, the consideration of the adverse effect should be based on the effect of
the fluency impairment on the child’s developmental skills in play, adaptive/self-help,
communication, social-emotional, cognitive, and sensorimotor.
Frequency of dysfluency: describes the number of dysfluencies as number per minute

or as a percentage. This is calculated using a sample of spoken language.
Description of dysfluency: describes the duration of pauses (from less than one second
to more than three seconds) and number of reiterations per repetition (from less than
four reiterations per repetition to six or more reiterations per repetition). This is
calculated using a sample of spoken language.
Associated nonvocal behaviors: describes the presence of facial grimaces; visible

tension of the head, neck, jaw, and/or shoulders; audible tension, as noted in uneven
stress, pitch changes, increased rate, or tension during inhalation or exhalation noted
by the examiner during assessment and in various educational settings.
Avoidance: describes a student’s behavior when required to speak. Examples include

changing words or topics, refusing to participate, social withdrawl, etc.
1 00 Virginia Department of Education, Office of Special Education and Student Services

Fluency Assessment Summary

Name: ________________________________________________________________ Date: ____________________
Review all assessment data prior to completing this form. For each assessment area column, circle the item that best
represents the student’s performance. When a valid comparison to a normative sample cannot be made or a student
has significant impairments, consider completion of the Functional Communication Summary form.
Academic
Activities, Tests, SLP Probes, Tests and Measures
and Measures
Data sources
include classwork,
homework, and Description of Associated
Frequency of
observations of oral, Nonvocal Avoidance
Dysfluency Dysfluency
written and Behaviors
pragmatic language
in school settings
Less than 4% Primarily whole multisyllabic

vocal word repetitions Does not
No dysfluencies Occasional whole-word No
Performs similarly to avoid
Apparent per speaking interjections and associated
peers in most areas speaking
Impact minute OR < 3 phrase/sentence revisions behaviors
situations
dysfluencies Less than 1 second pauses
per minute OR less than 4 reiterations
Transitory dysfluencies in
4% vocal specific speaking One
dysfluencies situations including associated Usually
Evidence of struggle
per speaking repetitions, prolongations, behavior does not
Minimal with one or more
minute blocks, hesitations or that is avoid
Impact areas when
OR 3 – 5 interjections, and vocal noticeable speaking
compared to peers
dysfluencies tension. but not situations
per minute 1 second pauses OR 4 distracting
reiterations
6 – 10% vocal Frequent dysfluencies in One

dysfluencies many speaking situations associated
including repetitions, Does avoid
Evidence of struggle per speaking behavior
Moderate prolongations, blocks, some
in most areas when minute that is
Impact hesitations or interjections speaking
compared to peers OR 6 – 10 noticeable
and vocal tension situations
dysfluencies and
per minute 2 second pauses OR 5 distracting
reiterations
Habitual dysfluencies in a Two or

10% or more majority of speaking more
vocal situations, including associated Generally
Evidence of very dysfluencies repetitions, prolongations,
Substantial behaviors avoids
limited ability in per minute OR blocks, hesitations or
Impact that are speaking
most areas 11 or more interjections, and vocal noticeable situations
dysfluencies tension and
per minute 3 or more second pauses distracting
OR 6 or more reiterations

1 01
Voice Assessment Summary
A voice impairment is defined as a pitch, loudness or quality condition that 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 (i.e., ear, nose and throat physician), clearing the child for intervention. This is
important to ensure the source of the voice impairment is not an organic problem for which
therapy is contraindicated. See the Voice Referral Form in Appendix E.
Assessment data should be gathered from four areas for comprehensive assessment: academic
regulations require that multiple sources of information be used to determine eligibility.
Teacher, child, and parent reports, interviews, norm-referenced tests, or checklists are not
sufficient evidence by themselves and must be supported with additional data.

Data sources include classwork, homework, and observations in school settings. Data from
achievement tests, SOL, benchmark tests, pre-referral intervention data should also be
reviewed. An observation of student’s speech and language during oral language activities in
the classroom/school environment should provide information on vocal quality and
appropriateness compared to peers.
Speech-Language Pathology Probes, Norm-Referenced Tests and Measurements
Data should include voice quality, resonance, loudness, and pitch. Data from pre-referral
interventions and dynamic assessment activities should also be included in this section. The
speech-language pathologist should complete the attached form and provide a description of
the student’s communication skills including information from each of the factors listed in the
assessment summary form.
A comprehensive voice examination should include information obtained from both subjective
measures (e.g., perceptual ratings and clinical impressions based on observations and analysis of
speech samples) and objective measures (e.g., standardized tests or instrument evaluations).
Observations should take place in situations calling for both low and high vocal demand:
• low vocal demand: utterances produced in a relatively quiet environment or short
responses that do not require talking over a prolonged period of time.
• high vocal demand: talking in a noisy environment (e.g., in the cafeteria), for a
prolonged period of time (e.g., oral presentation or reading aloud), or controlling
the voice over a wide pitch range (e.g., singing).

Voice Impairment Referral Form

Terminology
The following terminology is used on voice referral form.

