Catherine M. Constable, PhD, CCC-SLP, The Rye Learning Center, New York, New York
Work Setting: Schools
A team of education professionals collaborated across specialties to help a 7½-year-old boy with cerebral palsy improve his communication skills. By bringing in expertise from a local university’s speech and hearing center, the team was able to understand the student’s educational needs and develop an individualized education program (IEP) to address them. After 6 months of working with the team members, the boy could respond with 80% accuracy to familiar questions using his new Dynavox.
Finn is a 7½-year-old male student who was diagnosed with cerebral palsy at 6 months of age. He is a largely non-oral communicator who used a small language board with eight messages. He can successfully move around on four limbs, but he needs assistance getting into a chair. He has some movement in his right arm and hand. He can also eat chopped food using a spoon and can drink using a straw.
When Finn was 7, his parents placed him in a public school. Initially, he attended a self-contained first grade classroom with students who had mild intellectual impairments. In school, he received both occupational and physical therapy twice a week. He had one initial consult from the school-based speech-language pathologist (SLP), who recommended that he use his rudimentary communication board in the classroom.
Then, Finn began “acting out” in class. He made noise, disrupting the class, and he had to be removed to the hallway. His behavior in the classroom was interpreted as aggression. Finn’s parents asked for a reevaluation of his accommodations.
To reevaluate Finn’s needs, the director of special education at the school put together the following team of professionals:
During the first team meeting, the team members and Finn’s parents discussed his current situation. The team decided to each evaluate Finn individually and meet again to discuss the results and establish a collaborative plan.
During that meeting, the school’s SLP said that she lacked the experience to evaluate a non-oral communicator like Finn and would like to bring in additional support. After discussing the logistics of adding another SLP to the team, the team decided to reach out to a local university’s speech and hearing center. They found an SLP with expertise in AAC, and that SLP performed Finn’s speech-language evaluation.
During the second team meeting, the school team members as well as the SLP from the local university shared their individual evaluation results and discussed how to best meet Finn’s educational needs. Finn’s parents questioned the early literacy specialist’s assessment that Finn lacked cognitive functioning. The group discussed how results from traditional measures of cognition may not be valid here, and the SLP with expertise in AAC shared resources for future assessments.
The team discussed and agreed on an IEP, in which each member of the team committed to working routinely with Finn on specific skills. For example, the local university’s speech and hearing center would provide speech-language pathology services twice per week. These sessions would help Finn use a complex communication system as well as improve his conversation and literacy skills. OT and PT services would continue twice a week and would focus on increasing Finn’s fine motor control for using his AAC device and gross motor skills for more independent physical activity in school.
After 6 months, with moderate support from team members, Finn consistently responded with 80% accuracy to familiar questions using his new Dynavox. He also began initiating instruction-based questions on an inconsistent basis (20%–25%). Finn began decoding simple written words and answering simple questions using his AAC device.
The team agreed to follow up twice a year to discuss Finn’s progress and any needed changes. Once yearly, the whole team will meet to review his IEP. The classroom teacher will serve as the parent–school liaison, and the team will touch base monthly via email regarding concerns, progress, or other updates.