Meredith was born with multiple disabilities, including severe hearing loss. Through family involvement, early intervention, amplification, speech-language services in school and in a local university clinic, Meredith's communication skills are approaching age level, with language and listening deficits typical of a child with hearing loss. During Meredith's second-grade Individualized Education Program (IEP) meeting, some team members suggested that Meredith participate in the alternative assessment for special education students rather than the state assessment. Concerned about the implications for Meredith's ability to pass the high school assessments—and therefore earn a diploma—the parents and the speech-language pathologists advocated for participation in the state assessments. The team agreed and included in the IEP speech-language services that focused on the vocabulary and language skills needed for mastery of the standards and the assessments. The following year, Meredith successfully passed the third-grade assessments.
This success story is not unique. An essential element to achieving this success is making the proper match between the intervention and the child's needs. How do we ensure this match? Matching treatment to needs occurs in other settings: A speech-language pathologist working in a rehabilitation center to support a recent stroke client's return to the workplace would identify vocation-specific expectations to tailor the intervention to the client's employment expectations. For example, if a client wants to return to work as an auto mechanic, the SLP might look to the Automotive Service Excellence certification to identify skills required for successful re-entry.
All students have comparable standards they must meet for success in their "job"—the job of progressing through the K-12 education and earning a diploma. These standards, required by the No Child Left Behind Act, are the basis of classroom instruction and state assessments. Communication impairments affect students' acquisition of these skills.
More than 30 states have elected to adopt the recently released Common Core State Standards, a project of the National Governors Association Center for Best Practices and the Council of Chief State School Officers. These standards in language arts and mathematics for grades K-12 are evidence-based, internationally benchmarked, aligned with college and work expectations, and include rigorous content and skills.
Because oral language skills are foundational to reading and writing skills, it is not surprising to see that skills in oral language and phonological awareness are expected in the primary grades. The Common Core Standards provide examples of the skills children need. For example, students should be able to "count, pronounce, blend, and segment syllables in spoken words" to master foundation skills for the kindergarten reading standard.
Proficiency in oral language skills is expected at higher grade levels. For example, the Common Core Standards for grades 9–10 include the expectation that students "present information, findings, and supporting evidence clearly, concisely, and logically such that listeners can follow the line of reasoning and the organization, development, substance, and style are appropriate to purpose, audience, and task."
Mastering standards at both of these levels will be a challenge for children with articulation ("pronounce syllables"), pragmatic ("appropriate to the purpose, audience, and task"), or fluency ("presentations" in the speaking and listening standards) disorders. Both oral and written language skills are stressed throughout the grades, with focus on knowledge and use of morphology through use of prefixes and suffixes, possessive and plurals, and verb tense markers, beginning as early as kindergarten in the Common Core of Standards.
However, the semantic and syntactic-morphologic expectations of the curriculum present the greatest challenge to children with communication disorders. The academic curriculum has high expectations for vocabulary, with estimates of vocabulary size in 12th grade ranging from 17,000 to 45,000 words. To meet these expectations, students must master from 1,150 to 3,150 new words per year (Marzano, 2004).
Marzano's research (2004) informs us that children need six to 10 exposures to a word in context for mastery, and that children with low abilities have only an 8% chance of learning a new word from context alone. Although Marzano's meta-analysis of the research did not focus on children with speech-language impairments, it is likely that this figure would be typical of a child with a language-processing deficit. A review of the standards reveals that the majority of the vocabulary students must master comes from the content areas. Marzano's (2004) review of content area standards of 28 education organizations revealed nearly 8,000 vocabulary terms expected across 11 subject areas.
Mastering the presentation of the content material requires syntax-morphology proficiency. Comprehension of classroom material includes such skills as processing noun-pronoun relationships and complex sentences. Assessment of academic mastery also relies on sophisticated syntactic-morphologic skills. Test items from state assessments show the linguistic complexity required to understand the assessments: Rather than using the common sentence construction of an active proposition expressing one idea (e.g., subject-verb-object), the released test items often use multiple propositions, passive voice, and nontraditional word order (for example, Released Virginia Assessments include such questions as "If the author added a sentence at the end of paragraph 4, which of these would be the best fit?" or "This WWII poster appeals to which trait of an American citizen?").
Academic success also requires students to use language to think about language. Language arts instruction is based on such metalinguistic skills as labeling parts of speech, categorizing words (e.g., antonyms, homonyms, homophones), and creating relationships between words (e.g., analogies, metaphors). Children also are expected to use metalinguistic skills to manipulate the information presented in the classroom (e.g., analyze, compare, contrast, construct, create, generate, illustrate, predict, revise, support, suggest).
Meredith, the child in the example above, met the academic content areas and the linguistic complexity of the state assessment instrument. However, to graduate from high school, she will need to meet the increasingly difficult semantic, syntactic-morphological, and metalinguistic expectations of the classroom and the state assessments.
To help prepare the "Merediths" on our caseloads to meet the linguistic expectations of the classroom, SLPs need to match intervention with the expectations for mastery of the academic curriculum. Helpful resources are available on the websites of state departments of education. These websites include standards and released test items and may include curriculum frameworks. Most school districts offer pacing guides that identify the content by marking period. Although many bemoan the "teaching to the test" that is taking place nationwide, the expectation of the No Child Left Behind Act for annual assessment and mastery by all students provides SLPs with clear direction regarding the academic expectations for children with communication disorders. With the support of school-based clinicians who link their intervention to the academic curriculum, the "Merediths" on our caseloads will succeed.