Speaker 1 0:03

Welcome to the podcast. Let's talk sped law, a podcast dedicated to discussing special education rights of children with disabilities. I'm your host and special education attorney. Jeff forte. Now let's talk sped law.

Speaker 2 0:17

Our guest speaker, in this episode of let's talk, sped law is Katie Kirra . Katie Kirra is a speech and language pathologist and founder of kids language center located in cost cob Connecticut. In this episode, we go through all of their information regarding speech and language services that are provided under the individuals with disabilities education act as a related service together, Katie goes through the clinical importance of understanding expressive and receptive language of understanding social development and pragmatic language abilities. And also goes through many of the assessments that a parent can be asking a school team to conduct to more fully inform a child special education and related services by way of speech and language support. We also go through the importance of knowing when a speech and language evaluation is considered comprehensive as well as how you can best evaluate a child for speech and language services during the time of COVID speech language pathologist , Katie Corrado . Welcome to let's talk sped law . It's so nice to have you on the show. Thank you for having me. So today we're going to be , uh , really kind of diving into everything there is to know from a parent's perspective about speech and language evaluations. And it's so great that you're on because it's such an important part. Child's IEP with many, many different disabilities. And , um, you know, when we're talking about speech and we're talking about language, there they're two completely different things and the language process and understanding how a child is able to communicate expressively receptively on a logically pragmatically is all within your expertise. So I'm really excited and humbled to have you on the show. Uh, you know, I , I want to first start by talking about when is a speech and language evaluation usually required under the Ida. It can be obviously used as a related service and it's also a evaluation that's provided quite frequently by school district based speech and language evaluators. So as an independent private, that

Speaker 3 3:00

Is often hired by school districts to do an independent speech and language evaluation, but also by parents who just want to make sure that their districts speech and language evaluations are appropriate. When does a private speech and language evaluator, like you typically get involved in a child's education?

Speaker 4 3:23

Um, so I can be called , um, initially when the children, when the students are young, right? So maybe perhaps before they're even involved in an IEP process , um, and then I can guide them, the parents to , um, you know, seeking more , um, you know, an evaluation through the district or more help through the district if the family and the student already is early as involved in a district and already has an IEP or , um, you know, the district is aware of some , um, concern on the parent's part. Then oftentimes I get called from a parent , uh, with the concern that either a district doesn't see the need in testing , um, or has tested and hasn't found anything remarkable. Um, but the parent just really feels that the child is struggling in a specific area or multiple areas. And so in those cases, I bring them in for , um, for an evaluation. And we just do, we do a very thorough, comprehensive evaluation where as you know, sometimes initial evaluations through the district might be , um, might be , uh , more brief, right? So they look at basic receptive and expressive skills. They look at , um, maybe just one articulation battery. Um, our assessments will dive quite deeper into , um, into what other weaknesses might, might be impacting , um, academically or socially. So we listen a lot to the parent's concerns and , um, and look at assessments that would target those specific areas of weakness or possible areas of weakness.

Speaker 3 5:17

So you mentioned something that I really wanted to highlight for the audience, and that is sometimes there's a brevity, if you will, in a school district based speech, language evaluation, and the brevity could be for a number of reasons. And then it could be because the child simply needs to have a, a , uh , you know, informal assessment or consultation or the speech and language evaluator is spread thin over the entire district. But , um, when I look at valuations that you have done in the past for, for parents , um, I mean, I have one up right now

Speaker 2 5:58

And not that page count matters, but yes, you really underscored that it's comprehensive , uh, 35 plus pages of a speech and language evaluation for a child , uh, is, is certainly going to be much more informative than the brevity of , uh , of a school district space , speech and language evaluation. So let's kind of get into what disabilities that a child may qualify for on an IEP often need speech and language services as a related service, and will require an informative speech and language evaluations, like the ones that you conduct .

