Transcript Response to Intervention - Big East Educational Cooperative

Facilitated Discussion ~
Response to Intervention
Context, Evidence, Process
Kentucky Big East Coop
Special Ed Directors
June 28, 2013
JoAnn Wiechmann, EdD, CCC-SLP
1
Disclosure
Relevant financial relationship(s) & relevant
nonfinancial relationship(s)
 I have the following relevant financial
relationship(s) in the products or services
described, reviewed, evaluated or compared
in this presentation.
 ARtIC Lab ™, published by Super Duper, Inc.
 Language Lab™, published by Super Duper,
Inc.

Description of financial relationship: I receive
publication royalties on these products.
2
3 Discussion Strands

RTI: What Is It?
RTI: Where Does It Fit in Public
Education?
RTI: Why Does It Matter Now?
RTI: Do SLPs in Schools Have a Role?

RTI: What is the Evidence Base for RTI?

RTI: How can SLPs manage adding RTI to
full caseloads?



3
RTI: What is It?
RTI Defined
4
RTI is the practice of
 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
5
Goal of RTI
 Ensure that all children and adolescents have
access to high-quality instruction and learning
opportunities and
 Struggling learners are identified, supported
and served early and effectively.
 Interventions are generally provided in the
areas of:


Academics (reading, math, S/L)
Behavior
6
…in other words…
There are systems in place to help every
child meet grade level expectations in
academics and behavior…
“Whatever it Takes!”
(individualized, just-in-time, prevent failure, through general
education)
7
RTI Hypothesis
 If the student responds to an intense
diet of instruction, then s/he probably
does not have a language learning
disability or articulation disorder
8
RTI
 Is part of the general education system
 Parallels the spirit of individualized
education programs ~ previously available
only through an “IEP” in special education
 Emerged out of political agendas (funding,
No Child Left Behind, national standards,
era of accountability)
 Is probably here to stay
 So…we better figure out how to be part of
it!
9
RTI: Intuitive and Innovative
 Intuitive: makes sense that professionals
check to see if instruction is working…to
determine if the learner is
responding…and if not responding,
someone takes action to do something
about that.
 Innovative: public education is universal
but has not been individualized. The
burden has been on the learner to fit the
mold; not for the system to flex for the
needs of each individual.
10
RTI: Where Does It Fit in
Public Education?
11
Public Education in a Democracy
 Democracy is based on the premise that well-
educated, well-informed citizens will give
input to the advancement of the society.
 The universal right to a public education is
not found in the Constitution of the United
States of America,
 So public education becomes the
responsibility of the states and each local
community.
12
Texas Education Code §4.001
(for example…implements the state constitution…)
The mission of the public education system of
the State of Texas is to ensure that all Texas
children have access to a quality education
that enables them to achieve their potential
and fully participate now and in the future in
the social, economic, and educational
opportunities of our state and nation. The
mission is grounded on the conviction that a
general diffusion of knowledge is essential for
the welfare of this State and for the
preservation of the liberties.”
13
Public Education in the USA
 States and Local Communities
 establish schools and colleges,
 develop curricula and learning standards,
 determine requirements for graduation,
 establish a means of funding schools.
 Federal Funding = Purse Strings Legislation
 If you want $, then follow all the rules
 Current Administration Favors National Standards
 Common Core State Standards
 NCLB and IDEA aligned accountability systems
14
What about…
The Purpose of Special Education…
To prepare students for further education,
employment, and/or independent living
15
Special Education
 Based on federal education laws and the
premise that “all children can (and get to)
learn”
 In order to access federal funds, states and
local school districts must follow federal
statutes, regulations, and rules
 Speech Path listed as a special education
instructional or related service in P.L.94-142
(1973 – first special ed federal law)
16
SLP Services in Schools
 SLP services are provided to students who have
communication disorders that result in an adverse
effect on educational performance
 The setting affects the service delivery…services not
in isolation…
 Educational relevance is required!
 Important to link SLP clinical services to grade level
standards
17
RTI: Why Does It Matter Now?
18
Context for Change
 Two movements changed conditions in
America’s schools:

Standards-based reform



Improving America’s Schools Act and Goals
2000: Educate America Act (1994)
Challenging academic content and performance
standards; Assessments aligned with standards
Accountability for student performance


NCLB Adequate Yearly Progress
IDEA 2004
19
Context for Change
Research and Policy Considerations
 National Reading Panel (2000)
 Identified essential components of early reading
instruction
 Important in special ed since most students with LD
have reading problems
 President’s Commission on Excellence in Special
Education (2001)



Focus on results not identification process
Focus on prevention
General ed first
20
Context for Change
Research and Policy Considerations
 National Summit on Learning Disabilities (2002)



Sponsored by OSEP/USDE
Traditional LD identification not grounded in research
Supported “response to quality intervention”
 National Research Council Panel on Minority
Representation (2002)



No research to confirm benefit of special ed for minority
students
Should focus on prevention and early intervention
4-Tier system of intervention and treatment
21
Platform for Change to RTI
 In place for a decade
 Let’s work on systems, guidelines,
procedures for data-driven decisions, and
intervention approaches
 So that…
 SLPs have a clear, well-defined, and
measurable contribution for RTI:
 Intervention for Prevention and Identification
22
Context for Change (a little more)
Special Ed may not work well…
 Research studies show little benefit from
special education services for closing
achievement gap
 Special Ed instruction has been ~



Too general
Unsystematic
Provided too late…after history of failure
23
So…
In this era of accountability…
 We need to make sure all students meet
grade level expectations
 We need to make sure we teach students to
read in a way that matches how they learn
 We need deep understanding of the language
underpinnings of literacy
 We need deep appreciation for the fact that
without an intact language system…it is very
hard to “do” school.
24
RTI:
Do SLPs in Schools Have a
Role?
25
Speech-Language Pathology
Services [CFR §300.34(c) (15)]
 Identification;
 Diagnosis and appraisal of specific speech or
language impairments;
 Referral for medical or other professional attention
needed for habilitation of speech or language
impairments;
 Provision of speech and language services for the
habilitation or prevention of communicative
impairments; and
 Counseling and guidance of parents, children, and
teachers regarding speech and language
26
The definition of speechlanguage pathology services in
IDEA 2004 paves the way for
involvement of the school-based
SLP in RTI.
27
Roles and Responsibilities of SLPs
in Schools: 2010 ASHA Position
 Critical Roles in Education
 Working Across All Levels
 Serving a Range of Disorders
 Ensuring Educational Relevance
 Providing Unique Contributions to the Curriculum
 Highlighting Language & Literacy
 Addressing Cultural and Linguistic Diversity
 Range of Roles & Responsibilities
 Prevention
 Assessment
 Intervention
 Program Design
 Data Collection & Analysis - Accountability
 Compliance
28
Roles and Responsibilities in Schools
2010 ASHA Position
 Collaboration
 Collegiality with Educators
 Collaboration within the Community
 Partnerships with Universities
 Partnerships with Families
 Partnerships with Students
 Leadership
 Advocacy
 Communication
 Supervision and Mentorship
 Professional Development
 Parent Training
 Lifelong Learning
 Research
29
ASHA Position Statement
includes Prevention
in Roles and Responsibilities
of School-Based SLPs!!
30
SLPs in RTI:
Define R&R across Tiers
 Tier 1





All Students: effective, engaging, rigorous, individualized,
standards-based instruction
Universal screening procedures
Periodic progress monitoring
School-wide behavior expectations/standards
The key to RTI working well for students
 Tiers 2 & 3



Students struggling to meet expectations get help
Focused intervention on specific target skills needed to
support success in Tier 1
Frequent progress monitoring of target skills
31
Tier 1 SLP Activities
 Direct Services

Expanded speech and language screening

Additional support in the classroom




Classroom time during small group instruction to work on
speech or language development
Assist young children with “good speech” in centers
Provide lessons
Co-teaching bursts
 Indirect Services

Classroom observations, parent education, student support teams,
homework programs, C&I consultation, staff development
32
Tier 2 SLP Activities
 Direct Services





