Se Speech or Language Impairment Evaluation Guidance PDF
Se Speech or Language Impairment Evaluation Guidance PDF
Se Speech or Language Impairment Evaluation Guidance PDF
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Acknowledgements
The department recognizes and appreciates all of the listed educational professionals, higher
education faculty, parents, and advocates contributed to the development of the Speech or
Language Impairment Evaluation Guidance for their time and effort.
Susan Usery
Laria Richardson
Pamela Guess
(Middle TN)
Chattanooga
Annie Kelley
Lisa Rodden-Perinka
Scott Indermuehle
Education
Katie Kerley
Melanie Schuele
Nathan Travis
Education
Ashley Clark
Toby Guinn
Theresa Nicholls
Clarksville Montgomery
Franklin County Schools
Tennessee Department of
County Schools
Education
Andrea Ditmore
Cathy Brooks
Joanna Bivins
Tennessee
Education
Robin Faircloth
Jenny Williams
Kristen McKeever
Coalition
Education
Leslie Jones
Ron Carlini
Table of Contents
Introduction
Section I: Definition
Section II: Pre-referral and Referral Considerations
Section III: Comprehensive Evaluation
Section IV: Eligibility Considerations
Section V: Reevaluation Considerations
Appendix A: TN Assessment Instrument Selection Form
Appendix B: Resources and Links
Appendix C: Articulation Norms
Appendix D: Phonological Processing Norms
Appendix E: Language Milestones
Appendix F: General Classroom and Home Articulation Interventions
Appendix G: Articulation Impact in the Classroom
Appendix H: Disfluency/ Fluency Checklist
Appendix I: Language Skills Checklists
Appendix J: Teacher Pragmatics Checklists
Appendix K: Fluency Questionnaire for Parents/Caregivers
Appendix L: Voice Checklist
Appendix M: Vocal Habit Chart
Appendix N: Permission to Screen Language Skills
Appendix O: Examination of Oral Peripheral Mechanism
Appendix P: Language Severity Rating Scale
Appendix Q: Speech Sound Production Severity Rating Scale
Appendix R: Fluency Severity Rating Scale
Appendix S: Voice Severity Rating Scale
Appendix T: Evaluation Report Template
Introduction
This document is intended to provide school teams guidance when planning for student needs,
considering referrals for evaluations, and completing evaluations/re-evaluations for educational
disabilities. Disability definitions and required evaluation procedures and can be found
individually at the Tennessee Department of Education website (here).1
Every educational disability has a state definition, found in the TN Board of Education Rules and
Regulations Chapter 0520-01-09,2 and a federal definition included in the Individuals with
Disabilities Education Act (IDEA). While states are allowed to further operationally define
definitions and establish criteria for disability categories, states are responsible to meet the
needs of students based on IDEA’s definition. Both definitions are provided for comparison and
to ensure teams are aware of federal regulations.
The student must be evaluated in accordance with IDEA Part B regulations, and such an
evaluation must consider the student’s individual needs, must be conducted by a
multidisciplinary team with at least one teacher or other specialist with knowledge in the area
of suspected disability, and must not rely upon a single procedure as the sole criterion for
determining the existence of a disability. Both nonacademic and academic interests must
comprise a multidisciplinary team determination, and while Tennessee criteria is used, the
team possess the ultimate authority to make determinations.3
IDEA Definition
Per 34 CFR §300.8(c)(11) A speech or language impairment means “a communication disorder,
such as stuttering, impaired articulation, a language impairment, or a voice impairment that
adversely affects a child’s educational performance.”
Section I: Definition
Tennessee Definition of Speech or Language Impairment
A speech or language impairment (SLI) means a communication disorder, such as stuttering,
impaired articulation, a language impairment, or voice impairment that adversely affects a
child’s educational performance, which may be congenital or acquired. Identified speech and/or
language deficiencies cannot be attributed to characteristics of second language acquisition,
cognitive referencing, and/or dialectic differences.
1 https://www.tn.gov/education/student-support/special-education/special-education-evaluation-eligibility.html
2 https://publications.tnsosfiles.com/rules/0520/0520-01/0520-01-09.20171109.pdf
3 Office of Special Education Programming Letter to Pawlisch, 24 IDELR 959
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Cognitive Referencing
Cognitive referencing refers to the practice of comparing language skills to cognitive ability and
the belief that language functioning will not grow beyond cognitive levels. This is not a
consistent belief system and is not a best practice associated with the American Speech
Language-Hearing Association (ASHA). Nor is it consistent with IDEA, which does not place a
qualifier in regards to a specific level of cognitive ability or discrepancy in order to meet criteria
for a language impairment.
(OSEP) has provided guidance to clarify that “educational performance” is not limited to
academic performance.4 Impact is determined by the IEP team on a case-by-case basis and is
decided by the specific needs of the student to ensure a free and appropriate education (FAPE).
Language Impairment
The term language impairment is defined as a deficiency in comprehension and/or spoken
language that may also impair written and/or other symbol systems, and negatively impacts the
child’s ability to participate in the educational environment. The impairment involves at least
one of the following components: the form of language (phonology, morphology, and syntax),
the content of language (semantics), and/or the use of language in communication (pragmatics)
that is adversely affecting the child’s educational performance.
When analyzing the definition of language impairment, the following areas typically require
clarification:
Phonology – the speech sound system of language, and the rules for how speech sounds are
combined.
Morphology – the rules that govern how morphemes (the smallest meaningful units of
language) are used in a language. A morpheme can be a single word or a word part, such as an
ending, that changes its meaning.
Example: walk; walks, walking
Semantics – the meaning of words and combination of words, often broadly described as
“vocabulary.”
Syntax – rules in which words can be combined in language, often broadly referenced as
“grammar and sentence structure.”
Pragmatics – the rules that govern social communication—verbal and non-verbal—and the use
of language in various settings and people.
Speech Impairment
The term speech impairment is defined as a disability that can result from disorders in any of
the following three areas: articulation, fluency, and voice. While each disorder is evaluated and
treated differently, all three are recognized as a speech impairment.
often “SH,” “CH,” and “J” sounds. For example, the airstream for the /s/ sound that is
normally directed through the center of the oral cavity over the midline of the
tongue is instead thrust down laterally around the sides of the tongue.
Motor planning – the ability to conceive, plan, and carry out a skilled oral motor act in the
correct sequence from beginning to end.
Sequencing deficits – difficulties articulating sequenced sounds needed for clear speech.
Intelligibility – refers to speech clarity, or the proportion of a speaker’s output that a listener
can readily understand.
Phonological Processes – Phonology is associated with the rules and patterns of the sound
system of language, not the movement of the articulators. The phonological system of a
language governs the ways in which sounds can be combined to form words. With phonological
processes, errors have logical and coherent principles underlying their use. The errors can be
grouped on some principle and thus form patterns (e.g., final consonant deletion: no/nose,
ba/ball, pe/pen, consonant cluster reduction: poon/spoon, top/stop). The student’s patterns
of “simplification” of sound usage severely affect intelligibility. The advantage of identifying
phonological error patterns is that those patterns can then be targeted for remediation,
thereby affecting more than one sound at a time. For example, if a student exhibits a final
consonant deletion pattern, you may choose to target final consonants in general rather than
focus on each and every sound that is omitted at the end of words.
differences;
speech sound errors at or above age level according to established research-based
developmental norms or speech that is intelligible without documented evidence of
adverse impacts on educational performance;
errors due to physical structures (e.g., missing teeth, unrepaired cleft lip and/or palate)
that are the primary cause of the speech sound impairment; or
children who exhibit tongue thrust behavior without an associated speech sound
impairment.
Speech Impairment (Fluency) – Abnormal interruption in the flow of speech, such as stuttering
or cluttering, characterized by any of the following: atypical rate or rhythm; repetition of
sounds, syllables, words and/or phrases; prolongations of sounds; hesitations or blocks
interfering with the production of sounds/words; and secondary or covert behaviors, which
interfere with the speaker’s ability to communicate within the learning environment.
A voice impairment does include disorders found to be the direct result of or symptom of a
medical condition unless the impairment impacts the child’s performance in the educational
environment and is amenable to improvement with therapeutic intervention.
The following terms in the voice speech impairment definition are further described below:
Pitch: high, typical, or low,
Quality: may include descriptive terms such as hoarse, harsh, breathy, strained, or weak,
Differences that are the direct result of regional, dialectic, and/or cultural differences; or
Differences related to medical issues not directly related to the vocal mechanism (e.g.,
laryngitis, allergies, asthma, laryngopharyngeal reflux, acid reflux of the throat, colds,
abnormal tonsils or adenoids, short-term vocal abuse or misuse, neurological pathology).
It is the responsibility of school districts to seek ways to meet the unique educational needs of
all children within the general education program prior to referring a child to special education.
By developing a systematic model within general education, districts can provide preventative,
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supplementary differentiated instruction and supports to students who are having trouble
reaching benchmarks.
Pre-referral Interventions
Students who have been identified as at risk will receive appropriate interventions in their
identified area(s) of deficit. These interventions are determined by school-based teams by
considering multiple sources of academic and behavioral data.
