Parental consent is not required before administering screenings that are applied across the entire student population. Screening is not considered an evaluation under IDEA to determine eligibility for special education services,and parental consent is not required.
ASHA does not have an official position or policy on this issue. However, best practice indicates that you should use the most recent version of an assessment tool or test available. Test developers revise assessments to reflect changes in research, to improve validity and reliability, or to include populations that may not have been included in the previous version. If the most recent version is not available to you, contact the publisher to learn about the changes in the revised edition. The information that you obtain from the publisher may be useful in helping you advocate and gain support for purchasing the most current version.
The answer varies according to the particular standardized test that you are using. Some test manuals include test-retest schedules, and others do not. For example, Pro-Ed suggests guidelines ensuring that enough time has elapsed so that the student
In the end, make these decisions on a case-by-case basis, using as much information as is readily available and thoroughly documenting all diagnostic procedures and outcomes. If the publisher offers no guidance, the qualified examiner should use their clinical judgment and allow 6–12 months between administrations. If a student appears sick or anxious during the session, or if there are other factors that impact test validity, then you can repeat the test right away.
It is important to consider the school's testing schedule whenever possible. During periods of high-stakes classroom testing, students may be less engaged in additional testing—such lack of engagement may impact the outcomes. It may also be helpful to avoid administering tests on the day before or the day after a school holiday.
The Individuals With Disabilities Education Improvement Act of 2004 specifies that a public agency should
According to ASHA's 2007 Position Statement on CAS, the certified SLP is responsible for making the primary diagnosis of CAS, designing and implementing the individualized and intensive speech-language treatment programs. Diagnosis and treatment of childhood apraxia of speech (CAS) are the role of certified SLPs with specialized knowledge in motor learning theory, skills in differential diagnosis of childhood motor speech disorders, and experience with a variety of intervention techniques that may include augmentative and alternative communication and assistive technology.
SLPs play a central role in the screening, assessment, diagnosis, and treatment of persons with autism spectrum disorder (ASD). The professional roles and activities in speech-language pathology include
Interdisciplinary collaboration and family involvement are essential in assessing and diagnosing ASD. The SLP is a key member of an interdisciplinary team that includes the child's pediatrician, a pediatric neurologist, and a developmental pediatrician. See ASHA's Scope of Practice in Speech-Language Pathology (2016).
ASHA's position statement: Roles and Responsibilities of Speech-Language Pathologists With Respect to Reading and Writing in Children and Adolescents, states that SLPs play a critical and direct role in the development of literacy for children and adolescents with communication disorders, including those children with severe or multiple disabilities. The scope of practice for SLPs includes literacy assessment and intervention for children and adolescents as well as adults with developmental disabilities. See ASHA's Practice Portal page on Written Language Disorders; see also the U.S. Department of Education guidance on dyslexia [PDF].
ASHA does not recommend specific criteria for eligibility or dismissal of services for educational settings. Federal, state, and/or local guidelines determine criteria. For additional information, see Eligibility and Dismissal Criteria and Cognitive Referencing.
IDEA 2004 notes that each public agency must
The regulations specify that criteria for determination are conducted at the state level and
In addition, the regulations specify that "a public agency must use the state criteria adopted pursuant to the information presented above in determining whether a child has a specific learning disability."
Comparing IQ and language scores as a factor for eligibility for speech-language intervention is frequently referred to as cognitive referencing. Cognitive referencing is based on the assumption that language functioning cannot surpass cognitive levels. According to researchers, the relationship between language and cognition is not that simple. Some language abilities are more advanced, others are closely correlated, and still others are less advanced than general cognitive level. The results of research in recent years have demonstrated that cognitive prerequisites are neither sufficient nor even necessary for language to emerge. Therefore, ASHA does not support the use of cognitive referencing. For additional information, see ASHA's Cognitive Referencing resource.
Can a school district deny speech-language pathology services to a student with a "mild" articulation disorder if the district decides that the disability does not "adversely affect educational performance"?
