The SLP’s Role in RTI: Using a Workload Approach Judy Rudebusch, EdD, CCC-SLP Division Director ~ Special Services, Irving ISD November 3-4, 2009 Response to Intervention… What do you know now? What do you still want to know? What is most intriguing to you about RTI? Yesterday’s Agenda First Things First • • • • • RTI Defined Context for Change – What’s Going On??? RTI – Where did it come from??? Why a “Systems Approach?” SLPs – How can RTI work well for us??? RTI ~ Essential “System” Components SLP Roles ~ prevention, intervention, identification Today’s Agenda Managing Change ~ tips and tools Use a Workload Approach to Accommodate RTI • • • • SLP Roles and Responsibilities in Schools Workload Clusters Service Delivery Models Types of Schedules Action Plan for RTI Change • Across Tiers • Prevention, Intervention, Identification Quick Review… RTI is the practice of Providing high quality instruction/ intervention matched to student needs and Using learning rate over time and level of performance to Make important educational decisions RTI provides support w/ increasing intensity as needed …in other words… There are systems in place to help every child meet grade level expectations in academics and behavior… “Whatever it Takes!” Implications: Need infrastructure • Data management software/system • Processes in place for data integrity (data entry, data reporting, easy to access & use) Need shared understanding • About what data to collect • About how & when to collect data • About how to analyze & interpret data Need tools and procedures in place Need checks & balances RTI Three Pronged Approach Prevention Intervention Identification So… The SLP’s Role in RTI involves activities for prevention, intervention & identification of communication disorders that impede progess… So… Let’s think Not-a-Box For the rest of today!!!! Think About… If you want to offer prevention and intervention services through RTI, how will you manage it? If you want to use RTI data to augment evaluation data and eligibility determination, where will you get the data? If you want to participate in RTI, where will it fit in your schedule? Change yields Turbulence What changes in your work are you dealing with? Which changes challenge you most? Pivot Points for RTI Change What needs to change? • Classroom instruction • Instructional support • Intervention • Assessment • Measurement of progress Where will you contribute to RTI change? Change Pathway Awareness Interest Desire Action SLPs Supporting Change Get an attitude!!! Outcomes orientation Manage complex change Redirect your effort • Smaller caseload Larger impact Managing Complex Change Vision + Skills + Incentives + Resources + Action = Change Vision + Skills + Incentives + Resources + xxxxx+ Skills + Incentives + Resources + Vision + xxxx + Incentives + Resources + Vision + Skills + xxxxxxxx + Resources + Vision + Skills + Incentives + xxxxxxxxx + Vision + Skills + Incentives + Resources + Action Plan Action Plan Action Plan Action Plan Action Plan xxxxx = Change = Confusion = Anxiety = Resistance = Frustration = Treadmill What You Will Notice When RTI is Implemented Well The effort is owned by general, special and compensatory educators Shared responsibility to facilitate student outcomes Educators embrace new and expanded roles Infrastructure promotes collaboration Focus of the school is on core instruction What You Will Notice When RTI is Implemented Well A continuum of appropriate interventions are available outside of special education Local incidence matches national Special ed provides the most intensive, ongoing specialized instruction and related services Parents understand and are involved in RTI Students receive the help they need when they need it Let’s Talk about RTI in a Workload Approach What is Workload? Taking the total work activities of each schoolbased SLP into account when determining the number of students s/he can serve (well). Workload Essence Statement Attitude that emerges from belief system All-encompassing approach to organizing our work in schools Application of Workload Concept to: • Schedule • IEPs • Scope of Activities and Responsibilities • Prevention Activities (RTI) Advantages of workload perspective Focuses on individual needs of students Documents full range of roles and responsibilities carried out by SLPs Facilitates dialogue between SLPs and administrators regarding workloads Allows SLP to contribute to improved student performance What is Workload? Making decisions that allow for full implementation of all IEPs … and… Allows for full participation in student and school improvement ASHA’s revised policy on caseload size in schools “A Workload Analysis Approach for Establishing Speech-Language Caseload Standards in the