Assessment and Teaming
The team typically includes, at a minimum, the individual with severe communication disabilities, a family member or guardian, a speech-language pathologist (SLP), and a teacher (general or special education). Other members may include, but are not limited to, an occupational therapist, physical therapist, general education and/or special education teacher, direct care staff, employer/job coach, psychologist, and social worker.
The role of the interdisciplinary team is to work cooperatively to provide discipline-specific assessment and intervention, although some cross-disciplinary activity may occur as team members collaborate in the delivery of communication services and supports. They discuss their findings and activities to seek consensus and to develop goals and plans as a team.
Sometimes members of the team may not recommend the same communication intervention approach. In these cases, professionals should be guided by the scopes of practice for their respective professions and the evidence base. There are some things that only the SLP on a team is licensed to do. For example, insurance reimbursement for the purchase of speech-generating devices (SGDs) requires a formal written evaluation by an SLP; thus, if the family would like the device to be covered through insurance, the signature of an SLP is necessary.
A team may seek outside consultation when its members remain divided about an intervention approach or the team recognizes it doesn't have the requisite expertise represented within the group.
Bottom Line: Ideally, clinical decisions are based on the recommendations of members of an interdisciplinary team, consisting of the family and professionals who are engaged in supporting the individual. The key is having a team member who has a significant level of insight about language development, disorders, and evidence-based intervention practices.
Resources on Teaming
- See the NJC home page for information and links to resources related to the professional organizations represented on the National Joint Committee for the Communication Needs of Persons with Severe Disabilities (NJC).
- American Speech-Language-Hearing Association. (2004). Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication [Technical report]. Available from www.asha.org/policy.
- American Speech-Language-Hearing Association. (2008). Roles and responsibilities of speech-language pathologists in early intervention [Guidelines]. Available from www.asha.org/policy.
- Hill, K., & Corsi, V. (2012). Role of speech-language pathologists in assistive technology assessments. In Assistive technology assessment handbook (Vol. 1, pp. 301–311). Boca Raton, FL: Taylor & Francis.
- Snell, M. (2000). Collaborative teaming. Baltimore, MD: Brookes.
- Snell, M. E., & Janney, R. E. (2005). Practices for inclusive schools: Collaborative teaming (2nd ed.). Baltimore, MD: Brookes.
School systems and other service agencies may have student needs that cannot be addressed by their available funds or supply of trained professionals. This problem appears to occur more often in rural systems or in cases where the students have significant disabilities, such as autism, deafblindness, or multiple physical disabilities.
Two possible solutions available to schools and agencies in this position are:
- Tap public and private benefits to add more money to local funds (e.g., public and private insurance, low interest loans from state technology act funds, funds from state agencies serving individuals with special health care needs).
- Develop agreements between public and private schools and/or agencies that allow sharing of professionals with pertinent expertise/skills.
The challenges and solutions are different when available professionals lack the specialized skills needed to provide communication intervention to students with severe disabilities. It is not uncommon for trained professionals to feel they are not prepared to provide communication intervention to these students (Ogletree, Sportsman, VanGiesen, & Siegel, 2000; Simpson, Beukelman, & Bird, 1998). The professional organizations of speech-language pathologists, special education teachers, and physical and occupational therapists set standards for performance; performance that falls short of these standards violates that profession's code of ethical conduct. Agencies that 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 the Individuals with Disabilities Education Act (IDEA), No Child Left Behind, and case law based on the outcome of the Timothy W. vs. Rochester, NH School District (1989) decision.
Bottom Line: 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.
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 (1st Cir.), cert. denied, 493 U.S. 983 (1989).