Abusive Vocal Behaviors - activities such as frequent “throat clearing” or shouting (e.g.,
cheerleading).
Breathing Pattern - the general contributions of the thoracic, clavicular, and abdominal areas
involved in breathing during conversational speech. Look for reliance upon one pattern to the
exclusion of the others.
Glottal Attack - the relative (soft vs. hard) onset of vocal fold activity.
Loudness Level - the estimated level of the student’s speech during normal conversation in a
quiet environment. Persistent whispering or shouting would be positive indications.
Maximum Phonation Time - averaged over three different trials, the maximum amount of time (in
seconds) that the student can continuously sustain /a/ (or /i/) on one exhalation.
Muscle Tension - the amount of tension visible in the student’s face, neck, and chest areas during
normal conversation. Abnormal tension suggested by a stiff posture and/or accompanying
strain.
Nasal Resonance - the amount of perceived resonance associated with the production of nasal
consonants. An inappropriate degree of hypo – hyper nasality perceived during conversation
would be a positive indication. Note: mixed nasal resonance (i.e., both hypo – and hypernasal
resonance perceived within the same speaker) may occur.
Oral Resonance - the perceived amount of resonance associated with oral consonants and vowels.
Positive indications might include speaking with limited oral openings and reduced
intelligibility.
Phonation Breaks - the inappropriate cessation of voicing during speech. A positive indication
would be an unintentional and relatively brief period of silence during a normally voiced
consonant or a vowel.
Pitch - consider if the vocal pitch is too high, too low, or monotonic for a student’s height/weight,
age and gender.
Pitch Breaks - the cessation of a continuous and appropriate pitch level during speech.
Quality - the overall quality of the student’s conversational speech including hoarseness,
breathiness, and/or harshness.
s/z ratio - the ratio of the maximum sustained production of /s:/ (in seconds) relative to /z:/ (in
seconds). Two trials with the longer production of each sound used to compute the ratio. A
ratio greater than 1.4 is an indication of possible laryngeal inefficiency for speech. Report data
to the nearest single decimal place.

1 03
Voice Assessment Summary

Name: ________________________________________________________________ Date: _________________
Review all assessment data prior to completing this form. For each assessment area column, circle the
item that best represents the student’s performance. When a valid comparison to a normative sample
cannot be made or a student has significant impairments, consider completion of the Functional
Communication Summary form.
Academic
Activities, Tests, SLP Probes, Tests and Measures
and Measures
Voice Quality Resonance Loudness Pitch
Data sources include appropriateness
classwork, homework, hoarse, hypernasal judged for for age and
and observations of breathy, no or appropriateness gender, and for
oral, written and voice hyponasal and variability appropriate
pragmatic language variability
in school settings
No
Performs similarly to Normal voice Normal
Apparent Normal loudness Normal pitch
peers in most areas quality resonance
Impact
Inconsistent Inconsistent
Evidence of struggle Inconsistent Inconsistent
problems; problems;
Minimal with one or more problems; problems;
noticeable to noticeable to
Impact areas when noticeable to the noticeable to the
the trained the trained
compared to peers trained listener trained listener
listener listener
Consistent
Consistent Consistent
Consistent problems.
problems. problems.
problems in Inappropriate
Evidence of struggle Inappropriate for Inappropriate
Moderate conversational for age,
in most areas when age, gender or for age, gender
Impact speech gender or
compared to peers culture or culture.
Noticeable to culture
Noticeable to all Noticeable to all
all listeners Noticeable to
listeners listeners
all listeners
Persistent
problem. Persistent Persistent
Always problem. Always problem. Always
Persistent
Evidence of very inappropriate inappropriate for inappropriate
Substantial problem
limited ability in most for age, age, gender or for age, gender
Impact Noticeable at
areas gender or culture or culture
all times
culture Noticeable at all Noticeable at all
Noticeable at times times
all times

Functional Communication Assessment Summary
Functional communication skills are forms of behavior that express needs, wants, feelings, and
preferences that others can understand. When individuals learn functional communication
skills, they are able to express themselves without resorting to problem behavior or
experiencing communication breakdown. Functional communication includes spoken and
written communication, as well as gestures and pointing, and other forms of communication.
This Functional Communication Assessment Summary may be used to document functional

communication skills of any student in the education setting and may be helpful when
examining the educational impact of a suspected communication impairment.
Functional Communication Categories include:
Communicative Interaction
Evidenced by: initiation, topic maintenance turntaking, opening/closing conversations
Communicative Intention
Evidenced by: requesting objects/actions, commenting on objects/actions, etc.
Communicative Methods
Evidenced by: use of one or more modes of communication (e.g., verbal, manual sign, AT or
AAC system, gestures, pointing)
Comprehension of Language
Evidenced by: appropriate actions or communicative responses indicating comprehension
of what others say, sign, or show
Effect on Educational Performance

Student demonstrates communication skills adequate for participation in current
educational setting
Data collected from known and novel communication partners in a variety of settings should be
used when examining functional communication. Data should reflect interactions with persons
other than SLP.

