School Speech-language Pathologists Research Articles

AAC Business as Usual: Clinical Practice of School-Based Speech-Language Pathologists

AAC Business as Usual: Clinical Practice of School-Based Speech-Language Pathologists

Eligibility Determinations for Speech and Language Services in U.S. Public Schools: Experiences and Tensions.

The purpose of this study was to examine school speech-language pathologists' (SLPs) experiences regarding students' eligibility for services in public schools within the United States. Fifteen school SLPs participated in online focus groups to examine the complex nature of SLPs' participation within decision-making teams and describe practice experiences in U.S. schools. SLPs worked in one to 10+ schools serving students from pre-K through 12th grade. Data were analyzed using Cultural-Historical Activity Theory (CHAT; Engeström, 2015). School SLPs' practice is impacted by rules, community, and division of labor in schools. Participants discussed the following: culture of the work setting, interaction between team members, desire to assist families and children, knowledge of regulations, evaluation practices, and the impact of poverty, and cultural and linguistic differences. Nine major tensions were identified: need for greater SLP empowerment and advocacy, documentation of educational impact, complexities of students learning English as an additional language, concerns about evaluation data for decision making, SLPs' concerns regarding outcomes of eligibility decision making, overuse of speech-language impairment for students who do not qualify, parents' involvement in decision making, disagreement between team members, and administrations' adherence to rules. Within the schools, the CHAT framework was useful to identify tensions and opportunities for change at the individual and institutional levels, impacting team decision making for eligibility, SLPs' provision of services, and student outcomes. Acknowledgment of tensions and opportunities for change regarding students' eligibility for services may guide public policy; preservice training; and individual, local, and national advocacy.

A Balancing Act: How School-Based Speech-Language Pathologists Navigate Their Efforts Related to Individual Education Plans and Multi-Tiered Systems of Support.

Speech-language pathologists (SLPs) in public schools have a key role in assessment, intervention, program design, compliance, and prevention. They address the needs of students of all ages and disorders, ensure the educational relevance of their services, and provide culturally competent care. Given the scope of their work, SLPs must balance and prioritize their varying responsibilities in school settings. This study investigates how SLPs navigate their involvement with the prevention-oriented framework Multi-Tiered System of Supports (MTSS) while providing direct support to students with disabilities through Individualized Education Programs (IEPs). This study took place in a district with a stated goal for the academic year of deepening their involvement with the MTSS framework. Eight SLPs working in this rural district participated in a series of interviews over the course of the 2022-2023 school year. Qualitative data were collected about SLPs' motivations and evolving views related to MTSS. While participants in this study were motivated to engage in MTSS because they viewed this framework as a useful mechanism to support students outside of special education, they were limited by time constraints and the challenges of forming collaborative relationships. Each participant navigated the process of balancing their efforts related to MTSS and IEPs in a unique way that reflected their specific setting and circumstances. This study directly investigated how SLPs navigate this balancing act in real time and provided a novel perspective on the potential synergies and disconnects between SLPs' efforts related to MTSS and their responsibilities related to providing appropriate speech-language services via IEPs.

Determining an Effective Language Sample Elicitation Strategy for Early Language Learners Who Speak Using Augmentative and Alternative Communication.

This study evaluates three different language sample elicitation strategies to determine a valid elicitation strategy for early language learners who speak using augmentative and alternative communication (AAC). Ten children who speak using AAC participated in this study. Language samples were elicited from each participant using three strategies: the Communication and Symbolic Behavior Scales (CSBS), a generic play-based elicitation strategy, and automatic data logging. Samples were transcribed and coded. Additionally, each participant's school speech-language pathologist completed a Communication Matrix. Data from coded language samples were correlated with Communication Matrix results to determine the elicitation strategy that yielded the most valid language sample in comparison to Communication Matrix results. Both the CSBS and the play-based strategy yielded clinically relevant information. Because the log lacked communicative context, resulting data from the log was limited. An analysis of variance revealed significant differences in the amount of information elicited from each elicitation strategy. The CSBS repeatedly elicited the most data, followed by the play-based strategy and then the log. Generic play-based strategy results yielded the most correlations with Communication Matrix data. This preliminary data suggest that the play-based elicitation strategy elicited the most valid language sample when compared to the Communication Matrix from early language learners who speak using AAC. Additionally, results suggest that the CSBS may be an effective tool to measure the limits of this population's expressive language abilities.