Schools” • Guidelines, Position Statement, Technical Report, Implementation Guide • Developed by ASHA’s ad hoc committee on caseload size, supported by the 2001-2003 Focused Initiative for Schools Basic Components of a Workload Approach Delineation of Roles and Responsibilities Workload Activity Clusters Flexible Schedules EBP Service Delivery • Clinical Service Delivery • Administrative/Procedural Services Workload Analysis Process Problem Solving Process Advocacy Plan Evaluation of Workload Implementation Where Are We With Workload? High Awareness ~ Low Implementation Workload Implementation Status Rate yourself… (page 6 of handout) Reasons Workload May Be Difficult to Implement Need a Workload Attitude Requires much more coordination and communication Wants to be embedded in a systems approach Implementation is dynamic not static Business Office/HR/Special Ed still use numbers for staffing personnel units Doesn’t work well if you don’t frontload planning Deep Change …is not adding more to an already full load …means reconfiguring what we do and how we do it …and then evaluating how well we are doing it in terms of outcomes Roles and Responsibilities SLPs’ Roles and Responsibilities as outlined by ASHA Prevention/RTI Identification/RTI Diagnosis Assessment Data collection IEP/IFSP development Case management Intervention Transition services Consultation Supervision Documentation Parent/staff training Planning teams Research Advocacy Policy-making SLPs’ Roles and Responsibilities in IDEA 2004 IDEA 2004 expanded SLPs’ responsibilities... • definition of SLP services in IDEA (habilitation or prevention) • collaboration/consultation/teaming • links to the general curriculum • multiple forms of assessment • responsiveness to scientifically based intervention • increased paperwork and reporting Roles and Responsibilities New ASHA Guidance Coming… Critical Roles in Education • • • • Across All Levels Range of Disorders Language/Literacy Focus Cultural and Linguistic Diversity • • • • • • Educational Relevance Prevention Assessment Intervention Program Design Accountability Range of Roles & Responsibilities Roles and Responsibilities New ASHA Guidance Coming… Collaboration • • • • • • Schoolwide Services Unique Contributions Collegiality Partnerships with Universities Partnerships with Families Partnerships with Students • • • • • • Advocacy Communication Supervision and Mentorship Professional Development Lifelong Learning Research Leadership Balance Across Clusters SLP Workload Activity Clusters Direct services to students Indirect services that support students’ educational programs Indirect activities that support students in LRE/general education curriculum Activities that support compliance with federal/state/local mandates SLP Workload Activity Clusters *** Important to note … *** Enrollment of a student into direct intervention, regardless of service delivery option, will add to the workload in the other three clusters of activity Reflection Take time to spell out roles and responsibilities… And include RTI activities in the description of time well-spent Flexible Scheduling Options Flexible scheduling to meet the needs of each child Altering the frequency of services provided each week and/or month Providing opportunities for individual therapy Combining service delivery models Providing opportunities for indirect services Scheduling in compliance activities Service Delivery in a Workload Approach…. …changes as the needs of the student change… (think braided services!) Workload Analysis, Problem Solving and Advocacy: Tools to Help You Workload Analysis Five Guiding Questions Balanced Workload Activity Clusters Student Services Summary Flexible Scheduling Service Delivery Strategies Overload Analysis Worksheet Time Survey 3-2-1 Reflection Sheet Advocacy Plan - Making Things Happen Balanced Workload What Does it Look Like? (Reflection) Top 5 Leverage Points Toward Workload Change Increase Workload Advocacy Vary Service Delivery Embed Flexibility into Schedules “Refresh” Frequency-LocationDuration Considerations Put Educational Relevance in Eligibility Deliberations & Service Delivery Increase Workload Advocacy Increase Workload Advocacy Change is unlikely to occur if nobody knows about it but you Intentional – match the advocacy to the level of desired change • One teacher or grade level? • School/s? ~ Campus leaders are key players • District? ~ need administrative support The Basics: Know what employment contract says • • • • Is caseload/class size defined? Is length of day defined? What additional duties are required? How much prep time per week is stipulated? Increase Workload Advocacy Know your leadership and/or union structure • Officers • Grievance committee • Negotiations team • Building rep • Committees