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Communication Services in IDEA (Special Education)

Communication Services and Supports for Individuals With Severe Disabilities: FAQs

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How do you provide services if your district does not have enough personnel with appropriate training or experience to serve students with severe disabilities?

School systems and other service agencies may have student/client needs that are greater than their available funds or that exceed the available supply of trained professionals (also see question on lack of skills ). This problem appears to occur more often in rural districts or with students who have significant disabilities such as autism, deaf-blindness, or multiple physical disabilities (Ogletree, Sportsman, VanGiesen, & Siegel, 2000; Simpson, Beukelman, & Bird, 1998). A lack of funds and resources cannot be used as a legal basis for denying services required by federal statute. For some districts, the ability to secure the resources to provide appropriate communication services and supports is more of an issue than funding (Mineo Mollica, 1999). Two possible solutions are available to schools and agencies in this position:

  • Public and private benefits may be tapped to add more money to local funds (e.g., pubic and private insurance, low interest loans from state technology act funds, state agencies serving children with special health care needs).
  • "Interagency agreements" may be developed between schools and/or agencies that allow sharing of specialized professionals.

Agencies and schools cannot justify their failure to provide needed communication services and supports to the individuals they serve by citing a shortage of funding or other resources.

Mineo Mollica, B.A. (1999). Accessing AT devices and services: A follow-up with division of mental retardation clients. Wilmington, DE: University of Delaware.

Ogletree, B.T., Sportsman, J.S., VanGiesen, T., & Siegel, E. (2000). Communication-based services for persons with severe disabilities: A survey of speech-language pathologists working in North Carolina residential centers. Education and Training in Mental Retardation and Developmental Disabilities, 35, 336-346.

Simpson, K., Beukelman, D., & Bird, A. (1998). Survey of school speech and language service provision to students with severe communication impairments in Nebraska. Augmentative and Alternative Communication, 14 , 212-221.

What if my child is not learning because the SLP does not have the skills to teach my child?

It is not uncommon for trained professionals to feel they lack the specialized skills needed to provide communication intervention to students with severe disabilities (Ogletree, Sportsman, VanGiesen, & Siegel, 2000; Simpson, Beukelman, & Bird, 1998). The professional organizations of speech and language pathologists, special education teachers, physical and occupational therapists set standards for performance; when professionals fall short of these standards they violate their own professional codes of ethical conduct. Agencies who have hired personnel with insufficient skills often cite an inadequate supply of professionals as the reason they cannot provide quality services to students with multiple disabilities. But these arguments do not justify the use of inadequately trained personnel. Parents and teachers can argue against these practices by citing IDEA, No Child Left Behind, and case law based on the outcome of the Timothy W. vs. Rochester, NH School District (1989) decision. All of these legal statements assert that professionals must meet standards of competence and keep current in their training. Agencies and schools cannot use the lack of properly certified staff to justify their failure to provide needed communication services and supports to the individuals they serve.

For more information:

See the web site for NICHCY for information on IDEA and No Child Left Behind: http://www.nichcy.org/

Ogletree, B.T., Sportsman, J.S., VanGiesen, T., & Siegel, E. (2000). Communication-based services for persons with severe disabilities: A survey of speech-language pathologists working in North Carolina residential centers. Education and Training in Mental Retardation and Developmental Disabilities, 35, 336-346.

Simpson, K., Beukelman, D., & Bird, A. (1998). Survey of school speech and language service provision to students with severe communication impairments in Nebraska. Augmentative and Alternative Communication, 14 , 212-221.

Timothy W. vs. Rochester, NH School District, 875 F .2d 954 (1 st Cir.), cert.denied, 493 U.S. 983(1989).

Do children with severe disabilities really benefit from being around typical peers?

Yes. Typically developing children can serve as good language models. They can help children with severe communicate disabilities to communicate more effectively. Typical peers appropriately use shorter and simpler sentences that children with communication problems can better understand. However, interactions between children with and without disabilities may not occur naturally. The teacher, speech-language pathologist, or others may have to encourage children with severe disabilities and typically developing peers to communicate with each other.

Current federal legislation (i.e., the Individuals with Disabilities Education Act of 1997) conveys a clear preference for providing services for students with disabilities in settings that include typically developing children . Inclusive classrooms provide an opportunity for children with disabilities to interact with their peers who don't have disabilities.