Speaker 4 6:44

Okay. Yes. Um, so 35 pages is probably a lengthier evaluation, but points to, in that particular case points to the need to look into , um , many aspects of communication. So not just a receptive language issue or expressive language issue, but how does that child use those skills to be able to , um, you know, retell a story or have a conversation? Um, you know, in some cases we're looking at articulation and fluency and social language and narrative language and , uh, auditory processing, you know, so some, some evaluations will be longer than others depending on , um, what, what we need to look into, but in terms of , um, in terms of disabilities , we see, I think the speech language pathologists , um, at school districts are on most of the cases in special education. So I know from working in a school years ago, that if there were 60 kids with an IEP in a building, I was probably on 55 of those cases because , um, there's an underlying language issue to most disabilities. So , um, autism is a disability that we're certainly called in for , um, uh, kids with a , um, learning disability where you're, we're often have underlying language issues where we can tap into some phonological processing , um, at a fundamental level to help them with their reading. So that would be more of a related service to that disability. Um, and then there are students that their primary disability is speech and language impairment. So then we're certainly involved in writing. Um, and sometimes, you know, the main person involved in writing the IEP , um, and informing other staff members on how to include language objectives into academic objectives. Right?

Speaker 2 8:49

So , um, one of the things that we try to do in the podcast is empower to understand some of the vernacular that's involved with special education law and the individuals with disabilities education act. And , and you mentioned some words, some buzzwords within speech and language evaluator jargon that , um, I'd like to kind of unpack and unbundle , and you mentioned receptive language and expressive language and , uh, the use of pragmatic functions of language. Could you explain that in the context of you have a family that's going to a IEP meeting and they know that their child has and requires speech and language services, but we want to help the parents to be able to use the vernacular that we're using so they could hone in more specifically as to what their they should be requesting.

Speaker 4 9:47

Okay. Um, okay. So I'm going to try to do my best to start with , um, with the very, very fundamentals of language and work my way up. Okay. So , um, so when you're looking at a student that has a language issue, it's not really always that they don't have the best vocabulary or grammar or , um , understanding of a paragraph, right? So sometimes there's something much more fundamental to look at. So we look at , um, we look at phonological processing, which I mentioned before, and that's a student's ability to , to listen and process and remember sound sequences. So if your child is , um, speaking and is , is unintelligible, not necessarily because they're sound, each sound is not correct, but when they put those sounds together, it's sort of mumbled together. Those students might not under understood , or it might not be aware or have the processing of individual sounds that create language. So that can affect a student's articulation. And later a student's reading , um,

Speaker 2 11:00

Full awareness really is the knowledge that a student has with putting various sounds together in language itself,

Speaker 4 11:09

Phonological awareness and phonological processing are a bit different. So the buzzword of phonological awareness will you'll hear kindergarten, first grade teachers talking about rhyming and understanding , um, the first, what the first sound is of a word, the last sound of a word , um, phonological processing is a little bit more, a little bit more technical and a little bit more basic. So, you know, can the student really listen to say , um, a multi-syllabic even a nonsense word and be able to repeat that word? And if they can, you know, given the whatever age they are, but if they can't repeat what they've just heard, phonetically, then there's an issue with what their brain is doing after they've heard sounds. Um, so after that, I guess I would go to auditory processing, phonological processing as part of auditory processing, but phonological processing is, you know , a smaller component. So when you hear, or you think your, your child just , um, doesn't understand what you've said to them, doesn't understand stories. Can't remember , um, what, w you know, how , I can't remember something from a story , um, um, has difficulty repeating information. They are, and of course their hearing would have been tested, but they're hearing is they're hearing acuity is fine, but what their brain is doing after they hear the words, the phrases, the sentences is not working properly. Right. So then you see a decrease in , um, their ability to comprehend language as , um , the language gets longer and more complicated. So we'll see some kids where we read them a sentence or two sentences, and then that ask them a basic who, what or where question, and they can't answer it. And that's not necessarily because they don't understand the question, or they don't understand the information presented. It's possibly much more basic that they just haven't processed it and they need it repeated or reworded. And if you do that, and then they can't answer it, you know, that they understand the language, but their brain is not processing the information, you know , quickly or accurately enough. So after that would be receptive language to your question, and that's more of the comprehension, right. So, you know, can, does the student understand basic vocabulary? Does the student understand , um, sentences? Can they answer questions about a story? Can they follow a classroom discussion? Um, is it going to too fast for them, or , um, are they just not understanding , um, the , the words and the sentences based on , um, you know, like I said, decreased vocabulary , um, or, or a decreased understanding of what a wh word means , um, or what a concept is. So with receptive language, we look at understanding of basic concepts. So do, does the student understand the words before and after and what that means as an example, any questions so far?

Speaker 3 14:22

Well, so you you've really gone through a lot as far as what the speech and language pathologist does individually, but, you know, it takes a village, right? So it's, it's very often important to have the speech and language pathologist in consultation with the rest of the school team, rather than it being a siloed related service. Can you, can you walk through how you , um, we'll work with others on a child's school team to implement goals and objectives to implement other related services, to embed speech and language throughout the child's day?