What Plays a Role in Perceived Confidence for Managing Pediatric Feeding Disorders in the Public School.

This study examined public school (PS) speech-language pathologists' (SLPs') perceived confidence in managing pediatric feeding disorders (PFDs). Perceived confidence is a rater's self-reported assurance level to manage PFDs. The study then looked for relationships between personal and professional factors that might account for perceived confidence. Geographic location as well as administrative supports and resources were also examined. Participants were PS SLPs from across the United States who were recruited via American Speech-Language-Hearing Association Special Interest Groups. This study measured perceived confidence with a 5-point Likert-type scale for 17 roles and responsibilities in PFD management. Pearson and Spearman correlations were used to identify relationships with personal and professional characteristics. PS SLPs perceived themselves as having low confidence in managing PFDs. Personal and professional characteristics account for low perceived confidence (e.g., number of graduate courses, clinical experience with swallowing and feeding in early intervention or medical settings, managing swallowing and feeding currently, having more administrative support). This study provided a more representative sample (i.e., geographic regions) of PS SLPs. Perceived confidence in PFD management is linked to factors that can be modified through personal and professional changes.

School-Based Telepractice Assessment (STA)

Over 50% of American Speech-Language-Hearing Association (ASHA)-certified speech–language pathologists (SLPs) are employed in schools (ASHA, n.d.). Speech–language pathologists increasingly provide services to students with speech and language disorders via telepractice. ASHA's Roles and Responsibilities of Speech-Language Pathologists in Schools document states that telepractice services must be comparable to in-person services (ASHA, 2010). This article presents the School-Based Telepractice Assessment (STA; Lundblom et al., 2021), comprising aspirational questions related to compliance with federal legislation; personnel; roles and responsibilities of school-based SLPs; and privacy and security issues. The STA is designed for use by SLPs, school administrators, and contracted providers. The guide comprehensively evaluates the range of school-based telepractice components such as diagnostic and therapeutic services, the use of support personnel consultation, preventative services, integration with the school culture and curricula, and compliance with federal regulations. The STA can guide both school-based SLPs and administrators as they prepare for telepractice service delivery and later appraise whether the telepractice services are comparable to in-person school-based practice.

Speech-Language Pathologists’ Orthographic Knowledge

This study quantified the orthographic knowledge (i.e., knowledge of spelling conventions) of school speech-language pathologists (SLPs). On average, SLPs ( N = 48) answered 65% of the questions correctly on a measure of orthographic knowledge. SLPs need better preparation in written language structure to support reading acquisition in children with language disorders.

Speech-Language Pathologists' Experiences With Interpreters in the School Setting: A Preliminary Study

Purpose: The purpose of this exploratory study was to obtain documentation about interpretive interactions that include speech-language pathologists (SLPs) and interpreters in public schools, including information on best practices and difficulties. Method: Seven California public school SLPs were interviewed by the authors using preset questions. Their responses were transcribed, then coded into 55 codes, and then combined into six different themes. Results: Results included the following six themes: (a) interpreter roles, (b) SLPs' characteristics or actions, (c) characteristics of effective interactions, (d) interpreters' positive characteristics or actions, (e) characteristics of ineffective interactions, and (f) interpreters' negative characteristics or actions. Some of the positive characteristics or actions reported about some interpreters included direct translation without adding, changing, or deleting information, knowledge of professional vocabulary, training as an interpreter, and demonstrating empathy. In addition, the majority of respondents stated that they used the briefing, interaction, and debriefing process in interpreted interactions. Conclusions: It was concluded that additional training of SLPs and interpreters was indicated. Given the small sample, generalizability is limited, but there is a need for further research, especially given that the quality of bilingual assessments and individualized education program rests directly on the skills of effective interpretation.

Speaking like a scientist: A multiple case study on sketch and speak intervention to improve expository discourse.