1 05
Functional Communication Assessment Summary

Name: _____________________________________________________________________ Date: ____________
This form may be used to document functional communication skills in the education setting and may be
helpful when evaluating students when a valid comparison to a normative sample cannot be made or a
student has significant impairments. Data collected from a variety of communication partners in a variety
of settings should be used to complete this form.
 Usually  Frequently
Communicative  Successful  Not Successful
Successful Unsuccessful
Interaction Data Sources:
Evidenced by: initiation,
topic maintenance Describe Performance:
turntaking, opening/closing
conversations
 Successful  Not Successful
Communicative Intention
Evidenced by: requesting Data Sources:
objects/actions, commenting
on objects/actions, etc. Describe Performance:
Communicative Methods
Evidenced by use of one or Data Sources:
more modes of
communication (e.g., verbal, Describe Performance:
manual sign, AT or AAC
system, gestures, pointing)
Comprehension of Successful Unsuccessful
Language Data Sources:
Evidenced by appropriate
actions or communicative Describe Performance:
responses indicating
comprehension of what
others say, sign, or show
Effect on Educational
Performance Data Sources:
Student demonstrates
communication skills Describe Performance:
adequate for participation in
current educational setting

APPENDIX E:
Forms and Checklists
Communication Observation Form.......................................................................................108
Sample Educational Assessment of Communication Skills.........................................109
Preschool Educational Assessment of Communication Skills ....................................111
Parent Checklist: Speech-Language (School Age)..........................................................112
Parent Checklist: Speech-Language (Preschool).............................................................113
Parent Checklist: Fluency/Stuttering....................................................................................114
Parent Checklist: Voice ................................................................................................................115
Student Speech-Language Checklist: Kindergarten through 5th Grade.................116
Student Speech-Language Checklist: 6th through 12th Grade ...................................118
Speech and Language Therapy Data Sample Form .......................................................120
Speech-Language Therapy Log...............................................................................................121
Data Analysis Graph with Aim and Trend Lines................................................................123
Swallowing/Dysphagia Team Procedure Checklist ........................................................124
Swallowing Disorder Consultation and Referral Form

Part 1: Referral to School-based Swallowing Team ................................................125
Part 2: Interdisciplinary Swallowing Consultation .................................................126
Part 3: Request for Physician Input Regarding Swallowing Concerns ..........128
Voice Referral Form.......................................................................................................................129

1 07
Communication Observation Form
Student: __________________________________________ D.O.B. ____________ Date: ___________

Time: __________ Length of Observation: ________________________________ Grade: __________
Reason for Observation:____________________________________________________________________
Setting (classroom, playground, cafeteria, etc.):_________________________________________________
Physical Environment: Where is student seated? What is the student’s proximity to teacher?
 at table  at desk  on the floor

 on chair in group  at listening center  at learning center
 at chalkboard
 front of room  middle of room  back of room

Other:_________________________________________________________________________________
Auditory Environment (Background noise, outside noise, etc.)
Language Demands of the Activity / Instruction (include examples)
Comprehension  Low  High
Verbal Demands  Low  High
Responsiveness to Instructional Strategies:

 wait time  repetition  rephrasing
 visual supports  graphic organization
Other:_________________________________________________________________________________
Is the student’s communication comparable to the other students’?
Comments:
Summary:
___________________________________________ ______________
Speech-language pathologist’s signature Date

Sample Educational Assessment of Communication Skills

Student: ________________________________________________________ Grade: _____________
Teacher: ________________________________________________________ Date: ______________
Academic Performance Rating:
Reading Writing Science Soc. Stud. Math

Current Grade
SOL Score
Communication Skills: Please compare the student’s performance to that of his/her classmates. Answer
all questions by placing a circle around the appropriate answer.
Do you have difficulty understanding this student? Yes No Sometimes
Does the student avoid speaking in class? Y N S
Do peers tease the student about the way s/he talks? Y N S
Do you feel the student’s speech and language skills negatively affect
Y N S
his/her academic performance?
Does the student appear to be upset when communicating? Y N S
Have you observed the student’s speech and language skills influencing
Y N S
his/her personal adjustment (including adult and peer relationships)?
Does the student require classroom modifications to be successful? Y N S
Does this student have difficulty attending? Check all settings that
apply:
Y N S
 one to one  small group  large group
 during lengthy instruction  noise in the environment
Does the student have difficulty following directions? Y N S
Does the student have difficulty understanding curriculum vocabulary
Y N S
and/or concepts?
Does the student require excessive “wait time” to either comprehend or
Y N S
respond?
Does the student have difficulty expressing ideas in an organized and
Y N S
coherent manner?
Does the student use incorrect grammar? Y N S
Does the student have difficulty asking relevant questions? Y N S
Does the student exhibit noticeable hesitations, repetitions and/or
Y N S
tension?
Does the student’s voice sound unusual (e.g., hoarse, nasal, high-
Y N S
pitched)?
Does the student’s speech rate/volume interfere with your ability to
Y N S
understand him/her?
Does the student mispronounce sounds or words? Please provide
Y N S
examples:
Have the parents expressed concerns regarding communication? Y N S
*If you have circled YES for any items please complete page 2 of this form.