State and/or local school education agencies may apply different interpretations to the phrase "adversely affects educational performance"; however, they cannot deny IDEA-mandated services to a child with a speech or language impairment just because that child does not have a discrepancy in age/grade performance in an academic subject-matter area. If acquisition of adequate and appropriate communication skills is a required part of your school's academic standards and curriculum and is considered to be a basic skill necessary for all children attending school, then a child with a speech or language impairment has a disorder that adversely affects educational performance. Sound production errors may affect the way a student hears, speaks, reads, or writes phonemes, and thus can affect academic and social performance. For more information, see ASHA's Eligibility and Dismissal resource, "Adversely Affects Educational Performance" section.
Three key pieces of legislation—the Individuals with Disabilities Education Act of 2004 (IDEA), Title II of the Americans with Disabilities Act of 1990 (ADA), and Section 504 of the Rehabilitation Act of 1973 (hereafter, “Section 504”)—all address public schools' obligations to meet the communication needs of students with disabilities.But they do so in different ways:
Compliance with one set of regulations may—or may not—meet the requirements of the other. This ASHA Leader article addresses this issue in depth and includes links to an FAQ document from the U.S. Department of Justice and the U.S. Department of Education as well as a "Dear Colleague" letter authored by both agencies.
The Every Student Succeeds Act (ESSA) became law in November 2015 and replaced the No Child Left Behind Act (NCLB). The 2015 law includes a number of important provisions:
ASHA has developed an analysis of the ESSA for members. The Every Student Succeeds Act: Key Issues for ASHA Members [PDF] will help guide state association leaders, education advocates, and school-based members as each state begins its own implementation of the new law.
Section 504 of the Rehabilitation Act of 1973 (hereafter, “Section 504”) has a broader definition of disability than the Individuals with Disabilities Education Improvement Act of 2004 (IDEA). Section 504 is a federal civil rights law that prohibits discrimination against individuals with disabilities in programs and activities that receive federal financial assistance.
The Family Educational Rights and Privacy Act (FERPA) is the federal law that addresses student records, including who can have access to these records. This law ensures that parents/guardians have an opportunity to have the records amended and provides families some control over the disclosure of information from the records.
The Americans with Disabilities Reauthorization Act of 2009 was originally passed as the Americans with Disabilities Act in 1990 and requires "access to buildings, facilities, and transportation, and includes the provision of auxiliary aides and services to individuals with vision or hearing impairments."
The Health Insurance Portability and Accountability Act (HIPAA) is the law that pertains to protected health information (PHI). Originally enacted in 1996, the Act and its amendments (introduced in 2003) address electronic transmission of records and increased restrictions on accessibility to health records.
IDEA regulations state that the IEP for each child with a disability includes:
Section 504 is an anti-discrimination law that protects people who have a mental or physical disability that impairs one or more major life activity. The Individuals With Disabilities Education Improvement Act 2004 (IDEA) is an education law that requires the provision of specialized instruction to students with a disability in at least one of 13 qualifying categories.
Section 504 requires that students be provided with a reasonable accommodation, which is different than that of IDEA, which requires provision of specialized individualized instruction. This is commonly referred to as having a “504 plan.” Examples of reasonable accommodations include providing a student with a low-distraction work area, preparing a student for upcoming changes in routine, and allowing a person with attention-deficit/hyperactivity disorder (ADHD) or another learning disability extra time for test taking.
The 504 plan, unlike an individualized education program (IEP), does not have to be a written document, and rules for creation, review, and revision can be different between school districts and states.
See this chart for a detailed comparison between the IEP and the 504 plan. The chart was developed by Understood, an organization that serves parents whose children struggle with learning and attention issues.