This descriptive multiple case study examined the effects of a contextualized expository strategy intervention on supported and independent note-taking, verbal rehearsal, and reporting skills for three elementary students with language disorders. Two 9-year-old fourth grade students and one 11-year-old sixth grade student with language disorders participated. The intervention was delivered as sixteen individual 20-minute sessions across nine weeks by the school speech-language pathologist. Students learned to take written and pictographic notes from expository texts and use verbal formulation and rehearsal of individual sentences and whole reports in varied learning contexts. To explore both emergent and independent accomplishments, performance was examined in final intervention session presentations and pre/post intervention testing. Following the intervention, all three students effectively used notes and verbal rehearsal to prepare and present fluent, organized, accurate, confident oral reports to an audience. From pre- to post-test, the students showed a range of improvements in the quality of notes, use of verbal rehearsal, holistic quality of oral and written reporting, and strategy awareness. Sketch and Speak shows potential as an expository intervention for students who struggle with academic language learning. The results support further examination of this intervention for supported strategy use by younger students and independent use by older students.

Predictors of Comfort Level in Speech-Language Pathologists Working With Students With Attention-Deficit/Hyperactivity Disorder

Purpose Students with attention-deficit/hyperactivity disorder (ADHD) often demonstrate language deficits requiring speech-language pathologist (SLP) interventions. With the number of students diagnosed with ADHD on the rise, SLPs are being called upon increasingly to address the needs of these students. Ensuring SLPs are comfortable treating students with ADHD is of growing importance. To date, there is limited evidence examining what factors may predict how comfortable SLPs are working with students with ADHD. This study investigated the relationships between variables to better predict comfort levels of school SLPs in their management of students with ADHD. Method A total of 86 school SLPs from the American Speech-Language-Hearing Association's Special Interest Groups 1 (Language, Learning and Education) and 16 (School-Based Issues) whose clinical caseloads included students diagnosed with ADHD participated in an anonymous, online survey to determine the relationship between various factors and SLPs' comfort level when working with students with ADHD. Results Correlations revealed feeling adequately trained predicted SLPs' comfort level in working with students with ADHD. SLPs who either received coursework that included content regarding ADHD in school or sought out professional development reported feeling adequately trained. Regression analyses revealed feeling adequately trained and having a reasonable caseload as significant predictors of SLPs' comfort level. Conclusions Not all SLPs were comfortable working with students with ADHD. Many sought courses to increase their level of comfort, and many did not feel adequately trained. Results suggest the need for SLPs to have more preparation about managing ADHD prior to beginning their professional clinical careers.

Today's Graduate Students, Tomorrow's SLPs: Enhancing School Practicum Experiences

Purpose In this article, we describe a standards-driven, workforce-focused model of school practicum offered by an accredited graduate speech-language pathology program. Method To prepare more than 50% of the American Speech-Language-Hearing Association's membership for the school-based workforce, graduate students require real-life practicum experiences in the schools. Practicum experiences should be standards driven, anchored in the graduate curriculum, and paired with academic coursework to foster the growth of student clinicians' background knowledge prior to engagement in a school-based practicum. Results We outline the main content areas and minimum practice experiences that should be incorporated in a school-based practicum and provide suggestions for balancing the requirements across the graduate curriculum. Collaboration with school systems is essential for locating and maintaining high-quality placements. Conclusion School practicum experiences provide an important foundation for future school speech-language pathologists to enter the workforce with adequate preparation.