Speaker 4 15:06

Yes. So , um, you can embed phonological processing objectives into a reading objectives. So , um, rather than have a student just read simple words or write symbol words, have them really listen to tell you what the individual sounds are. Um, repeat, like I said, repeat nonsense words or repeat longer words. So a reading teacher can just incorporate some of those basics within their reading instruction before actually delving into actually , um , reading or writing. Um, when students are , are young , um, basic concepts, such as many, all , um, few , several, those sorts of things can be incorporated into math objectives. Um, and comprehension objectives can be incorporated throughout all grade levels within almost all subject areas, including reading, and then science and social studies with, with really working with other teachers, getting them to , um, understand what types of questions the student can answer , uh, what what's more difficult, how to phrase things, how to improve their ability to, to verbally respond , um , to a question sometimes , um, kids understand the question and understand the information, but they can't get their, their words or their sentences out correctly. So working with , um, general ed teachers and special ed teachers to scaffold how to make their expressive language work for them and in an academic area.

Speaker 3 16:47

So let's, let's switch gears for a moment cause we we've been talking about more of the instruction and the literacy and the reading component to how important it is to have a speech and language pathologist working with the other team members. But what about the social aspects is social language and social pragmatic, pragmatic aspects of speech and language services.

Speaker 4 17:12

Yes, and we, we, we evaluate this comprehensively when we do a comprehensive evaluation for kids with language disorders and particularly kids on the autism spectrum. Um, so it's hard, you know, in the younger grades, it's easier to work on these skills, but the , the nuanced needs or the needs are very nuanced, I should say. So really getting teachers and parents and , um, paraprofessionals to buy into , um, the importance of some of those objectives. So, you know, playing games are a great way to work on social language, and this doesn't happen really often enough in schools, but, you know, to be able to play a game, to watch somebody else's turn to make a comment about them, to ask a question during the game , um, you know, those are, those are invaluable , um, you know, activities that can be done. Um, but social language will lend if, if those early skills and nuanced skills are not worked on when the kids are little , um, those, those sort of areas of weakness can then , um , come out later when kids are , um, trying to have more sophisticated relationships and also, right . You know, because sometimes when there's a social language issue , um, students don't understand what information their listener has and what the listener doesn't have. So that's a problem in a conversation, right? If they're speaking to them about something that they think they have a lot of information about, and they're not being specific or the opposite. And so when, when a student then goes to write about something, they may then not be very specific in their writing because they think their listener knows , um, or they may be overly specific. Um, so it's important to work on those skills at a young age and then continue to make sure that those are embedded into academic areas as well. And not just, you know , um, it's a fundamental skill. So, you know, just teach writing , um, through a graphic organizer, you can use social language in terms of, you know, does your listener know what that word means? Um, is this clear to your listener or does it make sense that sort of thing

Speaker 3 19:32

Now for, for parents that feel that their school districts speech and language evaluator did not provide a comprehensive speech and language evaluation, right? It's , it's kind of a hotly contested issue is when should a parent who cannot otherwise afford to get a private speech language evaluation, either through insurance or not, or privately funded, when should they be seeking to have an independent speech and language evaluation. Um, and in your, in your opinion, and in your experience when you're called in , um, what are you looking for in a speech and language evaluation in which the parent can challenge the clinical sufficiency or lack thereof in its comprehensiveness, right? Are there certain, are there certain things and assessments and items and interviews and , and reviews that a parent should know about to say, well, you know what, I know that the speech and language evaluation is a comprehensive, but I need to be able to put it in terms that the district's going to understand why it is not

Speaker 4 20:53

Right. So I think the most important thing would be , um, you know, did the assessment, did the evaluation assess the specific areas of concern? So oftentimes I hear parents say , um, you know, they did all of these assessments, but , um, they didn't really tap into the area that he's struggling with most, you know, whether it be , um, the ability to, you know, formulate, you know, retrieve his words, formulate sentences, write a paragraph, retail and event. Um, those, those skills, you know, sometimes you have to just dive a little deeper there because , um, kids can often have the discrete skills independent, you know, they can have the discreet skills intact. Um, but when they go to apply them to a real life situation or an academic situation, things falter. So one good thing to present to the district is ESU did all of this testing, but I still don't understand my child's ability to, you know, X, whatever it might be. Um, so when an evaluation comes to me, I also look to see , um , if they've tested in various areas. So they, if a student has a language issue, they can't, you know , only give one assessment that a test that tests receptive and expressive language, they have to give numerous assessments , um, in, in the varied areas. Otherwise it's not considered , um, you know, a complete evaluation, right?

