Transcript 59th Annual Speech Institute RtI 2.

The SLP’s Role in RTI:
Using a Workload
Approach
Judy Rudebusch, EdD, CCC-SLP
Division Director ~ Special Services,
Irving ISD
November 3-4, 2009
Response to Intervention…
What do you know now?
What do you still want to know?
What is most intriguing to you about
RTI?
Yesterday’s Agenda
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First Things First
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RTI Defined
Context for Change – What’s Going On???
RTI – Where did it come from???
Why a “Systems Approach?”
SLPs – How can RTI work well for us???
RTI ~ Essential “System” Components
SLP Roles ~ prevention, intervention,
identification
Today’s Agenda
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Managing Change ~ tips and tools
Use a Workload Approach to
Accommodate RTI
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SLP Roles and Responsibilities in Schools
Workload Clusters
Service Delivery Models
Types of Schedules
Action Plan for RTI Change
• Across Tiers
• Prevention, Intervention, Identification
Quick Review…
RTI is the practice of
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Providing high quality instruction/
intervention matched to student
needs and
Using learning rate over time and
level of performance to
Make important educational decisions
RTI provides support w/ increasing
intensity as needed
…in other words…
There are systems in place to help every
child meet grade level expectations in
academics and behavior…
“Whatever it Takes!”
Implications:
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Need infrastructure
• Data management software/system
• Processes in place for data integrity (data entry,
data reporting, easy to access & use)
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Need shared understanding
• About what data to collect
• About how & when to collect data
• About how to analyze & interpret data
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Need tools and procedures in place
Need checks & balances
RTI
Three Pronged Approach
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Prevention
Intervention
Identification
So…
The SLP’s Role in RTI involves activities
for prevention, intervention &
identification of communication
disorders that impede progess…
So…
Let’s think
Not-a-Box
For the rest of today!!!!
Think About…
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If you want to offer prevention and
intervention services through RTI, how
will you manage it?
If you want to use RTI data to augment
evaluation data and eligibility
determination, where will you get the
data?
If you want to participate in RTI, where
will it fit in your schedule?
Change yields Turbulence
What changes in your work are
you dealing with?
Which changes challenge you
most?
Pivot Points for RTI Change
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What needs to change?
• Classroom instruction
• Instructional support
• Intervention
• Assessment
• Measurement of progress
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Where will you contribute to RTI
change?
Change Pathway
Awareness
Interest
Desire
Action
SLPs Supporting Change
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Get an attitude!!!
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Outcomes orientation
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Manage complex change
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Redirect your effort
• Smaller caseload
Larger impact
Managing Complex Change
Vision
+ Skills
+ Incentives
+ Resources
+ Action =
Change
Vision + Skills + Incentives + Resources +
xxxxx+ Skills + Incentives +
Resources +
Vision + xxxx + Incentives + Resources +
Vision + Skills + xxxxxxxx + Resources +
Vision + Skills + Incentives + xxxxxxxxx +
Vision + Skills + Incentives + Resources +
Action
Plan
Action
Plan
Action
Plan
Action
Plan
Action
Plan
xxxxx
= Change
= Confusion
= Anxiety
= Resistance
= Frustration
= Treadmill
What You Will Notice
When RTI is Implemented Well
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The effort is owned by general,
special and compensatory educators
Shared responsibility to facilitate
student outcomes
Educators embrace new and
expanded roles
Infrastructure promotes collaboration
Focus of the school is on core
instruction
What You Will Notice
When RTI is Implemented Well
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A continuum of appropriate interventions
are available outside of special education
Local incidence matches national
Special ed provides the most intensive,
ongoing specialized instruction and related
services
Parents understand and are involved in
RTI
Students receive the help they need when
they need it
Let’s Talk about RTI in a
Workload Approach
What is Workload?
Taking the total work
activities of each schoolbased SLP into account
when determining the
number of students s/he
can serve (well).
Workload Essence Statement
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Attitude that emerges from belief
system
All-encompassing approach to
organizing our work in schools
Application of Workload Concept to:
• Schedule
• IEPs
• Scope of Activities and Responsibilities
• Prevention Activities (RTI)
Advantages of workload
perspective
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Focuses on individual needs of
students
Documents full range of roles and
responsibilities carried out by SLPs
Facilitates dialogue between SLPs
and administrators regarding
workloads
Allows SLP to contribute to improved
student performance
What is Workload?