Family’s Story and Connections Move Major Hearing Health Legislation

You have accessThe ASHA LeaderFirst Person on the Last Page1 Oct 2019Family’s Story and Connections Move Major Hearing Health LegislationThe father of an educational audiologist’s client propels passage of a bill requiring hearing-device coverage. Tena McNamaraAuD, CCC-A/SLP Tena McNamara Google Scholar More articles by this author , AuD, CCC-A/SLP https://doi.org/10.1044/leader.FPLP.24102019.72 SectionsAboutPDF ToolsAdd to favorites ShareFacebookTwitterLinked In A new law in Illinois requires health insurers to cover hearing instruments for children. And the family of one of my clients played a major role in getting that legislation passed. Signed into law on Aug. 22, 2018, House Bill 4516 amends the Illinois Insurance Code, the Health Maintenance Organization Act, and the Voluntary Health Services Plans Act to mandate hearing device coverage for children through age 18 years. When we learned the bill had been introduced in February 2018, my first instinct was to contact Clint and Sarah Drury, the parents of one of my students. Their daughter Sawyer, 11, has Mondini dysplasia, resulting in a bilateral moderate-to-profound sensorineural hearing loss. During the five or so years I have worked with Sawyer as an educational audiologist, I forged a close working relationship with the family. The Drurys remember the time Sawyer was initially diagnosed with hearing loss as life-changing. They were stunned at the price of hearing technology and totally unprepared for the cost. They had family insurance coverage, but amplification devices and related services were not covered. They knew firsthand how beneficial the bill would be to families of children with hearing loss. The Drurys had been staunch advocates for hearing loss-related causes—for example, along with some help from Sawyer’s school speech-language pathologist, Sarah Moon, they raised approximately $7,000 for the Hearing Loss Association of America’s Walk4Hearing—so I knew they would work hard and be dedicated to promoting this legislation. In addition, Clint’s professional position as executive director of the West Central Illinois Building and Construction Trades Council had prepared him for work with the state legislature; he has developed relationships with many legislators throughout the state. Clint promptly began promoting the bill in the General Assembly. He shared his family’s story, illustrating the hardships that parents encounter when they must pay out-of-pocket for hearing instruments for their children. By contacting dozens of senators and representatives, he boosted the number of sponsors for the bill. Clint’s efforts were not, however, self-serving. His family’s insurance is through a union health and welfare fund not required to comply with legislative mandates. But he continued to work on behalf of the children with hearing loss who would benefit from the legislation. The efforts of the Drurys, other families, and the Illinois Speech-Language-Hearing Association paid off. The bipartisan legislation passed both the House and Senate with little opposition. Now, insurers included under the mandate must provide coverage for one hearing instrument every 36 months, along with repairs, selection, fitting, adjustments, and earmolds when medically necessary. I learned two important lessons from this experience. The first is to know your clients and their families beyond their educational or medical needs. They may have skills and knowledge that can help you professionally and aid with specialized practice needs. This is especially true with legislation. Second, I have learned the power of personal and human-interest stories in influencing government officials. Legislators want to know how prospective laws may affect their constituents, and these testimonials are effective in illustrating that. Author Notes Tena McNamara, AuD, CCC-A/SLP, professor emeritus at Eastern Illinois University, is a pediatric audiologist at Mueller Pediatric Therapy in East Peoria, Illinois. [email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 24Issue 10October 2019 Get Permissions Add to your Mendeley library History Published in print: Oct 1, 2019 Metrics Downloaded 523 times Topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2019 American Speech-Language-Hearing AssociationLoading ...

Mental Health First Responders

Mental Health First Responders

Unique Contributors to the Curriculum: From Research to Practice for Speech-Language Pathologists in Schools.

This lead article of the Clinical Forum focuses on the research that supports why speech-language pathologists (SLPs) are an integral part of the overarching curriculum for all students in schools. Focus on education has shifted to student performance in our global world, specifically in college and career readiness standards. This article reviews recommendations on best practice from the American Speech-Language-Hearing Association on SLPs' roles in schools, as well as data on school-based services. Implementation of these practices as it is applicable to school initiatives will be explored. Methods of interventions available in schools, from general education to special education, will be discussed based on national guidelines for a Response to Intervention and Multi-Tiered System of Support. Research regarding teacher knowledge of the linguistic principles of reading instruction will be explored, as well as correlation between teacher knowledge and student performance. The implications for how SLPs as the linguistic experts offer unique roles in curriculum and the evidence available to support this role will be explored. Implications for future research needs will be discussed. The demands of a highly rigorous curriculum allow SLPs a unique opportunity to apply their knowledge in linguistic principles to increase student performance and achievement. With the increased focus on student achievement, growth outcome measures, and value-added incentives, it is critical that SLPs become contributors to the curriculum for all students and that data to support this role are gathered through focused research initiatives.

Word-Level Stress Is to Decoding as Phrase-Level Stress Is to Reading Comprehension: A Study of Prosodic Influence in Children’s Reading Development

This study aims to determine how the use of prosody in spoken language can effect reading development and later, reading ability as an adult. Research shows that individuals who can identify which syllables or words are emphasized within a phrase also have more advanced decoding abilities (i.e. are more proficient at translating letters into speech sounds) and have more advanced reading comprehension. To date, there has been little research examining the precise method by which this awareness of emphasis or “stress” at the word-level and the phrase-level uniquely contribute to reading ability. In this study, I predict that adults’ word-level stress awareness will be more strongly predictive of their word decoding ability than their reading comprehension. I also postulate that adult’s awareness of stress at the phrase-level will be more predictive of their reading comprehension than decoding, when word-level stress sensitivity is removed from the equation. Eighty students from Queen’s University were recruited to participate in two 60-minute interview sessions, during which completed a battery of reading and executive functioning tasks. Multiple regression analyses will be conducted to evaluate the relationship between the measures of interest. The results from this study will benefit elementary school teachers, speech-language pathologists and others working towards providing children with a solid foundation in the spoken language from which their literacy skills can grow. These results may also have important implications for the development of educational programs for individuals with specific reading impairments.