One way the Tennessee Department of Education (“department”) supports prevention and
early intervention is through multi-tiered systems of supports (MTSS). The MTSS framework is a
problem-solving system for providing students with the instruction, intervention, and supports
they need with the understanding there are complex links between students’ academic and
behavioral, social, and personal needs. The framework provides multiple tiers of interventions
with increasing intensity along a continuum. Interventions should be based on the identified
needs of the student using evidenced-based practices. Examples of tiered intervention models
include Response to Instruction and Intervention (RTI2), which focuses on academic instruction
and support, and Response to Instruction and Intervention for Behavior (RTI2-B). Within the RTI2
Framework and RTI2-B Framework, academic and behavioral interventions are provided
through Tier II and/or Tier III interventions (see MTSS Framework, RTI2 Manual, and RTI2-B
Manual).
These interventions are in addition to, and not in place of, on-grade-level instruction (i.e., Tier I).
It is important to recognize that ALL students should be receiving appropriate standards-based
differentiation, remediation, and reteaching, as needed in Tier I, and that Tiers II and III are
specifically skills-based interventions.
Cultural Considerations
Interventions used for EL students must include evidence-based practices for ELs.
speaking to other children and adults in the classroom. An effective approach to intervention is
a multi-tiered educational framework aimed at early identification and support of students
whose learning needs are not being met. This type of system involves high-quality instruction
and interventions aligned with the student need, routine progress monitoring to inform
instruction, and using data-based decision making for referral and programming needs.
Speech language pathologists (SLP) are valuable resources as schools design and implement a
multi-tiered system of supports. Professional development provided by the SLP is vital in
helping educational staff understand the roles and responsibilities of their position, and how
they contribute to the whole child within the general education setting. Professional
development can include: (This list is not exhaustive.)
developmental norms associated with language, articulation, phonological
processing, and fluency
the role that language plays in curriculum, assessment, and instruction
the identification of systemic patterns of student need with respect to language skills
the interconnection between spoken and written language
guidelines for a multi-tiered system of supports focused on students demonstrating
concerns in the areas of speech-language
resources and intervention strategies for language, articulation, fluency, and voice
initial referral procedures, assessment, eligibility, and placement
re-evaluation process procedures
Collaboration:
Speech-language pathologists (SLPs) have an extensive history of working collaboratively with
families, teachers, administrators, and additional service providers. SLPs play a critical role in
collaboration around the speech-language MTSS process. Collaboration can include: (This list is
not exhaustive.)
Assisting general education classroom teachers with universal screeners
Participating in the development and implementation of progress monitoring systems
and the analysis of student outcomes
Serving as members on the school-based intervention teams
Consulting with teachers to meet the needs of students in identified tiers
Interpreting screening and progress assessment results
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It is important to understand that students with speech or language impairments can often be
supported in the general education setting. In fact, attempts should be made to offer
interventions in the least restrictive way prior to considering a referral for special education. As
with other learning, children often make marked improvements in their speech and language
skills through focused instruction implemented in the general education setting. With progress,
the student’s needs can be met without the need for direct support from an SLP or intensive
specialized instruction provided through an Individualized Education Plan (IEP).
Speech and language impairments (SLIs) are considered educational disabilities. SLI categories
are reserved for students whose communication skills cannot be supported in the general
education setting, and whose speech or language skills are impeding learning, social
participation, and/or vocation. While a tiered intervention model is recommended prior to a
referral to special education, if at any point there is a suspicion that an educational
disability exists, the team should consider conducting a comprehensive evaluation to
determine the need for special education.
ASHA indicates the prevention of language impairments is one of the primary roles of the
profession. While the identification and treatment of language disorders remains a principal
focus, prevention is equally important. The U.S. Preventive Task Force identified the following
as risk factors for speech/language deficits: premature birth/low birth weight, being male, a
family history of speech/language problems, and lower education levels of parents.
The following are tips for parents and caregivers to prevent a language impairment:
Have your child’s hearing checked and follow up with all doctor’s appointments
regarding your child’s ears (i.e., ear infections).
Talk to your child from the time they are born.
Read to your child from the time they are born.
Sing to your child even when they are a baby.
Respond to your child’s babbling.
Play simple games like “peek-a-boo and patty-cake” with your baby.
Describe for your child what they are doing, feeling, and hearing throughout the day.
Answer your child’s questions (when they ask why, encourage their curiosity).
During pregnancy, abstain from use of tobacco, alcohol and drugs.
Make sure your child wears a helmet and seat belt regularly to prevent head injury.
See Appendix E for typical developmental milestones and Appendix I for a language checklist by
grade.
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Even so, a number of studies have identified risk and protective factors associated with speech
sound disorders in children. Risk factors include:
being male;
pre- and perinatal problems;
oral sucking habits (e.g., excessive sucking of pacifiers or thumb);
ear, nose, and throat problems;
a more reactive temperament;
family history of speech and language problems;
low parental education; and
lack of support for learning in the home.
As children who stutter get older, they may become adept at word and situational avoidances
that may result in a low frequency of overt stuttering. In addition, children with cluttering or
stuttering may only experience symptoms situationally, particularly during times of high
emotion, either positive or negative, or through seasons of significant change in the home or
school environment. However, despite the fact that some children may show little observable
disfluency, they may still be in need of treatment for a fluency disorder due to the negative
effect stuttering or cluttering is having on the development of social skills, quality of social
interactions, and/or ability to participate in oral classroom activities.
ASHA further explains that differentiating between typical disfluencies and stuttering is a critical
piece of assessment, particularly for preschool children. For school-age children, it is important
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to distinguish stuttering from other possible diagnoses (e.g., language formulation difficulties,
cluttering, and reading disorders) and to distinguish cluttering from language-related difficulties
(e.g., word finding and organization of discourse) and other disorders that have an impact on
speech intelligibility (e.g., apraxia of speech and other speech sound disorders). Keep in mind
that children may have fluency disorders as well as co-occurring conditions (ASHA).
Without proper intervention, children who exhibit signs of early stuttering are more at risk for
continued stuttering. The chart below describes some characteristics of "typical disfluency" and
"stuttering" (Adapted from Coleman, 2013).
The following characteristics are considered non-developmental red flags and warrant further
evaluation:
Stuttering persists beyond six months
Struggle behaviors, or secondary characteristics, associated with stuttering are observed
Family history of stuttering or related communication disorders is documented
Age of onset – if a child begins stuttering before age three and a half, s/he is more likely
to outgrow the stuttering
Presence of other speech and/or language delays
Avoidance of speaking situations or marked increase in frustration with speaking tasks
Gender Male
5 http://www.stutteringhelp.org/risk-factors
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Chart: Disfluency versus Stuttering6
For some students, early treatment may prevent developmental stuttering from turning into a
lifelong problem. A key point to consider is to try changing the speaking environment but not
the child. Creating positive and calm communication experiences is very impactful to the
student. It is important to assure the speaker that the listener cares more about the message
being communicated than the manner in which it is delivered.
The following are some strategies that can help children learn to improve their speech fluency
while developing positive attitudes toward communication:
1. Give the student your full attention; maintain consistent eye contact and positive
2. Change your conversation style - comment more and asked fewer questions. Lots of
questions or interruptions may seem more confrontational and make the child feel
under pressure to speed things up. Comments encourage elaboration and show you are
listening (Anderson, 2011).
3. Use a slow rate of speech; model slow and easy speech; pause often and take an extra
pause before responding to the student.
4. Create a relaxed environment; set aside a specific time for the student to speak with
decreased social pressures and interruptions.
6 Coleman, C. (2013). How can you tell if childhood stuttering is the real deal? Available from
http://blog.asha.org/2013/09/26/how-can-you-tell-if-childhood-stuttering-is-the-real-deal/
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5. Try not to become upset or annoyed with the student’s speech; avoid negative
nonverbal reactions, such as frowning, wincing, widening your eyes, looking away, or
tensing up.
6. Model fluent speech; do not try to define it to the student. For example, telling the
student to “slow down,” “take a deep breath,” or “think about what you are going to say,”
will only increase anxiety and generate negative attention to the stuttering behaviors.
7. Do not complete sentences for the student or try to “help” by filling in the blanks or
talking for him/her during disfluent moments.
When working with students who begin to exhibit disfluent speech, it is important to obtain an
objective analysis of their speech patterns, and then to educate parents, teachers, and others
around the student on typical versus atypical speech fluency as well as provide tips to create a
positive communication environment.
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Voice health as a part of good health is not just for voice professionals. Just as hygiene plays
a key role in general health issues and the prevention of diseases, vocal hygiene plays a key
role in voice preservation and the prevention of voice disorders.7
For teachers:
Children are with teachers for six hours a day during the school year. Many teachers
have an interest in the child's voice difficulty but may not know how to help.
Suggestions for teachers include:
o Music/choir teacher: This instructor's training in use of the voice is a real bonus
to the treatment program. Vocal warm-ups have some similarities to vocal
function exercises as well as to resonant voice treatment. Consider requesting
that the child participate in the vocal warm-up section of the class and lip sync
the rest (ASHA, 2005).
o Science teacher: Offer to show a video of vocal fold vibration. If human anatomy
is the subject, request that the development of vocal fold nodules, as well as
good vocal hygiene, be discussed.
o Art teacher: Suggest an art project, such as banners to hang in classrooms to
dampen noise.
o All teachers: Discuss allowing child to bring a water bottle to class. Have a
prewritten letter supporting the need for increased hydration for the child.
