The Proof is in the PLAAFP

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There has been a lot of discussion among SLPs in our district recently concerning documenting a student’s present levels of academic achievement and functional performance (PLAAFP) in the IEP. In our roles, we are continuously reviewing and recommending revisions to proposed IEPs. The present levels of performance (or PLOPs as we often refer to them) are one of the major areas of the IEP needing improvement.

 

In the definition of an individualized education program, section 300.320, IDEA (2004) provides general guidance on what should be included. It indicates that the present levels include a statement of how the disability impacts the student’s ability to participate and progress in the curriculum – or how a preschool child’s disability impacts participation in appropriate activities (Sec. 300.320(a)(1)).

It further discusses what is included in Sec. 300.324 Development, review, and revision of IEP. The team is responsible for considering the student’s strengths, parental concerns, most recent evaluation results, and the student’s needs related to academic, developmental, and functional performance (Sec. 300.324(a)(1)).

Those are the basics (and the legal jargon)…but in our district we are provided with additional specifics to assist in the development of descriptive and legally-defensible IEPs.

So here are some of the tips we share with our SLPs to insure this occurs and enable any SLP to pick up an IEP and get to work…no guesswork, no wondering!

  • The discussion of the student’s present levels of performance should be, first and foremost, data driven. Whether an initial IEP based on the results of the initial evaluation or an annual IEP based on progress on goals and objectives, it must include data, data, data! Areas of strength should be quantified with data! Areas of need should be quantified with data! If there’s no data, it didn’t happen!

 

  • The discussion in the PLAAFP should be descriptive and specific. Data should be quantified and explain how the student reached that level. Things to consider include:
    • Were prompts provided – visual or verbal; how many of each?
    • Was information presented orally? Was text provided? Was text on the student’s grade level or instructional level?
    • Did the student’s ability increase with repetition?
    • Was the student successful with sound production in the initial and final position of words but had more difficulty in the medial position?
    • Did the student’s dysfluencies increase when speaking to adults or peers outside of the speech room?

 

  • Remember that the needs in the PLAAFP are what drive the development of IEP goals (and objectives where required). The information provided serves as baseline so any SLP knows where therapy should begin.

 

We often find that it can be very helpful to think about the next steps related to goals before drafting up the needs in the present levels section of the IEP. More often than not we have easily identified the skills that the student continues to struggle with and have some ideas of what we want to recommend working on for the next IEP. Sometimes working backward can make for much more explicit, specific, and complete PLAAFP in the area of communication.

Let’s look at a specific case for an annual review IEP. Please be aware that different districts and states have varied requirements and IEP documents can look different. For the purposes of this post, we are focusing on the present levels related to strengths and needs related to communication; therefore, our sample below will not include a discussion of parent concerns, specific academic skills, or most recent evaluation results. These pieces are, however, legally required in the IEP.

Johnny is a 2nd grader. His previous IEP goals are as follows:

  • Johnny will produce /r/ in words with 80% accuracy for 4 sessions
  • Johnny will answer factual ‘what’ and ‘where’ questions about a grade level paragraph read aloud with 1 visual cue in 4 out of 5 opportunities
  • Johnny will point to items in a picture scene in response to ‘show me…’ to demonstrate understanding of the spatial concepts ‘in, on, out, under, over’ with 80% accuracy in 3 out of 4 opportunities.

So using data (quantitative and qualitative), we might write his present levels something like this:

When presented with picture cards in the speech-language room, Johnny currently produces /r/ in words independently with 95% accuracy in 5 sessions. He has begun making sentences with these words with 70% accuracy in 3 sessions independently. His accuracy increases to 90% when he is given a verbal reminder for accurate placement and asked to repeat his sentence. The SLP, Johnny and his teacher worked together to come up with a visual cue for use in the classroom (picture of a target). When the teacher hears an error with /r/, she will point to or hold up the target symbol to prompt Johnny to repeat the word. Johnny also has this symbol on his desk. This has begun to increase his carryover and independence with correct /r/ production in the classroom. Production of /r/ will continue to be addressed at the sentence level to increase his independence working toward production in structured conversation. He will be provided with verbal reminders for placement at first in the speech-language room and the visual ‘target’ will continue to be used with the SLP and teacher to encourage carryover in the classroom.

