Facilitated Discussion ~ Response to Intervention Context, Evidence, Process Kentucky Big East Coop Special Ed Directors June 28, 2013 JoAnn Wiechmann, EdD, CCC-SLP 1 Disclosure Relevant financial relationship(s) & relevant nonfinancial relationship(s) I have the following relevant financial relationship(s) in the products or services described, reviewed, evaluated or compared in this presentation. ARtIC Lab ™, published by Super Duper, Inc. Language Lab™, published by Super Duper, Inc. Description of financial relationship: I receive publication royalties on these products. 2 3 Discussion Strands RTI: What Is It? RTI: Where Does It Fit in Public Education? RTI: Why Does It Matter Now? RTI: Do SLPs in Schools Have a Role? RTI: What is the Evidence Base for RTI? RTI: How can SLPs manage adding RTI to full caseloads? 3 RTI: What is It? RTI Defined 4 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 5 Goal of RTI Ensure that all children and adolescents have access to high-quality instruction and learning opportunities and Struggling learners are identified, supported and served early and effectively. Interventions are generally provided in the areas of: Academics (reading, math, S/L) Behavior 6 …in other words… There are systems in place to help every child meet grade level expectations in academics and behavior… “Whatever it Takes!” (individualized, just-in-time, prevent failure, through general education) 7 RTI Hypothesis If the student responds to an intense diet of instruction, then s/he probably does not have a language learning disability or articulation disorder 8 RTI Is part of the general education system Parallels the spirit of individualized education programs ~ previously available only through an “IEP” in special education Emerged out of political agendas (funding, No Child Left Behind, national standards, era of accountability) Is probably here to stay So…we better figure out how to be part of it! 9 RTI: Intuitive and Innovative Intuitive: makes sense that professionals check to see if instruction is working…to determine if the learner is responding…and if not responding, someone takes action to do something about that. Innovative: public education is universal but has not been individualized. The burden has been on the learner to fit the mold; not for the system to flex for the needs of each individual. 10 RTI: Where Does It Fit in Public Education? 11 Public Education in a Democracy Democracy is based on the premise that well- educated, well-informed citizens will give input to the advancement of the society. The universal right to a public education is not found in the Constitution of the United States of America, So public education becomes the responsibility of the states and each local community. 12 Texas Education Code §4.001 (for example…implements the state constitution…) The mission of the public education system of the State of Texas is to ensure that all Texas children have access to a quality education that enables them to achieve their potential and fully participate now and in the future in the social, economic, and educational opportunities of our state and nation. The mission is grounded on the conviction that a general diffusion of knowledge is essential for the welfare of this State and for the preservation of the liberties.” 13 Public Education in the USA States and Local Communities establish schools and colleges, develop curricula and learning standards, determine requirements for graduation, establish a means of funding schools. Federal Funding = Purse Strings Legislation If you want $, then follow all the rules Current Administration Favors National Standards Common Core State Standards NCLB and IDEA aligned accountability systems 14 What about… The Purpose of Special Education… To prepare students for further education, employment, and/or independent living 15 Special Education Based on federal education laws and the premise that “all children can (and get to) learn” In order to access federal funds, states and local school districts must follow federal statutes, regulations, and rules Speech Path listed as a special education instructional or related service in P.L.94-142 (1973 – first special ed federal law) 16 SLP Services in Schools SLP services are provided to students who have communication disorders that result in an adverse effect on educational performance The setting affects the service delivery…services not in isolation… Educational relevance is required! Important to link SLP clinical services to grade level standards 17 RTI: Why Does It Matter Now? 18 Context for Change Two movements changed conditions in America’s schools: Standards-based reform Improving America’s Schools Act and Goals 2000: Educate America Act (1994) Challenging academic content and performance standards; Assessments aligned with standards Accountability for student performance NCLB Adequate Yearly Progress IDEA 2004 19 Context for Change Research and Policy Considerations National Reading Panel (2000) Identified essential components of early reading instruction Important in special ed since most students with LD have reading problems President’s Commission on Excellence in Special Education (2001) Focus on results not identification process