Speaker 3 22:33

So what you're saying is that in speech and language evaluations, that we've seen them where they're just providing one battery of assessment, they're just, they're just applying one tool in which to either qualify or not qualify a child for speech and language service hours, that should be a red flag to a parent that's reviewing that evaluation and wanting to challenge the comprehensiveness of it when only one tool one assessment is being applied.

Speaker 4 23:05

Yes, that's correct. Um, and also if there's a glaring issue, so we had a case where we were , we worked , um, where we had some, a student in common , um, and that particular student , um, he, his speech did not sound appropriate. He was going into middle school and his speech was way off, like just sounded very, very atypical. Um, but the school district gave him articulation assessments. He scored perfectly average. Um, but this is a case where you have to go to your district and say, the score is perfectly average, but here's a recording of my son, and this does not sound typical. And everybody around that particular,

Speaker 2 24:02

That's a good point. Right? That's that I remember that case. It's such a great point, Kate , and, and the , um , um , I want to be like a stickler on the vernacular. So what you're referring to is actual a , the prosody, right? The actual, the actual , uh, punctuation and communication of, of, of , uh , verbal speaking.

Speaker 4 24:24

Yes. Yeah. So he, yeah, his speech sounded off. So set, your speech can sound off if you don't produce certain sounds correctly, if you're disfluent or if you place stress or intonation in the wrong, in the wrong place of a sentence or a word, all of those things can affect , um, you know, the tip of quality of how you sound, right . Um , and this , this, this student was, was struggling socially because he, you know, everybody, everybody agreed that his speech did not sound typical. Um, but it didn't show any, you know, the testing didn't show anything. So in those cases, we have to look into it more deeply to figure out what exactly is going on.

Speaker 2 25:08

So parents could bring a recording of their child and say, listen, I understand that you did a, what you feel to be a comprehensive evaluation school team. But listen to this recording, this was just on my child yesterday, or here's a list of words that my child cannot , um , pronounce correctly , uh , when he's home. So whatever you're providing him or not in school, isn't , isn't really generalizing into his or her , uh, you know, speech and language , uh, tools,

Speaker 4 25:45

Right. And sometimes, you know, school districts and teachers look so closely at how the skills are affecting , um, the students' academics. So they sometimes miss, you know, the , the forest through the trees, right? So , um , given a graphic organizer, for example, and , and a group discussion and a little bit of help from the teacher and like several edits on a written piece, you know, the student is meeting great expectations, but it's great to be able to record, you know, your child , either telling you a story or telling you how to do something or answering a question and bring that in and say like, this makes no sense. You know, everybody will listen and know that, you know, that's an example of something that's not right. Um, so yeah, bring a recording in , um, or bring a , uh , not an unedited written piece in , um, those, those things I think can be, because in many cases, you know , you'll sit around the table and people will look at it or listen to it and say, yeah, that's horrible. You know, it's really not good. Um, you know, and then, then you can have maybe a more honest discussion about how you can help the studio ,

Speaker 2 27:01

You know , um , um , um , I'm sure that you've heard this and your experience with working with parents and districts. Oftentimes I will hear a parent call me and say, you know, my speech at my school district speech and language evaluator said that there's really nothing that they can do at this point, because my child's list or tongue tie is a medical , um, is a medical challenge. And , uh, it's not going to be rectified , uh, but for a medical intervention or your , your child's , uh, facial features and body movement is very low tone. And again, that may be because of some underlying medical condition. Um, so therefore we're going to provide speech, but it's not necessarily going to be improving the outcome of your child's , uh , speech and language abilities. What do you say to a parent that may be faced with something like that?