Johnny has demonstrated the ability to answer factual ‘what’ questions after listening to a grade level paragraph in 4/5 opportunities independently. He was originally presented with a visual showing what each question word refers to (i.e., where=place) and these were discussed at the beginning of each session. This is no longer verbally discussed with Johnny and he does not rely on this visual. He answers ‘where’ questions in an average of 2/5 opportunities. However, it appears that his difficulty with this task is not related to an understanding of ‘where’ but instead related to his difficulties with expressing spatial concepts. For example, he can point to the correct answer in a picture or provide a response such as ‘at school’ in 4/5 opportunities. When the question requires a response such as ‘under the table’ or ‘in the mailbox’, his accuracy greatly decreases. The spatial concepts ‘in, on, out, under, over’ have been addressed receptively with Johnny and he is pointing to items in a picture to demonstrate his understanding (i.e. ‘show me the girl who is under the table’) with 75% accuracy in 3 out of 4 opportunities. Language therapy will continue to focus on Johnny’s ability to answer factual ‘who’ and ‘when’ questions after listening to grade level paragraphs to help increase his comprehension in the classroom. The visual of the question words will first be utilized as a reminder to be sure Johnny has understanding that who=person and when=time. ‘Where’ questions and spatial concepts ‘in, on, out, under, over’ will also be addressed as Johnny is asked ‘where’ questions to elicit these concepts about a picture scene. Visual and verbal prompts will be utilized as needed as we fade to independence.

Johnny’s proposed goals for the upcoming IEP are as follows:

  • Johnny will produce /r/ in structured conversation with 1 visual cue with 80% accuracy in 4 sessions
  • Johnny will answer factual ‘who’ and ‘when’ questions about a grade level paragraph read aloud in 4 out of 5 opportunities
  • Johnny will state the spatial concepts of ‘in, on, out, under, over’ by responding to ‘where’ questions about a picture scene with 80% accuracy in 3 out of 4 opportunities.

Do the PLAAFP above include the necessary components? Are they descriptive and specific? Is the information data-driven and directly related to the new proposed goals? Without knowing this student, would you be able to pick up this IEP and have a good idea how to gather baseline, where to start with therapy and what he is expected to achieve in the course of this IEP?

What are some tips you use to write legally-defensible PLAAFP?

Layers of vocabulary

As an SLP, we live and breathe vocabulary! It is the basis of it all, right? Without words, communication would have little meaning – it doesn’t matter if the words are spoken, pictured, signed, gestured, or produced through a voice output device. They are foundational to acquiring language – both written and oral.

Increasing vocabulary is a HUGE part of the daily life of school-based SLPs. It can be overwhelming at times, especially when we think about the sheer number of words students are exposed to and expected to learn in a school year. Or the amount of repetitions needed to learn them all.

So many words, so little time

The words we choose to focus on are as important as the therapeutic methods and strategies we use. There should definitely be nothing random about it. Relying only on spelling lists or vocabulary lists from the teachers’ lesson plans just won’t cut it. But where should we begin?

Starting at the core

Core vocabulary is a small set of words (250-350) that are simple, and are common in any context. These words are familiar and frequent including all parts of speech and most have six or fewer letters. In any age group, core vocabulary makes up 80% or more of the words we use in daily conversation. WOW!

These make up the first words and phrases of toddlers and continue through adult conversations.

Working with students using AAC? What about students who are minimally verbal or have low cognitive ability? Teaching high frequency core vocabulary is the way to go!

This article at Minspeak has various word lists

Praactical AAC has monthly lists and tips for instruction including suggested books to increase practice! Just type ‘core vocabulary’ in the search box and away you go!

Beyond the core

When choosing words to teach beyond the core, it is helpful to consider the three tiers of vocabulary as discussed in the second edition of Bringing Words to Life by Beck, McKeown, and Kucan. Their article on Reading Rockets summarizes it nicely.

Tier One is made up of basic words that typically are learned without instruction. These words include sight words and basic nouns and verbs – and core vocabulary too. We definitely work with individuals who need to build their Tier One vocabulary, don’t we?!?

Tier Three words are low frequency and usually learned specific to content or context. If these are the words we focus on, will our students be able to converse with anyone about anything? Probably not where we should focus our energy and all-too-valuable time!

Tier Two words, however, are the words to know! These are highly frequent in literature and conversations among adults. They are invaluable for reading comprehension and generalize across environments. These words have multiple meanings and can help increase descriptive language.

Cha-ching!!

Comment below and tell us how you choose which words to teach.

Follow us as we continue the vocabulary conversation. Future posts will further discuss teaching vocabulary concepts and strategies, tools for identifying Tier 2 words, breaking down prerequisite skills and writing measurable vocabulary goals.

