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Collaborating with Teachers to Improve Referrals and Interventions with Bilingual Students
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Transcript of Collaborating with Teachers to Improve Referrals and Interventions with Bilingual Students
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Collaborating with Teachers to Improve Referrals and Interventions with Bilingual StudentsAlyson Hendry, M.A., CCC-SLPKatherine Marting, M.A., CCC-SLPTSHA Convention March 7, 2013Dallas, Texas
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Disclosure Statement
No relevant financial relationship(s) or nonfinancial relationship(s)•I have no relevant financial or
nonfinancial relationships in the products or services described, reviewed, evaluated or compared in this presentation.
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Why can’t I understand
him?
Identification
Intervention
Referrals
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Objectives
•Describe the acquisition of sounds and when teachers should be concerned.
•Explain red flags for expressive and receptive language impairment to teachers.
•Identify variables that can complicate the process of identifying a child with speech and language needs.
•List ways in which to help teachers carry over therapeutic strategies into the classroom.
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Speech and Language Referrals
DNQs? DNQ due to second language influence?
Teachers who need more support and understanding?
Overwhelmed with number of evaluations? Work with
children who come from CLD backgrounds?
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What can Complicate Identifying a Child with Needs
My gut feeling or experience tells me that this student is not communicating well.Is he communicating normally for his age or should he be referred to speech?
SecondLanguageIssues
Low
SES
Issues
Atypica
l Fam
ily
Dynam
ics
Parents
with lo
w
litera
cy abilit
ies,
reduce
d support
and
involve
ment
Reduced experience
with, and exposure to,
vocabulary and
academic topics
Frequent movement between schools
Cultural Differences
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Taking Everything into Account
Account for developmental differences resulting from second language influence.
SecondLanguageIssues • Similar amount of
vocab • Code switching• BICS vs. CALP
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Taking Everything into Account
Account for possible limited
book and vocabulary exposure, reduced
community access, etc.
Low SES Issues
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Taking Everything into Account
Account for possible low
literacy skills, home
involvement, reduced
communication between parent
and teacher.
Atypical Family Dynamics Parents with low literacy abilities, reduced support and involvement
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Taking Everything into Account
Academic measurement is heavily weighted by vocabulary.
Reduced experience with, and exposure to academic topics
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Taking Everything into Account
Account for disruptions in an academic career.
Frequent movements between schools
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Taking Everything into Account
Account for cultural
importance on communication and differences
in communication
style.
Cultural Differences
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Summary• A proper Speech-language referral
and diagnosis will take into account:▫Second language▫Socio-economic Status▫Family Dynamics▫Academic Experience and Exposure▫Culture
• Go to www.speechpathologyceus.net for more resources on these issues
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What are the greatest difficulties we face?
Speech Language Pathologists:
•My caseload is too large• I have too many campuses• I have too much paperwork• I don’t have time to complete the
evaluations given to me
•Can you think of any others?
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What are the greatest difficulties we face?
Principals and Assistant Principals:
• I can’t get this student into special education
•There are too many annual meetings• I can’t believe this child didn’t qualify•The evaluation process is too long
•Any others that you have heard?
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What are the greatest difficulties we face?
Speech Department Leads:
•My staff is stretched too thin•There are not enough bilingual SLPs•There is no money in the budget•We are over-identifying certain minority
groups
•Any others that you have heard?
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What are the greatest difficulties we face?
Teachers:
• I can’t understand my student• I want to help in the classroom but I don’t
know what to do• I have 19 other students•The referral process:
▫Is complicated▫Takes too much time▫Involves a lot of paperwork▫Doesn’t result in students getting help.
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Distribution of time over a student’s week
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 2
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Are Teachers Referring the Right Students?
Research on agreement between teachers and SLPs
• Numerous studies have explored the rate of agreement between teachers and SLPs about who should receive speech services (Friberg, 2008).
Diehl & Sinnet (1959) – 60% James & Cooper (1966) – 40% Clauson & Kopatic (1975) – 18% Davis and Harris (1992) – 81% Cartwright-Gard, Harmon & Bryne (2002) – 58%
• On average, teachers- SLP agreement is 60%.• Research indicates that 40% of students who
should be referred are not (Mosheim, 2009)
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 2
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Teacher confidence•Cartwright-Gard, Harmon & Bryne (2002)
surveyed teachers and found:▫75% of teachers reported low confidence in
making referrals▫80% of teachers indicated a desire for more
training to improve their referrals•Many teachers report very low confidence
when making referrals for bilingual children
Are Teachers Referring the Right Students?
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 2
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Helping Teachers understand
•Documents for support:▫What is Speech and Language?▫Apples to Apples▫Developmental Articulation Norms▫Red Flags for Speech/Language
impairment
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Defining how a child is having difficulty facilitates success in improving their communication
When you say a child “can’t communicate.”