Speaker 4 28:03

Um, well, I think there are some cases where , um, the parent will need to seek medical advice or medical intervention , um, before the speech therapy can be as effective as we would like it to be. Um, so a hearing impairment, a tongue tie , um, you know, those, those are very specific , um, medical needs that need to be addressed, you know, prior or in, you know, in conjunction to therapy. Um, but some other things like, like low tone , um, I'm drawing a blank on something else, but like, you know, that's not necessarily something a doctor needs to help with a speech pathologist is trained to help with, with low tone. And if you work with low tone, then their speech and language will improve. Um, so , um, there , you know, there's a distinction there,

Speaker 2 29:15

Right? Right. Uh , you know, one thing we haven't touched based on yet, but it's also at the crossroads of where a speech and language pathologist works in, and that is where a child may be requiring the assistive technology with their IEP. And , um, can you talk about that? Can you talk, we talked about how speech and language evaluators should be working with the special ed ,

Speaker 3 29:42

Uh, implementing , uh, speech services throughout their understanding of assignments and reading. We talked about the general ed teacher. What about 80? How, how can a speech and language pathologist be integrating assistive technology into the SLP recommendations or , uh, working collaboratively with an a T related service provider?

Speaker 4 30:11

Okay. Right. So I think there are a couple of outside of 80 . I mean, I'll get into 80, but I think there are a couple of recommendations that you're sort of touching on at the end of an evaluation. And those are not necessarily, you know, speech what a speech pathologist is going to do or what a teacher is going to do, but what, what the student might need outside of that. So oftentimes there's a recommendation for a consultation with an audiologist because there's, there's more going on then , um, then , uh, you know, the speech pathologist may need more information or there might be more going on than what a speech pathologist could test for or countries. So , um, a consultation with an audiologist to see if , um, an FM system or , or an amplification system in the classroom could work. Um, so that's certainly a recommendation that's that , um, that we make some times , um, to your point about oral motor. Um, I just wrote an evaluation where I recommended that the students should see, you know, a dentist or an orthodontist because , um, some of the oral structure was impacting his, his speech. That doesn't mean that he shouldn't have speech therapy. It just means in addition to that, can some , you know , can something outside the school , um, help, you know, help him. Um, and 80 audiologists can be seen in school, but , um, and school districts have 80 evolves as well. So that's often a common recommendation to coincide with the , um, speech and language therapy. Um, and this could be, there's, there's so many uses for assistive technology, but if , um, if you're looking at a student that has a minimal expressive language, there should definitely be an assistive technology evaluation to see if there's technology of computerized device , um, a speech generating device that can speak for the student, if any of those could be helpful in , um, in having the child communicate. But sometimes the child is communicating, but an assistive technology device can be used to , um, to expand their language. You know, they need the visual, they need the auditory feedback , um, in order to really expand and, and , you know, and use language properly. So , um, you know, and then there's assistive technology that can be used, you know, if somebody is having fine motor issues or writing issues or , um, you know, need just needs auditory books read to them on tape , um, you know, audio books. Now we used to say books on tape, but , um, so those, you know, those specialized areas are important, especially for kids with complex needs, because it takes a really full , uh , collaborative team to make the biggest difference.

Speaker 3 33:04

Right, right. Uh, so let's , let's talk a little bit about , uh , cultural sensitivity in the, in the context of perhaps inadvertently overidentifying for speech and language services and where students have English as a second language. Um, can you get into where , uh , services, speech and language services should be provided , um, for a child that , uh, you know, may have a different cultural background. Um, and the school district is saying, well, you know what, because English is not their first language or , um, uh, there's a different , uh , culture involved with the family , um, the child for cultural reasons, the child's not needing speech language services. Can you talk a little bit about how , um, cultural sensitivity may impact positively or negatively in the outcome of, of triggering speech and language support?

Speaker 4 34:09

Yes. So the student , the families that generally come to me are , um, are , you know, families that, that know it's beyond a second language issue. Um, there are a couple of key factors and, you know, one very important one is, is there a language weakness or disability or deficit in, in the other language, the first, the first language, if they're speaking to , or if they were taught one first. So if, if they can speak their , um , primary language without any evidence of a language disorder, then English has probably, you know, just delayed, right? Because they have been learning two languages at the same time. Of course, it's dependent on age and how long they've been exposed, but that's, that's one of the most important factors. So you would want the student tested in their , in , in their primary language. And in some cases you want them tested in both languages to compare. Um, but , uh , a student with a language disorder will have language disorder in both languages. Um, the other issue is , um, amount of time that the student has been exposed to the second language. So if a student has been in school for preschool kindergarten, first, second grade, third grade, you know, that's many years of intense exposure to the English language. Um, so you can only kind of, you know , um, rely on it being a first or second language issue for so long. Right . Um, and, and in one case I had a family come , um, where they had some, you know, the , the student had siblings right around the same age, exposed to language, you know , English for the same amount of time, they were not having trouble. And she was, you know, so that's another key factor to look at if you, if you have siblings.