Understand decision-making at building, district, and state levels Increase Workload Advocacy Identify the Issues • Barriers to adequate services? Lack of student progress due to large caseload? No mechanism for collaboration with other educators? Support Issues with Data Identify Possible Solutions Develop a Support Base Develop a Communication System about Workload Implementation Develop, Implement, Evaluate Action Plan Houston ISD Success Story Largest school district in Texas 4 Years Ago…38 vacancies…50+ uncovered campuses Today…8 vacancies…4 uncovered campuses How??? By using a Workload Approach! Houston ISD Success Story Workload Approach Administrative Support • • • • Compensation package Stipends Supervision Superintendents’ Expectations Changed IEPs from weekly minutes to minutes per grading period Used 3:1 Model STAT Teams Focus on Service Delivery – Especially Indirect Services Consistent Eligibility and Dismissal Guidelines Vary Service Delivery Leverage (Workload) Change with Varied Service Delivery Service Delivery in the 21st Century • Includes direct and indirect IEP services • Includes support and compliance activities • Includes direct and indirect non-IEP services IN ORDER TO… Work on 21st Century Skills NCREL/Metiri Group 2007 Effective Communication • Teaming, collaboration, interpersonal skills • Personal, social, civic resposibility • Interactive Communication Inventive Thinking • Adaptability, Managing Complexity, Self-Direction • Curiosity, Creativity, Risk-Taking • Higher-Order Thinking and Sound Reasoning Work on 21st Century Skills NCREL/Metiri Group 2007 Digital-Age Literacy • Basic, Scientific, Economic, and Technological Literacies • Visual and Information Literacies • Multicultural Literacy & Global Awareness High Productivity • Prioritize, plan, manage for results • Effective use of real world tools • Relevant, high-quality products Service Delivery Models RTI/Prevention ~ Direct Tier 1, 2, or 3 Services Pull-out Classroom-based Self-Contained Speech Class Community-based Indirect services RTI ~ Direct (Prevention of Placement in Speech) Tier 2 • • • • • Artic Lab, Language Lab, Communication Lab Small homogenous group Working on the same skills Programmed approach Usually 2-4 times/week; Total about 15 hours Tier 3 • More frequent, intense, longer duration • Smaller group; more individualized • Close to considering referral for FIE Pull-Out Service Delivery • Individual or small group direct • Speech room (or location other than classroom) • Considered a restrictive placement • Good fit: speech-based disorders or language disorders if combined with other models • Most common speech service delivery Drill Bursts Short – 10 minute drill bursts to increase rate of progress in articulation therapy Individual therapy Reduced time away from classroom instruction Classroom-Based Individual, small group or whole group, direct In classroom Least restrictive environment Good fit: language disorders Easiest to manage in elementary grades and special ed classes Classroom-Based Options Team Teaching Complementary Teaching Supportive Teaching Parallel Teaching Remedial Teaching Station Teaching Push In Therapy Self-Contained Speech Class Small group or whole group, direct Speech classroom SLP teaches classroom curriculum and implements speech IEPs Examples • Preschool speech class • Middle school study skills • Secondary communication lab Community Based Indirect or small group, direct or indirect Off school site, often at job site Least restrictive – functional environment Good fit: communication skills needed in work, home, community settings Indirect Services Support for • Student’s educational program • Services in LRE • Maximizing effectiveness of direct services Student-specific activities provided • On behalf of students with speech IEPs Indirect Service Options Monitor Consultation Collaborative Consultation Curriculum Support Contextual Support Instructional Support AT/AC Support Factors Affecting Service Delivery Individual Considerations • • • • • • • Nature & severity of communication disorder Age, grade, developmental level Strengths, needs, emerging abilities Frequency and intensity of service needed Need for peer modeling Student’s attitude, motivation, social skills RTI data Need for services in non-academic or extra curricular activities Factors Affecting Service Delivery Classroom/Curriculum Considerations • Alignment of general curriculum & IEP goals • Communication needs related to curriculum • Grade-level standards for language • Need for classroom consultation • Natural communication supports Which Service Delivery Models? Guiding Principles LRE Student needs Student’s rate of progress in the curriculum Reasonable course of therapy Language disorder – at