Typically developing peers can serve as appropriate language models and support communication. Studies have shown that typically developing children adjust the complexity and functions of their language in accord with the chronological age and developmental level of their communication partner. They also can modify their language structure, content, and use during communication interactions with children with developmental disabilities. For example, typically developing children may use shorter sentences and be more directive in their style during interactions with children with severe disabilities. The communication interactions between peers with severe disabilities and typically developing peers need to be structured and prompted to increase the likelihood of occurrence

For more information:

Studies of typically developing children adjusting their language level for younger children

Garvey, C., & BenDebba, M. (1974). Effects of age, sex, and partner on children's dyadic speech. Child Development , 45 , 1159-1161.

Goldstein, H., & Kaczmarek, L. (1992). Promoting communicative interaction among children in integrated intervention settings. In S. Warren & J. Reichle (Eds.), Causes and effects in communication and language intervention (pp. 81-111). Baltimore, MD: Brookes.

Masur, E. F. (1978). Preschool boys' speech modifications: The effect of listeners' linguistic levels and conversational responsiveness. Child Development , 49 , 924-927.

Sachs, J., & Devin, J. (1976). Young children's use of age-appropriate speech styles. Journal of Child Language , 3 , 81-98.

Shatz, M., & Gelman, R. (1973). The development of communication skills: Modification in the speech of young children as a function of the listener. Monographs of the Society for Research in Child Development , 38 (5, Serial No. 152).

Studies of typically developing children adjusting their language level for children with developmental delays

Guralnick, M. J., & Paul-Brown, D. (1977). The nature of verbal interactions among handicapped and nonhandicapped preschool children. Child Development , 48 , 254-260.

Guralnick, M. J., & Paul-Brown, D. (1980). Functional discourse analyses of nonhandicapped preschool children's speech to handicapped children. American Journal of Mental Deficiency , 84 , 444-454.

Guralnick, M. J., & Paul-Brown, D. (1984). Communicative adjustments during behavior-request episodes among children at different developmental levels. Child Developmen t, 55 , 911-919.

Guralnick, M. J., & Paul-Brown, D. (1986). Communicative interactions of mildly delayed and normally developing preschool children: Effects of listener's developmental level. Journal of Speech and Hearing Research , 29 , 2-10.

Guralnick, M. J., & Paul-Brown, D. (1989). Peer-related communicative competence of preschool children: Developmental and adaptive characteristics. Journal of Speech and Hearing Research, 32 , 930-943.

Guralnick, M. J., Paul-Brown, D., Groom, J. M., Booth, C. L., Hammond, M. A., Tupper, D. B., & Gelenter, A. (1998). Conflict resolution patterns of preschool children with and without developmental delays in heterogeneous playgroups. Early Education & Development , 9 , 49-77.

Studies of children with mild developmental delays adjusting their language use during interactions with children with and without disabilities

Guralnick, M. J., & Paul-Brown, D. (1986). Communicative interactions of mildly delayed and normally developing preschool children: Effects of listener's developmental level. Journal of Speech and Hearing Research , 29 , 2-10.

Guralnick, M. J., & Paul-Brown, D. (1989). Peer-related communicative competence of preschool children: Developmental and adaptive characteristics. Journal of Speech and Hearing Research, 32 , 930-943.

Studies of children with specific language impairment adjusting their language use with peers

Fey, M., & Leonard, L. (1984). Partner age as a variable in the conversational performance of specifically language-impaired children and normal-language children. Journal of Speech and Hearing Research, 27 , 413-423.

Fey, M. E., Leonard, L. B., & Wilcox, K. A. (1981). Speech style modifications of language-impaired children. Journal of Speech and Hearing Disorders , 46 , 91-96.

Paul-Brown, D., & Caperton, C. (2001). Inclusive practices for preschool children with specific language impairment. In M. J. Guralnick (Ed.), Early childhood inclusion: Focus on change (pp. 433-463). Baltimore, MD: Brookes.

Studies of the language used during structured dyadic interactions between typically developing children and peers with language and developmental disabilities

Goldstein, H., English, K., Shafer, K., & Kaczmarek, L. (1997). Interaction among preschoolers with and without disabilities: Effects of across-the-day peer interaction . Journal of Speech, Language, and Hearing Research, 40, 33-48.