Highlighting Highlights®

– a post by Elissa

So my daughter is in kindergarten. For the last 2 years she has been receiving Highlights® High Five™Magazine each month. I remember how much I LOVED looking at these magazines in waiting rooms when I was a kid. And wow, what a goldmine. School-based SLPs look at how ANYTHING we see, touch, experience can be used in therapy, right?? And lucky for me, my slightly type-A daughter doesn’t like to do anything but read her copies – she doesn’t pull any pages apart, color or draw in it – she keeps them looking pristine. Score for mom. Because I can create a multitude of lesson plans out of these babies!!!

A little background in case you’re not familiar with these gems:

Highlights® has magazines for 2 different age groups. There is the High Five™ Magazine for ages 2-6 and the Highlights™ Magazine for ages 6-12.

Both have a variety of activities including recipes, crafts, Hidden Pictures® scenes, puzzles, games and short stories. Many of the stories incorporate the same characters from month to month and include themes related to the season or upcoming holidays/events. The older version even includes science experiments and nature topics. There are silly pictures to find ͚what͛s wrong͛, 2 picture scenes to discuss similarities and differences, riddles and jokes and matching games. Is your head spinning yet with all of the skills you can target and goals you can address?

Look at some of this fun stuff…

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There is always something to discuss using the front cover-describing, predicting, something silly…

 

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Spot makes an appearance each month. Sequencing pictures? Done! A little inferencing. Describe characteristics of fall. Talk about feelings. Always an adventure with Spot!
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The title alone, right???  These twins always have a social obstacle to overcome. And cute, short stories allow for wh-questions and so much more!

 

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Articulation anyone? I think I see a few verbs in there too…
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So much comparing and contrasting!
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Wrap it all up with a recipe or a craft…step by step instructions for sequencing and following directions. Throw in some fine motor activities at the same time!

Are you drooling yet? There is so much more I could share!!!

Don’t have access to a subscription? Have you checked your school or county library?

No worries…check out Highlights Kids for even more – did I mention it is FREE.

Find Hidden Pictures® Puzzles, art activities, games and jokes in the Play It section. Looking for some short stories to work on comprehension? They have that covered in the Read It section. Stories can be read aloud – and some are even animated. How about poetry and articles as well as The Timbertoes: Comic Creator. Why not have the students create their own dialogue describing the pictures, talking about sequencing, constructing sentences…

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The Make It section has crafts and recipes plus science experiments!

There is even a Share It section where kids can read what other kids have asked and even ask their own questions!

So basically I have a stockpile of 2 years’ worth of High Five™ Magazine and pretty soon I͛ll be adding Highlights™ Magazine to it…so many preschool and elementary school lessons DONE!

Have you ever used Highlights® in therapy? Comment below and tell us about it!

Bilingual evaluations: Documenting results

In our two previous posts, we talked about the importance of interpreters and how to effectively collaborate with one before, during and after an evaluation.

Once you’ve completed your evaluation it’s time to write up the results…(sigh).

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For the most part, this won’t be too different from how you report on any of the other endless number of evaluations you complete as a school-based SLP. But there are some very important pieces to include when a student is evaluated in more than one language, with an interpreter.

Remember, most of the tests you just administered weren’t normed in the client’s primary language and they certainly weren’t normed through administration with an interpreter! So be sure you are documenting this information. Specify when and how you collaborated with the interpreter. Which portions were given by you, and which portions by the interpreter?

When documenting your analysis of the test results, be sure to discuss instances when the student may have responded incorrectly in one language but then correctly in the other.

Be careful not to report standard scores when a test is not administered per standardization requirements – read those manuals!

Was the test normed on an English speaking population? Most of them are!

Did you administer it with an interpreter to a student for whom English is not his first language?  Chances are, yes!

Can you report the standard score? Ummmm, no!

However, looking at the score certainly can help guide you as to whether the student is performing within normal limits or not.

And don’t forget to consider the responses in EITHER language. If the question was answered correctly in one language or the other, count it as correct…we’re looking at the SKILLS the student does or does not have, not in which language she demonstrates it.

Keep in mind that we are looking for language disorder, not difference (discussed further in Part 1, here).

One of the trickiest areas is syntax. So much of our English syntax (forms and word order) is different in the primary language. Take a close look at the errors in both languages with these syntax concepts. If the errors are present in both languages (with a syntax form that is expected and developmentally appropriate in both languages), that would be considered an error in syntax.  However, if the errors are only present in English, this would not be considered an impairment with syntax.  Make sure discussion of all of this is included in the report.