1 09
Sample Educational Assessment of Communication Skills – Page 2
Describe the weaknesses of the student’s speech and language skills, and his/her academic
progress.
Identify any classroom strategies that you have used to adapt to the student’s communication
needs.
What adaptations, modifications have you used to assist the child with communication in the
classroom setting?
Comments:
Teacher’s Signature:_______________________________________________ Date: __________
Please return to:___________________________________________________ by: ____________
Preschool Educational Assessment of Communication Skills

Student:_________________________________________________ Date of Birth: ______________
Teacher: _________________________________________________ Date:_____________________

Please compare the child’s performance with his/her peers.
The child: Yes Sometimes No
uses social language (hi, by, please, thank you)
is learning new words every week
repeats new words without being asked
uses describing words (big, red, etc.)
gets my attention with words
rejects/denies/says no
takes turns in a “conversation”
asks for help
is understood by familiar adults
is understood by unfamiliar adults
names pictures in a book
listens to a short picture book
answers “yes/no” questions
answers “wh” questions
asks questions with his/her tone of voice
asks “yes-no” questions
asks “wh” questions (what, where, why, how)
uses pronouns correctly (I, she, he, my, etc.)
knows some songs or nursery rhymes
has trouble saying sounds; list:
is teased by peers about the way s/he talks
has difficulty following directions
has difficulty attending If Yes or Sometimes, check all that apply:
 one to one  small group  large group
 during lengthy instruction  noise in the environment
has noticeable hesitations, repetitions, or tension when speaking
has an unusual voice (e.g., hoarse, nasal, high-pitched)
has a rate or volume that interferes with understanding him/her
Rate your concern for the child’s communication skills. None 1 2 3 A lot
Approximately how many words are in the child’s vocabulary?  10  11 to 50  more than 50
How many words does the child usually combine into sentences? ____________
Do the child’s communication skills influence his/her adult and peer relationships or participation in activities?
 Yes  No If YES, explain:
What does the child do when he/she is not understood (Check all that apply)?  points or gestures
 gives up  repeats the words  says different words  other (explain):
Teacher signature: _________________________________________________ Date: _______________
Please return to: _______________________________________________________ by: ______________

111
Parent Checklist: Speech-Language (School Age)

Student:_________________________________________________ Date of Birth: _________________
Person completing this form: _____________________________________ Date: _________________
Your input will help us understand your child’s speech and language skills. Please check the following
comparing your child with other children his/her age. Thank you.
My child... Yes Sometimes No

interrupts politely
starts conversations appropriately and takes turns in a conversation
stays on the topic and changes topics appropriately
asks for help/clarification appropriately
uses correct grammar
uses complete sentences
tells what happened in the recent past
uses words to reject or deny information
uses words to negotiate
uses words to express feelings
tells a story in sequence
has a similar vocabulary to children his/her age
is understood by family members and familiar adults
can follow 2-3 step directions
knows when a listener does not understand his/her message
can reword information/questions if not understood by listener
understands and remembers school vocabulary
participates in conversations with friends
understands figures of speech (for example “butterflies in my stomach”)
is a good listener
has trouble thinking of the right word to say
has trouble saying what he/she is thinking and getting to the point
has trouble making speech sounds; list:
Do the child’s communication skills influence his/her adult and peer relationships or participation in
activities?  Yes  No If YES, explain:
Please share information you think would be helpful on the back of this form.
Please return to: ______________________________________________________ by:______________
Parent Checklist: Speech-Language (Preschool)

Child’s Name:___________________________________________________ Date of Birth: _________
Person completing this form: _____________________________________ Date: ________________
Your input will help us understand your child’s speech skills. Please check the following. Thank you.

responds to his/her name
says 10 words
is learning new words every week
repeats new words
says 50 words
puts two words together
gets my attention with words
rejects/says no
asks questions with his/her tone of voice
takes turns in a “conversation”
asks for help
says 3-4 word sentences
is understood by family members
is understood by familiar adults
follows one-step directions
follows two-step directions
listens to a short picture book
names pictures in a book
answers “yes/no” questions
answers “wh” questions
asks “yes/no” questions
asks “wh” questions (what, where, why, how)
uses pronouns correctly (I, me, we)
knows some songs or nursery rhymes
participates in pretend play
What does the child do when he/she is not understood (Check all that apply)?  points or gestures
 gives up  repeats the words  says different words  other (explain):
Please return to: ______________________________________________________ by: ______________

113
Parent Checklist: Fluency/Stuttering
Child’s name: ____________________________________________ Date of Birth: _____________

Person completing this form: _____________________________________ Date: _____________
Your input will help us understand your child’s speech skills. Please check the following. Thank you.
My child.... Yes Sometimes No
repeats whole words “why, why, why, why”

repeats parts of words
reports sounds “w-w-w-w-hy”

prolongs or holds onto a sound “w-----------hy”
blocks - sounds and airflow are shut off
is frustrated by his/her speech difficulty

has a family member with similar difficulty
has vocal tension
avoids speaking situations
avoids eye contact
has associated physical behaviors (eye blinking,

body movements, grimacing, etc.)
speaks rapidly
What things seem to help your child’s speech?
What things seem to make your child’s speech worse?
Which situations seem to be the most difficult for your child?
Tell us about the speech of members of your family. Does anyone: speak like your child, speak
rapidly, or stutter? If so, who? (Describe)
What other information do you think would be helpful for this evaluation?
Parent Checklist: Voice
Child’s name: ____________________________________________ Date of Birth:_____________