See Appendix L and Appendix M for voice checklists and vocal monitoring.
7 http://voicefoundation.org/health-science/voice-disorders/overview-of-diagnosis-treatment-prevention/voice
disorder-prevention/
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Background Considerations
Developmental norms: Most young children produce sound errors as their speech and
language develops. For instance, typical sound errors than many young children
produce include substituting a "W" sound for an "R" sound, or an “F” sound for a “TH”
sound (e.g., "wabbit" for "rabbit"; “baf” for “bath”), or leaving off parts of words, such as
"nana" for "banana." These early speech behaviors are expected as children’s
articulatory (mouth movements) language (learning and understanding new words) and
phonology (understanding the way sounds are used within their language) systems
develop.
A speech sound disorder occurs when errors continue past a certain age. Sound errors
may include one sound or multiple sounds being substituted for another, sounds being
omitted from words, sounds being added to words, or sounds being distorted. Every
sound has a different range of ages at which the child should make the sound correctly.
Cultural or Dialectal Factors: Not all sound substitutions and omissions are speech
errors. Instead, they may be related to a feature of a dialect or accent. For example,
speakers of African American Vernacular English (AAVE) may use a "d" sound for a "th"
sound (e.g., "dis" for "this"); and a student whose native or home language is Spanish
may produce the “R” sound differently than those who are native English speakers. In
many other languages, the sounds produced in Standard American English do not
occur; therefore in the case of a student whose primary language is any other than
English, it is expected that sound substitutions or omissions would occur. These
differences are not considered speech errors and do not warrant a referral.
Language Acquisition: Before a student is referred for a formal language evaluation, the
person making the referral needs to provide sufficient background information for the
student and describe the types of difficulties the student is having. It is very important
for the person making the referral to understand that there is a difference between a
language impairment/disorder and language differences. A child who is learning English
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as a second language may display some of the characteristics of a child with a language
impairment. However, this is not a disability, and there should be a rule out that the
student’s difficulties are not due the fact that he or she does not understand or speak
English efficiently. A language impairment must exist in a child’s first language to be
considered a disability according to Clark and Kamhi (2009).
Educational Impact: In the educational setting, the school team and SLP may identify
errors or differences in a child’s speech, but a student may not be found eligible with a
speech impairment unless the sound errors are not due to regional/dialectal
differences. The errors must persist beyond the age of typical development, impact
overall intelligibility (ability to be understood by others), and impact a student’s
academic, social, or vocational development.
Vision/Hearing Issues: As with all evaluations, vision and hearing screenings are integral
pieces. Ensuring typical vision and hearing assists teams in focusing intervention and
determining possible causes of difficulty.
Conduct and analyze results from a language screener. A screener can assist in
determining if a child is developing within the “average” compared to peers his or her
age.
Collect developmental history of the child including family history of speech delays,
persistent thumb/finger sucking, feeding development, and motor/speech/language
development.
Collect a sample of the student’s speech.
In addition to ruling out a second language as the primary cause of a child’s difficulty with
language, the referral source and SLP should ensure that the areas of concern are not the
result of language differences. Individuals who come from linguistically different cultural
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backgrounds may have certain language patterns and dialects that are specific to that
population; the differences from standard English do not indicate a disability.
The following are important considerations for the team during pre-referral:
linguistically and culturally appropriate screening measures;
the home language survey;
developmental history of the child;
previous preschool experiences (Has the child been home with relatives up until
enrollment in school, or was there prior pre-school exposure?);
ASHA has established guidelines related to the role of the speech-language pathologist (SLP).
SLPs play a central role in the screening, assessment, diagnosis, and treatment of persons with
speech sound disorders. The professional roles and activities in speech-language pathology
include clinical/educational services (diagnosis, assessment, planning, and treatment),
prevention and advocacy, and professional development. See ASHA's Scope of Practice in
Speech-Language Pathology (ASHA, 2016).
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counseling persons with speech sound disorders and their families/caregivers regarding
communication-related issues and providing education aimed at preventing further
complications related to speech sound disorders;
consulting and collaborating with professionals, family members, caregivers, and others
to facilitate program development and to provide supervision, evaluation, and/or expert
testimony;
remaining informed of research in the area of speech sound disorders, helping advance
the knowledge base related to the nature and treatment of these disorders, and using
evidence-based research to guide intervention;
advocating for individuals with speech sound disorders and their families at the local,
state, and national levels.
As indicated in the Code of Ethics (ASHA, 2016), SLPs who serve this population should be
specifically educated and appropriately trained to do so.
When school teams meet to determine intervention needs, there should be an outlined process
that includes:8
documentation, using multiple sources of data, of difficulties and/or areas of concern;
a problem-solving approach to address identified concerns
documentation of interventions, accommodations, strategies to improve area(s) of
concern;
recommendations based on the student’s possible need for more intensive services
and/or accommodations; and
8 National Alliance of Black School Educators (2002). Addressing Over-Representation of African American
Students in Special, Education
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Referral
Pursuant to IDEA Regulations at 34 C.F.R. §300.301(b), a parent or the school district may refer a
child for an evaluation to determine if the child is a child with disability. If a student is suspected
of an educational disability at any time, s/he may be referred by the student's teacher, parent,
or outside sources for an initial comprehensive evaluation based on referral concerns. The use
of RTI2 strategies may not be used to delay or deny the provision of a full and individual
evaluation, pursuant to 34 CFR §§300.304-300.311, to a child suspected of having a
disability under 34 CFR §300.8. For more information on the rights to an initial evaluation,
refer to Memorandum 11-07 from the U.S. Department of Education Office of Special Education
and Rehabilitative Services.
School districts should establish and communicate clear written referral procedures to ensure
consistency throughout the district. Upon referral, all available information relative to the
suspected disability, including background information, parent and/or student input, summary
of interventions, current academic performance, vision and hearing screenings, relevant
medical information, and any other pertinent information should be collected and must be
considered by the referral team. The team, not an individual, then determines whether it is an
appropriate referral (i.e., the team has reason to suspect a disability) for an initial
comprehensive evaluation. The school team must obtain informed parental consent and
provide written notice of the evaluation.
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reach that decision. If the district refuses to evaluate or if the parent refuses to give
consent to evaluate, the opposing party may request a due process hearing.
Referral information and input from the child’s team lead to the identification of specific areas to
be included in the evaluation. All areas of suspected disability must be evaluated. In addition to
determining the existence of a disability, the evaluation should also focus on the educational
needs of the student as they relate to a continuum of services. Comprehensive evaluations shall
be performed by a multidisciplinary team using a variety of sources of information that are
sensitive to cultural, linguistic, and environmental factors or sensory impairments. The required
evaluation participants for evaluations related to suspected disabilities are outlined in the
eligibility standards. Once written parental consent is obtained, the school district must conduct
all agreed upon components of the evaluation and determine eligibility within sixty (60) calendar
days of the district’s receipt of parental consent.
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English Learners
To determine whether a student who is an English learner has a disability it is crucial to
differentiate a disability from a cultural or language difference. In order to conclude that an
English learner has a specific disability, the assessor must rule out the effects of different
factors that may simulate language disabilities. One reason English learners are sometimes
referred for special education is a deficit in their primary or home language. No matter how
proficient a student is in his or her primary or home language, if cognitively challenging native
language instruction has not been continued, he or she is likely to demonstrate a regression in
primary or home language abilities. According to Rice and Ortiz (1994), students may exhibit a
decrease in primary language proficiency through:
inability to understand and express academic concepts due to the lack of academic
instruction in the primary language,
simplification of complex grammatical constructions,
replacement of grammatical forms and word meanings in the primary language by
those in English, and
the convergence of separate forms or meanings in the primary language and English.
These language differences may result in a referral to special education because they do not fit
the standard for either language, even though they are not the result of a disability. The
assessor also must keep in mind that the loss of primary or home language competency
negatively affects the student’s communicative development in English.
In addition to understanding the second language learning process and the impact that first
language competence and proficiency has on the second language, the assessor must be aware
of the type of alternative language program that the student is receiving.
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The answers to these questions will help the assessor determine if the language difficulty is due
to inadequate language instruction or the presence of a disability.
It is particularly important for a general education teacher and an ESL teacher/specialist to work
together in order to meet the linguistic needs of this student group. To ensure ELs are receiving
appropriate accommodations in the classroom and for assessment, school personnel should
consider the following when making decisions:
Student characteristics such as:
o Oral English language proficiency level
o English language proficiency literacy level
o Formal education experiences
o Native language literacy skills
o Current language of instruction
Instructional tasks expected of students to demonstrate proficiency in grade-level
content in state standards
*For more specific guidance on English learners and immigrants, refer to the English as a
Second Language Program Guide (August 2016).
Best Practices
Evaluations for all disability categories require comprehensive assessment methods that
encompass multimodal, multisource, multidomain and multisetting documentation.
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Multidomain: Teams should take care to consider all affected domains and provide a
strengths-based assessment in each area. Domains to consider include cognitive ability,
academic achievement, social relationships, adaptive functioning, response to
intervention, and medical/mental health information.