Technically, all special education services can be delivered through a 504 plan. However, Section 504 defines the term disability more broadly than IDEA—and, consequently, a child who does not qualify for an IEP may still be able to get a 504 plan. According to the U.S. Department of Education, “an appropriate education for a student with a disability under the Section 504 regulations could consist of education in regular classrooms, education in regular classes with supplementary services, and/or special education and related services.”
In cases where a student requires minimal support from the speech-language pathologist, then documenting and implementing these services through a 504 plan may be appropriate. For example, a student with a well-managed hearing loss who needs the SLP only to consult with teachers and/or troubleshoot equipment issues can receive this support through a 504 plan.
In some states, speech sound disorders, consisting of errors with only one or two sounds, are addressed through a 504 plan or through response to intervention (RTI) rather than through an IEP. The specific guidance under which speech-language supports and services are provided depends on state law. Consult with your state and school district for specific rules and regulations. See ASHA’s resource on Response to Intervention and Multi-Tiered Systems of Support.
ASHA does not recommend a maximum or minimum caseload number. Rather, schools should consider the total workload activities required and performed by school-based SLPs to ensure that students receive the services they need. ASHA's Practice Portal page on Caseload and Workload describes how to organize and document necessary SLP workload activities provides strategies for implementing this approach. Caseload and workload data are available from the ASHA Schools Survey. In addition, this State Caseload chart [PDF] lists guidelines for caseload in each state.
ASHA does not recommend using one service delivery model versus another. You should not use only one service delivery model. ASHA's Position Statement and Technical Report from the family of documents titled "Inclusive Practices for Children and Youths With Communication Disorders" indicate that schools should choose and combine options according to the students' needs as determined by the school's multidisciplinary team. Schools should combine and/or change service delivery models as the students' needs change during treatment. The traditional pull-out model for providing speech-language pathology services is still a viable choice but is considered to be just one of several options available. The SLP may choose to use other service delivery models, which can include collaborative consultation, classroom-based intervention programming, or self-contained intervention programming. See ASHA's web resource, School-Based Service Delivery in Speech-Language Pathology.
ASHA does not have a policy or position on making up missed sessions. However, we have sought input and guidance from the Office of Special Education and Rehabilitative Services that indicates that districts should consider each case to determine whether the impact of the missed sessions interferes with the student's progress toward their IEP goals and access to a FAPE. Read ASHA's IDEA Part B Issue Brief: Missed Sessions and the ASHA webpage that explains OSERS' guidance on missed services.
The quality of work settings and equipment varies widely in schools around the country. ASHA's Appropriate School Facilities for Students With Speech-Language-Hearing Disorders addresses issues such as hearing screening, confidentiality, classroom acoustics, and advocacy for appropriate facilities for services to students with speech, language, and hearing disorders.
Applied behavior analysis (ABA) therapy is one of many therapy options available to children on the autism spectrum. The appropriate assessment and treatment of autism spectrum disorder (ASD) involves a multidisciplinary team of professionals collaborating with one another to ensure that these children receive all of the appropriate services necessary to achieve successful outcomes. All appropriate therapies should be provided to children with a diagnosis of ASD, and ABA should not be the sole means by which to treat children with ASD. SLPs are critical members of the interprofessional team.
ASHA's guidelines document, Roles and Responsibilities of Speech-Language Pathologists in Schools, states that SLPs in schools have integral roles in education and are essential members of school faculties. They help students meet the performance standards of a particular school district and state by assuming a range of responsibilities:
There are several considerations that SLPs should address with administrators in response to being asked to serve as classroom substitutes (subs):
Teaching Certification and State Licensure
SLPs' knowledge of normal and disordered language acquisition—and their clinical experience in developing individualized programs for children and adolescents—prepares them to assume a variety of roles related to the development of reading and writing. Appropriate roles and responsibilities for SLPs include but are not limited to
These roles are dynamic and have implications for research and professional education. See ASHA's Practice Portal page on Written Language Disorders.