Speaker 2 36:08

So one of the big takeaways there is that if English is your second language, it's important for parents to understand that their child's speech and language evaluation should actually conducted in the language of which the child predominantly speaks. If the , if the district's evaluated , just so happens to not be versed in that language. Well, then you may be needing to bring someone in that is, that is a speech and language evaluator to implement the evaluations with, with fidelity and with comprehensiveness. So that that's a huge takeaway for , um, our audience that, that has , uh , you know, diverse cultural backgrounds. So that that's really key. Um,

Speaker 4 36:53

And then the opposite sense, like I've had, I've had families come say they only want to test my, my student in Spanish and they won't allow, you know , for instance, I don't do evaluations in other languages. So , um, so, you know, we wanted an evaluation, but they won't let us get a private Val , unless the evaluator can do a Spanish evaluation. And that was in particular that the student whose really primary language was English. Like they speak Spanish in the home, but because of his other weaknesses, they were speaking Spanish to him for many years and he's been in school for many years. So, you know, what's practical. Um, what makes sense?

Speaker 2 37:32

Right. So we, we, we, I kind of want to pivot now a bit and talk about speech and language services in the context of a child that is on the autism spectrum. And , uh, I can't wait in a future episode, I'm actually having a board certified behavior analyst on , um, who talks about the importance of partnering with the SLP, with the implementation of ABA based services and how key it is to work together, to implement social pragmatic , um, goals and objectives. So can you talk about how you get involved with identifying speech and language services that a child on the autism spectrum requires?

Speaker 4 38:21

Yes. And I think speech pathologists are uniquely trained in that area, right? We're , we're highly trained in understanding how kids and adults understand language, use language and process language, and then use it for many different functions. Um, so a lot of our focuses on how you use language socially , um, BCBA is, and ABA therapists are, you know, the , the frontline technicians, if you will, right? So they're working with the students more than anybody else. In many cases, if the student is , um, is, is , uh, you know, impacted in that way on the spectrum, but generally, so , um, BCBS are involved and very prominent. Um, so I think speech and language fetologist can be used for identifying needs, writing objectives that , um, that really targets social language in a natural pragmatic way. Um, and then working with BCBAs to get those skills addressed within their ABA program on a regular intense basis while keeping it very pragmatic. And , um, you know , uh, ABA services have changed so much over time where it's not, everything's not , um, um, you know, data-driven, I mean, it is data-driven, but it's not, you know , uh, ABA used to be a lot of times, you know, do this great, do that. Great. What's this, what's that , um, say hi, say bye, like, and digging down on those things, but really like they're much more social are objectives. Um , ABA therapists goals are much more social now. So as I mentioned before, playing a game, you know, just going throughout the school , um, using those social language skills in a variety of settings with a variety of people in a variety of ways. Um, but I think the speech pathologist is uniquely qualified to assess and write the objectives and work with the BCPA on how best to address them.

Speaker 2 40:40

Right. Yeah. And it's such a great point because social pragmatics is key, especially as children get older. And , um, if you're not, if your child's IEP that is on the spectrum does not have, you know, perhaps a word bank that they could rely on when presented it presented with , uh , a social situation in which they're not necessarily able to successfully navigate the speech and language pathologists could work with the BCB provider to develop that word bank, to put that word bank into a context of social situations. Right. And then the PCBA can then go ahead and do the data and the observations either within the contrived social situations, or just naturally within the school environment.

Speaker 4 41:30

Right. Yeah. And I think to that point, it's, it's really helpful when , um, ABA therapists and or abuse CBAs will , um, sit in on speech language pathology sessions, right. Um, you know, not all the time, not every day or, you know , every session, but , um, every discipline works and addresses things differently. And I think I can learn from how a BCBA would address a certain skill and , um, that they, you know, they can learn by watching, you know, how we address certain skills in terms of, you know, getting a child to ask a question or make a comment or , um, or , um, you know, take turns, whatever it might be. So I think the overlap is extremely important, especially in the social pragmatic area.

Speaker 2 42:21

You know, one of the cliches and in the Ida world is if it's not on the IEP, it's not happening. And , uh, what we're talking about isn't necessarily something that would be on the service hour page , uh , but more in the , um, uh , accommodations page where it would, you know, say something like that, the SLP and the CBA will have a , uh , monthly consultation to discuss the child's , uh, social pragmatic developments or the social pragmatics , uh, implemented throughout the day. So parents should be asking for these things to be specifically put on the IEP, right?