(3) Voice Impairment – evaluation of vocal characteristics shall include the following:
(a) Hearing screening;
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The SEM should be reported and considered when reviewing all sources of data collected as
part of the evaluation. Below is guidance on when to use the scores falling within the SEM:
Only use on a case-by-case basis.
Use is supported by the TnAISF and/or other supporting evidence that the other options
may be an under- or overestimate of the student’s ability.
Assessment specialists that are trained in evaluation provide professional judgement
and documented reasons regarding why this may be used as the best estimate of ability
Standardized tests evaluate discrete skills in a decontextualized setting (i.e., away from natural
communicative environments). Norm-referenced tests do not document functional
performance in educational settings. In addition, not all children are suitable candidates for
standardized tests. A comprehensive language assessment should incorporate formal and
informal measures that adequately describe how a child is able to understand and use
language with adults and his or her peers. While individual subtest scores shall not be used to
determine eligibility for services, if there are significantly low scores on subtests or composites,
which are consistent with other sources of data, a variety of data sources should be used to get
a “true” picture of a student’s ability to use language in his or her environment.
After completing a standardized measure, the SLP should consider the results and performance
on all areas of the assessment in relation to referral concerns, other sources of data, the
normative sample, and other factors that may impact performance. If there is reason to
believe the results are an overestimate of the student’s current communication skills,
additional assessment (formal or informal) may be needed, while taking the standard
error of measure (paying attention to all composite confidence intervals) into
consideration.
One type of informal assessment that may especially helpful in such cases in the completion of
a language sample analysis. A language sample provides a great deal of information on a child’s
language abilities and overall conversational skills. Specific language areas include syntax
(grammar), semantics (word meanings), morphology (word parts, such as suffixes and prefixes),
and pragmatics (social skills). A language sample often consists of 50 to 100 utterances spoken
by the child, but it can have as many as 200 utterances. The SLP writes down exactly what the
child says, including errors in grammar. Errors in articulation or speech sounds are not
recorded.
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The selected assessment tools should be purposeful and be designed to explore and
investigate the area/s of concern, as well as provide useful information relative to the
suspected deficit.
Norm-referenced Assessments - speech-language tests which measure communication
skills using formalized procedures. They are designed to compare a particular student’s
performance against the performance of a group of students with the same
demographic characteristics. One of the considerations made by the SLP in selecting
valid and reliable assessment tools is ensuring the normative population of any
instrument matches the student’s characteristics. This information is found in the
technical manual for the test.
Checklists - a developed form or scale which allows a rater to consider various skills and
indicate a student’s use of a skill in a particular setting, or indicate potential absences of
the expected skills.
Direct Observations - the SLP observes the student during everyday classroom activities
or across educational settings, and allows for a more natural opportunity to identify
communication strengths and weakness.
Interviews - conversations with or questionnaires given to parents, caregivers, medical
professionals, or educators, which provide information related to a student’s
communication history and current functioning.
Play-based Assessments - assessments, which provide an opportunity to observe and
evaluate a child in the natural context of play. Play-based assessments are an important
tool when evaluating preschool children and are often completed by a multidisciplinary
team so multiple areas of development can be considered.
Dynamic Assessments - are a method of conducting a language assessment which seeks
to identify the skills that the student possesses as well as their learning potential. This
enables the examiner to determine what type and degree of assistance the student
requires in order to be successful. In short, dynamic assessments are a process of test,
teach, and retest. This type of assessment helps to identify the level of support or
teaching structure a student may need in order to learn a particular skill. Dynamic
assessments are not norm-referenced, but can be a valuable tool in understanding a
child’s potential response to various intervention styles.
Speech and/or Language Sampling - a sample of a child’s spoken speech/language
during a particular task (conversation, retell, describing tasks, narratives) which helps
the SLP determine intelligibility, production of speech sounds in connected speech,
and/or the use of expected structures and components of language (sentence length
and complexity, variety of words, vocabulary use, grammatical components, etc.).
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The IEP team should discuss and consider cultural and linguistic bias before determining
a student is eligible for a language impairment.
Standard scores from norm-referenced tests should only be a SMALL part of the
assessment picture.
The speech-language evaluation report should be written in an easily understood
language without extensive use of professional jargon.
The SLP should document the presence or absence of a language impairment in the
speech-language evaluation report.
The SLP should not make an eligibility determination or recommendations for or against
language therapy in the speech-language report. (The IEP team does this.)
Culturally and Linguistically Diverse students: When evaluation data reveals evidence of dialect
use or language differences, they should be documented as such and should not be counted as
errors. If language differences and/or dialects are incorrectly treated as errors, students may be
inappropriately identified as having a language impairment. When selecting the most
appropriate test to administer, the SLP should review the test manual to see if students who do
not speak Standard American English will be penalized for their language differences. Dynamic
assessment can be very useful when evaluating students from culturally and linguistically
diverse backgrounds. Dynamic assessment includes a test-teach-test approach to assist with
differential diagnosis of a language impairment as opposed to a language difference. When
provided with modeling and guided practice, the student who does not have a disability will
often show significant improvement when reassessed.
Special Populations: For some student populations, such as children with severe disabilities, the
provision of unbiased assessments can only be made with descriptive measures. The
Functional Communication Profile, the Functional Communication-Teacher Input, and the
Functional Communication Rating Scale can be utilized to assess the communication skills for
these students.
English Language Learners: When assessing children for whom English is not the primary
language, it is important to utilize evaluation tools that accurately reflect a child’s true language
abilities. Tests should be administered in the child’s native language. According to ASHA, if the
test utilized was not normed on children who speak the particular language being tested, it is
not appropriate to report standard scores.9 However, descriptive information obtained
during the administration of the test can be used to describe the child’s strengths and
weaknesses in the area of communication. When assessing the bilingual child, the SLP should
use an interpreter, conduct an interview with the parent/caregivers, and always utilize a
conversational sample.
9 http://www.asha.org/practice/multicultural/issues/assess/
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These rules may vary across cultures and within cultures. It is important to understand the rules of
your communication partner.
33
It is not unusual for children to have pragmatic problems in only a few situations. However, if
problems in social language use occur often and seem inappropriate considering the child's
age, a pragmatic disorder may exist. Pragmatic disorders often coexist with other language
problems such as vocabulary development or grammar. Pragmatic problems can lower social
acceptance. Peers may avoid having conversations with an individual with a pragmatic disorder.
assessments. Informal assessments can include checklists, skill inventories, observations, and
functional language samples. The areas of auditory processing are defined below.
Selective attention - a process whereby the brain selectively filters out large amounts of sensory
Discrimination - the brain's ability to organize and make sense of language sounds. Children
who have difficulties with this might have trouble understanding and developing language skills
because their brains either misinterpret language sounds or process them too slowly.
Sequencing - the ability to remember or reconstruct the order of items in a list, or the order of
Integration - the ability to combine information that is given in more than one medium. This
may translate as a problem when a child has to listen to directions and then perform a physical
34
This information is important as the evaluators interpret results of the formal assessments in
order to gain perspective of the student’s performance and skills in typical environments and to
determine the impact and severity of possible impairments.
Standard 1 (h) Documentation, including observation and/or assessment (to include the
severity rating scale), of how the language impairment adversely affects the child’s
educational performance in his/her learning environment and the need for specialized
instruction and related services (i.e., to include academic and/or nonacademic areas).
The school environment places a heavy demand on students to comprehend, interpret, and use
all aspects of verbal and nonverbal communication. Students must be able to communicate for
a variety of purposes and in different settings. They must be competent in listening, speaking,
reading, and writing as they learn the curriculum and interact with others. Therefore, it is
paramount that a child receives a comprehensive assessment that balances formal and
descriptive assessment instruments. A thorough case history is crucial to the selection of an
individualized test battery and valid interpretation of assessment results. A child’s
communicative attempts and abilities may vary depending on the setting he or she is in and
who the listener happens to be. Additional assessments, such as individual achievement tests,
may be needed for some students to help determine adverse impacts. Procedures that identify
areas of strength and weakness and examine how the student functions communicatively in
the environments in which he/she participates are needed to appropriately determine
eligibility.
Language Severity Rating Scale: The Language Severity Rating Scale is a tool used after a
complete assessment of the student’s communication abilities and after the SLP has
interpreted assessment results. This scale is designed to document the presence of assessment
findings according to the intensity of those findings and to facilitate a determination, based on
assessment results, if the student has a language impairment according to the definition in the
Tennessee Rules and Regulations. The severity rating scale is not a diagnostic instrument and
should not be used in the absence of assessment data. In order to be identified as a student
with a language impairment, the language difficulties must be determined to have an adverse
effect on educational performance. The rating scale serves three purposes:
1. to document the absence or presence of a language deviation and to what degree (mild,
moderate or severe);
2. to indicate the absence or presence of adverse effect on educational performance; and
35
3. to determine whether or not the student meets eligibility standards for a language
impairment.
Articulation Impairment
Standard 2 (b) Articulation Impairment: Articulation error(s) persisting at least 1 year behind
expectancy compared to current developmental norms
Developmental norms are helpful for estimating approximately how well a student’s sounds are
developing. Although norms are extremely useful, there are limitations to over-relying on or
using them exclusively to identify a sound production impairment. Several factors limit their
value. An age norm is only an average age at which a behavior occurs. Most norms do not
reflect normal and acceptable developmental variability. Certain errors are developmentally
appropriate while others are not. Different norms are rarely in agreement with each other. The
differences are caused by many factors, including when the study was conducted, where the
study was conducted, the size and characteristics of the sample, the research design followed,
and the mastery criteria used.
