Facilitated Discussion ~Response to Intervention Context, Evidence, Process

Kentucky Big East Coop

Special Ed DirectorsJune 28, 2013

JoAnn Wiechmann, EdD, CCC-SLP

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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.

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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 Discussion Strands

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RTI: What is It?

RTI Defined

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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

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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

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…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)

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If the student responds to an intense diet of instruction, then s/he probably does not have a language learning disability or articulation disorder

RTI Hypothesis

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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.

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RTI: Where Does It Fit in Public Education?

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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.

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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.”

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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

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What about…The Purpose of Special Education…

To prepare students for further education, employment, and/or independent living

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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)

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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

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RTI: Why Does It Matter Now?

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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

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Context for ChangeResearch 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

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Context for ChangeResearch 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

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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

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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

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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.

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RTI:

Do SLPs in Schools Have a Role?

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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

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The definition of speech-language pathology services in IDEA 2004 paves the way for involvement of the school-

based SLP in RTI.

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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

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Roles and Responsibilities in Schools2010 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

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ASHA Position Statement includes Prevention

in Roles and Responsibilities of School-Based SLPs!!

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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

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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

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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

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RTI:

What is the Evidence Base?

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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

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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).

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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

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Summer Pilot Program: Quantitative Data

StudentStudent Hrs. Hrs.

InterventionIntervention

Sound Sound

ErrorsErrors

# of Errors: # of Errors:

EntryEntry

# of Errors: # of Errors:

ExitExit

ChandlerChandler 77 s, zs, z 1616 33

MaryMary 88 s, zs, z 1010 55

RalphRalph 88 ch, sh, jch, sh, j 3232 1717

RyanRyan 1010 r r 1212 22

SaturnSaturn 99 rr 1414 1313

JeffreyJeffrey 10 10 r r 2121 77

KatyKaty 1111 r r 1111 11

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2006-2007 Fall Data

18 elementary campuses 89 RtI students 97% (87) Responders 3% (2) Non – Responders needed referral for

special education evaluation

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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

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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

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Cost SavingsArticulation (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.

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

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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 rate-referred for special education testing

Limitation: n of 3246

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

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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)

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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

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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

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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”

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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

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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

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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

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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.

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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

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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

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Story Lab

Data Tracking

Name Who What When Where Why How

Sally /// //

Tom //

Dick //

Harry // //

Alice //

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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.

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Discussion Topics

What can you do to collaborate to gather an evidence base for: Articulation Intervention/s Language Intervention/s

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RTI:

How can SLPs manage adding RTI to an already full

caseload?

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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

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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

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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)

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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

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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

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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

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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

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RTI

Why is it a Good Thing?

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RTI: Why It Is a Good Thing

Allows SLPs to provide intervention for prevention of speech-language-communication 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

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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

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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.

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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.

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