Making decisions that allow
for full implementation of
all IEPs … and…
Allows for full participation
in student and school
improvement
ASHA’s revised policy on
caseload size in schools
“A Workload Analysis Approach for
Establishing Speech-Language Caseload
Standards in the Schools”
• Guidelines, Position Statement, Technical
Report, Implementation Guide
• Developed by ASHA’s ad hoc committee on
caseload size, supported by the 2001-2003
Focused Initiative for Schools
Basic Components of a
Workload Approach
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Delineation of Roles and Responsibilities
Workload Activity Clusters
Flexible Schedules
EBP Service Delivery
• Clinical Service Delivery
• Administrative/Procedural Services
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Workload Analysis Process
Problem Solving Process
Advocacy Plan
Evaluation of Workload Implementation
Where Are We With Workload?
High Awareness ~
Low Implementation
Workload Implementation Status
Rate yourself…
(page 6 of handout)
Reasons Workload May Be
Difficult to Implement
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Need a Workload Attitude
Requires much more coordination and
communication
Wants to be embedded in a systems
approach
Implementation is dynamic not static
Business Office/HR/Special Ed still use
numbers for staffing personnel units
Doesn’t work well if you don’t frontload
planning
Deep Change
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…is not adding more to an already
full load
…means reconfiguring what we do
and how we do it
…and then evaluating how well we
are doing it in terms of outcomes
Roles and Responsibilities
SLPs’ Roles and Responsibilities
as outlined by ASHA
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Prevention/RTI
Identification/RTI
Diagnosis
Assessment
Data collection
IEP/IFSP
development
Case management
Intervention
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Transition services
Consultation
Supervision
Documentation
Parent/staff
training
Planning teams
Research
Advocacy
Policy-making
SLPs’ Roles and
Responsibilities in IDEA 2004
IDEA 2004 expanded SLPs’
responsibilities...
• definition of SLP services in IDEA
(habilitation or prevention)
• collaboration/consultation/teaming
• links to the general curriculum
• multiple forms of assessment
• responsiveness to scientifically based
intervention
• increased paperwork and reporting
Roles and Responsibilities
New ASHA Guidance Coming…
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Critical Roles in Education
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Across All Levels
Range of Disorders
Language/Literacy Focus
Cultural and Linguistic Diversity
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Educational Relevance
Prevention
Assessment
Intervention
Program Design
Accountability
Range of Roles & Responsibilities
Roles and Responsibilities
New ASHA Guidance Coming…
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Collaboration
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Schoolwide Services
Unique Contributions
Collegiality
Partnerships with Universities
Partnerships with Families
Partnerships with Students
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Advocacy
Communication
Supervision and Mentorship
Professional Development
Lifelong Learning
Research
Leadership
Balance Across Clusters
SLP Workload Activity Clusters
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Direct services to students
Indirect services that support students’
educational programs
Indirect activities that support students in
LRE/general education curriculum
Activities that support compliance with
federal/state/local mandates
SLP Workload Activity Clusters
*** Important to note … ***
Enrollment of a student into
direct intervention,
regardless of service delivery
option, will add to the
workload in the other three
clusters of activity
Reflection
Take time to spell out
roles and
responsibilities…
And include RTI activities
in the description of time
well-spent
Flexible Scheduling Options
Flexible scheduling to meet the
needs of each child
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Altering the frequency of services
provided each week and/or month
Providing opportunities for
individual therapy
Combining service delivery models
Providing opportunities for indirect
services
Scheduling in compliance activities
Service Delivery in a
Workload Approach….
…changes as the needs of
the student change…
(think braided services!)
Workload Analysis, Problem Solving
and Advocacy:
Tools to Help You
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Workload Analysis Five Guiding
Questions
Balanced Workload Activity Clusters
Student Services Summary
Flexible Scheduling
Service Delivery Strategies
Overload Analysis Worksheet
Time Survey
3-2-1 Reflection Sheet
Advocacy Plan - Making Things Happen
Balanced Workload
What Does it Look Like?
(Reflection)
Top 5 Leverage Points
Toward Workload Change
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Increase Workload Advocacy
Vary Service Delivery
Embed Flexibility into Schedules
“Refresh” Frequency-LocationDuration Considerations
Put Educational Relevance in
Eligibility Deliberations &
Service Delivery
Increase Workload
Advocacy
Increase Workload Advocacy
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Change is unlikely to occur if nobody knows
about it but you
Intentional – match the advocacy to the level of
desired change
• One teacher or grade level?
• School/s? ~ Campus leaders are key players
• District? ~ need administrative support
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The Basics: Know what employment contract
says
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Is caseload/class size defined?
Is length of day defined?
What additional duties are required?