It is important that the assessing SLP use articulation norms as designated by the school
district. Districts should designate specific norms to be used based on the area demographics.
The use of developmental norms, and the compared production of sound errors, is one
component of the overall scope of assessment for identifying a student with a speech
impairment.
Articulation tests usually elicit phonemes in only one phonetic context within a pre-selected
word. There may be other contexts and words in which the student can/cannot produce the
target sound correctly. Most tests elicit phonemes at the word level for the assessment of
initial, medial, and final position production. Conversational speech, however, is made up of
complex, co-articulated movements in which discrete initial, medial, and final sounds may not
occur. Thus, sound productions in single words may differ from those in spontaneous speech.
Keep in mind that normative data tell only part of the story when assessing for a speech sound
production impairment, and contextual samples are necessary to properly identify a speech
impairment.
When assessing articulation skills, the sound in question must be in error in at least two
positions (initial, medial, or final). Information gathered from the formal/informal assessment
36
Assessment procedures typically evaluate the child's speech sound system, including:
sounds, sound combinations, and syllable shapes produced accurately, including:
o sounds in various word positions (e.g., initial, within word, and final word
position) and indifferent phonetic contexts,
o phoneme sequences (e.g., vowel combinations, consonant clusters, and blends),
and
o syllable shapes (e.g., simple CV to complex CCVCC);
37
In some cases, the examiner may complete a process analysis after first administering an
articulation test. Some phonological processes can be detected from the results of traditional
articulation tests. For example, when most of the phonemes in the final position column of the
articulation test form show a deletion symbol, perceptive examiners can recognize the pattern
of final consonant deletion. Most substitution and deletion processes can be identified in this
manner, particularly if the examiner is familiar with phonological process terminology and
descriptions. For example, the student who produces /p/ for /f/, /b/ for /v/, /t/ for /s/, and /d/ for
/z/ is replacing a fricative with a stop, a process commonly known as Stopping. Other error
patterns, however, are not as easily identified from traditional articulation test results.
Depending upon the complexity of the student’s errors, a more in-depth phonological analysis
may be indicated in order to identify all processes used by the student. This in-depth analysis
becomes particularly important in determining the hierarchy of intervention targets.
It should be noted that an articulation assessment and phonological process analysis can be
derived without the use of a published standardized assessment instrument. Developmentally
appropriate errors and patterns are taken into consideration during assessment for speech
sound disorders in order to differentiate typical errors from those that are unusual or not age
appropriate.
See phonological processes (patterns) and age of customary consonant production [PDF].
CLASSIFICATION of CONSONANTS (Lowe, R.J. (2010)
Standard 2 (d) Articulation Impairment: Evidence that the child’s scores are at a moderate,
severe, or profound rating (i.e., severity rating scale)
The Speech Sound Production Severity Rating Scale is to be used as a tool after a complete
assessment of the student’s sound production performance to determine the overall impact
and severity of the child’s speech. The scale is designed to assist the examiner with
interpretation and documentation of the results of assessment findings in terms of severity or
intensity. This is not a diagnostic instrument and should not be used in the absence of
assessment data.
38
impairment in articulation.
This information is important as the evaluators interpret results of the formal assessments in
order to gain perspective of the student’s performance and skills in typical environments and to
determine the adverse impact and severity of possible impairments.
39
Standard 2 (h); 3(c); & 4 (c) Articulation/ Voice/ Fluency Impairments: Oral peripheral
examination
The SLP will examine the size, shape, and adequacy of the oral, lingual, resonatory, laryngeal,
and respiratory structures. The SLP will determine if the structures perform their function for
non-speech and speech-related purposes. Specific areas to examine include teeth and
occlusion, soft palate, hard palate, tongue, face, nose, mouth, neck, shoulders, body posture,
and respiration. See Appendix O for a sample Oral Peripheral Examination form.
(b) Error Types – The types of errors identified by traditional articulation tests generally fall
into four major categories: (1) Substitutions, (2) Omissions, (3) Distortions, and (4)
Additions. Typically, the presence of omissions and additions affect intelligibility to a
greater degree than substitutions and distortions. In addition to providing descriptive
information as to the problem, analyzing error types also helps to select, prioritize, and
plan intervention targets.
40
(d) Consistency of Errors – the assessment data and/or speech sample should be analyzed
for consistency of errors between the speech sample and the articulation
test/phonological process assessment within the same speech sample and between
different speech samples. A student may be able to produce a designated sound
correctly at the single word level, yet correct productions may break down as the length
and complexity of utterances increase. Typically, more sound errors will be identified
during the connected speech sample.
(f) Rate of Speech – Occasionally a student’s speech rate can directly affect articulation and
intelligibility. Speech rates vary tremendously among normal speakers, making it
difficult to assign a standard word-per-minute (WPM) index. Purcell and Runyan (1980)
measured the speaking rates of students in the first through fifth grades and found a
slight increase in their average rate at each grade level. The first graders averaged 125
words per minute, and the fifth graders averaged 142 words per minute. It is imperative
to recognize that some people who speak exceedingly fast or slow still have excellent
intelligibility and control of their speech, while others exhibit significant communication
problems due to their rate.
41
The importance of measuring rate of speech does not lie in comparing it with pre
established norms, which only indicate whether the speech rate is normal, faster than
normal, or slower than normal. The value of assessing rate of speech is that it allows
evaluation of its effect on the student’s communication abilities.
Questions to consider:
Will the use of a faster or slower rate result in better communication?
Can a better speech rate be elicited?
Can it be maintained?
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problem affects educational performance. The presence of any deviation in speech sound
production does not automatically indicate an adverse effect on the student’s ability to function
within the educational setting. The deviation must be shown to interfere with the student’s
ability to perform in the educational setting before a disability is determined. In order to be
identified as a student with a speech impairment in articulation, the deviation(s) in sound
production must be determined to have an “adverse effect on educational performance.”
Voice Impairment
Standard 3 (b) Voice Impairment: Examination by an otolaryngologist
Disorders of laryngeal structure and function are physical characteristics that must be
diagnosed by a physician, usually an otolaryngologist [ear, nose, and throat doctor specialist
(ENT)].
Voice quality is a perceptual phenomenon that cannot be diagnosed by
instrumentation.
Vocal function can be determined by assessing physical measured of pitch, loudness,
and respiratory support.
acquired
o papilloma
3. Neurological
cerebral palsy
muscular dystrophy
43
head injury
4. Resonance Disorders
hypernasality
hyponasality
nasal air emission
Additional health information obtained from either the physician or parent includes the
following:
history of allergies;
history of chronic ear infections, colds, asthma;
variation in voice by times of day, seasons or weather, and days of the week;
family voice problems;
history of care under of physician and/or hospitalization;
onset of disorder;
progression of disorder;
association with other physical ailments, emotional distress, or psychological
disturbance;
use of medications (e.g., inhalants, decongestants);
history of laryngeal procedures (e.g., intubation);
diagnosis of general motor impairments (e.g., cerebral palsy);
assessment of chronic vocal behaviors at home and at school (e.g., yelling, throat
clearing);
amount of daily hydration;
perception of the problem (child, parent, teacher); and
physician diagnosis of laryngeal pathology or structural impairment.
Information obtained through observations, assessments, and teacher input that may assist
when determining impact may include:
harsh, breathy, or hoarse voice;
hyper- or hypo-nasal voice;
44
Among the many protocols available for rating perceptual qualities of voice in children are:
Buffalo III Voice Profile (Boone, et al. 2009)
GRBAS Scale (Karnell, et al. 2007)
Quick Screen for Voice (Lee, et al. 2004)
Standard 4 (b) Fluency Impairment: Information obtained from parents, students, and
teacher(s) regarding non-fluent behaviors/attitudes across communication situations
The SLP should obtain detailed observational data regarding stuttering behaviors/attitudes in
the school environment as well as data and information as related to student’s current level of
academic functioning and progress. For example, does the student initiate verbal interaction?
Is the student’s level of language complexity commensurate with peers? Does the student
volunteer during whole group and small group discussions? For preschoolers, obtain this
information from child care providers or other adults who see the child outside of the family
structure. This information can be collected via interview or checklist.
The parent should provide concerns, detailed medical history, family history of stuttering,
developmental history of student, and a description of stuttering behaviors/attitudes in the
home environment.
Obtain data (i.e., benchmarking assessment, report card, work samples, attendance,
etc.) related to academic progress in the general curriculum from classroom teacher.
45
Multiple sources of information will help determine how fluency Impairment adversely affects
the child’s educational performance in his/her learning environment and the need for
specialized instruction and related services (i.e., to include academic and/or nonacademic
areas).
Multiple classroom observations (i.e., two or more) of the student, in both structured
and unstructured settings
200–300-syllable speech sample in at least two2 contexts including, but not limited to,
narrative, conversation, or reading sample
Formal fluency assessments for frequency, descriptive assessment, and speaking rate.
