Sound
System Disorder
The diagnosis of ‘Sound System Disorder’ includes
disorders of articulation and/or phonology.
The evaluation report must include sufficient data to
document the existence of a Sound System Disorder which is
present when the following criteria are met:
1)
The student exhibits delays in correct speech sound
production based upon data from a single word test and/or a
sentence/phrase repetition task and
a connected speech sample
2)
Consideration is given to the type of error recorded (SODA
– substitutions, omissions, distortions and/or additions)
occurring as single sound errors and/or phonological processes
3)
The disorder significantly impedes educational performance
or performance in age-appropriate activities
4)
The sound system disorder is not due to dialectal
differences or second language influences
ALSO
5)
A sound system disorder can be present if multiple errors in
the student’s speech significantly compromise listener
intelligibility and/or perception even when the results of
standardized data indicate that errors are within
age-appropriate guidelines.
Professional judgment can
be used to qualify borderline students. In those cases where
normative data conflict with your professional judgment, the
most important key is that you have the connected speech
sample/observation included in your report to back up your
professional opinion.
Language
Disorder
The evaluation report must include sufficient data to
document the existence of a language disorder which is present
when the following criteria are met:
1)
The student exhibits misuse of any of the structures of
language (morphology, syntax, semantics, and/or pragmatics) as
measured by language sampling
2)
The student’s language functioning falls two standard
deviations below the mean as measured by two
or more standardized language assessments
3)
The disorder significantly impedes educational performance
or performance in age-appropriate activities, and
4)
The sound system disorder is not a due to dialectal
differences or second language influences
ALSO
5)
A language disorder can be present even though standard
scores do not meet criteria outlined in #2 above if a deficit is
documented through both formal and informal assessment, such as
observations and language sampling.
As with the sound system disorder, professional judgment can
be used to qualify borderline students for language services.
However, when normative data conflict with your professional
judgment, documentation of observations and language sampling
are key elements of the report.
Fluency
The evaluation report must include sufficient data to
document the existence of a fluency disorder which is present
when the following criteria are met:
1)
The student consistently exhibits one or more of the
following dsysfluent behaviors:
a)
sound, syllabic, or word repetition
b)
prolongations of sounds, syllables, or words
c)
blocks, and
d)
hesitations
2)
The student’s dysfluencies occur five or more times per
minute or at a rate of 10 percent in a connected sample and are
distracting to the listener
3)
The disorder significantly impedes educational performance
or performance in age-appropriate activities
ALSO
4)
A fluency
disorder can be present even though standard scores do not meet
the criteria outlined in #2 above if the disorder is documented
through both formal and informal assessment, such as
observations and connected speech sampling.
Voice
The evaluation report must include sufficient data to
document the existence of a voice disorder which is present when
the following criteria are met:
1)
The student consistently exhibits deviations from the norm
in pitch, quality, or volume as related to his/her age, gender,
and culture and
these deviations are distracting to the listener
2)
The voice disorder is not the result of a temporary problem
such as allergies, colds, recent surgery (such as
tonsillectomy), or other similar conditions, and
3)
The disorder significantly impedes educational performance
or performance in age-appropriate activities.
The
YCDD Question
“Young Child with a Developmental Delay” (YCDD) is a
label for three to five year-old students who exhibit
developmental delays as measured by appropriate assessment
procedures in one or more of the areas of physical (fine and
gross motor combined), cognitive, communication (speech and/or
language), social/emotional, or adaptive development.
A developmental delay in any one of these areas is
present when the following criteria are met:
1)
The results of standardized testing fall at or below 1.5
standard deviations from the mean in any
two areas OR at or below 2.0 standard deviations in any
one area. (The areas being: physical, cognitive,
communication, social/emotional, or adaptive.)
2)
The student needs special education and/or related services.
Note:
Children who are five years of age and eligible for Kindergarten
may continue eligibility under YCDD as long as they were
initially identified prior
to Kindergarten age eligibility.
ALSO
3)
Eligibility for YCDD may be deemed appropriate even though
standard scores do not meet criteria outlined in #1 above if
there is sufficient documentation through both formal and
informal assessment that a deficit exists.
4)
A team may decide to qualify a student for YCDD if that
student is functioning above the stated criterion level because
of intensive early intervention and the team expects the student
to regress should services suddenly be terminated.
Finally, I have received questions asking whether a child
with a significant sound system disorder can qualify under YCDD
instead of the categorical-type label of ‘Sound System
Disorder’. The
answer, according to DESE, is YES,
if the YCDD criteria are indeed met.
The YCDD criteria clearly state that a significant delay
in any one area can
qualify a student. However,
it is important to remember that we cannot use standard scores
for articulation tests in the same manner as we do for other
assessments because articulation ability differs greatly even in
students who are developing typically.
Percentile rank often gives us better information as to
the severity of a student’s articulation delay, although there
is no ‘standard deviation’ to use with the YCDD criteria.
For that reason, the diagnosis of Sound System Disorder
often is the more accurate choice.
The decision to allow YCDD diagnoses for ‘speech only’
students is up to personnel in individual districts. Bear in mind, however, that if you allow YCDD diagnoses, it
can create much work for elementary-based SLPs who receive your
incoming early childhood students. This is because the YCDD
label is only good until the end of Kindergarten. Regardless of
when their initial evaluation was completed, all students given
a YCDD label must be re-evaluated at the end of Kindergarten in
order to give them a diagnosis that is appropriate to their new
school-age status.
A year ago, we were dreading possible changes to the
criteria reviewed above. Thankfully, those proposed changes were
dropped from the state plan.
As you continue to provide early childhood services, I
have no doubt there will be individual case questions to
consider. Please do
not hesitate to contact me at asaus@estigers.k12.mo.us
if any questions should arise that cannot be answered with this
review.