How much prep time per week is stipulated?
Increase Workload Advocacy
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Know your leadership and/or union
structure
• Officers
• Grievance committee
• Negotiations team
• Building rep
• Committees
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Understand decision-making at
building, district, and state levels
Increase Workload Advocacy
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Identify the Issues
• Barriers to adequate services? Lack of student
progress due to large caseload? No
mechanism for collaboration with other
educators?
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Support Issues with Data
Identify Possible Solutions
Develop a Support Base
Develop a Communication System about
Workload Implementation
Develop, Implement, Evaluate Action Plan
Houston ISD Success Story
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Largest school district in Texas
4 Years Ago…38 vacancies…50+
uncovered campuses
Today…8 vacancies…4 uncovered
campuses
How???
By using a Workload Approach!
Houston ISD Success Story
Workload Approach
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Administrative Support
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Compensation package
Stipends
Supervision
Superintendents’ Expectations
Changed IEPs from weekly minutes to minutes per
grading period
Used 3:1 Model
STAT Teams
Focus on Service Delivery – Especially Indirect
Services
Consistent Eligibility and Dismissal Guidelines
Vary Service Delivery
Leverage (Workload) Change
with Varied Service Delivery
Service Delivery in the 21st Century
• Includes direct and indirect IEP services
• Includes support and compliance
activities
• Includes direct and indirect non-IEP
services
IN ORDER TO…
Work on 21st Century Skills
NCREL/Metiri Group 2007
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Effective Communication
• Teaming, collaboration, interpersonal skills
• Personal, social, civic resposibility
• Interactive Communication
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Inventive Thinking
• Adaptability, Managing Complexity, Self-Direction
• Curiosity, Creativity, Risk-Taking
• Higher-Order Thinking and Sound Reasoning
Work on 21st Century Skills
NCREL/Metiri Group 2007
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Digital-Age Literacy
• Basic, Scientific, Economic, and
Technological Literacies
• Visual and Information Literacies
• Multicultural Literacy & Global Awareness
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High Productivity
• Prioritize, plan, manage for results
• Effective use of real world tools
• Relevant, high-quality products
Service Delivery Models
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RTI/Prevention ~ Direct Tier 1, 2, or
3 Services
Pull-out
Classroom-based
Self-Contained Speech Class
Community-based
Indirect services
RTI ~ Direct
(Prevention of Placement in
Speech)
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Tier 2
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Artic Lab, Language Lab, Communication Lab
Small homogenous group
Working on the same skills
Programmed approach
Usually 2-4 times/week; Total about 15 hours
Tier 3
• More frequent, intense, longer duration
• Smaller group; more individualized
• Close to considering referral for FIE
Pull-Out Service Delivery
• Individual or small group direct
• Speech room (or location other than
classroom)
• Considered a restrictive placement
• Good fit: speech-based disorders or
language disorders if combined with
other models
• Most common speech service delivery
Drill Bursts
Short – 10 minute drill bursts to
increase rate of progress in
articulation therapy
Individual therapy
Reduced time away from classroom
instruction
Classroom-Based
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Individual, small group or whole
group, direct
In classroom
Least restrictive environment
Good fit: language disorders
Easiest to manage in elementary
grades and special ed classes
Classroom-Based Options
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Team Teaching
Complementary Teaching
Supportive Teaching
Parallel Teaching
Remedial Teaching
Station Teaching
Push In Therapy
Self-Contained Speech Class
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Small group or whole group, direct
Speech classroom
SLP teaches classroom curriculum
and implements speech IEPs
Examples
• Preschool speech class
• Middle school study skills
• Secondary communication lab
Community Based
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Indirect or small group, direct or
indirect
Off school site, often at job site
Least restrictive – functional
environment
Good fit: communication skills
needed in work, home, community
settings
Indirect Services
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Support for
• Student’s educational program
• Services in LRE
• Maximizing effectiveness of direct
services
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Student-specific activities provided
• On behalf of students with speech
IEPs
Indirect Service Options
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Monitor
Consultation
Collaborative Consultation
Curriculum Support
Contextual Support
Instructional Support
AT/AC Support
Factors Affecting Service
Delivery
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Individual Considerations
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Nature & severity of communication disorder
Age, grade, developmental level
Strengths, needs, emerging abilities
Frequency and intensity of service needed
Need for peer modeling
Student’s attitude, motivation, social skills
RTI data
Need for services in non-academic or
extra curricular activities
Factors Affecting Service
Delivery
Classroom/Curriculum Considerations
• Alignment of general curriculum & IEP
goals
• Communication needs related to
curriculum
• Grade-level standards for language
• Need for classroom consultation
• Natural communication supports
Which Service Delivery Models?