Person completing this form: _____________________________________ Date: _____________
Your input will help us understand your child’s speech skills. Please check the following items.
Thank you.

has a hoarse voice
clears his/her throat frequently
sounds nasal - talks through his/her nose
sounds denasal - stuffed up
speaks too quietly
speaks too rapidly
has pitch unusual for his/her age or sex
speaks in a monotone
has breaks in his/her voice
is frustrated by his/her speech difficulty
has a family member with similar difficulty
has allergies
has frequent ear infections
is exposed to environmental factors like kerosene
fumes, wood or cigarette smoke
frequently yells or plays loud games (for example,
car, gun or animal noises)
participates in sports or activities (singing) where
he/she uses his/her voice loudly
Does your child’s voice change during the day? If so when is it better?
Please share information you think would be helpful.
Please return to: __________________________________________________ by: ________________

115
Student Speech-Language Checklist

Kindergarten through 5th Grade
Student:__________________________________________________ Grade: ____________
Teacher: __________________________________________________ Date: _____________
Directions: Please read and check the box that is the best answer to each question. (If student needs
items read to them, please assist.)
Yes No Sometimes Don’t

Know
Do you like to talk with your family and friends?

Do you like to answer questions in class?
Do you like to talk in class?
Do others tease you about the way you talk?
Do people have trouble understanding what you say?
Does your speech sound different from the other students?
Is it hard for you to make some of your sounds?
Is it hard to hear the sound the letter makes?
Can you follow the teacher’s directions?
Can you follow directions from your family?
Can you tell what happened in a story you read or had read
to you?
Is it hard to think of the words you want to say?
Is it hard to answer questions?
Is it hard to remember information you have learned?
Is it hard to learn new words?
Is it hard to make complete sentences?
Do you like the way your voice sounds?
Do you speak in a loud voice or shout?
Do you speak in a soft voice?
Do you ever lose your voice?
Do you repeat some of your words or sounds?
Is it sometimes hard to get your words out?
Is it hard for you to look at people when you talk?
(Please complete Page 2)
Student Speech-Language Checklist Kindergarten through 5th Grade – Page 2
Please answer the following questions:

1) What do you like best about the way you talk?
2) What would you like to change about the way you talk?
3) Would you like some help with the way you talk?
Student

117
Student Speech-Language Checklist: 6th through 12th Grade
Student:_____________________________________________ Grade:_____________
Teacher:______________________________________________ Date:______________
Directions: Please read and check the box that best answers each question. (If student needs items read
to them, please assist.)

Know
Do you like to talk with your family and friends?
Do you like to answer questions in class?
Do you like to express yourself in class?
Do others tease you about the way you talk?
Do people have trouble understanding what you say?
Does your speech sound different from the other

students?
Is it hard for you to make some of your sounds?
Is it hard for you to hear the sound differences in words?
Do you have difficulty using grammatically correct

sentences?
Do you have difficulty following oral directions?
Do you have difficulty following written directions?
Do you have difficulty recalling and telling what

happened in a story you read?
Do you have difficulty recalling and telling what

happened in a story read or told to you?
Is it hard to think of the words you want to say?
Is it hard to answer questions?
Is it hard to remember information you have learned?
Is it hard to learn and remember new vocabulary words?
Do you like the way your voice sounds?
(Please complete Page 2)
Student Speech-Language Checklist: 6th through 12th Grade – Page 2

Know
Do you speak in a loud voice or shout?
Do you speak in a soft voice?
Do you ever lose your voice?
Do you repeat some of your words or sounds?
Is it sometimes hard to get your words out?
Is it hard for you to look at people when you talk?
Please answer the following questions:

1) What do you like best about the way you talk?
2) What would you like to change about the way you talk?
3) Would you like some help working on your speech and language skills?
Student

119
Speech and Language Therapy Data Sample Form
Student: _____________________________________________ School Year: ___________________ Grade: _________

IEP Due Date: __________________ SLP Services listed on IEP: ______________________________________________
Teacher(s): ___________________________________________________________________________________________
Response Key: + Correct ⊕ Correct w/ cue - Incorrect  Incorrect w/ cue
Date Goal/Objective Response Observations

121
Data Analysis Graph with Aim and Trend Lines
Student: __________________________________________________ Date: ______________

Use this form to graph aim and trend lines and document student progress over time. Label the dates
for data point at the bottom and indicate the amount or frequency of the skill or behavior on the left.
Description of Skill: __________________________________________________________________
Baseline Skill Level: ______________________ Target Skill Level: ___________________
Data for this graph was collected between ____/____/____ and ____/____/____.
Label Graph: Label the graph with dates and values for response rates
Baseline: Calculate baseline by averaging 3 trials.
Aim Line: Plot the baseline and target point and connect them to create an aim line.
Trend Line: Begin with an even number of data points, not including the baseline and target points.
Divide the data points in half and draw a short vertical line through the mid-date for each set of data
points. Draw a short horizontal line through the mid-rate (median) for each set of data points.
Place a mark where the short lines intersect and connect the two marks to create the trend line.

