SCHOOLS
FREQUENTLY
ASKED QUESTIONS
Speech
Implementer Model and State Licensure Q&A
Does a child
have to demonstrate reduced grades or achievement test scores
in order to qualify as Sound System Disordered in Missouri
Public Schools in order to meet the "adverse educational
impact" requirement?
The U.S.
Department of Education has provided clear interpretation of
the phrase "adversely affects educational performance" as it
applies to children with speech-language impairments. This
interpretation clearly states that a child who has a
disability can not be denied services because she or he does
not demonstrate concurrent academic problems (ASHA, 2005).
Following is a quote from a letter from Edwin Martin, Acting
Assistant Secretary of Special Education and Rehabilitation of
the U.S. Department of Health, Education, and Welfare (Office
of Education in Washington, D.C.):
"The meaning of educational performance" cannot be limited to
showing of discrepancies in age/grade performance in academic
subject-matter areas. The extent of a child's mastery of the
basic skill of effective oral communication is clearly
includable within the standard of "'educational performance'
set by the regulations. Therefore, a speech/language
impairment necessarily adversely affects educational
performance when the communication disorder is judged
sufficiently severe to require the provision of speech
pathology services to the child." "It is clear that, in
establishing the existence of a speech/language impairment
that is 'handicapping' in Part B (IDEA), a professional
judgment is required. The basis for that judgment is the
child's performance on formal and/or informal measures of
linguistic competence and performance, rather than heavy
reliance on the results of academic achievement testing. The
impact of the child's communicative status on academic
performance is not deemed the sole or even the primary
determinant of the child's need for special education
services. It is the communicative status - and professional
judgments made in regard to assessments of communicative
abilities - which has overriding significance.
In the event
that the speech-language pathologist establishes through
appropriate appraisal procedures the existence of a
speech/language impairment, the determination of the child's
status as a 'handicapped child' cannot be conditioned on a
requirement that there must be a concurrent deficiency in
academic performance."
Although the current Missouri Compliance Plan does not define
the term "educational performance," an excellent explanation
was included in previous state plans as follows: Educational
performance shall be interpreted as not only classroom
applications of academic skills and concepts, but also as
generalization of skills and behaviors such as social
interaction, functional communication, and prevocational and
vocational skills and behaviors in other environments.
Is it okay for a Special Education
teacher to provide the services to a student with a language
disorder, instead of the SLP?
It depends on what the IEP team determines is needed for
the child. If the IEP says that the child needs
speech/language therapy, then the only acceptable models in MO
to provide this therapy are from an SLP or through the approved
implementer model. If the IEP has goals and objectives
addressing language skills and the team determines that those
needs can be addressed in the regular education program or
through specialized instruction, then the IEP would not indicate
speech/language therapy and those identified needs would be
addressed by someone other than the SLP.
I would like some different views on the
roles and responsibilities for SLP's and dysphagia in the school
setting. Is the school responsible for the nutrition of the
student or is it a medical issue? Who pays for the swallowing
eval? I would like any
info that you could provide on this subject. I have listened to
a lot of different views. Are there any official guidelines
through DESE?
Often tongue-thrust and swallowing issues are viewed as
medical issues and typically are not considered applicable to
educational outcomes. However, if an IEP team determines
that the child needs speech therapy designed to address either
of these issues in order to receive FAPE, the district would be
required to provide the therapy. Eligibility in the
category of Speech Impairment based on either of these
conditions alone would likely not meet the definition in the
Missouri State Plan for Special Education. If the child
demonstrates other communication difficulties as outlined in the
State Plan and has accompanying tongue thrust or swallowing
problems, the team should consider how those problems impact the
child’s overall communication skills and if needed, provide
the necessary intervention.
If it is determined that swallowing
needs to be addressed, would the school district have to pay for
a modified barium swallow at a hospital or would informal
assessment of swallowing be used to diagnose the problem?
I think that part of the decision-making process would be
a review of existing reports available to the team from the
medical doctor’s assessment of the child’s condition.