Focus on prevention General ed first 20 Context for Change Research and Policy Considerations National Summit on Learning Disabilities (2002) Sponsored by OSEP/USDE Traditional LD identification not grounded in research Supported “response to quality intervention” National Research Council Panel on Minority Representation (2002) No research to confirm benefit of special ed for minority students Should focus on prevention and early intervention 4-Tier system of intervention and treatment 21 Platform for Change to RTI In place for a decade Let’s work on systems, guidelines, procedures for data-driven decisions, and intervention approaches So that… SLPs have a clear, well-defined, and measurable contribution for RTI: Intervention for Prevention and Identification 22 Context for Change (a little more) Special Ed may not work well… Research studies show little benefit from special education services for closing achievement gap Special Ed instruction has been ~ Too general Unsystematic Provided too late…after history of failure 23 So… In this era of accountability… We need to make sure all students meet grade level expectations We need to make sure we teach students to read in a way that matches how they learn We need deep understanding of the language underpinnings of literacy We need deep appreciation for the fact that without an intact language system…it is very hard to “do” school. 24 RTI: Do SLPs in Schools Have a Role? 25 Speech-Language Pathology Services [CFR §300.34(c) (15)] Identification; Diagnosis and appraisal of specific speech or language impairments; Referral for medical or other professional attention needed for habilitation of speech or language impairments; Provision of speech and language services for the habilitation or prevention of communicative impairments; and Counseling and guidance of parents, children, and teachers regarding speech and language 26 The definition of speechlanguage pathology services in IDEA 2004 paves the way for involvement of the school-based SLP in RTI. 27 Roles and Responsibilities of SLPs in Schools: 2010 ASHA Position Critical Roles in Education Working Across All Levels Serving a Range of Disorders Ensuring Educational Relevance Providing Unique Contributions to the Curriculum Highlighting Language & Literacy Addressing Cultural and Linguistic Diversity Range of Roles & Responsibilities Prevention Assessment Intervention Program Design Data Collection & Analysis - Accountability Compliance 28 Roles and Responsibilities in Schools 2010 ASHA Position Collaboration Collegiality with Educators Collaboration within the Community Partnerships with Universities Partnerships with Families Partnerships with Students Leadership Advocacy Communication Supervision and Mentorship Professional Development Parent Training Lifelong Learning Research 29 ASHA Position Statement includes Prevention in Roles and Responsibilities of School-Based SLPs!! 30 SLPs in RTI: Define R&R across Tiers Tier 1 All Students: effective, engaging, rigorous, individualized, standards-based instruction Universal screening procedures Periodic progress monitoring School-wide behavior expectations/standards The key to RTI working well for students Tiers 2 & 3 Students struggling to meet expectations get help Focused intervention on specific target skills needed to support success in Tier 1 Frequent progress monitoring of target skills 31 Tier 1 SLP Activities Direct Services Expanded speech and language screening Additional support in the classroom Classroom time during small group instruction to work on speech or language development Assist young children with “good speech” in centers Provide lessons Co-teaching bursts Indirect Services Classroom observations, parent education, student support teams, homework programs, C&I consultation, staff development 32 Tier 2 SLP Activities Direct Services Focused intervention on specific skills ~ generally articulation and language Intervention provided in addition to Tier 1 Frequent progress monitoring Frequent intervention ~ intervention period measured in terms of hours (15 to 20 hours) Correct production of target followed by opportunities for mass practice Indirect Services Observe Tier 2 students to identify when struggle linked to speaking, listening, reading, writing; assist with progress monitoring; communicate Tier 2 progress to teacher & parent 33 RTI: What is the Evidence Base? 34 3 Examples ARtIC Lab (Super Duper) Effectiveness for preventing referrals Cost savings Language Lab (Super Duper) Effectiveness for preventing referrals Program evaluation data Story Lab (Pasadena ISD, Tx) Locally developed 35 Evidence Base for Articulation (based on tracking results from ARtIC Lab) Tier 2 Intervention Program for 1st – 3rd graders One or two simple sound errors ~ may or may not meet eligibility criteria for IEP services Nonstimulable for target sounds Monitor students who are stimulable; treatment probably is not warranted. Research suggests that stimulable sounds will develop without intervention (Gierut, 2007). 