123
Swallowing/Dysphagia Team Procedure Checklist

Student:________________________________________________________ Date: ________________
Speech-Language Pathologist: ____________________________ Nurse: ______________________
Occupational Therapist: __________________________________ Teacher: ____________________
Use this form to document the actions of the dsyphagia team. Attach additional pages as needed.
Swallowing Team Actions Decision Date

Parent/Guardian informed of concern  Yes  No  N.A.
Interdisciplinary consultation conducted  Yes  No  N.A.
Individual Health Care Plan Developed  Yes  No  N.A.
Referral made to physician for clinical evaluation  Yes  No  N.A.
Studies conducted (MBSS attended by case manager)  Yes  No  N.A.
IEP/504 Team meeting held on ____/____/____ attended by:

 Classroom teacher
 Administrator
 SLP
 Yes  No  N.A.
 Nurse
 Occupational therapist
 Parents/Guardians
 Other: ________________________________________
Physician referral for special diet received  Yes  No  N.A.

School cafeteria manager and parent notified of diet order  Yes  No  N.A.
Diet change started at school:  Yes  No  N.A.
Training is conducted on feeding techniques and

emergency plan:
 Classroom teacher
 Administrator
 Paraprofessional
 Yes  No  N.A.
 SLP
 Nurse
 Occupational therapist
 Parents/Guardians
 Other: ________________________________________
Feeding plan initiated:  Yes  No  N.A.

Part 1: Referral to School-based Swallowing Team
Student: Date:
Person Requesting Consultation:
Instructions: Please check ALL characteristics that apply to the student.
Medical Information and Conditions

 Repeated respiratory infections/history of  History of Neurological Disorder (e.g.,
recurring pneumonia cerebral palsy, brain injury, etc.)
 Vocal fold paralysis  Weight loss/undernutrition
 Craniofacial Anomaly (cleft palate,  Chronic constipation, diarrhea, or other
velocardiofacial syndrome, etc.) gastrointestinal tract problems
 Reported medical history of swallowing  Reported reflux (GERD)
problems
Observed Behaviors
 Requires special diet or diet modifications  Effortful swallowing
(e.g., thickener, soft food only)  Eyes watering/tearing during
 Poor upper body control mealtime
 Poor oral motor functioning  Unusual head/neck posturing during
 Maintains open mouth posture eating
 Drooling  Hypersensitive gag reflex
 Nasal regurgitation  Refusal to eat
 Food remains in mouth after meals  Food and/or drink escaping the
(pocketing) mouth or tracheostomy tube
 Wet breath sounds and/or gurgly voice  Spitting up or vomiting associated
quality following meals or drinking with eating and drinking
 Coughing, choking, or frequent throat  Limited or slurred speech
clearing during meals  Receives nutrition through feeding
 Swallowing solid food without chewing tube
 Mealtimes take more than 30
minutes
Additional Information or Comments:

125

Part 2: Interdisciplinary Swallowing Consultation
Student:_________________________________________________ Consultation Date: ______________
Date of birth: ________________ Physician: __________________________________________________
Medical History/Diagnosis: __________________________________________________________________
List any known food allergies: ________________________________________________________________
Current Diet: ______________________________________________________________________________
Designated Case Manager: __________________________________________________________________
Team members (names /titles): ________________________________________________________________
General Observations of the student during consultation:
Behavior:  cooperative  resistant  refusal  other

Alertness:  alert  lethargic  irritable  fatigues easily  other
 verbal  gesture/imitation  none
Follows directions:
 step  2 step  complex
Vision:  no known deficit  deficit:
Abnormal reflexes observed:
 excessive extension  dystonia  scoliosis
Trunk:
 kyphosis  asymmetric  Other:
 adequate  poor
Head Control:  receives manual positioning  receives external positioning
 excessive head/neck hyper extension  reflexive position patterns
 asymmetric  contortions  jaw extensions
Facial:  increase tone  decrease tone  grimaces/tics
 open mouth posture  other:
Breathing  mouth breather  audible inhalation  nasal congestion
Patterns:  tracheostomy*  ventilator *
* If tracheostomized and/or ventilator dependent, consideration for medical consultation is

advised prior to feeding trials.

