March 3, 2009 Feature

Guidelines Help Texas Clinicians Manage Caseloads

 2009_March3_NeGuidelines
JoAnn Wiechmann, lead speech-language pathologist for the Pasadena (Texas) independent School District, conducts a speech/language assessment with 8-year-old Clay Brabston at Turner Elementary School.

A 10-year effort in Texas to implement consistent guidelines for identifying students with speech impairments is yielding successful results, according to a survey conducted by the Texas Speech-Language-Hearing Association (TSHA).

The effort began in 1999 when school-based professionals concerned about high caseloads and over-identification of students with speech impairments met during the TSHA annual convention. The attendees reached consensus on the statewide need for appropriate and consistent identification of children with speech impairments. Ten speech-language pathologists volunteered to serve on a TSHA task force to develop guidelines for eligibility for services in the four areas recognized in the Individuals with Disabilities Education Act (IDEA)—articulation, language, voice, and fluency.

Developing Templates

The task force focused on developing templates to help SLPs determine a student's eligibility for services. Three templates—for articulation, language, and language with other disabilities—were developed between 2000 and 2003. Templates for voice and fluency were completed in 2005. Since that time, a cultural and linguistic diversity (CLD) companion to the articulation eligibility template has been completed. In addition, manuals to facilitate and extend eligibility determinations have been developed for use by SLPs who complete template training.

TSHA received overwhelming support for statewide eligibility guidelines from Texas special education directors and regional education service center directors. A joint committee of TSHA and the Texas Council of Administrators in Special Education (TCASE) approached the Texas Education Agency in 2005 to provide information about and lobby for the implementation of statewide guidelines. The state agency chose not to endorse the guidelines but agreed to support TSHA endeavors.

The Texas Education Agency provided access to the 20 educational service centers and district-level directors of special education through the Texas Education Television Network; through that venue, the joint TSHA/TCASE Committee provided an overview of the eligibility guidelines and encouraged participation of the educational service centers and school districts. In addition, basic presentations on the principles of the guidelines and their value have been provided for special education directors at the TCASE conference twice a year and at regional meetings as requested by an educational service center or district. The joint committee has also provided overview sessions at statewide conferences for elementary school principals.

Training

Training in the use of the templates is critical to proper implementation, and TSHA developed a training of trainers system to provide statewide access to the information. The goal of the system is to provide intensive training to at least one trainer from each of the 20 regions for each of the six templates. The training of the regional template trainers has been conducted during TSHA conventions for the past four years. There are now 18 articulation template trainers, 18 language trainers, 16 fluency trainers, eight voice trainers, 18 language with other disabilities trainers, and 22 trainers for the CLD companion to the articulation template across the state. For each template there is at least one lead trainer who helped develop the template.

Regional template trainers provide training at educational service centers or districts upon invitation and continue to provide ongoing support to SLPs who have participated in the training. School districts may elect to have all of their SLPs trained in a template or have a representative trained, who then becomes responsible for training other SLPs in that district. Regional template trainers maintain contact and receive updated training at the annual TSHA convention and at statewide videoconference meetings.

A part-time TSHA professional who was instrumental in the development of the templates collects data from districts that have received training on and implemented the guidelines. To date, 63% of districts/cooperatives/shared service arrangements (SSAs) in Texas have received training in articulation guidelines; 65% in language; 25% in language with other disabilities; 11% in fluency; and 8% in voice.

Survey Results

TSHA conducted a survey in May 2008 on implementation of the articulation guidelines. Respondents included 100 SLPs representing 81 districts and 16 SSAs in 17 of the 20 educational service centers that had participated in training. Results indicated that 100% of those responding had implemented articulation eligibility guidelines in their respective districts/SSAs; 96% reported that their guidelines were based on the TSHA articulation eligibility template.

For 96% of the respondents, implementation of the articulation guidelines had resulted in more consistency in the identification of children with articulation disorders. More than 75% indicated a decrease in the number of children identified as having an articulation disorder, 92% reported better identification of children with articulation disorders, and 70% indicated receiving more support from special education staff in their districts following implementation.

Responses to training issues revealed challenges: 54% reported limited time to train the SLPs in their districts, 47% reported resistance to change, and 11% reported lack of administrative support.

Additionally, 53% of the SLPs indicated that with implementation of the articulation guidelines, some children whom they felt should qualify for services did not meet the criteria. Only 9% indicated that some children who did not require services did qualify based on the criteria. These challenges will continue to be investigated and addressed.

Anecdotal feedback from directors of special education and SLPs has been positive. The teacher/parent training segments have helped to provide the information needed to ensure more appropriate referrals, resulting in fewer unnecessary evaluations. In addition, pre-referral intervention suggestions presented to student support teams are consistent with providing classroom intervention (e.g., response to intervention) prior to a special education referral for some students.

With 1,035 school districts in the state, implementation of eligibility guidelines in Texas public schools is a huge endeavor. Because implementation is not required by the state education agency, participation by districts in the TSHA training is voluntary. TSHA hopes that administrators and officials interested in improving the appropriate and consistent identification of students who qualify for services—and ultimately in addressing the shortage of SLPs in their districts—will continue to realize the benefits of the eligibility guidelines. 

Cherry Wright, MS, CCC-SLP, is chair of the TSHA Public School SLP Vacancies Committee and facilitator of the TSHA/TCASE Committee. Contact her at cwright@omniglobal.net. 

Debra Bankston, MA, CCC-SLP, is past chair of the TSHA Eligibility Trainer of Trainers Committee. Contact her at debrabankston@yahoo.com.

cite as: Wright, C.  & Bankston, D. (2009, March 03). Guidelines Help Texas Clinicians Manage Caseloads. The ASHA Leader.

  

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