36 Evidence Base for Articulation (based on tracking results from ARtIC Lab) 3 – 4 30 minute sessions/week Groups of 3 – 5 students Station rotation Quick correct production Mass practice ~ drill, drill, drill SLP monitors productions and shapes sounds Treatment selection and randomization are key! 37 Data Collection Summer pilot program Data collection in 2006 – 2007 RTI services IEP services More data collection in 2007 - 2008 38 Summer Pilot Program: Quantitative Data Student Hrs. Sound Errors Intervention # of Errors: # of Errors: Entry Exit Chandler 7 s, z 16 3 Mary 8 s, z 10 5 Ralph 8 ch, sh, j 32 17 Ryan 10 r 12 2 Saturn 9 r 14 13 Jeffrey 10 r 21 7 Katy 11 r 11 1 39 2006-2007 Fall Data 18 elementary campuses 89 RtI students 97% (87) Responders 3% (2) Non – Responders needed referral for special education evaluation 40 2006-2007 Fall Data (same approach for students with IEPs) Students with an Individualized Education Program (IEP) for articulation 18 elementary campuses 91 students with an articulation IEP 25 dismissed or ready for dismissal 27% reduction in caseload 41 2007-2008 Fall Data (data snapshot 1 – 20 hours of intervention) Elementary campuses: 21 RtI students: 110 97% (107) Responders 20% of Responders (22) exited RTI 80% of Responders (85) continued 3% (3) Non-responders referred for special education (speech) evaluation The closer to 20 hours of intervention, the more students are ready to exit 42 Cost Savings Articulation (only) Referral Paper Approximately 52 pages per student 52 pages X 89 = 4,628 pieces of paper Time investment Approximately 7 hours X 89 students = 623 hours Personnel costs Approximately $24,920 to test/place 89 students Preventing pull-out IEP services? Priceless. 43 Evidence Base for Language (based on tracking results from Language Lab) Tier 2 intervention program K – 4th grade Students struggling with oral language Fail reading comp portion of reading universal screener Fail story retell screener Teacher concern Groups of 4 – 5 students 2 – 3 30 minute sessions/week 44 Evidence Base for Language (based on tracking results from Language Lab) Station rotation Homework Component Designed to work on: Nouns, adjectives Verbs, adverbs Connecting language Narrative skills Story Station with SLP Work on target skills through connected narrative language 45 Language Lab: RTI Program Data Outcomes of Pilot Programs 3 districts (2 Texas, 1 Nevada) Spring 2010 pilot focused on program development Fall 2010 pilot focused on student responsiveness During the fall semester, 81% of students exited or were progressing at the expected rate to recommend continuing Language Lab 19% students did not respond at expected ratereferred for special education testing Limitation: n of 32 46 Program Evaluation Language Lab Studied SLP reported effectiveness of the program Examined utility, feasibility, and accuracy of Language Lab as a program for use with students struggling with oral language 47 What were the Outcomes? Research Question 1: How effective were the instructional strategies in the program in reducing the need for referral for special education evaluation? Data sorted by responders and non-responders Responders—exited (n=131) or continued in program (n=111) Non-responders—referred (n=102) 70.3% reduction in referrals (n=242) 48 What were the Outcomes? Research Question 1: Overall effectiveness ratings (effective/very effective Exited students 90% Continued students 60% Referred Students 70% Value ratings for Intervention Data (effective/very effective) 90% of SLPs 49 What were the Outcomes? Research Question 2: In what ways did the program improve oral language and narrative skills? Common Themes Student Improvement Generalization of Skills Specific Instructional Strategies 50 What were the Outcomes? Question 2: Student improvement 90% commented about improvement (1 participant did not respond) “syntax improved notably”, “syntax improved by direct instruction”, “some improved especially with irregular past tense and plurals” “narrative skills improved”, “all students used skills and showed proficiency”, “story telling skills improved…stories sequenced correctly” 51 What were the Outcomes? Question 2: Generalization or carryover of skills (7 SLPs) “students began self-correcting”, “techniques were able to be carried over into the hallways and at home”, “objectives were evident in their conversational speech” Specific Strategies Visual prompts or supports Scaffolding Corrective feedback Naturalistic modeling 52 What were the Outcomes? Research Question 3: Which components of Language Lab™ were most effective? Skill Drill 90%* Talk Aloud 70%* Listen ‘n Learn 70%* Story Station 100%* Curriculum Connections 70%* * Effective/Very Effective 53 What were the Outcomes? Research Question 4: In what ways were the printed instructions effective or ineffective in implementing components of Language Lab™, considering time sufficiency and clarity? Clarity of Printed Instructions Skill Drill 80%* Talk Aloud 70%* Listen ‘n Learn 70%* Story Station 90%* Curriculum Connections 80%* *Effective/Very Effective 54 Significance of Findings Overall findings supported and validated use of Language Lab™ for improving students’ oral language skills and reducing referrals for special education evaluation. 