On SSDs and Eligibility (required reading!)
Remember last month, when we promised to point you towards any really good stuff coming out of ASHA’s revamped Perspectives journal? Yeah, we didn’t have to wait very long. We (and others) have been shouting from the social media rooftops about this new Clinical Forum since it first hit the web a couple weeks ago, but consider this your official notice to get clicking!
There’s an introduction and four articles that dive into all the thorniest issues about qualifying students for articulation services in schools: standardized testing, use of developmental norms (relevant for the recent hoopla around the new/not-new speech sound norms—see this blog post), single sound errors, and the social impact of speech sound disorder (SSD) as a basis for qualification. We’re giving you some highlights and don’t-misses below, but seriously: if you diagnose and treat a lot of SSDs, especially in the schools, read it all. These articles are all open-access, so no barriers there! This would also be a great issue for school-based SLPs to grab for a professional development session with your co-workers! The discussion will be so good, you won’t even need the coffee and donuts. Probably. Maybe. Better bring them just to be safe...
If you’re in a big hurry, read this quote...
“Unfortunately, because the majority of standardized tests of articulation and phonology currently did not meet basic psychometric requirements (Kirk & Vigeland, 2014), it is essential that they do not act as the cornerstone of speech sound assessment.”
...and jump to the section called “Evidence-Based Evaluations of SSDs,” which starts on page 61 of the PDF. It lays out the 10(!) elements that would comprise a best-practice evaluation plan. They do suggest school SLPs not be “discouraged” by their recommendations, but to use them as a basis for advocating for more time to complete your assessments in the manner our field’s best evidence supports.
And before you go, print out page 62 (Table 1, a summary of criterion references for phonology) and laminate it for your next round of eval write-ups.
“Developmental norms for phonological error patterns or speech sounds can be a useful tool in determining eligibility, but some guidelines seem to overemphasize the use of norms, particularly single age cutoffs, and, in some cases, even advocate for use that is inappropriate.”
If the powers-that-be have given you eligibility guidelines that hinge on developmental norms, there may be an issue, so don’t skip this article. The gist of it all? Age of acquisition needs to be viewed as a range, not a single age, and developmental norms should not be your only data point. The case studies in this article are especially helpful in considering this issue—they walk you through the process of integrating standardized test results with developmental norms to make clinical decisions.
Does your school/district/state support serving students with single sound errors? There’s a lot of variability in whether, when, and how these kids get therapy in school, and many reasons offered for why they perhaps don’t need to. This article asks you to reconsider some of those reasons, given evidence of the effects on literacy and other areas of functioning. Make sure you check out the appendix, for a bulleted list of recommendations on assessment, treatment, and advocacy—and we’re not just saying that because she links to a TISLP piece!
The jury is in, whether or not your district is on board: we need to consider social impact when assessing the “academic” impact of SSDs on our students. Here, you’ll find several methods you can use to evaluate social impact, and reading through the case studies will help you consider which methods are best for which situations.
Final note—if you just can’t right now with the reading, try a podcast episode instead. A bit easier to fit into a busy schedule, and may even get you excited about checking out the full articles! Try here and here.
More Perspectives & Tutorials
Challenges and opportunities in augmentative and alternative communication: Research and technology development to enhance communication and participation for individuals with complex communication needs
This open-access article is your advocacy pick of the month! See a previous review on this important topic here.