Focused intervention on specific skills ~ generally
articulation and language
Intervention provided in addition to Tier 1
Frequent progress monitoring
Frequent intervention ~ intervention period measured in
terms of hours (15 to 20 hours)
Correct production of target followed by opportunities for
mass practice
 Indirect Services
 Observe Tier 2 students to identify when struggle linked to
speaking, listening, reading, writing; assist with progress
monitoring; communicate Tier 2 progress to teacher & parent
33
RTI:
What is the Evidence
Base?
34
3 Examples
 ARtIC Lab (Super Duper)


Effectiveness for preventing referrals
Cost savings
 Language Lab (Super Duper)


Effectiveness for preventing referrals
Program evaluation data
 Story Lab (Pasadena ISD, Tx)

Locally developed
35
Evidence Base for Articulation
(based on tracking results from ARtIC Lab)
 Tier 2 Intervention Program for 1st – 3rd
graders
 One or two simple sound errors ~ may or may
not meet eligibility criteria for IEP services
 Nonstimulable for target sounds


Monitor students who are stimulable;
treatment probably is not warranted.
Research suggests that stimulable sounds
will develop without intervention (Gierut,
2007).
36
Evidence Base for Articulation
(based on tracking results from ARtIC Lab)
 3 – 4 30 minute sessions/week
 Groups of 3 – 5 students
 Station rotation
 Quick correct production
 Mass practice ~ drill, drill, drill
 SLP monitors productions and shapes
sounds
 Treatment selection and randomization are
key!
37
Data Collection
 Summer pilot program
 Data collection in 2006 – 2007


RTI services
IEP services
 More data collection in 2007 - 2008
38
Summer Pilot Program:
Quantitative Data
Student
Hrs.
Sound Errors
Intervention
# of Errors:
# of Errors:
Entry
Exit
Chandler
7
s, z
16
3
Mary
8
s, z
10
5
Ralph
8
ch, sh, j
32
17
Ryan
10
r
12
2
Saturn
9
r
14
13
Jeffrey
10
r
21
7
Katy
11
r
11
1
39
2006-2007 Fall Data
 18 elementary campuses
 89 RtI students
 97% (87) Responders
 3% (2) Non – Responders needed referral for
special education evaluation
40
2006-2007 Fall Data
(same approach for students with IEPs)
 Students with an Individualized Education
Program (IEP) for articulation




18 elementary campuses
91 students with an articulation IEP
25 dismissed or ready for dismissal
27% reduction in caseload
41
2007-2008 Fall Data
(data snapshot 1 – 20 hours of intervention)
 Elementary campuses: 21
 RtI students: 110
 97% (107) Responders


20% of Responders (22) exited RTI
80% of Responders (85) continued
 3% (3) Non-responders referred for special
education (speech) evaluation
 The closer to 20 hours of intervention, the
more students are ready to exit
42
Cost Savings
Articulation (only) Referral
 Paper


Approximately 52 pages per student
52 pages X 89 = 4,628 pieces of paper
 Time investment

Approximately 7 hours X 89 students = 623
hours
 Personnel costs

Approximately $24,920 to test/place 89
students
 Preventing pull-out IEP services? Priceless.
43
Evidence Base for Language
(based on tracking results from Language Lab)
 Tier 2 intervention program K – 4th grade
 Students struggling with oral language



Fail reading comp portion of reading universal
screener
Fail story retell screener
Teacher concern
 Groups of 4 – 5 students
 2 – 3 30 minute sessions/week
44
Evidence Base for Language
(based on tracking results from Language Lab)
 Station rotation
 Homework Component
 Designed to work on:




Nouns, adjectives
Verbs, adverbs
Connecting language
Narrative skills
 Story Station with SLP

Work on target skills through connected
narrative language
45
Language Lab: RTI Program
 Data Outcomes of Pilot Programs




3 districts (2 Texas, 1 Nevada)
Spring 2010 pilot focused on program
development
Fall 2010 pilot focused on student responsiveness
During the fall semester, 81% of students exited or
were progressing at the expected rate to
recommend continuing Language Lab