Remember, most of the tests you just administered weren’t normed in the client’s primary language and they certainly weren’t normed through administration with an interpreter!

There are a multitude of resources available to delve into the differences between languages – phonemic inventories, influences of one language on another, dialectal differences. ASHA includes phonemic inventories for various languages along with a brief discussion of how to use this information and links to additional resources. Celeste Roseberry-McKibbin has a great book titled Multicultural Students with Special Language Needs-4th Edition covering various topics.

Do you have any go-to resources? Share below.

Effective Collaboration with Interpreters

In our previous blog we discussed the importance of when to work with an interpreter.  Now let’s take some time to discuss some tips on how to best collaborate with an interpreter when testing the speech and language skills of students for whom English is not the first language.

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We’ve broken it down into three parts:

  • Prior to testing

  • During testing

  • After testing

In all phases, when working with the interpreter, be sure you are speaking directly to the student, not the interpreter.  It is best to speak in short sentences, giving the interpreter time to translate.  Also, stay away from professional jargon – keep it user friendly!

Prior to testing

It is vital to the process that you are able to meet with the interpreter prior to beginning your testing.  You can do this on a prior day or before you start testing (we know time is never on a school-based SLP’s side).  During this meeting, you will need to walk through what you expect to accomplish during the testing session.

  • Allow the interpreter time to become familiar with the actual tests that will be administered.

  • Explain that what the student says must be interpreted as closely as possible into English, even if there are mistakes. Just as we record exactly what the student says, there will be times that the interpreter will need to record exactly what is said, even if there are errors.

  • Discuss allowable prompts and what NOT to say to the student. Ensure that the interpreter understands that we are trying to keep things as standardized as possible to get a true picture of what the student can and cannot do regarding speech and language.

During testing

Start with introductions (of course)! Make sure the student understands what each person’s role is. You may want to conduct these introductions in both the child’s native language as well as English to increase comprehension.

You may consider following up these introductions with a short conversation with the student.  This will allow the student to warm up to both of you.  Also, with the interpreter’s assistance, you may determine some valuable information regarding the give and take of conversation (including if the student responds appropriately to the interpreter).  What about with you in English? It may be a good idea to audio or videotape this.  Make sure the student knows that he or she can answer in either English or their native language.  Make note of which the student prefers.  If the student is responding in English (as many prefer to do), remind them or cue them to answer in their native language when they seem to not give an answer.  If the student struggles to provide an answer in their native language, prompt them for the answer in English.

Remember, our goal is to find out what speech and language skills the student has PERIOD – in either language!

Now you may be thinking, what language should I start testing in?

One tool we use is the student’s English proficiency which is derived from the CALP score to help determine if we want to start in English or the first language.  If the CALP score is 3.5 – 4, we recommend administering the test in English and then re-administering the missed items in the first language with the help of the interpreter.  If the CALP score is below 3.5, you may choose to administer the test in the first language and then re-administer missed items in English.  By doing it this way, you can better determine which may be considered the stronger language.

Whichever language you start with, it is a good idea to state the directions in English and then have the interpreter state the directions in the native language. This gives the student a better chance to understand the task he or she is expected to do.

When administering the test in the primary language, the interpreter would state the stimulus in the primary language.  The interpreter would write down exactly what the student says (for the expressive portions). You would probably need to take a break to review the expressive responses with the interpreter in order to determine which answers are correct or incorrect.  For the receptive parts, where the student is just pointing, the interpreter would present the stimulus and you can record the answer.

Keep in mind that testing with an interpreter takes longer so you will likely need more than one session to complete the evaluation.

After testing

Once testing is completed with the student for that session, you and the interpreter still have quite a bit to discuss! How did the student do during the initial conversation?  For answers recorded in the primary language, what did the client actually say?  What errors did the interpreter notice in the primary language?  What are the interpreter’s overall impressions of the student’s speech and language skills? How does this compare to what you have identified with their skills in English?

At this point it may or may not be necessary to arrange another time for the interpreter to come and assist in completion of testing.

ASHA provides some tips for school-based SLPs working with culturally and linguistically Diverse (CLD) students including collaborating with interpreters.

We would love to hear some of your tips for collaborating effectively with an interpreter.

Stay tuned for our next blog post where we will provide some tips on writing up the results of your evaluation.

How important IS that interpreter anyway?

If you ask us, pretty important!!!

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We are coming across increasing numbers of ELL students in our schools – those who are bilingual or monolingual, whose first language is one other than English.  Are you noticing this where you work?