Examples of formal assessments:
o Stuttering Severity Instrument (SSI-4)
o Test of Childhood Stuttering (TOCS)
o Overall Assessment of the Speaker’s Experience of Stuttering (OASES)
o Cognitive Affective Linguistic Motor Social Scale (CALMS)
Naturalness rating scale
Assessment of feelings and attitudes which is completed via observations, rating scales,
and interview. Beliefs about stuttering and reactions to stuttering behavior are
identified and defined as it relates to the individual student. Observational data on how
the child responds in moments of disfluency as well as an interview of the student to
determine his/her perceptions of their communication skills is valuable information for
the team. Although much of this information is subjective in nature, it is valuable in
predicting the student’s response to fluency interventions and may also indicate the
need for more comprehensive evaluation in the areas of social/emotional development
by other team members (i.e., school psychologist). Some possible tools to assess
feelings/attitudes include:
o Perceptions of Stuttering Inventory (PSI)
o Overall Assessment of the Speaker’s Experience on Stuttering (OASES-S for ages 7
12; OASES-T for ages 13-17)
46
The SLP should review all observations, assessments (formal and informal), relevant
developmental information, and historical information from all team members. This
information should be used to complete the Fluency Severity Rating Scale.
47
impairment in fluency.
Once all evaluation procedures have been completed, the SLP should rate each of the defined
areas (Frequency, Descriptive Assessment, Speaking Rate), based on objective and subjective
data collected during the evaluation process. This tool will be beneficial to the team in
determining appropriate accommodations, modifications services, supplemental aids and
goals.
A Note on Cluttering
Although cluttering and stuttering can co-occur, there are some important distinctions between
the two. Children who stutter are more likely to be self-aware about their disfluencies and
communication, and they may exhibit more physical tension, secondary behaviors, and
negative reactions to communication. Children who clutter may exhibit more errors related to
reduced speech intelligibility secondary to rapid rate of speech. This student does not sound
fluent in the sense that they appear to not know what to say or how to say it. Along with fast
rate, a high level of “typical disfluencies,” such as interjections and revisions are often observed.
A student who is demonstrating cluttering often appears to communicate in a disorganized
manner with poor conversation skills and little awareness of his/her fluency and rate problems.
Evaluation Participants
Information shall be gathered from the following persons in the evaluation of a speech or
language impairment:
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(2) Student’s general education classroom teacher(s) (e.g., general curriculum/core instruction
teacher)
Observational information
Academic skills
Differentiation strategies
Rating scales
Work samples
Intervention data, if appropriate
Behavioral intervention data
Other relevant quantitative and/or qualitative data
(5) Other professional personnel (e.g., school psychologist, special education teacher), as
indicated
Direct assessment
Functional behavior assessments/behavior intervention plans
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Rating scales
Observations in multiple settings with peer comparisons
Medical information
Clinical information
Other relevant quantitative data/qualitative data
summary
recommendations
50
Evaluation results enable the team to answer the following questions for eligibility:
Are both prongs of eligibility met?
o Prong 1: Do the evaluation results support the presence of an educational
disability?
The team should consider educational disability definitions and criteria
referenced in the disability standards (i.e., evaluation procedures).
Are there any other factors that may have influenced the student’s
performance in the evaluation? A student is not eligible for special
education services if it is found that the determinant factor for eligibility
is either lack of instruction in reading or math, or limited English
proficiency.
o Prong 2: Is there documentation of how the disability adversely affects the
student’s educational performance in his/her learning environment?
Does the student demonstrate a need for specialized instruction and
related services?
Was the eligibility determination made by an IEP team upon a review of all components
of the assessment?
If there is more than one disability present, what is the most impacting disability that
should be listed as the primary disability?
The information gathered from all sources is just as important as the scores on
the standardized assessments and should play a significant role in the eligibility
determination. For example, a formally analyzed language sample can help to provide
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more complete, more accurate, and more reliable information regarding a student’s
ability to use language in the educational environment.
(b) The results of the second measure and other sources of data show evidence of and
support the deficit area identified on the comprehensive measure.
(c) The deficit(s) is not due to cultural or linguistic differences or dialect.
(d) The student exhibits a deficit in his primary language.
(e) There is documentation of adverse impact on the student’s educational performance.
Eligibility should be based on a child’s ability to use language with different people in varied
settings. Assessment results should for the most part build a database of a child’s abilities
across tasks and settings to determine their true communicative functioning level in the
schools. A student can demonstrate communication differences, delays, or even impairments
without demonstrating an adverse effect on educational performance.
The following should NOT be used to determine eligibility for a language impairment:
(a) Standardized test scores alone: Standard scores from norm-referenced language
tests should be only a small part of the eligibility determination.
(b) Cognitive Referencing: the practice of comparing IQ scores and language scores as a
factor for determining eligibility for speech-language eligibility. It is based on the
assumption that language functioning cannot surpass cognitive levels. However,
according to research, some language abilities may in fact surpass cognitive levels.
Therefore, ASHA does not support the use of cognitive referencing. (see
http://perspectives.pubs.asha.org)
(c) Age and grade level scores: Age- or grade-equivalent scores do not account for normal
variation around the test mean and the scale is not an equal interval scale. Therefore,
the significance of delay at different ages is not the same. Furthermore, the different
ages of students within the same grade make comparisons between students within
and between grades difficult. In addition, grade equivalents do not relate to the
curriculum content at that level. While seemingly easy to understand, equivalent scores
are highly subject to misinterpretation and should not be used to determine whether a
child has a significant deficit.
Adverse Impact: Evidence that the deviation has an adverse effect on educational
performance must be gathered and considered along with background information before a
determination of eligibility can be made. Educational performance refers to the student’s ability
to participate in the educational process and must include consideration of the student’s social,
emotional, academic, and vocational performance, not just academic skills. A low score on a
standardized test or the presence of any deviation in language does not automatically indicate
an adverse effect on the student’s ability to function within the educational setting. The
deviation must be shown to interfere with the student’s ability to perform in the educational
52
setting before a disability is determined. Teacher checklists and observations are useful for
determining specifically how language problems affect educational performance.
Academic impact could be reflected in difficulty with language-based activities, difficulty
understanding orally presented material, and/or efficiently and effectively expressing
information orally.
Social/emotional impact might be manifested when a student is unable to formulate
sentences and questions in order to interact with peers, harassed because of
communication skills, or the student is embarrassed or frustrated because of the deficit
in language skills.
Vocational impact might include a student’s inability to comprehend/follow oral
directions, ask and answer questions, and/or produce inappropriate responses to a
coworker or supervisor in a work setting.
Once the evaluation is completed, the SLP must consider all information related to types of
errors, frequency of errors, intelligibility of connected speech, and impact of the child’s speech
on his/her educational performance. The Speech Sound Severity Rating Scale is a tool to assist
in summarizing the pieces of the evaluation and ultimately assign a severity rating of the child’s
overall speech functioning. The Speech Sound Severity Rating Scale should be completed
following all evaluations and used when considering eligibility and the need for individualized
instruction.
The IEP team may not identify a child as speech impaired who exhibits any of the following:10
mild, transitory, or developmentally appropriate sound production difficulties that
students experience at various times and to various degrees
speech difficulties resulting from dialectal differences, learning English as a second
language, temporary physical disabilities, or environmental, cultural, or economic
factors;
tongue thrust which exists in the absence of a concomitant impairment in speech sound
production;
elective or selective mutism or school phobia without a documented speech sound
production impairment; and
errors that do not interfere with educational performance.
(a) more than two percent atypical disfluencies based on frequency and/or durational
measurements of disfluencies, with or without the presence of struggle behaviors
during a speech sample of 200 syllables, 200 words, or 10 minutes in one or more
settings; or
(b) more than five percent atypical disfluencies during a speech sample (of 200 syllables,
200 words, or 10 minutes) with or without the presence of struggle behaviors, covert
stuttering behaviors, or coping mechanisms; or with the presence of one or more risk
factors; or
(c) rate of speech at least +1.5 standard deviations from the mean; or
(d) speech naturalness outside the normal range of 3.0 for children and 2.12-2.39 for
adolescents/adults on a nine-point naturalness rating scale.
10 Coplan, J., & Gleason, J. R. (1988). Unclear speech: Recognition and significance of unintelligible speech in
preschool children. Pediatrics, 82, 447–452.
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According to ASHA, educational impact includes the impact on functional communication in key
school situations and on quality of life (Beilby, Byrnes, Yaruss, 2012; Yaruss, Coleman, & Quesal,
2012). As indicated by Ribbler (2006), "For students who stutter, the impact goes beyond the
communication domain. In fact, stuttering can affect all areas of academic competency,
including academic learning, social-emotional functioning, and independent functioning".
Fluency disorders, however, do not necessarily affect test scores or subject grades. It is the role
of the SLP to inform and educate the IEP team about the multiple ways stuttering can influence
educational performance.
It is important to note here that eligibility and services are not based solely on academic
achievement. IDEA 300.101(c)(1) states, “Each state must ensure that FAPE is available to any
individual child with a disability who needs special education and related services even though
the child has not failed or been retained in a course or grade, and is advancing from grade to
grade,” nor are services provided to only support classroom performance. IDEA 300.42 says
that “supplementary aids and services means aids, services, and other supports that are
provided in regular education classes, other education related settings, and in extracurricular
and nonacademic settings, to enable children with disabilities to be educated with nondisabled
children to the maximum extent appropriate.”
