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screenings are important (but not enough) the speech bubble slp

It seems like no matter where you are or what setting you work in, you’ll always have referrals and requests for screenings on your desk.  I remember one year during the second week of school, I noticed a bunch of papers in my mailbox at work.  I had already gotten my new student files so I was curious what they were.  Did I win some contest? Could they be drawings from my students depicting their love of speech?  Nope, they were requests for screenings.  Seven to be exact.  It was the very beginning of the school year and my teachers were like…

 

screen all the kids speech meme the speech bubble slp

 

After I got over the shock of all these new little friends I was about to meet, I set to work going over the forms to see what concerns the teachers had that made their speechie red flags start waving.  Some articulation, some language, the usual mix.  I grabbed the screenings I needed (for a list of the screenings I use pretty much all the time, scroll to the bottom of the post) and set out to start crossing names off my list.  Most came out average, their difficulties stemming more from new school year jitters than true articulation or language difficulties. However, a few set off the red warning light in my head.

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Now in Illinois, we do RtI/MTSS ( Response to Intervention/Multi-Tiered Systems of Support) if a child fails a screening rather than moving right to an evaluation.  It is kind of like the Lite version of therapy.  A goal is created and targeted for a length of time. If progress is made they can keep going with the intervention. If not, it is time to look deeper.

I have a love/hate relationship with this model.  When it comes to students who failed screenings because of just one or two specific areas like describing and irregular past tense verbs, the intervention route works well.  They don’t need an IEP if they are just having difficulty with one area (let’s say describing) and that weakness is making it difficult to perform in classes like science and writing.  By getting support in just this one area, because that is all your screening showed they needed at that time, they can improve in their other academic areas.

That is my love part of this model: I can focus on just one goal without the mountain of paperwork that comes with an IEP. Yes, these kids still get progress updates, but that is usually a one page document — not a 16 page packet of information in size 10 font.

Here comes my hate part of this model. OK, maybe hate is too strong of a word. How about extreme dislike, does that sound better? Well, my extreme dislike part of this model is if the child fails the screening, and I mean fails every single area, gets a big ole goose egg, a zero, I still have to do interventions.  In my district, it has to be a team decision to go straight to an evaluation.  If speech is the only area assessed or if they didn’t completely fail other areas that were screened ( i.e. reading, math, writing) the chances of going straight to an evaluation are small.

Yes, I can provide the student with interventions, which is better than nothing. However, if I’m not working on the right thing with this student, it is time wasted for both of us.  When a student significantly fails a screening, it is glaring that there is more going on than meets the eye.

Screenings are snapshots of a student’s abilities, not a photo album.

They don’t tell us everything about a student’s language use or skill ability.  I have tested kids who completely failed screenings only to have them come out average in some areas on certain assessments and show significantly delays in maybe two or three areas that were causing a ripple effect and creating difficulties with other skills.   What is the point of that little tangent? If we don’t start targeting the root of the their struggles right out of the gate then we are simply ‘prettying’ up their language instead of addressing the problem.  Think of it like putting new windows in an old house with a bad foundation.  Yeah, those windows would make that house look better, but would they fix the crumbling cement that is supposed to provide support for the entire house? Nope.

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So what can you do if a student fails their screening in all areas but you are expected to do interventions?

– First, if you feel that the student has deeper, more serious underlying issues that only an evaluation can reveal let your team know. Support your request with the data from your screenings.
– If you are over ruled and instructed to do interventions prior to an evaluation use these points to help you choose what to work on:
-1) Look at their screening and identify what skill should have developed first: i.e following one step directions vs comparing/contrasting
– 2)Choose 2-3 skills that should have developed first and ask the teacher: if improved, which would benefit the child the most in the classroom?
– 3) Keep it simple and focus on just one goal/objective.  Keep notes of any things that pop up during sessions. For example, the need for frequent repetition, benefits from visuals, etc. Pass them on to the teacher.
– 4) After your intervention time frame is up, ask for an eval again if you feel it is necessary.  Stand your ground in a polite and professional way.  You are the language expert. You spent years specializing your knowledge in this area for this reason.

 

My fav screenings:

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Meet Maureen

Hey there! I’m Maureen Wilson, a school-base SLP who is data driven and caffeine powered. My passion is supporting other pediatric SLPs by teaching them how to harness the power of literacy and data to help their students achieve their goals…without sacrificing time they don’t have.

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