Part 2: Interdisciplinary Swallowing Consultation continued
OBSERVATION OF FEEDING:
The student displayed the following during this consultation: ___________________________________
During this assessment the student was fed by: ___________________________________________
Positioning:  Chair  Wheelchair  Tumbleform  Other: _______________________
Utensils used (including adaptive utensils) : _______________________________________________
FEEDING TRIAL DATA:
List of liquids and foods used____________________________________________________________
Key: (+) present (-) not present (DNT) did not test/observe
Indicate food consistency Indicate observed Additional
Liquid Puree Soft Solid behaviors Comments
Accepts food
Foods Avoided
Lips
Poor lip closure
Drooling
Reduced lip action to
clear material
Tongue
Poor bolus
formation/movement
Decreased
anterior/posterior
movement
Food residue
Absence of rotary jaw
movement
Munching jaw movement
Delayed swallow initiation
Swallow delay
Cough following swallow
Increased clearing throat
Residual food in oral
cavity
Cued Swallow
Additional Comments/ Observations:

127
Swallowing Disorder Consultation/Referral Form

Part 3: Request for Physician Input Regarding Swallowing Concerns
Student: Date:
Student Date of Birth:
Dear Dr. ____________________,

Your patient was observed during speech and/or occupational therapy on ____________ due to
feeding and swallowing concerns. The clinical indication(s) of oral pharyngeal dysphagia (with
possible aspiration) included:
 Pneumonia (current of history)  Coughing

 Chronic low grade fever  Oral residue
 Chronic, copious secretions  Gagging
 Gurgled vocal quality  Delay in swallowing/reflex
 Audible breathing  Refusal to eat
 Changes in respiration rate  Questionable nutritional intake
 Other
To ensure safe and adequate nutrition and hydration during school we suggest the following:
 Special Diet: _________________________________________________________________
 Modified Barium Swallow/Videofluoroscopy in a Medical Setting
 Other
Additional comments:
Sincerely,
School-Based Dysphagia Case Manager Phone Fax
Physician Feedback: (please return your recommendations via facsimile)

I recommend the following:
 Modified Barium Swallow/Videofluoroscopy
 Interdisciplinary Clinical Swallowing Evaluation in Medical Setting
 Special Diet: ______________________________________________________________
 Other: ___________________________________________________________________
 I have reviewed. No recommendations at this time.
Physician’s Signature: ________________________________________________ Date: _______________
Voice Referral Form
Part I. General Information

Student’s Name: _____________________________________ Gender: _________ DOB: _______________
Address: ______________________________________ Parent’s Name: _____________________________
School: ______________________________________________________________ Grade:______________
Speech-Language Pathologist: __________________________________________ Date: ______________
Part II. Speech-language evaluation results (completed by a Speech-Language Pathologist)

Reason(s) for referral: ______________________________________________________________________
Student’s complaint (if any): ________________________________________________________________
Brief description voice (e.g., onset pattern, variations, impact on communication, student’s level of
awareness and motivation for possible therapy). Include relevant oral-peripheral examination and
hearing screening/evaluation results.
Clinical Impressions: Rate each attribute (1 = normal, 2 = Mild Impairment, 3 = Moderate Impairment,
4 = Severe Impairment, 5 = Profound Impairment, and X = Not Observed).
Quality (breathy, hoarse, harsh) ______________________ Muscle tension _____________________
Pitch (too high/ too low) ____________________________ Oral resonance _____________________
Nasal resonance (hypo-/hypernasal/mixed)____________ Phonation breaks ___________________
Loudness (too soft/ too loud)_________________________ Breathing pattern __________________
Pitch breaks _______________________________________ Abusive vocal behaviors _____________
Glottal attack (hard/soft) ____________________________
Maximum phonation time: /a:/= _____________ seconds
s/z ratio (maximum /s:/= ______ seconds/maximum /z:/= ______ seconds):
Other (describe in detail):
_______________________________________ ______________________
Signature of speech-language pathologist Date

129
Voice Referral Form Page 2
Student’s Name __________________________________ Date __________________
Part III. To be completed by the parent or caregiver
Instructions: Please circle “yes” or “no” and provide additional information as needed.
Does your child’s voice sound like that of other family members? Yes No
Has he/she had frequent ear infections? Yes No
Does he/she have a sore throat frequently? Yes No
Does he/she have allergies? Yes No
Does he/she often breathe through the mouth? Yes No
Does he/she snore while sleeping? Yes No
Does your child seem unusually tense when speaking? Yes No
Have you noticed that your child has a persistent voice problem? Yes No
If yes Does your child’s voice sound hoarse? Yes No
Does your child seem short of breath when speaking? Yes No
Does your child’s voice sound as though it is coming
through his/her nose rather than through the mouth? Yes No
Does your child’s voice sound as though he/she has a
stopped-up nose? Yes No
Does your child’s voice sound worse in the morning? Yes No
Does your child’s voice sound worse in the evening? Yes No
Does your child seem to speak more loudly than necessary? Yes No
Has he/she had a serious injury to the neck? Yes No
to the head? Yes No
to the chest? Yes No
Has your child had any surgery to the lips, mouth, throat, or ears? Yes No
If yes, please describe and include dates
Does your child have any problems swallowing? Yes No
Does he/she often have heartburn or acid indigestion? Yes No
Does your child use tobacco products? Yes No
Does your child consume caffeinated drinks? Yes No
Does he/she consume alcoholic beverages? Yes No
Is your child in choral groups, cheerleading, or other talkative activities? Yes No
Is your child frequently exposed to dust, mold, or air-borne chemicals? Yes No
Does he/she have any other health problems? Yes No

Describe: _______________________________________________________________________
Is your child currently taking any medications? Yes No

Please list: ______________________________________________________________________
When did you first notice the problem and how has his/her voice changed since then?
Parent signature: _________________________________________ Date: __________________
Voice Referral Form Page 3
Student’s Name __________________________________ Date __________________

Part IV: To be completed by a licensed physician.
What is the physical condition of the patient’s larynx?
Are there any abnormal growths/edema on any part of the vocal

mechanism? Please specify type and location. Yes No
Are there vocal fold asymmetries during phonation?