19% students did not respond at expected ratereferred for special education testing
 Limitation: n of 32
46
Program Evaluation
Language Lab
 Studied SLP reported effectiveness of the
program
 Examined utility, feasibility, and accuracy of
Language Lab as a program for use with
students struggling with oral language
47
What were the Outcomes?
Research Question 1: How effective were the
instructional strategies in the program in reducing the
need for referral for special education evaluation?
 Data sorted by responders and non-responders



Responders—exited (n=131) or continued in
program (n=111)
Non-responders—referred (n=102)
70.3% reduction in referrals (n=242)
48
What were the Outcomes?
Research Question 1:
 Overall effectiveness ratings (effective/very effective



Exited students 90%
Continued students 60%
Referred Students 70%
 Value ratings for Intervention Data (effective/very
effective)

90% of SLPs
49
What were the Outcomes?
Research Question 2: In what ways did the program
improve oral language and narrative skills?
 Common Themes



Student Improvement
Generalization of Skills
Specific Instructional Strategies
50
What were the Outcomes?
 Question 2:
 Student improvement



90% commented about improvement (1
participant did not respond)
“syntax improved notably”, “syntax improved by
direct instruction”, “some improved especially
with irregular past tense and plurals”
“narrative skills improved”, “all students used
skills and showed proficiency”, “story telling skills
improved…stories sequenced correctly”
51
What were the Outcomes?
 Question 2:
 Generalization or carryover of skills (7 SLPs)

“students began self-correcting”, “techniques
were able to be carried over into the hallways and
at home”, “objectives were evident in their
conversational speech”
 Specific Strategies




Visual prompts or supports
Scaffolding
Corrective feedback
Naturalistic modeling
52
What were the Outcomes?
Research Question 3: Which components of
Language Lab™ were most effective?
Skill Drill 90%*
 Talk Aloud 70%*
 Listen ‘n Learn 70%*
 Story Station 100%*
 Curriculum Connections 70%*
* Effective/Very Effective

53
What were the Outcomes?
Research Question 4: In what ways were the
printed instructions effective or ineffective in
implementing components of Language Lab™,
considering time sufficiency and clarity?
 Clarity of Printed Instructions
Skill Drill 80%*
 Talk Aloud 70%*
 Listen ‘n Learn 70%*
 Story Station 90%*
 Curriculum Connections 80%*
*Effective/Very Effective

54
Significance of Findings
Overall findings supported and validated use of
Language Lab™ for


improving students’ oral language skills and
reducing referrals for special education
evaluation.
55
Discrepant Findings
 Two areas of findings needed further explanation
(not necessarily discrepant findings)

Overall effectiveness ratings


Study did not require students to have completed the
program
Time sufficiency for Story Station



There was not a format for SLPs to provide additional
explanation
Interpreted responses to mean time was not enough
to finish the lesson
Possible contributing factors: # of target skills, pace of
presentation of lesson
56
Story Lab (Pasadena TX)
 Co-teach, Gen Ed
 Tier 1
 Story telling
 Question asking/answering
 2 30 min lessons / week
 Data gathered: writing portfolio, wh-Q
57
Story Lab
 Data Tracking
Name
Who
Sally
///
Tom
Dick
When
Where
Why
How
//
//
//
//
//
Harry
Alice
What
//
58
Story Lab: Benefits
 By scanning the story, they really develop main





idea.
Meaningful question asking and answering is
developed.
They learn the structures of a story without getting
stuck in prescriptive writing (and then, and then).
Increases descriptive language.
Increases expression of feelings/ emotions.
Segues nicely from oral language to written
language.
59
Discussion Topics
 What can you do to collaborate to gather an
evidence base for:


Articulation Intervention/s
Language Intervention/s
60
RTI:
How can SLPs manage
adding RTI to an already full
caseload?
61
1. SLP RTI embedded in the
district processes and procedures
 Work in the same system ~ not in a separate system
for…