Guiding Principles
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LRE
Student needs
Student’s rate of progress in the
curriculum
Reasonable course of therapy
Language disorder – at least some time in
the classroom
Benefit of combining models
Evidence-based practice
Service Delivery Models
for non-IEP Services: RTI
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Desired Outcomes:
• Prevention
• Intervention
• Identification
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3 Tier Model:
• Tier 1 Core Instruction
• Tier 2 Targeted Group Intervention
• Tier 3 Intensive Individualized
Intervention
RTI and Workload
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Front-load schedule to reserve time
for RTI and CEIS activities
• Screening
• Problem solving team
• Tier 2/3 Interventions
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Adjust attitude about working with
struggling students
• SLP services includes prevention
• We’re not just special ed anymore!!!!
RTI: Challenges and Opportunities
for SLPs
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New and expanded roles
• Program design
• Collaboration
• Willingness to re-allocate time for
prevention and early intervention
activities
• Willingness to change the way we spend
our time
• Strong focus on student outcomes
Flexible Schedules
Embed Flexibility in Schedules
Types of Schedules
1. Traditional Weekly Schedule (Caseload and
Student)
• Same weekly schedule for students
• Same weekly schedule for SLP
• The “norm” and assumed type of schedule
2. Receding Schedule (Student)
- “Test Kitchen” Concept
- Intense direct contact followed by monitoring
transfer of skill to home or school
environment
- Example: More frequent direct services in fall
semester for 4th or 5th grader…very little direct
service in spring semester during heavy state
assessment period…monitor skill maintenance
Types of Schedules
3. Pulse Schedule (Student)
• intensive contact followed by a period of
no contact
• growth and skill transfer monitored
• encourage growth at beginning of each
pulse cycle
Types of Schedules
4. Cyclical Scheduling (Caseload)
One Example: 6 Weeks Cycle
Two weeks intense, one week off
A= Low incidence B= Speech Manner
C= Language Processing
1.AB
4.AB
2.CA
5.CA
3.BC
6.BC
Types of Schedules
5. Block Schedule (Caseload)
Examples:
a. AB Block Schedule – every other
day schedule. Usually whole school
goes to AB Block…SLP has to “fit in”
b. Modified Block Schedule – longer
class periods, finish a course in a
trimester rather than long semester
Types of Schedules
6. Flexible Schedules
a. May use one or more type of
schedule at any given time
b. Combine different schedules and
service delivery to maximize
outcomes for students
c. It’s still a schedule – with
structure, predictability, patterns
of time-usage, you ‘stick to it’,
flexible ≠ free form
Flexible Schedules to Accommodate
Services Outlined in IDEA 2004
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Flexible schedules allow for
• Altering the frequency of services
provided each week and/or month
• Providing opportunities for individual
therapy
• Combining service delivery models
• Providing opportunities for indirect
services
• Providing RTI services and interventions
• Completing comprehensive evaluations
• Scheduling in compliance activities
Flexible Scheduling Tips
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Close-up Lens: Look at each student’s IEP
Wide-angle Lens: Look at caseload needs
• Summarize direct services
• Summarize indirect services needed to fully
implement IEPs
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Panoramic View: Look at campus needs
• Master school schedule
• Need for RTI models/direct or indirect
intervention
• Instructional programs
• Service environments – academic,
nonacadmeic, extra-curricular…
More Flexible Scheduling Tips
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Schedule time each week to participate in
RTI activities and interventions
Schedule times to provide supplementary
aids and services in settings other than
the therapy room
Schedule times throughout the week to
conduct comprehensive evaluations
• Time slots on different days of the week
• Time slots at different times of the day
• Mixture of short bursts of time and extended
periods during the day
More Flexible Scheduling Tips
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IEP: # of minutes/ grading period
direct services; # of minutes/grading
period indirect
Schedule activities, not students
Consider backloading your schedule
Do one new thing with your schedule
Lay groundwork with principal
Develop a management system to
support your new and improved
schedule
Remember
Schedule activities
Not
Students
Monday
Tuesday
Wednesday Thursday Friday
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Well-Written IEPs
“Refresh” Frequency-LocationDuration (IEP) Considerations
Implementing a Workload
Approach…and IEPs
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Student’s IEP is a blueprint for
progress and accelerating learning
IEP team (with parent and student)
help design the blueprint
Consider “taking back the reigns”
Use EBP to recommend frequency,
location, duration of services
IEP-Schedule of Services
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IEP must specify frequency, location,
duration of speech services (§300.347a6)
• Frequency – interval of services and how often
sessions are provided
• Location – where service is provided
• Duration – anticipated length of time (often
defaults to a year…term of annual IEP)
• Type (Texas requirement) – direct or indirect
i.e. must list consult separate from direct
Location: Classroom and Beyond
“classroom, other academic, nonacademic,
extracurricular”
IDEA allows for provision of services in
a variety of locations
• Classroom
• Therapy room
• Playground
• Lunch room
• Clubs or extracurricular activity
locations
• Fieldtrips
A Word About LRE
Least Restrictive Environment:
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LRE is not only a place but also amount of
time removed from typically developing
peers.