I doubt that a school based team would be the first to determine
that the problem exists and my response was that a school team
may have to respond to the condition and the need for services
as they write the IEP. Some children in our State Schools
for the Severely Handicapped have disabilities that impact
swallowing and interventions for their problems are a part of
their IEP when the team determines that the child needs the
services in order to receive FAPE. An example may be the
child with excessive drooling stemming from cerebral palsy and a
determination that oral-motor interventions would reduce or
eliminate the problem and improve communication. In those
cases the team may decide that the therapy is necessary and the
need directly related to the long term goals for the child in
communication. If a team determines that an assessment of
the child’s swallowing function is necessary in order to
appropriately program for the child, then yes, the district
would pay for the testing. However, I don’t see this as
an issue that would originate at the school level but something
that comes to the school team based on information from other
evaluations and/or recommendations from the child’s medical
team.
If a speech therapist currently holds a
PCII teaching certificate, what will they renew it as? It
was my understanding at the student services certification
meetings that the new requirements and new title of student
services would not apply to people already holding certificates.
If a SLP just moved to
Missouri and is interested in getting a teaching certificate, is
it in her best interest to wait until the new certification
requirements are approved and then pursue getting a student
services certificate, or would it be in her best interest to
pursue getting her certificate now? She is not planning on
working in the schools for the next year or two, but would like
to get her certificate.
The old Speech Language Specialist certificates will
remain under the professional certification classifications.
The Student Services classification began for individuals who
apply after 8/28/03.
Typically, I would advise people not to wait for the new
changes unless they are not going to be using the certificate in
the near future; then I would recommend that they wait.
Can SLPs use Substitute Teachers?
The
only individual that can substitute for an SLP is another
appropriately credentialed SLP. If an appropriate
credentialed substitute SLP cannot be provided and services are
missed because of absence or illness of the SLP, then services
must be made up.
There
is flexibility in how missed sessions are made up. They do
not have to be made up in the same way that they are originally
scheduled. The make-up session can be done in shorter or
longer increments of time than originally indicated and can be
done in a group or individual. For example, if a child was
scheduled to have one-on-one therapy two times a week for 30
minutes each session and one of those sessions was missed, then
the make-up could be for two15 minute sessions with a small
group. Another
option would be to make up time after school or in the summer.
I do understand that if this were done there would be an
additional cost to the district to hire someone to do the
make-up sessions outside of their regular contract, but it is an
option.
Can Missouri school-based SLPs use the
3:1 model?
DESE does not specify how
minutes must be documented (see compliance plan).
Many providers list “minutes per day” or “minutes
per week,” but “minutes per month” could be listed.
For more information on the
3:1 model or creative options for scheduling, visit the ASHA
website. ASHA has
published information on the 3:1 model in the ASHA leader and
there are several publications available to ASHA members free of
charge related to workload in the public schools.
If a 3:1 model is used, decide how many minutes the
student needs per month to complete goals/objectives and then
schedule services for 3 weeks of the month and have a week that
is used for meetings, paperwork, consultation, and classroom
observations.
Example:
Student was previously scheduled for 60 minutes per week
which would be 240 minutes per month.
Dividing 240 minutes per month over a 3 week time period
would result in four 20 minute sessions for 3 weeks or two 40
minute sessions per week for 3 weeks.
Where can I find the SLP caseload
formula? Can I make
my director of special education use the formula instead of the
40-60 students? Does
40-60 students include the students I see as a related service?
Can SLPs use the special education teacher formula?
Information
about caseload numbers and formula can be found within Regulation
IX – Funding of the State Plan for Special Education (http://www.dese.state.mo.us/divspeced/stateplan/FY2004/Reg_IX.pdf
or in your
districts compliance plan.
Districts/Directors of Special Education can chose to use
the SLP formula or caseload size when applying for funding from
DESE. Many SLPs
will submit both their caseload size and the formula to their
supervisor so that a comparison of caseload to workload can be
made. The state
plan specifically states that for district using the 40-60
count: “The
pathologist provides direct services to 40-60 children with
disabilities. For
some students in this count, the pathologist may not be the
designated
case manager.”