Many of us may not have access to a bilingual SLP for that student’s primary language.  Some of us may have a test normed with a Spanish speaking population, but there aren’t that many options out there…and languages other than Spanish? Nope!   Some of the students may be fluent in their native language but may tell you they prefer English.  Others may not speak fluently in either language.

Language difference does not equal language disorder!

There are also a variety of normal processes related to second language learning. Some of the students brought to our attention are just in the process of learning English.  As SLPs, we certainly want to identify if the student has a language impairment; however, we don’t want to place them in special education if their primary language is within normal limits and they are learning English typically.

So when is it necessary to collaborate with an interpreter?  Sometimes it’s obvious and sometimes it’s not.

For the student who uses very little English, you would typically use an interpreter (if a bilingual SLP is not available) – kind of a no-brainer.  For the student who speaks some or quite a bit of English, you have to determine in which language he is stronger; how well does he understand and speak English?  One thing to look at is his CALP (Cognitive Academic Language Proficiency) level.  A student can receive a score of 1-6 (negligible-very advanced).  In our experience, a CALP score of 4 (fluent) or lower, would necessitate working with an interpreter for some level of testing in the first language.  If the CALP score is above 4, the individual should have enough English to take standardized tests; however, it is possible the student has some language skills in the first language that are not present in English – collaboration with interpreters can help you discern these skills. Also, the student may still be demonstrating some of those normal processes of second language acquisition we just talked about!

Gaining background information and a case history from the parent(s) is also vital to making accurate determinations with ELL students. You may need an interpreter when doing this – whether through questionnaires or interviews.  The answers to some of the questions can help point you in certain directions during your assessment. For example, maybe there are other siblings in the household and parents indicate that this child did not develop language at the same rate as the other child(ren).  That’s a big red flag.  But it doesn’t automatically mean this student is disordered in their first language and lead you to believe that you don’t need an interpreter!

Think of the role of the interpreter and the purpose of your testing. You need to determine if the student has a language disorder. You have to tease out if what the student demonstrated difficulties with is due to second language acquisition or due to a language impairment. The interpreter will be invaluable in helping you through this process.

Certified interpreters are definitely the best for this process! They are specially trained to work with professionals in administering assessments. Stay tuned for our next blog post where we will discuss some tips on effective collaboration with interpreters.

How do you determine when to call in an interpreter? Comment below

Proving your value as a school-based SLP

A post by Elissa…

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During my first year as a speech-language pathologist, a CF, in the school system, I had an interesting conversation with a classroom teacher. I was walking down the hall one day (who knows where I was headed- to pick up a student, to attend a meeting, to talk to a teacher…). She was standing at the door and commented, “I wish I could walk around all day…how do I become a speech teacher?”

I’m sure the look on my face was priceless and I took in this statement and calmly responded as non-condescendingly as possible. I don’t remember my exact words but it was something to the effect of, “Well after I completed my undergraduate degree I spent 5 semesters getting my Master’s degree including practicum experience in about 5 different settings…”

Silence, wide eyes…and, “Oooooohhhhh, maybe not”

That was the first (and definitely not the last) time that I had to justify my worth and the value I add to the students, the teachers, the classrooms, the school.

It’s frustrating, right? Who really understands what we do?

“why does he go to speech; he talks fine”

“you can’t pull him from reading, it’s really hard for him”

“why do you need bigger room?”

Even better “why do you need your own room?”

So whose job is it to show everyone what you have to offer? Only you can!!

Most non-SLPs are really never going to fully understand your role but that shouldn’t stop you from trying.

Some ways I’ve done this include:

  • Trainings for staff (and parents) on communication disorders:

highlight the relationship between language and the curriculum

highlight the relationship between articulation/phonology and phonemic awareness/reading

share the impact of a social language impairment

teach about the communication impairments associated with some of the common syndromes or disabilities

invite administrators to observe some of your sessions-I know they’re busy but keep trying to get them in there

  • Go into the general education classrooms – even if you pick one room, one teacher…word of mouth is powerful and good news travels fast!

 

  • Be seen in the school – don’t hide out in your room; eat lunch with staff; get in on their conversations about struggling students – give suggestions to show what you know

 

  • Give your students tools to be successful in the classroom so they can show what you are capable of – and share them with the teachers

 

  • Take on an extra responsibility in your school – I know you are already SO busy but even a small effort can make a huge difference. You may be pleasantly surprised by the things that get offered to you after that – and of course you can say no!

What are some of the ways you have had to advocate for yourself and show your value in the schools you serve? Comment below…