• Can’t follow directions
• Doesn’t remember
• Repetitions• Stuttering
• Doesn’t speak much
• Grammar is wrong
• Can’t understand
• Can’t say sounds
Articulation
Expressive
Language
Receptive LanguageFluency
What is Speech and Language?
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Developmental Articulation Norms
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Red Flags For Speech or Language Impairment in Bilinguals
• Family history of language/learning disabilities
• Slower development than siblings • Speech and Language performance unlike
others with similar cultural/linguistic experiences
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Red Flags For Language Impairment in Bilinguals
• Difficulty learning both languages, even with adult assistance
• Difficulty interacting with peers• Difficulty with language in many routines• High use of non-specific vocabulary (e.g. stuff, thing,
that)• Disorganized sentences and narratives• Limited sentence length and complexity• Does not understand what the teacher says• Difficulty understanding and following directions• Difficulty understanding classroom concepts that are
part of their daily routine that all other students with the same exposure have picked up on.
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Red Flags For SpeechImpairment in Bilinguals
• Deletion of sounds or syllables• Lateral /s/- air coming out of the sides of the
mouth• Teacher and/or peers have a hard time
understanding the child• A school-age child should be 100%
intelligible
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Red Flags For Pragmatic LanguageImpairment in Bilinguals
• Isolation from peers during play• Difficulty making and keeping friends• Perseveration on certain activities or topics• Difficulty transitioning from one activity to another or from
room to room (tantruming) • “In their own world” • Difficulty turn-taking• Poor topic maintenance• Inappropriate non-verbal communication (body language, eye
contact)
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Normal disfluenciesAbnormal disfluency (should be referred)
• Whole word repetition▫ I-I-I went to the
playground • Phrase repetition
▫ I went, I went, I went there
• Normal rate of speech• No tension
• Prolongation▫ mmmmom
• Syllable repetition▫ te-te-te-teacher
• Sound repetition▫ b-b-b-ball
• Blocks▫ I want the b---ball
• Raise in pitch• Facial/body tension• Abnormal blinking • Poor eye contact• Frustration• Social anxiety• Family history
Red Flags For Fluency Disorders in Bilinguals
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Response to Intervention (RTI)
• “RTI is not something that happens in special education. Rather, it is a method for teaching all students that needs to be driven by general education teachers in the general education classroom.”
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What is RTI?
•A regular education initiative to deal with the problems of the discrepancy model (discrepancy between IQ and achievement).
•A way to determine how students respond to intervention (in the classroom with the teacher)
•A screening to identify children with learning disabilities.
•A way of determining whether children who receive “intensive” intervention in the classroom respond.
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•“RTI was first proposed by Gresham (2002 ) as a viable alternative to the discrepancy model.”
• Provide children from culturally and linguistically diverse populations with the assistance they need to succeed.
• To better identify children with reading disabilities.
• To better identify children with learning disabilities.
• How does RTI serve SLPs in it’s intended mission of correctly identifying populations?
*Fasko, 2006
Why was RTI implemented?
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Response to Intervention (RTI)
•RTI has 3 basic phases called Tiers▫Tier 1 – Identify a child that has difficulties ▫Tier 2 – Attempt to remediate the problem
in the classroom▫Tier 3 – Continue working with the child in
the classroom and have outside support (SLP) begin working with the student
▫“Why can’t an SLP just do an observation or start working with a child?”
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What is our role?
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Why are we involved?
•Over identification •Reduce number of DNQs and workload•Help general education teachers increase
effectiveness •Improve the quality of referrals
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How can we be involved in RTI without being overwhelmed by it?
•Helping with the referral process (See attached packet –Speech and Language Concerns)
•Referral Portfolio - Decision Tree with Teacher Letters and 35 Speech & Language Probes found at http://speechpathologyceus.net/cld-resource-library/
•How do we make time to collaborate with the teacher during the referral process?
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RTI Problem Solving Method*
*Adapted from NASDSE, 2006
Gather Student
Information
Analyze student’s
difficulties
Develop strategies
Implement the
strategies
Evaluate student’s success
Who is concerne
d?Is there a problem?
What shall we do about
it?
Here are the steps.
Did our plan
work?
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Gather Student Information
1. Name2. Date of Birth3. Grade4. Teacher5. Vision and Hearing6. Parent Concern and History7. Teacher Concern
1. I can’t understand my student2. My student doesn’t speak enough, is
confusing, or can’t understand me
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 1
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Initial Data
• Hearing Concern• Parent Concern• Teacher Concern
• I can’t understand the words that my student uses.
• My student doesn’t speak enough, is confusing, or can’t understand me.
Part A - Everyone
Part B – Which best describes your student
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Speech and Language ConcernsGather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 1
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Speech and Language Concerns
The Language Information generates data about each area of possible concern.