If yes, please describe Yes No
Is there evidence of inadequate velopharyngeal function?

If yes, please describe Yes No
Is there obstruction(s) of the nasal passages?

If yes, please explain Yes No
Is there presence of any sinus infection or nasal allergy? Yes No
During phonation did the vocal folds exhibit normal amplitude? Yes No
Is there evidence of excessive muscular tension during phonation? Yes No
How were the vocal folds visualized during the examination?
What is your medical diagnosis?
Are there any contraindications for voice therapy? Yes No
How may the Speech-Language Pathologist best contact you for consultation if needed?
Phone #: _______________ E-mail: _________________________________ (with parental consent)
Examining Physician’s Signature: __________________________________ Date: ________________
Please return this form to: ___________________________ at _________________________ (fax) or
_____________________________________________________________________________ (address).
Thank you.

131
Notes
© 2011 Commonwealth of Virginia Department of Education
The Virginia Department of Education does not discriminate on the basis of

race, sex, color, national origin, religion, age, political affiliation, veteran status,
or against otherwise qualified persons with disabilities in its programs and activities.

Speech-Language Pathology Services in Schools:: Guidelines For Best Practice

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Speech-Language Pathology

Virginia Department of Education, Office of Special Education and Student Services

Overview of School-Based Speech-Language Pathology . . . . . . 4

Assessment and Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Virginia Department of Education, Office of Special Education and Student Services i

References and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Figures and Tables

Table 1. Roles/Responsibilities of School-Based Speech-Language Pathologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ii Virginia Department of Education, Office of Special Education and Student Services

This guidelines document is designed to assist school-based SLPs, administrators,

The Virginia Department of Education (VDOE) Regulations Governing Special

The VDOE employs staff who provide assistance understanding information

Virginia Department of Education

Virginia Department of Education, Office of Special Education and Student Services 1

Cynthia O’Donoghue, Ph.D. Myra Flint Amy Edwards

Donna Bryant Marie Ireland Patricia Abrams, Ph.D.

2 Virginia Department of Education, Office of Special Education and Student Services

Commonly Used Acronyms

ASHA American Speech- EI Early Intervention LRE Least Restrictive

Virginia Department of Education, Office of Special Education and Student Services 3

4 Virginia Department of Education, Office of Special Education and Student Services

Table 1. Roles/Responsibilities of School-Based Speech-Language Pathologists

Role Speech-Language Pathologist Responsibilities

Identification Conducts speech-language and hearing screenings

Evaluation: Assessment Conducts a comprehensive assessment to determine the existence of a disability

Evaluation: Interpretation of Identifies child’s communication strengths and weaknesses

Eligibility Decision Presents speech-language assessment results at team meeting

Documentation Completes progress reports (for special education and Medicaid)

Unique Contributions Contributes to the literacy achievement of students

Adapted from American Speech-Language-Hearing Association. (2010).

Virginia Department of Education, Office of Special Education and Student Services 5

(swallowing), and auditory-oral/ experience (tracking the requirements Speech-Language

Speech-Language eligibility for special education 1. A licensed audiologist and

6 Virginia Department of Education, Office of Special Education and Student Services

Virginia Department of Education, Office of Special Education and Student Services 7

8 Virginia Department of Education, Office of Special Education and Student Services

Virginia Department of Education, Office of Special Education and Student Services 9

Work Environment Some examples of adjustments to evaluations, services and administrative

Table 4. SLP Recruitment Strategies

10 Virginia Department of Education, Office of Special Education and Student Services

Virginia Department of Education, Office of Special Education and Student Services 11

student is making progress. At a

include publications from the medical

minimum, SLPs should use data and

profession that explain EBP in depth, documentation of efforts to evaluate

such as the book Evidence-Based outcomes during naturally occurring

Rosenberg, & Haynes, 2000), online periods.

portals such as the Cochrane

Collaboration (www.cochrane.org), and Current

12 Virginia Department of Education, Office of Special Education and Student Services

Documentation and toward all annual goals will be Intervention Documentation

Virginia Department of Education, Office of Special Education and Student Services 13

Table 5. Types of Data Commonly Collected in Education Settings

Data Type Description Example

14 Virginia Department of Education, Office of Special Education and Student Services

Virginia Department of Education, Office of Special Education and Student Services 15

Assessment and Evaluation

16 Virginia Department of Education, Office of Special Education and Student Services

has a disability and, if so, the Figure 4. The

Virginia Department of Education, Office of Special Education and Student Services 17

following: 1) language sampling, 2) A comprehensive speech-language • What is the functional result

Figure 5. Comprehensive Assessment of School Communication Abilities

18 Virginia Department of Education, Office of Special Education and Student Services

Name: School: Meeting Date: ____

Student ID: D.O.B. _________________ Age: _ Grade: ________