Robertson, S. B., & Ellis Weismer, S. (1997). The influence of peer models on the play scripts of children with specific language impairments. Journal of Speech, Language, and Hearing Research , 40 , 49-61.

Studies demonstrating need to structure interactions in inclusive classrooms

Guralnick, M. J. (1976). The value of integrating handicapped and nonhandicapped preschool children. American Journal of Orthopsychiatry , 46 , 236-245.

Rice, M. L., Sell, M. A., & Hadley, P. A. (1991). Social interactions of speech- and language-impaired children. Journal of Speech and Hearing Research , 34 , 1299-1307.

Weiss, A. L., & Nakamura, M. (1992). Children with normal language skills in preschool classrooms for children with language impairments: Differences in modeling styles. Language, Speech, and Hearing Services in Schools , 23 , 64-70.

How are typically developing children affected by interactions with children who have severe disabilities?

Parents of typically developing children may be concerned that their child will be influenced in negative way by the slower learning rate, possible inappropriate behavior, or communication problems of children with severe disabilities. However, research s tudies demonstrate that typically developing children do not show a decline in their academic performance as a result of interactions with children with severe disabilities. Typically developing children even show above average scores in educational outcomes following participation in an inclusive preschool program, where children with and without disabilities are placed together. Concomitant benefits related to compassion, acceptance of disability, and appreciation of individual differences also may occur.

Speech-language pathologists and other professionals need to address family concerns about inclusive classrooms and the impact on typically developing children. Such concerns may prevent parents from enrolling their child in an inclusive preschool; Parents of school-age typically developing children may fear negative outcomes in their own children when children with severe disabilities are included in regular education programs. It may be helpful to provide parents with evidence about the value of inclusive practices for students with and without disabilities.

For more information:

Harris, S. L., Handleman, J. S., Kristoff, B., Bass, L., & Gordon, R. (1990). Changes in language development among autistic and peer children in segregated and integrated preschool settings. Journal of Autism and Developmental Disorders, 20, 23-31.

Paul-Brown, D., & Caperton, C. (2001). Inclusive practices for preschool-age children with specific language impairment. In M.J. Guralnick (Ed.), Early childhood inclusion: Focus on change (pp. 433-463). Baltimore: Brookes.

Rice, M. L., & Wilcox, K. A. (Eds.) (1995). Building a language-focused curriculum for the preschool classroom: Volume 1. A foundation for lifelong communication. Baltimore: Brookes.

Staub, D., & Peck, C. A. (1995, Winter). What are the outcomes for the nondisabled students? Educational Leadership, 52 , 6-40.

Voorhees, M. D., Landon, R., & Harvey, J. (1997). Early childhood education. In L. A. Power-deFur & F. P. Orelove (Eds.), Inclusive education: Physical implementation of the least restrictive environment (pp. 131-152). Gaithersburg, MD: Aspen.

What is the difference between direct and indirect services?

The term "direct services" usually describes services provided by a specialist while in direct contact with a child or adult learner. These services may be provided in a one-to-one context, where the specialist is working with only one learner at a time or in a group context where the specialist is working directly with more than one learner at a time. For example, a speech-language pathologist might facilitate a learner's use of natural gestures by providing communication opportunities while playing with a child or teaching a learner how to select pictures to request foods at meal time. These would be examples of direct services.

Whenever a specialist works with a teacher or parent or other individual who will be responsible for directly working on communication, the services are described as indirect. Sometimes a specialist will consult with a child's teacher or other individuals who frequently interact with an individual with communication impairments about strategies that will improve communication. For example, a specialist might teach a parent how to position a child in a way that promotes good breathing for speech, or teach a classroom teacher how to use a picture schedule to facilitate transitions between activities. These would be examples of indirect services.

Both direct and indirect services are effective methods used to teach communication skills to individuals with severe disabilities. The decision regarding which method or combination of methods to use should depend upon the intervention goals. If the goals are to increase someone's facility producing a particular skill or behavior, direct services are often appropriate. However, if the goals are to increase spontaneous use of a communication skill or behavior across many settings and with many different communication partners, indirect services are appropriate. If the goal is to increase interactions with peers or answer questions in class it may be more beneficial to provide services in the context of the classroom. For example, teachers may need to learn to use gestures or visual cues to enhance comprehension of class routines or lesson content. Peers may need to learn to interpret a child's behavior to interact with them in meaningful ways. In this case, a speech-language pathologist may act as a communication and language coach for the learner, teachers, and peers. Indirect services may allow students with severe disabilities to have increased time with peers, fewer disruptions to class routines, and increased communication among specific team members.