Teachers read it from top to bottom
SLPs read it from left to right
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 1
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Why referrals might be daunting to teachers
•There are 7 pieces of data from three sources
•Multiple Causes▫There are 27 common speech outcomes▫There are 7 common language outcomes
•There are 12 steps across 3 tiers
•Referral Manuals can be 12-58 pages•Teachers on average receive less than 2
hours of training per year
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 2
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Analyze Student Difficulties
1. I can’t understand my student.2. 27 common outcomes (not
including multiple issues, 2nd language, or age).
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 2
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Analyze Student Difficulties
1. My student doesn’t speak enough, is confusing, or can’t understand me
2. 7 common outcomes across expressive and receptive domains
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 2
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Develop Strategies
1. What problem is a child having?2. Example: Answering questions
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 3
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Implement Strategies1. Example: Answering questions2. Tell the student this story and ask him these
questions
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 4
Who wanted to go to the ball?
What did Cinderella lose?
When did she have to leave?
Where did the prince live?
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Evaluate Student Success
1. Example: Answering questions2. How did he do?
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 5
Who wanted to go to the ball?
What did Cinderella lose?
When did she have to leave?
Where did the prince live?
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Repeat if unsuccessful
Develop Strategi
es
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 3
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 4
Gather Student
Information
Analyze Student
Difficulties
Develop Strategies
Implement Strategies
Evaluate Student Success 5
Implement
Strategies
Evaluate Success
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Case Study
•One of our colleagues put this plan into play from start to finish
•Only there 2 days/week!•Started the year with a teacher training on
speech and language•Over 23 referrals came in, 6 for eval, 4
qualified•Used the steps in this packet, tracked number
of students who went on for evaluation and number who resulted in qualifying
•Approx 1 hour or less/week
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Collaboration after Identification
“Education takes place through the process of communication. The ability to participate
in active and interactive communication with peers and adults in the educational
setting is essential for a student to access education”
– Michigan Speech-Language-Hearing Association (1995)
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Why do we need collaboration?
•Generalization of skills in the academic setting▫IDEA requires that intervention be relevant▫Focus on speech/language in the context of
academics•Continued teacher education of
speech/language▫How teachers can continue to support the
student in the classroom
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Language and Speech in the Context of Academics
•Focus on what is most functional for excelling in the classroom: ▫Follow the curriculum ▫Use classroom materials
•Therapy programs that support curriculum:▫Lit Kits▫PPCD Plans▫FLS Plans
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Literacy Based Intervention• Using books that the student is reading in class • Refer to Using storybooks in speech-language
intervention for templates to create speech and language activities▫ Found on SpeechPathologyCEUs.net in the Resource
Library• Pre-reading activities• Post-reading activities• Category, Attribute, Function Activity Template• Character and Setting Activity Template• WH. Card Template• Sequencing Activities• Articulation Word and Data Collection Template
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PPCD Plans
•Small group routine in the classroom•Consistent schedule with themes that
change, according to the curriculum•Identify goals that can be targeted with
each activity
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PPCD Plan Activities• Greeting/attendance• Calendar• Introduction of theme• Music• Surprise Bag• Phonological goal• Read book• Centers
▫Auditory bombardment▫Language activity
• Review language goal and phonological target
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PPCD Plan Materials
•Book •Song•Surprise bag materials•Phonological/artic cards•Auditory bombardment •Themed coloring page•Language activity •Homework sheet
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•Similar to PPCD plans but with modifications for students with different disabilities
•Focus on basic functional skills▫Basic personal information (name, age)▫Social introductions
Life Skills Plans
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Strategies for reinforcing academics and carryover•Do a short presentation at the beginning
of the year and provide handouts for reference
•Schedule 30 min every week in your calendar to collaborate with teachers
•Get a copy of the curriculum•Join the weekly planning meeting –
different grade level every week •“Walk and talk”•Weekly emails to teachers
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For more great resources visit our resource library at SpeechPathologyCEUs.net
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Visit us at bilinguistics.com
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References• Farber, J.G., Klein, E.R. (1999). Classroom based assessment of a
collaborative intervention program with kindergarten and first-grade students. Language, Speech, and Hearing Services in Schools, 30, 83-91.
• Loeb, D.F., Gillam, R.B., Hoffman, L., Brandel, J., Mauris, J. (2009). The effects of fast forward language on the phonemic awareness and reading skills of school-age children with language impairments and poor reading skills. American Journal of Speech-Language Pathology, 18, 376-387.
• Nind, M. (2000). Teachers’ understanding of interactive approaches in special education. International Journal of Disability, Development and Education, 47(2), 183-199.
• Cartwright-Gard, Harmon & Bryne (2002) surveyed teachers and found:• Numerous studies have explored the rate of agreement between teachers
and SLPs about who should receive speech services (Friberg, 2008).• Research indicates that 40% of students who should be referred are not
(Mosheim, 2009)
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Thank you!