The “All
Other Special Education Caseloads” formula is not recommended
for SLPs unless they are serving as a “teacher” with a
population that is receiving a high number of minutes per week
of speech-language services.
What is the issue with speech
implementers and state licensure law?
Speech
implementers provide services under a model established by the
Department of Elementary and Secondary Education (DESE). (See
www.dese.mo.gov/divspeced/Compliance/Guidance/speechimp.html
for specific details about the model.) Speech implementers appear
to function in a role very similar to speech-language pathology (SLP)
assistants as described in state licensure law for speech-language
pathologists (Chapter 345 of the Missouri statutes.) Currently
DESE is approving speech implementers to work in the schools
without those individuals being registered as an SLP assistant as
required by licensure law.
Can a speech implementer
register and provide services as an SLP assistant?
Yes -- if they
meet the SLP assistant requirements including training and
supervision, an implementer can register as an SLP assistant.
However, the education and supervision requirements for an SLP
assistant are substantially different from those for a speech
implementer. The SLP assistant must have a bachelor’s degree in
communication disorders and one of every three therapy sessions
provided by the assistant must be directly supervised by a
licensed SLP. The speech implementer may hold a bachelors degree
in communication disorders or hold a teaching certificate
“preferably” in special education or elementary education. Direct
supervision may be provided by either a licensed or DESE
certificated SLP and the supervision is “periodic” at the school’s
discretion. It is advisable for an implementer to check with
their school district to see if the level of supervision necessary
for an SLP assistant can or will be available.
Is there an exemption for schools in the
speech-language pathology (SLP) licensure law?
No
-- there is no blanket exemption for individuals working in the
schools. The exemption in the licensure law is limited to
individuals who hold the DESE SLP certificate and provide services
while employed by the schools. Speech implementers do not hold a
DESE SLP certificate so they are not covered by this exemption.
When will schools know if speech
implementers must be registered and meet the requirements for SLP
assistants?
The Board of
Healing Arts, Speech-Language Pathology and Audiology (SLP/A)
Commission has been reviewing information from DESE in an attempt
to determine if speech implementers should be registered and meet
the requirements for SLP assistants. As of January 2007, the
Board and Commission asked the Attorney General’s office for an
official opinion on the matter. Until that opinion is available,
the issue remains unresolved.
If I supervise a speech implementer,
is my SLP license in any jeopardy?
The SLP/A
Commission recently opined that RSMo. 345.025.1(6) exempts SLPs
who have a DESE SLP certificate from application of chapter 345
(the entire licensure law) while they are providing services in
the schools. So even if it is eventually determined that speech
implementers are practicing in violation of the licensure law by
not being registered as SLP assistants, the license of the
supervising SLP will not be in any jeopardy so long as they are
practicing and supervising the implementer pursuant to their DESE
SLP certificate as a school employee. If an SLP supervising a
speech implementer does not have a DESE certificate and is
providing the supervision, as a contractor pursuant to their
license, that supervising SLP may have a problem if it is
determined that implementers are practicing in violation of the
licensure law.
Is there a problem with speech
implementers becoming a fully licensed SLP?
Some speech
implementers with bachelor’s degrees in communication disorders
have a desire to become fully licensed SLPs. If it is determined
that implementers are practicing in violation of the licensure
law, it may be difficult for individuals who served as
implementers to obtain their SLP licensure. The only apparent
redress is for the implementer with a bachelor’s degree in
communication disorders to register as an SLP assistant, make sure
their supervising SLP is licensed, and make sure the level of
supervision conforms to the Board of Healing Arts requirements for
SLP assistants. Until the issue is resolved, this appears to be
the only way to ensure the practice of an implementer does not
violate licensure law.
To submit a question, email Brenda Martien, VP for School
Services at
bmartien@mail.nixa.k12.mo.us