In the educational environment, stuttering can be impactful in multiple dimensions. The overall
quality and quantity of oral classroom participation (i.e., classroom discussion, oral
presentations, class speeches, oral testing, etc.) can be adversely impacted. These students can
also experience difficulty working and communicating within cooperative learning groups.
Students may be hesitant to verbally express their ideas, offer explanations, or ask and answer
questions to familiar or unfamiliar adults. Poor fluency skills can also be highly impactful to the
student’s social interactions with peers and adults in locations such as the cafeteria or
playground. It is the role of the SLP to educate teachers, peers, and other persons in the
educational environment on appropriate verbal and non-verbal reactions, and listening
behaviors when conversing with a student with poor fluency skills.
55
advisable for the IEP team to meet at least 60 calendar days prior to the re-evaluation due date.
Depending on the child’s needs and progress, re-evaluation may not require the administration
of tests or other formal measures; however, the IEP team must thoroughly review all relevant
data when determining each child’s evaluation need.
The IEP team may decide an evaluation is needed or not needed in order to determine
continued eligibility. All components of The RSR must be reviewed prior to determining the
most appropriate decision for re-evaluation. Reasons related to evaluating or not evaluating are
listed below.
NO evaluation is needed:
The team determines no additional data and/or assessment is needed. The IEP team
decides that the student will continue to be eligible for special education services with
his/her currently identified disability/disabilities.
The team determines no additional data and/or assessment is needed. The IEP team
decides that the student will continue to be eligible for special education services in
his/her primary disability; however, the IEP team determines that the student is no
longer identified with his/her secondary disability.
The team determines no additional data and/or assessment is needed. The student is
no longer eligible for special education services.
(Out of state transfers): The team determines additional data and/or assessment is
needed when a student transferred from out of state, because all eligibility
requirements did NOT meet current Tennessee state eligibility standards. Therefore, the
IEP team decides that the student would be eligible for special education services in
Tennessee with their previously out-of-state identified disability/disabilities while a
comprehensive evaluation to determine eligibility for Tennessee services is conducted.
Evaluation is needed:
The team determines no additional data and/or assessment is needed for the student’s
primary disability. The IEP team decides that the student will continue to be eligible for
special education services in his/her primary disability; however, the IEP team
determines that the student may have an additional disability; therefore, an evaluation
56
When a student’s eligibility is changed following an evaluation, the student’s IEP should be
reviewed and updated appropriately.
According to IDEA 2004, dismissal criteria mirror eligibility criteria. Therefore, in making
decisions to dismiss a child from IEP services, the following questions must be considered:
(1) Does the student continue to exhibit a communication disorder?
(2) Does the communication disorder continue to adversely affect academic achievement
and/or functional performance?
(3) Does the student continue to require specially designed instruction to be involved in
and make progress in the curriculum? (IDEA, 2004)
57
The criteria for eligibility is the same as the criteria for initial eligibility.
(b) The criteria for exit from services for speech and language impairments should be
discussed with IEP team members at the beginning of intervention.
(c) The decision to dismiss is based upon IEP team input (i.e., parent, teacher, etc.) initiated
by the SLP or any other team member.
(d) The student no longer exhibits a language impairment.
(e) If progress is not observed over time, changes must be made in the
interventions/accommodations. If continued lack of progress is shown, specific goals
and intervention approaches must be re-examined.
(f) The student’s current academic level, behavioral characteristics, and impact on
(g) Dual support is being provided within other services of special education.
It is also important to remember that continued eligibility is not dependent on the identification
of sound errors alone, but a continued educational impact resulting from the speech sound
errors. It is possible that a child had been initially identified with a speech impairment, received
three years of speech therapy through an IEP, and then is found not eligible upon re-evaluation,
58
despite continued speech sound errors. While the ultimate goal of the SLP is to remediate all
speech sound errors, there are some children who do not correct all sounds, but no longer
demonstrate any education impact related to the residual errors. Imperfection does not equate
to an educational disability.
According to research reported by ASHA, once a child reaches the age of eight, it is much more
likely that the stuttering behavior will persist in some form. The team should give careful
consideration to the student’s feelings/attitudes and overall self-awareness of his/her speech
disfluencies. A child should not be discharged unless the team determines that stuttering is no
longer having a negative impact on how the child is participating in activities, interacting with
others and communicating in the educational environment. Furthermore, the impact of
stuttering cannot be measured strictly by the number of disfluencies observed. The type and
severity of disfluencies along with the prevalence of secondary behaviors must also be
identified as well as presence of avoidance behaviors.
The SLP is responsible for communicating to the team that stuttering can be a lifelong disability
and that students who stutter will likely experience periods of time with increased disfluencies
throughout their lifespan, particularly during times of change, highly stressful situations or
times of extreme emotion, either positive or negative. A continuum of services should be
considered, as it is likely that the student’s stuttering behaviors will vary drastically throughout
his/her educational career. It is expected that there will be periods of time where direct services
are necessitated and time periods when consultation services are more appropriate.
59
(a) the child’s voice impairment is not due to any temporary factor such as respiratory virus,
infection, allergies, short-term vocal abuse, or puberty; and
(b) the child’s voice impairment significantly affects the child’s educational performance or
social, emotional, or vocational development.
60
As is the case with all referrals for intellectual giftedness, assessment instruments should be selected that most accurately
measure a student’s true ability. However, this is especially true for students who may be significantly impacted by the factors
listed above. Determine if the checked items are compelling enough to indicate that this student’s abilities may not be
accurately measured by traditionally used instruments. Then, record assessment tools and instruments that are appropriate
and will be utilized in the assessment of this student.
Assessment Category/Measure: Assessment Category/Measure: Assessment Category/Measure:
61
Helpful links:
American Speech-Language-Hearing Association (ASHA)
http://www.asha.org/
62
An articulation disorder involves problems making sounds. Sounds can be substituted, left off,
added, or changed. These errors may make it hard to understand the child.
Young children often make speech errors. For instance, many young children sound like they
are making a "w" sound for an "r" sound (e.g., "wabbit" for "rabbit") or may leave sounds out of
words, such as "nana" for "banana." The child may have an articulation disorder if these errors
continue past the expected age. Not all sound substitutions and omissions are speech errors.
Instead, they may be related to a feature of a dialect or accent.
63
Phoneme yrs:mo 3:0 3:6 4:0 4:6 5:0 5:6 6:0 6:6 7:0 7:6 8:0 8:6 9:0
h initial
w initial
j initial
th voiced
f final
sh
ch
l final
th
dz
r final voiced
ng final
Word-initial clusters 3:0 3:6 4:0 4:6 5:0 5:6 6:0 6:6 7:0 7:6 8:0 8:6 9:0
tw kw
pl bp kl gl fl
64
pr br tr dr kr gr fr
sp st sk
sm sn
sw
sl
skw
spl
thr
h initial
w initial
j initial
f final
sh
ch
l final
th voiced
65
dz
th
r final voiced
ng final
Word-initial clusters 3:0 3:6 4:0 4:6 5:0 5:6 6:0 6:6 7:0 7:6 8:0 8:6 9:0
tw kw
pl bp kl gl fl
pr br tr dr kr gr
fr
sp st sk
sm sn
sw
sl
skw
spl
thr
2:0–2:5
3:0–3:5 /b/ /d/ /n/ /f/ /h/ /d/ /g/ /m/ /ɳ/ /f/ /p/ /n/ /f/
3:6–3:11 /k/ /w/ /n/ /z/ /j/ /b/ /d/ /k/ /m/ /nt/
5:0–5:11 /p/ /z/ /l/ /j/ /bl/ /pl/ /sp/ /s/ /l/ /ɳ / /z/
/st/ /sw/
66
7:0–7:11 /ð/ /r/ /br/ /fr/ /pr/ /sl/ /v/ /ɚ/ /l/ /r/
Ages at which 90 percent of the GFTA-3 normative sample mastered consonants and consonant
clusters by initial, medial, and final position (female)
Age Initial Position Medial Position Final Position
2:0–2:5 /p/
2:6–2:11 /m/
3:0–3:5 /b/ /d/ /k/ /n/ /w/ /h/ /d/ /g/ /m/ /n/ /f/ /p/
4:0–4:5 /t/ /sp/ /st/ /b/ /k/ /ɳ/ /z/ /j/ /d/ /k/ /m/ /f/ /v/ /nt/
4:6–4:11 /tʃ/ /dʒ/ /l/ /j/ /fr/ /gl/ /pl/ /tʃ/ /l/ /b/ /t/ /g/ /ʃ/ /tʃ/
/tr/
5:0–5:11 /p/ /s/ /z/ /ʃ/ /bl/ /dr/ /kw/ /ʃ/ /s/ /l/
/pr/ /sl/ /sw/
6:0–6:11 /v/ /ð/ /r/ /br/ /gr/ /kr/ /v/ /s/ /dʒ / /r/ /br/ /ɚ/ /ɳ/ /z/ /r/
8:0–8:11
9:0 & up
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Another rule of speech is that some words start with two consonants, such as broken or spoon.
When children don't follow this rule and say only one of the sounds ("boken" for “broken” or
"poon" for “spoon”), it is more difficult for the listener to understand the child. While it is
common for young children learning speech to leave one of the sounds out of the word, it is
not expected as a child gets older. If a child continues to demonstrate such cluster reduction,
he or she may have phonological process disorder.