For more information:

Downing, J. (1999). Teaching communication skills to students with severe disabilities . Baltimore: Brookes.

What is the difference between individual and group treatment?

Individual treatment and group treatment are two service delivery approaches used to address the communication needs of learners. When individual treatment is provided, the interventionist provides one-on-one treatment services. The treatment may be provided either (a) in a separate room or (b) directly in the classroom or other natural setting. Individual treatment that is provided in a separate room is sometimes called "pull-out" therapy or treatment because the interventionist typically "pulls" the child from the classroom setting and from interactions with adults and peers that take place during ongoing classroom activities. With pull-out services, the interventionist typically is the child's primary communication partner. When individual treatment is provided in the classroom, peers and other adults may serve as communication partners.

In contrast, group treatment refers to intervention services that are provided to address the needs of more than one learner at the same time. Group treatment may take place either in a pull-out room or in the natural environment. When classroom-based group treatment is used, there is emphasis on providing services to learners within the classroom in the context of ongoing, naturally occurring activities. Team teaching by the speech-language pathologist and the classroom teacher is frequent with this model.

Research has identified several advantages and disadvantages of using these approaches.

Advantages of a pull-out approach (for either individual or group treatment):

  • May have greater control over the context
  • May be able to reduce auditory/visual distractions
  • May be able to structure activities in ways that provide the learner or learners with more opportunities to take turns and produce specific intervention targets

Disadvantages of a pull-out approach (for either individual or group treatment):

  • Lack of generalization of skills to daily communication situations
  • Reduced naturalness of pull-out settings
  • Fragmentation of learner's schedule as a result of removing learner or learners from classroom and ongoing curricular activities
  • Not aligned with policy changes that have increased the extent to which learners with disabilities are served in general education settings

Advantages of a classroom-based approach (provided with individuals or groups):

  • Efficient use of time
  • Increased generalization of skills
  • Opportunities for increased teacher-learner-peer interactions
  • Greater potential for observational and incidental learning
  • More likely to result in greater productive use of target skills in learner's home setting
  • Greater diversity of routine activities as intervention contexts
  • Increased diversity of conversational partners including peers
  • Communication goals integrated with the classroom curriculum
  • Facilitates collaboration with teachers
  • Offers potential for the prevention of communication problems by helping teachers identify communication needs in a natural setting

Decisions about the best approach for any specific learner should be guided by questions such as, how can we maximize the opportunities for this person to acquire the language and communication abilities needed to participate in important life contexts? The optimal use of individual and group treatment and pull-out or classroom-based services is likely to differ for individual children. Special education laws require that options for communication intervention services be based on the specific needs of each learner. Any comprehensive intervention must include a plan that enables the student to use newly learned target skills in additional natural environments.

In a study comparing vocabulary learning by preschool children in pull-out versus classroom-based group instruction, Wilcox, Kouri, and Caswell (1991) found a tendency for children with less mature cognitive abilities to benefit the most from the classroom-based intervention. They recommended that a classroom program be given a high priority for less cognitively mature children who need initial lexical training. Researchers attributed increased generalization by children with the group in-class treatment model (over individual pull-out sessions) to increased diversity of partners, including peers, and increased diversity of routine activities across the school day.

Roberts, Prizant, and McWilliam (1995) compared the interactions of young children and their speech-language pathologists during pull-out and in-class language intervention sessions. Findings demonstrated that some aspects of both speech-language pathologists' and children's interactions differed during in-class versus pull-out sessions. For example, speech-language pathologists took more turns in the pull-out class sessions than in the classroom-based sessions. Children complied more with requests in the pull-out sessions and responded less in classroom-based sessions. No significant differences were noted in the number of turns, type of turns, or language functions for children between the two approaches. This suggests that when other children are present and instruction is occurring in the naturalistic classroom setting, opportunities for children to be active participants in conversations did not appear to differ. The finding that children's opportunities for interaction did not differ is encouraging given that one concern about in-class sessions is that there is less opportunity to practice treatment targets, compared with pull-out sessions.

Shelton, Gast, Wolery, and Winterling (1991) concluded that learners who are members of a heterogeneous group, in which different students are being taught different and unrelated tasks, may benefit from group diversity through observational learning.