Identification of students (universal screening)
Decision making – which tier, moving between tiers, exiting
RTI, referral for evaluation
Progress Monitoring
Evaluating effectiveness of interventions
 Example from Irving, TX


3 RTI Pillars – Academics, Behavior, Language Proficiency
Academics – Reading, Math, Artic & Language
62
2. Develop Consistent Procedures
 Expanded Screening for Speech/Language
 Identification for


Tier 1 support
Tier 2/3 interventions
 Progress Monitoring Procedures
 Decision Points



Exit RTI
Continue RTI
Refer for special education evaluation
63
3. Provide Tools
 Forms for decision making and
documentation
 Forms/software for progress monitoring
 Intervention programs for articulation and
language
 Expanded Screener for artic and language


Develop your own
Purchase
 Consistent RTI Reporting Protocol (to
document prevention)
64
4. Specify Tier I RTI for
Speech/Language
 Identified target skills





Establish a baseline
Provide teacher/aide with Tier I activities and simple data
collection sheets
Define dosage of intervention (how often, how long, how
many weeks)
Progress Monitoring probes (at defined weeks) done by SLP
Recommendation to teacher and RTI committee regarding
adjustment to Tier I
 Options: progressing, continue
 Not progressing, change RTI plan
 Not progressing, refer
65
5. Use a Workload Approach
 Describe direct and indirect intervention
services through RTI
 Focus on educational relevance and helping
students master CCSStandards
 Continuum of service delivery models – most
often for RTI: classroom based for Tier 1 and
some Tier 2; pull-out for Tier 2/3
 Flexible scheduling
 Data Driven Decisions
66
6. Scheduling Issues
 If school has an intervention period during
school day one or more days per week, use
time to provide artic and language
interventions
 Schedule at beginning and/or end of school
day
 Start small…no more than 15% of time on
RTI activities


E.g. one artic group and 1 language group
3 hours of direct Tier 2/week; 1 hour Tier 1 direct & indirect
67
7. Document RTI Effectiveness
 Keep track of the number of referrals
prevented through RTI
 Keep track of (non-responder) students
referred for evaluation


Eligible?
How RTI data used to augment evaluation and
recommendations
 Evaluate RTI processes and procedures
68
RTI
Why is it a Good Thing?
69
RTI: Why It Is a Good Thing
 Allows SLPs to provide intervention for
prevention of speech-languagecommunication disorders
 Allows SLPs to provide intervention as part of
dynamic evaluation to provide new
component to eligibility deliberations
 Allows SLPs to contribute to strong language
learning systems for all students
 Allows SLPs to participate in school reform
70
RTI ~
RADICAL Change Potential
 General Education ~ new locus of support
for struggling learners
 Just-in-Time ~ not Wait-to-Fail
 Teachers and SLPs work like detectives
 Master schedules change in order to
“invent time”
 Everyone has access to an IEP
 Different attitudes about learners and
learning
71
References & Resources
 American Speech-Language-Hearing Association (2010). Roles
and Responsibilities of Speech-Language Pathologists in
Schools. [Professional Issues Statement}. Available from
www.asha.org/policy.
 Klotz, M.B. & Canter, A. (2006). Response to intervention (RTI):
A primer for parents.
www.nasponline.org/resources/factsheets/rtiprimer.aspx.
 McCook, J.E. (2006). The RTI guide: Developing and
implementing a model in your schools. Horsham, PA: LRP
Publications.
 National Association of State Directors of Special Education.
(2006). Response to intervention: Policy considerations and
implementation. Alexandria, VA: Author.
72
 Rudebusch, J. (2007). Guide to RTI. East Moline, IL:
Linguisystems.
 Rudebusch, J. (2008). The source for RTI. East Moline, IL:
Linguisystems.
 Wiechmann, J. & Balfanz, D. (2008). Artic Lab: A bilingual
response to intervention (RtI) program for articulation.
Greenville, SC: Super Duper Publications.
 Wiechmann, J., Rudebusch, J. & Kuhles, N. (2011). Language
Lab. Greenville, SC: Super Duper Publications.
73