Investigation into the Actual Condition and Job Satisfaction of School Speech Language Pathologists

Investigation into the Actual Condition and Job Satisfaction of School Speech Language Pathologists

Engaging Your Growth Mindset for a Successful School Year

This manuscript will focus on the value of a growth mindset, the belief that our abilities are not static, rather, those abilities can be developed upon and improved while utilizing hard work, dedication, and effort. In this article, we describe the value of a growth mindset for speech-language pathologists in schools who support language and literacy skills of students with disabilities and strive to increase academic success in the general education classroom. Speech-language pathologists in a school-based setting can use the principles of growth mindset, putting in into practice for themselves and to foster growth mindset within their students. We present recommendations and examples of implementing a growth mindset during the school year. Additionally, resources are provided for further understanding of growth mindset and the research behind growth mindset principles.

Positive Outcomes for Speech Telepractice as Evidence for Reimbursement Policy Change

Oklahoma has a large population living in rural areas where it is difficult to fill school speech-language pathologist (SLP) positions. To meet this need, telepractice has been used in rural Oklahoma school districts since 1999. Medicaid policies have allowed schools to receive reimbursement for speech therapy provided by onsite therapists; however, reimbursement for speech telepractice was excluded. The current project measured the effectiveness of a speech telepractice program so this policy could be revised. Speech and language skills of 578 children, grades PreK–12, were followed over one of two school years and were rated using Functional Communication Measures (FCM) established by the American Speech Language and Hearing Association (ASHA). Our data show that 67–87% of the children advanced by one or more levels on three common FCM scales. These changes are similar to, or greater than, what was reported in a large sample of students compiled by ASHA's National Outcomes Measurement System (NOMS) with clinicians who worked onsite in schools. Average weekly treatment time was also less in our teletherapy practice than what was reported in the reference database. Therefore, the current study demonstrates that speech telepractice is an effective and efficient method of delivery for the school age population.

Data-Based Decision Making in Professional Learning for School Speech-Language Pathologists.

School-based speech-language pathologists (SLPs) are often asked to adopt new policies or practices at the school, district, or state level. Professional learning (PL) opportunities usually accompany these changes but are often delivered in a one-size-fits-all workshop format. The authors challenge school-based SLPs and district leadership to consider PL in a new light, guided by data-based decision making to ultimately improve student outcomes. This article discusses the research supporting the assessment and delivery of high-quality PL for school professionals, including SLPs, and a specific model for measuring change: the concerns-based adoption model (CBAM; Hall & Hord, 2015). An example of how CBAM was used to examine the adoption process with school-based SLPs in a large school district is provided. Based on the review of the literature, the current approach to PL experienced by most SLPs is problematic. High-quality PL should target improvement in student outcomes and should be focused, ongoing, supported, and evaluated.

Nonword repetition in children with cochlear implants: a potential clinical marker of poor language acquisition.

Cochlear implants (CIs) can facilitate the acquisition of spoken language for deaf children, but challenges remain. Language skills dependent on phonological sensitivity are most at risk for these children, so having an effective way to diagnose problems at this level would be of value for school speech-language pathologists. The goal of this study was to assess whether a nonword repetition (NWR) task could serve that purpose. Participants were 104 second graders: 49 with normal hearing (NH) and 55 with CIs. In addition to NWR, children were tested on 10 measures involving phonological awareness and processing, serial recall of words, vocabulary, reading, and grammar. Children with CIs performed more poorly than children with NH on NWR, and sensitivity to phonological structure alone explained that performance for children in both groups. For children with CIs, 2 audiological factors positively influenced outcomes on NWR: being identified with hearing loss at a younger age and having experience with wearing a hearing aid on the unimplanted ear at the time of receiving a 1st CI. NWR scores were better able to rule out than to rule in such language deficits. Well-designed NWR tasks could have clinical utility in assessments of language acquisition for school-age children with CIs.