For more information:

Cirrin, F., & Penner, S. (1995). Classroom-based and consultative service delivery models for language intervention. In M. Fey, J. Windsor, & S. Warren (Eds.), Language intervention: Preschool through the elementary years (pp. 333-362). Baltimore: Brookes.

Elksnin, L., & Capilouto, G. (1994). Speech-language pathologists' perceptions of integrated service delivery in school settings. Language, Speech, and Hearing Services in Schools , 25, 258-267.

Nelson, N. (1998). Language disorders in context: Infancy through adolescence (2nd ed.). Boston: Allyn & Bacon.

Paul-Brown, D., & Caperton, C. J. (2001). Inclusive practices for preschool-age children with specific language impairment. In M. J. Guralinck (Ed.), Early childhood inclusion: Focus on change (pp. 433-463). Baltimore: Brookes.

Roberts, J., Prizant, B., & McWilliam, R. (1995). Out-of-class versus in-class service delivery in language intervention: Effects on communication interactions with young children. American Journal of Speech-Language Pathology , 4 (2), 87-94.

Shelton, B., Gast, D., Wolery, M., & Winterling, V. (1991). The role of small group instruction in facilitating observational and incidental learning. Language, Speech, and Hearing Services in Schools , 22, 123-133.

Throneburg, R, Calvert, L., Sturm, J., Paramboukas, A., & Paul, P. (2000). A comparison of service delivery models: Effects on curricular vocabulary skills in the school setting. American Journal of Speech-Language Pathology , 9, 10-20.

Wilcox, J., Kouri, T., & Caswell, S. (1991). Early language intervention: A comparison of classroom and individual treatment . American Journal of Speech-Language Pathology , 1 (1), 49-62.

What types of related services are appropriate for secondary students already in a specific learning disabilities class? Oftentimes, students are being pulled out for language therapy and are being seen daily by the special education teacher for help with language, spelling, or writing.

The term "related services" refers to a wide range of services-such as speech-language pathology, audiology, transportation, counseling, and recreation-provided for children with disabilities. There are a number of different ways that related services can be used to supplement and enhance ongoing instruction in the classroom by a teacher. These services will be provided by a team of professionals from different disciplines. The choice of what is an appropriate related service for a student will depend on the student's individualized education program (IEP) and on the team model used. The critical point in the following examples, and in any interdisciplinary team approach, is that the team members are all aware of, and working to support, a commonly identified set of outcome goals for each student.

Different kinds of service provision options typically address different aspects of learning and communication. For instance, a student with severe intellectual disabilities and complex communication needs may be learning to use visual pictures for a variety of functions, including social greetings and early etiquette. The student has two challenges in this program:

  1. Learning which picture symbol to choose for each communicative act
  2. Learning to use the picture symbol in appropriate social-communicative contexts

So the student must learn to distinguish the symbol for "hi there" from symbols for "please" or "no, thank you." But the student must also learn that these symbols are used under specific circumstances with a variety of people.

The speech-language pathologist (SLP) may use specialized, separate "pull-out" time specifically to target the symbols and their meanings, role-playing conversations, or structured opportunities like snack time to allow the student to learn how each symbol matches to each meaning. In this setting, there are few distractions, and the SLP can emphasize the relation between specific symbols and what they mean. The special educator or classroom teacher, however, may be teaching the student how to use the symbol meanings during natural interactions and within larger groups. The goals of the two service providers are complementary-and success with both is essential for the student-but they are not identical to one another. Each setting offers unique advantages for reaching these specific goals.

The same principle applies to other goals like spelling and writing; the professional responsible for individualized instruction on these targets may be working on formal aspects of spelling and writing-like rules governing spelling or capitalization-whereas the classroom teacher may be instructing the student how to construct a narrative (write a story), in which the spelling/grammar conventions are important but not the central emphasis. Effective teaming between these two professionals is crucial so that instruction is complementary and not redundant or incomplete.

Similarly, an SLP might work on articulation of specific sounds during individual sessions, whereas a goal for oral communication in the classroom may be achieving fluid and organized speech in either formal presentation or social conversation.

For more information, see these other related FAQs:

Who are members of an interdisciplinary team? What is their role?

What is the difference between direct and indirect services?

What is the difference between individual and group treatment?

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