least some time in the classroom Benefit of combining models Evidence-based practice Service Delivery Models for non-IEP Services: RTI Desired Outcomes: • Prevention • Intervention • Identification 3 Tier Model: • Tier 1 Core Instruction • Tier 2 Targeted Group Intervention • Tier 3 Intensive Individualized Intervention RTI and Workload Front-load schedule to reserve time for RTI and CEIS activities • Screening • Problem solving team • Tier 2/3 Interventions Adjust attitude about working with struggling students • SLP services includes prevention • We’re not just special ed anymore!!!! RTI: Challenges and Opportunities for SLPs New and expanded roles • Program design • Collaboration • Willingness to re-allocate time for prevention and early intervention activities • Willingness to change the way we spend our time • Strong focus on student outcomes Flexible Schedules Embed Flexibility in Schedules Types of Schedules 1. Traditional Weekly Schedule (Caseload and Student) • Same weekly schedule for students • Same weekly schedule for SLP • The “norm” and assumed type of schedule 2. Receding Schedule (Student) - “Test Kitchen” Concept - Intense direct contact followed by monitoring transfer of skill to home or school environment - Example: More frequent direct services in fall semester for 4th or 5th grader…very little direct service in spring semester during heavy state assessment period…monitor skill maintenance Types of Schedules 3. Pulse Schedule (Student) • intensive contact followed by a period of no contact • growth and skill transfer monitored • encourage growth at beginning of each pulse cycle Types of Schedules 4. Cyclical Scheduling (Caseload) One Example: 6 Weeks Cycle Two weeks intense, one week off A= Low incidence B= Speech Manner C= Language Processing 1.AB 4.AB 2.CA 5.CA 3.BC 6.BC Types of Schedules 5. Block Schedule (Caseload) Examples: a. AB Block Schedule – every other day schedule. Usually whole school goes to AB Block…SLP has to “fit in” b. Modified Block Schedule – longer class periods, finish a course in a trimester rather than long semester Types of Schedules 6. Flexible Schedules a. May use one or more type of schedule at any given time b. Combine different schedules and service delivery to maximize outcomes for students c. It’s still a schedule – with structure, predictability, patterns of time-usage, you ‘stick to it’, flexible ≠ free form Flexible Schedules to Accommodate Services Outlined in IDEA 2004 Flexible schedules allow for • Altering the frequency of services provided each week and/or month • Providing opportunities for individual therapy • Combining service delivery models • Providing opportunities for indirect services • Providing RTI services and interventions • Completing comprehensive evaluations • Scheduling in compliance activities Flexible Scheduling Tips Close-up Lens: Look at each student’s IEP Wide-angle Lens: Look at caseload needs • Summarize direct services • Summarize indirect services needed to fully implement IEPs Panoramic View: Look at campus needs • Master school schedule • Need for RTI models/direct or indirect intervention • Instructional programs • Service environments – academic, nonacadmeic, extra-curricular… More Flexible Scheduling Tips Schedule time each week to participate in RTI activities and interventions Schedule times to provide supplementary aids and services in settings other than the therapy room Schedule times throughout the week to conduct comprehensive evaluations • Time slots on different days of the week • Time slots at different times of the day • Mixture of short bursts of time and extended periods during the day More Flexible Scheduling Tips IEP: # of minutes/ grading period direct services; # of minutes/grading period indirect Schedule activities, not students Consider backloading your schedule Do one new thing with your schedule Lay groundwork with principal Develop a management system to support your new and improved schedule Remember Schedule activities Not Students Monday Tuesday Wednesday Thursday Friday auauaua auauau kinder kinder kinder kinder dbdbdb dbdbdb dbdbdb kinder dbdbdb smgrp dbdbdb dbdbdb sstsstsst smgrp assess sstsstsst assess dbdbdb assess assess Well-Written IEPs “Refresh” Frequency-LocationDuration (IEP) Considerations Implementing a Workload Approach…and IEPs Student’s IEP is a blueprint for progress and accelerating learning IEP team (with parent and student) help design the blueprint Consider “taking back the reigns” Use EBP to recommend frequency, location, duration of services IEP-Schedule of Services IEP must specify frequency, location, duration of speech services (§300.347a6) • Frequency – interval of services and how often sessions are provided • Location – where service is provided • Duration – anticipated length of time (often defaults to a year…term of annual IEP) • Type (Texas requirement) – direct or indirect i.e. must list consult separate from direct Location: Classroom and Beyond “classroom, other academic, nonacademic, extracurricular” IDEA allows for provision of services in a variety of locations • Classroom • Therapy room • Playground • Lunch room • Clubs or extracurricular activity locations • Fieldtrips A Word About LRE Least Restrictive Environment: LRE is not only a place but also amount of time removed from typically developing peers. The SLP should carefully consider the benefits of providing intervention in natural environments with typically developing peers who provide appropriate linguistic and behavioral models. Services “to or on behalf of”… IDEA calls for direct services “to” students with IEPs IDEA calls for indirect services “on behalf of “ students with IEPs The Key: Balance the Statement of Services in the IEP to clarify by direct and indirect services IEP – Schedule of Services One option: list minutes of direct services per grading period and minutes of indirect services and activities per grading period Provide addendum to IEP Team minutes that outlines in detail the frequency, duration, and location of services provided each week. Think About… Would it change frequency-locationduration in the IEP if you • varied service delivery? • planned for change in service delivery as the needs of the student change? • combined different types of service delivery for the student? • really (really) provided services in the LRE? Educationally Relevant Services Put Educational Relevance in the Forefront of Eligibility Deliberations Quick Review: IDEA Definition Speech-Language Impairment 300.8 (c)(11) Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance [emphasis added] Begin with the End in Mind… The purpose of evaluation activities: 1. 2. 3. Determine if there is a disability And if there is an adverse effect on educational performance resulting from the disability And if specially designed instruction from the SLP is needed to help the student make progress in the general curriculum Comprehensive Evaluations Gather functional, developmental, and academic information about the child Including information provided by the parent Evaluate in all areas related to the suspected disability Identify all special education and related services needs (i.e. don’t fragment evaluation among assessment professionals) IDEA 2004 Allows us to consider the student’s response to “scientific, researchbased intervention” as one data point when making eligibility recommendations (Decisions cannot be made on the basis of a single criterion) RTI: Challenges and Opportunities for SLPs Evaluation • Dynamic assessment models • Pragmatic orientation based on educational relevance • Measure changes in performance over time • Contextual perspective • Expanded evaluation tool kit • Expanded definition of ‘comprehensive evaluation’ What does this sound like??? More than administration of standardized tests More informal data about the student’s language and communication skills in school environments Perhaps more descriptive reports Perhaps more interesting descriptions of students as communicators Perhaps the need to use a Workload Approach for conducting comprehensive evaluations Comprehensive Evaluations A Workload Approach Front-load schedule to reserve time for a variety of evaluation activities • • • • Observations Conversations with teacher and parents Direct testing Multiple settings (academic, nonacademic, extra-curr) Adjust attitude about evaluations • Use a Communication Model for consistent decisions • Use uniform Eligibility Guidelines in your district/state • Just say no…when SLP services won’t help Workload Implementation How Can You Start? Analyze your eligibility determination Analyze your dismissal practices Determine your role in RTI Define your workload problem Do a Gap Analysis re Service Delivery Determine which of the Workload Tools you can use Develop an Action Plan for Change Enter into crucial conversations Workload… So what will you do differently? Consider a wider range of activities (inside and outside of special ed) Location Location Location Stronger ties to curriculum and functional performance…data-driven! Get credit for more of what you already do Write IEPs differently Balance Your Workload …In Reverse Order… What indirect services will you need to provide to fully implement each IEP and participate in prevention/RTI What indirect activities will you need to provide to support students in the gen ed curriculum? (IEP and RTI) What are the compliance/mandated non-negotiables? What direct services are needed? (IEP and RTI) RTI Chatter jrudebusch@irvingisd.net