Speaker 4 43:03

Yes. And I think it's really important for the paraprofessional to , um, for that to be written on the IEP that the instructional assistant or paraprofessional go to not only speech therapy, but whatever , um, professional the student is seeing the instructional assistants should be observing them so that they can implement it in the same way. It's , it's much different to observe than to, you know, hear or read what's been done. So again, I mean, the instructional assistants and paraprofessionals have their jobs are really tough. Um, and oftentimes they , um, the schedule is such that they're that when the student is in a special service or related service, that that paraprofessional might be taking lunch , um, or assigned to another student or whatever it might be. And I think, I think that that's not in the best interest of, of the, of the team and of the student.

Speaker 2 44:05

So let's , let's , uh, let's pivot again. And let's now talk about reevaluate, right? So under the Ida a child, well by law has to be re-evaluated for eligibility every three years, the triennial about the infamous triennial evaluation. And , um, uh, oftentimes parents may hear , you know, you know , um , your son has blossomed so well, his speech and language abilities have just flourished that , um, you know what, he doesn't really need the services anymore, or we're going to be reducing his services from an hour and a half a week to 30 minutes a week. And this is great mom and dad, because he's no longer needing these services. What does a parent do if they're still feeling you're clinically speaking, what does a parent do if they're faced with that as a recommendation , um, and it's going to be pitched to them obviously in a way that is successful, but parents might not feel that way if their child is still , uh , if their speech and language abilities is still impeding their ability to get access to education. So how, how do you handle a situation like that when you come in Katie ?

Speaker 4 45:28

So I think that that's when the comprehensive evaluation is most important. Um, so you want to look at not only the assessments that maybe the student has already completed, you know, three years prior, you want to see if they've made progress in those areas, especially the areas of weakness. Sometimes we see evaluations where the student three years prior scored particularly low in a certain area. And , and then , um, for the triennial, they didn't test that area. Um, they tested other areas and showed that he, that the student didn't necessarily need to continue or could decrease services. So I think , um, what we discussed earlier in terms of , um, requesting that your child be tested in the very specific, specific areas that show weakness or impacting learning, reading, writing, social skills , um, that those areas are tested and , um, and looked at really closely. Um, when I attend meetings, oftentimes I'm recommending increased services based on the evaluation results , um, or services to begin with. And something that comes back to me a lot is that the student is meeting their objectives. So they've written an IEP that can be achieved within a year, and they've set that sort of boundary for the student. And they're saying, he's going to meet his objectives, given the amount of time that that's left on his IEP. And so we don't need more time, need more services, but it doesn't really make any sense when you're looking at a student that is so significantly behind, you know, and even if they master their co the IEP and completion by the end of the year, they're still going to be so intensely behind. Um, so I don't, I think it's great if they're meeting their, but , um, you know what , uh, I don't see that that is a reason to not give them more services. So I know that didn't exactly answer that the , the , your question, the first part did, but it reminded me that this is what I hear very often in meetings. And I don't quite understand.

Speaker 2 47:51

Yeah, no, it , it goes to the whole point of, well, if you disagree with the, with the reduction in services, then that's probably a time where you're at an impasse with the school team and you could arguably say, well, look, you know, we feel that our child's continuing to need these services and we're at a disagreement. So we're going to be requesting an independent speech and language evaluation to help more fully inform our disagreement.

Speaker 4 48:20

Right . Yeah. I think that that is very important and a good time to do it. Right.

Speaker 2 48:25

You know, while we have a little bit of time left , um, can you go through some of the common assessment tools that should be in the battery of assessments that are done in a comprehensive evaluation? And we'll put it in the context of the child that, you know, let's say elementary school , um , a and , um , is having difficulty with pronunciation and , um, you know, difficulty with , um, you know, the kind of normal flow of speaking , um, and, and, and having difficulty with comprehending questions and following commands. Right. So what specific type of assessments should be evaluator be conducting with a student that may present with that type of persona.