SLPs play a central role in the assessment, diagnosis, and treatment of infants and children with swallowing and feeding disorders. The professional roles and activities in speech-language pathology include (a) clinical/educational services (diagnosis, assessment, planning, and treatment); (b) prevention and advocacy; and (c) education, administration, and research. See the following two ASHA resources: Scope of Practice in Speech-Language Pathology and ASHA's Practice Portal page on Pediatric Feeding and Swallowing.
As indicated in ASHA's Code of Ethics, audiologists and SLPs are obligated to provide culturally and linguistically appropriate services to their clients and patients, regardless of the clinician's personal culture, practice setting, or caseload demographics. School-based SLPs play an integral role with students who are English language learners (ELLs) and who have speech-language disorders. SLPs evaluate and treat these students while using all available resources to ensure that the students are neither over-identified nor under-served. ASHA offers many resources to guide SLPs in serving students who are ELLs, including the following:
According to ASHA's Scope of Practice for the Speech-Language Pathology Assistant, an SLPA should engage in the following activities when performing necessary tasks related to speech-language service provision:
Prevention and Advocacy
State laws vary. Check specific state regulations to determine the tasks that a particular state permits SLPAs to perform. For example, some states do not permit the use of support personnel. See ASHA’s Practice Portal page on Speech-Language Pathology Assistants for more information.
According to ASHA's Scope of Practice for the Speech-Language Pathology Assistant, an SLPA should NOT engage in any of the following activities:
State laws may differ. Check specific state regulations to determine which tasks fall outside the scope of responsibility for SLPAs in a particular state.
Significant changes were made in the reauthorization of IDEA 2004. Under this law, qualifications for related services personnel, including speech-language pathologists, must now be consistent with ANY state-approved or state-recognized certification, licensing, or other comparable requirement applicable to a specific professional discipline. States are now allowed to establish requirements for school-based personnel which may be significantly less rigorous than qualifications and credentials required for ASHA certification (CCC) and/or state licensure. In short, it may be permissible for a district to hire personnel who do not meet ASHA's requirements to practice speech-language pathology. See Frequently Asked Question: Qualified Providers in Schools.
To date, most states have implemented or plan to implement Medicaid billing in the schools. There are provisions in federal and state law requiring state and local education agencies to seek sources other than those available under Part B or Part C of IDEA to pay for services for students with disabilities. Schools are increasingly tapping other sources to help finance special education programs. Covered Medicaid benefits include speech-language pathology services identified in the child's individualized education program (IEP) or individualized family service plan (IFSP). There are a number of legal, ethical, and professional issues that SLPs who are providing services and submitting claims to Medicaid for reimbursement should review. See ASHA's resources, Introduction to Medicaid and Medicaid in the Schools.
According to ASHA's Issues in Ethics statement, Obtaining Clients for Private Practice from Primary Place of Employment, it is possible for practitioners to accept cases for their private practice from the primary place of employment if the following guidelines are observed:
Contractual employment is a private arrangement between an SLP and a school or school district to provide services to students. In a traditional arrangement, the SLP is hired by the district to work full or part time as a staff member receiving employment benefits from the district. As an independent contractor, the SLP works under an agreement or contract with the school district or agency that contracts with the public school or charter school. In some cases, SLPs may work for companies who have established contracts with schools. The terms and benefits of these arrangements are determined by the company that employs the SLP. The Internal Revenue Service (IRS) defines independent contracting [PDF] for tax purposes.
Becoming an independent contractor requires several steps that will ensure both success and compliance with relevant state regulations. You must be licensed to practice in the state where you will be providing services. Check your state's licensing regulations. Also, apply for an Employer Identification Number (EIN). It is also recommended that you
ASHA offers coverage for members through Mercer Consumer. Learn more about business practices, in general, by consulting ASHA's Frequently Asked Questions About Business Practices.
No, ASHA does not determine fee schedules because these schedules can vary widely across the country and are subject to possible allegations of "price fixing," which is a violation of antitrust laws. Read more about what to consider when determining fees for services.