55 Discrepant Findings Two areas of findings needed further explanation (not necessarily discrepant findings) Overall effectiveness ratings Study did not require students to have completed the program Time sufficiency for Story Station There was not a format for SLPs to provide additional explanation Interpreted responses to mean time was not enough to finish the lesson Possible contributing factors: # of target skills, pace of presentation of lesson 56 Story Lab (Pasadena TX) Co-teach, Gen Ed Tier 1 Story telling Question asking/answering 2 30 min lessons / week Data gathered: writing portfolio, wh-Q 57 Story Lab Data Tracking Name Who Sally /// Tom Dick When Where Why How // // // // // Harry Alice What // 58 Story Lab: Benefits By scanning the story, they really develop main idea. Meaningful question asking and answering is developed. They learn the structures of a story without getting stuck in prescriptive writing (and then, and then). Increases descriptive language. Increases expression of feelings/ emotions. Segues nicely from oral language to written language. 59 Discussion Topics What can you do to collaborate to gather an evidence base for: Articulation Intervention/s Language Intervention/s 60 RTI: How can SLPs manage adding RTI to an already full caseload? 61 1. SLP RTI embedded in the district processes and procedures Work in the same system ~ not in a separate system for… Identification of students (universal screening) Decision making – which tier, moving between tiers, exiting RTI, referral for evaluation Progress Monitoring Evaluating effectiveness of interventions Example from Irving, TX 3 RTI Pillars – Academics, Behavior, Language Proficiency Academics – Reading, Math, Artic & Language 62 2. Develop Consistent Procedures Expanded Screening for Speech/Language Identification for Tier 1 support Tier 2/3 interventions Progress Monitoring Procedures Decision Points Exit RTI Continue RTI Refer for special education evaluation 63 3. Provide Tools Forms for decision making and documentation Forms/software for progress monitoring Intervention programs for articulation and language Expanded Screener for artic and language Develop your own Purchase Consistent RTI Reporting Protocol (to document prevention) 64 4. Specify Tier I RTI for Speech/Language Identified target skills Establish a baseline Provide teacher/aide with Tier I activities and simple data collection sheets Define dosage of intervention (how often, how long, how many weeks) Progress Monitoring probes (at defined weeks) done by SLP Recommendation to teacher and RTI committee regarding adjustment to Tier I Options: progressing, continue Not progressing, change RTI plan Not progressing, refer 65 5. Use a Workload Approach Describe direct and indirect intervention services through RTI Focus on educational relevance and helping students master CCSStandards Continuum of service delivery models – most often for RTI: classroom based for Tier 1 and some Tier 2; pull-out for Tier 2/3 Flexible scheduling Data Driven Decisions 66 6. Scheduling Issues If school has an intervention period during school day one or more days per week, use time to provide artic and language interventions Schedule at beginning and/or end of school day Start small…no more than 15% of time on RTI activities E.g. one artic group and 1 language group 3 hours of direct Tier 2/week; 1 hour Tier 1 direct & indirect 67 7. Document RTI Effectiveness Keep track of the number of referrals prevented through RTI Keep track of (non-responder) students referred for evaluation Eligible? How RTI data used to augment evaluation and recommendations Evaluate RTI processes and procedures 68 RTI Why is it a Good Thing? 69 RTI: Why It Is a Good Thing Allows SLPs to provide intervention for prevention of speech-languagecommunication disorders Allows SLPs to provide intervention as part of dynamic evaluation to provide new component to eligibility deliberations Allows SLPs to contribute to strong language learning systems for all students Allows SLPs to participate in school reform 70 RTI ~ RADICAL Change Potential General Education ~ new locus of support for struggling learners Just-in-Time ~ not Wait-to-Fail Teachers and SLPs work like detectives Master schedules change in order to “invent time” Everyone has access to an IEP Different attitudes about learners and learning 71 References & Resources American Speech-Language-Hearing Association (2010). Roles and Responsibilities of Speech-Language Pathologists in Schools. [Professional Issues Statement}. Available from www.asha.org/policy. Klotz, M.B. & Canter, A. (2006). Response to intervention (RTI): A primer for parents. www.nasponline.org/resources/factsheets/rtiprimer.aspx. McCook, J.E. (2006). The RTI guide: Developing and implementing a model in your schools. Horsham, PA: LRP Publications. National Association of State Directors of Special Education. (2006). Response to intervention: Policy considerations and implementation. Alexandria, VA: Author. 72 Rudebusch, J. (2007). Guide to RTI. East Moline, IL: Linguisystems. Rudebusch, J. (2008). The source for RTI. East Moline, IL: Linguisystems. Wiechmann, J. & Balfanz, D. (2008). Artic Lab: A bilingual response to intervention (RtI) program for articulation. Greenville, SC: Super Duper Publications. Wiechmann, J., Rudebusch, J. & Kuhles, N. (2011). Language Lab. Greenville, SC: Super Duper Publications. 73