Speaker 4 49:17

Um, and you said a difficulty with speech production as well. Right. Um, so with speech production, I like to see what is the underlying cause , um , of the issue because the treatment is different , um, depending on what , what the disorder might be in school districts, you know, aren't really looking for medical diagnoses. They're looking for, you know, an, an academic label. Um, they have a speech and language issue that's affecting their academics and that's it, they don't, they don't go into what type of , um, disability it might be or disorder it might be. So when I'm looking at speech, I want to know if it's a phonological issue or an articulation issue, or , um, or based in, in motor planning. So generally I can get that feel from just listening to the child , um, you know, just in meeting, just listening and doing some preliminary informal assessments. So , um, so you may want to give the Kaufman , um, speech Praxis test, if you're suspecting that there's a motor planning issue, or if you're suspecting verbal Praxia , um, or if you're just not sure why the S the sounds are off, you know, the vowels are off the syllabication is off. You're just not sure that's , that's a really good assessment to give, not only for the diagnosis, but just to get more information. Um, from there you can , um, you can give a phonological assessment. Um, so as we spoke up to before they processing the sounds appropriately to be able to combine them into speech , um, the C top is one comprehensive test of phonological processing. Um, there's a Goldman Fristoe test of articulation. If you just want to see what sounds consonant sounds they have, and they don't have, the Coffman is better for when you're hearing Val distortions or just inappropriate. Um, you know, you're just not quite sure what sounds off, but something is off. The important thing with the Goldman Fristoe is to, is to analyze it specifically. So there's a con Lewis , um, articulatory assessment, I think. Um, but we call it the con Lewis . Um, I forget the rest of the, the name, but , um, but that goes into that. That's done with the Goldman Presto. So you, you basically chart their errors and you see what, what they are actually doing with their speech that's causing those errors. So are they consistently moving their tongue forward to the front of their mouth rather than where it's supposed to be in the back? Are they , um, are they deleting a continent out of , uh , uh, out of a cluster, so saying stop instead of stop. So those are really important in terms of , um, identifying what is actually going on and then treating it most effectively.

Speaker 2 52:22

That's, that's great. I mean, that's such useful information for parents, you know, the Kauffman evaluation, the Goldman Fristoe , um, the comprehensive, receptive and expressive vocabulary test . I mean, the , these are things that if a parent is going down the road of requiring speech and language services for their son, this is really, you know, an introductory crash course for them. They can now go and Google these, these, these assessments and get more fully informed on their own. Right. Um, my last question , uh , Katie is we're in the middle of COVID , um, schools are about to shut down again, at least in the state that we're in , um , and , and go remote. How has COVID impacted the ability , uh, to implement speech and language services remotely? How has it impacted the ability to , uh , conduct speech and language evaluations, or has it not, and how were you getting involved with that?

Speaker 4 53:33

Um, so during the shutdown , uh , March through may , um, families really weren't seeking evaluations or therapy at that time , um, I did have a few cases where we were able to complete an evaluation virtually. So there are some , um , students and some assessments that can easily be done in that manner. So if you're looking for an evaluation and you're worried about in-person contact, you know , certainly call a speech pathologists and see what the options are because , um, because a lot can be done virtually, and even if everything can't be done virtually a lot can. So , um, a little bit is better than not having the information , um, in terms of therapy. Um, for, for, for my practice, we're doing in-person and virtual. Um, it's trickier for the little kids. So if little kids need remote teaching , um, it ends up being kind of , um, a lot of consultation with the parent and instructing the parent on how to help them. Um, so as soon as , uh , we were able to safely treat in the office, those young kids started coming in , um, and we have tons of precautions in place, and I feel it's fairly safe, at least right now. Um, and then , um, assessments currently are being done either in-person or virtually , um, mostly in-person right now, if we do do another shutdown , um, you know, I don't want to anticipate it , um, you know, closing down to the extent it did in March and April and may. Um, but a lot, you know, a lot can still be done. And so if you're concerned, you , you know, don't wait, COVID lasting a long time, you know, we're going to be in it for a year before it's going to be back to normal. So , um, you know, March, April, may, everybody was kind of hiding out and nervous and everything, but I think , um, we can't, we can't let things go for that for that long for a whole year. So, so call somebody and figure out what can be done.

Speaker 2 55:45

Well, Katie, Cara , thank you so much for being on, on the show. Uh , now your website is kids language center.com, right? Yes . So parents, if you, if you want to learn more about Katie and , uh, you know, reach out to her and get her services for your child, kids language center.com, it's going to be also in the script notes and in the bio on this. Thank you for being on the show, Katie, and thank you everyone for listening. Stay tuned for another episode.