The SLP should carefully consider the
benefits of providing intervention in
natural environments with typically
developing peers who provide appropriate
linguistic and behavioral models.
Services “to or on behalf
of”…
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IDEA calls for direct services “to”
students with IEPs
IDEA calls for indirect services “on
behalf of “ students with IEPs
The Key: Balance the Statement of
Services in the IEP to clarify by direct
and indirect services
IEP – Schedule of Services
One option: list minutes of direct
services
per grading period and minutes of
indirect services and activities per
grading period
Provide addendum to IEP Team
minutes that outlines in detail the
frequency, duration, and location of
services provided each week.
Think About…
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Would it change frequency-locationduration in the IEP if you
• varied service delivery?
• planned for change in service delivery
as the needs of the student change?
• combined different types of service
delivery for the student?
• really (really) provided services in the
LRE?
Educationally Relevant
Services
Put Educational Relevance in
the Forefront of
Eligibility Deliberations
Quick Review: IDEA Definition
Speech-Language Impairment
300.8 (c)(11) Speech or language
impairment means a communication
disorder, such as stuttering, impaired
articulation, a language impairment,
or a voice impairment, that adversely
affects a child’s educational
performance [emphasis added]
Begin with the End in Mind…
The purpose of evaluation activities:
1.
2.
3.
Determine if there is a disability
And if there is an adverse effect on
educational performance resulting from
the disability
And if specially designed instruction
from the SLP is needed to help the
student make progress in the general
curriculum
Comprehensive Evaluations
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Gather functional, developmental,
and academic information about the
child
Including information provided by
the parent
Evaluate in all areas related to the
suspected disability
Identify all special education and
related services needs (i.e. don’t
fragment evaluation among assessment
professionals)
IDEA 2004
Allows us to consider the student’s
response to “scientific, researchbased intervention” as one data point
when making eligibility
recommendations
(Decisions cannot be made on the
basis of a single criterion)
RTI: Challenges and Opportunities
for SLPs
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Evaluation
• Dynamic assessment models
• Pragmatic orientation based on
educational relevance
• Measure changes in performance over
time
• Contextual perspective
• Expanded evaluation tool kit
• Expanded definition of ‘comprehensive
evaluation’
What does this sound like???
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More than administration of standardized
tests
More informal data about the student’s
language and communication skills in
school environments
Perhaps more descriptive reports
Perhaps more interesting descriptions of
students as communicators
Perhaps the need to use a Workload
Approach for conducting comprehensive
evaluations
Comprehensive Evaluations
A Workload Approach
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Front-load schedule to reserve time for a
variety of evaluation activities
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Observations
Conversations with teacher and parents
Direct testing
Multiple settings (academic, nonacademic, extra-curr)
Adjust attitude about evaluations
• Use a Communication Model for consistent decisions
• Use uniform Eligibility Guidelines in your district/state
• Just say no…when SLP services won’t help
Workload Implementation
How Can You Start?
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Analyze your eligibility determination
Analyze your dismissal practices
Determine your role in RTI
Define your workload problem
Do a Gap Analysis re Service Delivery
Determine which of the Workload Tools
you can use
Develop an Action Plan for Change
Enter into crucial conversations
Workload…
So what will you do differently?
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Consider a wider range of activities
(inside and outside of special ed)
Location Location Location
Stronger ties to curriculum and
functional performance…data-driven!
Get credit for more of what you
already do
Write IEPs differently
Balance Your Workload
…In Reverse Order…
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What indirect services will you need
to provide to fully implement each
IEP and participate in prevention/RTI
What indirect activities will you need
to provide to support students in the
gen ed curriculum? (IEP and RTI)
What are the compliance/mandated
non-negotiables?
What direct services are needed?
(IEP and RTI)
RTI Chatter
[email protected]