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Normative Data: These guidelines for determining if a process should be a concern are reprinted with permission from Rules
Phonological Evaluation (Webb and Duckett, 1990a). These guidelines are based on normative data collected from the
literature and from field testing (Webb and Duckett, 1990b, 1992). Each horizontal bar in the chart above identifies the age
ranges when phonological processes disappear in normally developing children.
69
Ages DELETIONS
4 poon/spoon, top/stop
3. Consonant Cluster Reduction
SUBSTITUTIONS
4. Fronting/Backing
4–5 dum/gum cop/top
5. Affrication/Deaffrication
5–6 chew/shoe ship/chip
ASSIMILATION
OTHER (infrequent)
7 asks/ask
3. Transposition (Metathesis)
mud/mother
5
4. Vowel Naturalization
op/stop
2
5. CC Deletion ca/cats
2
6. Reduplication wawa/water d du/thank you
Bennett (11/85: 9/87) Adapted from Hodson (1980); Ingram (1981); Shribert & Kwiakowski (1981); Kahn (1982).
Appendix E: Language Milestones
Language/Play Developmental Scales
72
AGE LANGUAGE SYMBOLIC PLAY CONSTRUCTIVE PLAY
24 to 30 months Can introduce a topic Uses one object to represent Sand and water play consists
Engages in short dialogue of a different object that is of filling, pouring and
a few turns similar dumping
Repetition used to remain on Can build with blocks
topic horizontally and vertically
30 to 47 months Uses attention-getting words Uses multiple related action Combines 4–6 structured
with intonation schemes in sequence (feed objects with regard to
Understands WH questions: doll with bottle, pat doll on ordinal relationship (stacks
→what for object back, put doll in bed) seriated rings, nests seriated
→what to do for action Pretend themes are cups)
→where for location restricted to personally
MLU = 1.75–2.25 experienced events
30 to 36 months Sentence Grammar Pretends with object Produces simple 3
Uses language to regulate dimensional structure (builds
own and other’s actions, to bridge with blocks)
plan and anticipate Produces very simple figure
outcomes, report on present using fluid materials with
and past experiences, resemblance to target
comment on imagined (draws a face, makes a hot
context, project own and dog with play dough)
other’s feelings, and regulate
interactions
Expresses more than one
function in a single utterance
Develops semantic relational
terms to encode spatial,
dimensional, temporal,
causal, quantity, color, age
and other relations
Uses grammatical
morphemes, prepositions,
tense markers, plural
endings, pronouns and
articles
MLU = 2.75–3.5
Understands questions:
→whose for possession
73
AGE LANGUAGE SYMBOLIC PLAY CONSTRUCTIVE PLAY
→who for person
→why for cause or reason
→how many for number
Understands gender
contrasts in third person
pronouns
Asks WH questions—
generally puts WH at
beginning of sentence
36 to 42 months Uses syntax (word order) Gives dialogue to puppets Constructive play
Understands sentences and dolls predominates from 36
based on morphological and Pretends without an object months
syntactical rules (uses word for a prop (uses imaginary Uses blocks and sand box for
order strategy for agent objects) imaginative play
action-recipient relations) Pretend themes involve Can build vertical block
Uses direct requests (may I, events that child has structure that requires
could you) observed but not balance and coordination (9
MLU = 3.75 experienced; acts out blocks)
Uses past tense sequences with miniature
Uses future aspect (gonna) dolls (in house, garage,
airport)
42 to 47 months Uses modals (can, may, might, Group play begins Produces 3-dimensional
would, could) Joins other children in play enclosed structure (builds
Engages in sociodramatic fort with blocks end to end to
play in which child takes role form enclosure)
of someone else and Produces figure with some
elaborates on the theme in detail included (draws arms
cooperation with other and legs without body,
players makes animal figure using
Plans out pretend situations hot dog and pancake shapes)
in advance, organizing who
and what are needed for role
playing
Events in play are sequenced
into a scenario that tells a
story; links schemes into
complex script with
74
AGE LANGUAGE SYMBOLIC PLAY CONSTRUCTIVE PLAY
beginning, middle, and end
(fix dinner, serve it, wash
dishes, go to bed)
Can make dolls carry out
several activities or roles
Creates imaginary characters
Can direct actions of two
dolls, making them interact
48 to 60 months Discourse Grammar Develops novel schemes for Creates and repeats patterns
Learns to abide by events child has not in 3-dimentional structures
conversational rules to be experienced or observed (repeated use of pattern in
clear, concise, informative Develops cooperative play fence with different pattern
and polite for gate in fort)
Produces connected Produces figure resembling
discourse by setting up target (draws body and
transitions between many body parts; draws
sentences and clarifying house that resembles a face
shifts in reference from one - windows placed like eyes
clause or sentence to and door like mouth floating
another to convey personal in space
experiences and tell stories
Understands connected
discourse by using
knowledge of scripts and
story grammar to
comprehend narratives
Develops metalinguistic
awareness of language
structure and meaning
(ability to focus attention on
both language and content)
Develops skills in making
grammatical judgments,
resolving lexical ambiguity,
using multiple meanings of
words in humor, and
75
AGE LANGUAGE SYMBOLIC PLAY CONSTRUCTIVE PLAY
segmenting words into
phonemes
60 to 65 months Modifies language when Organizes other children and Games-with-rules play
talking to younger child props for role play Constructs elaborate
Discusses state, feelings, Can direct actions of 3 dolls structures and uses
emotions and attitudes microspheric objects in play
with structure
Produces figure in
perspective of paper (draws
house resting on bottom of
paper as a baseline)
65 to 72 months Can sustain topic through a Can direct dolls where each Constructs elaborate
dozen turns doll plays more than one structure that is realistic
role (father and doctor, reproduction with patterning
daughter and patient) and symmetry and uses
structure with microscopic
dramatic play
Produces a 2-dimensional
perspective in drawing
(draws a baseline taking on
qualify of a horizon with
house in proper perspective)
76
Levels of Play
77
Developmental Milestones of Narrative Production Used for Macrostructure*
Developmental Personal and Fictional Narratives Narrative Level Story Structure Level
Age
About 2 years Children embed narratives in adult-child Heaps and
conversations, with basic elements of sequences, and
narrative structure but no identifiable centering
high point.
About 3 years Children can produce verbal descriptions Primitive narrative Descriptive and action
of temporally organized general and unfocused sequences; more likely if
knowledge about routine events; chain retelling than generating a
children can independently report story
memories of past specific episodes with
little support
(i.e., questions and cues); no identifiable
high point.
About 4 years Children’s narratives have no identifiable Focused chains Complete episodes in 16% of
high point; 13% of personal narratives 4-year-olds’ stories; reactive
incorporate goal-directed episodes. sequences
About 5 years 42% of 5-year-old children incorporate True narratives Earlier story structure levels
goal-directed episodes; 95% of stories by still occur; some complete
children 5 and older have a central focus episodes may occur. In
or high point; children end narratives at fictional stories, children
the high point. include setting information
and may attempt to develop
a plot
About 6 years After age 5 years, children build to a high Abbreviated episode
point and resolve it in classic form.
Around 7-8 years Children use codes to tie personal Narrative 60% of 8-year-olds’ stories
narratives together; children use summaries are complete episodes.
introducers in elicited personal Stories include internal goals,
narratives. motivations, and reactions
that are largely absent in
stories produced by younger
children; some episodes will
be incomplete.
Multiple episodes
Around 11 years/ Children tell coherent, goal-based, Complex narratives Complex episode
5th grade fictional stories, although reference to
internal states is still rare. 10-year-olds Embedded episode
may be limited to number of embedded
or interactive episodes they can handle Interactive episode
when retelling a story.
Around 13 years Analysis and
generalization
*Note that information is based on narrative generation, not retelling unless specified.
Sources: Hedberg and Westby (1993); Hudson and Shapiro (1991); Kemper (1984); Peterson and McCabe (1953)
Source: Guide to Narrative Language: Procedures for Assessment (p. 144), by D. Hughes, L. McGillivray, and M. Schmidek, 1997, Eau
Claire, WI: Thinking Publications. Copyright by Thinking Publications. Reprinted with permission.
Story Structure Levels – Ordered from Least to Most Complex
5b. Complete Around 7-8 years Includes aims and plans of a character; may reflect evidence of
Episode planning in the attempts of a character to reach the goal; has at
minimum an initiating event, an attempt, and a consequence; uses
words like decided to
5c. Multiple Around 7-8 years Is a chain of reactive sequences or abbreviated episodes, or a
Episodes combination of complete and incomplete episodes
6. Complex Around 11 years Includes elaboration of a complete episode by including multiple
Episode plans, attempts, or consequences within an episode; includes an
obstacle to the attainment of a goal; may include a trick as in
“trickster tales”
7a. Embedded Around 11 years Embeds another complete episode or reactive sequence within an
Episode episode
7b. Interactive None established Describes one set of events from two perspectives, with characters
Episode by research; and goals influencing each other; may have a reaction or
beyond 11-12 consequence for one character serving as an initiating event for
years another character
Sources: Glenn and Stein (1980); Hedberg and Wesby (1993); Liles (1987); Steing (1988); Peterson and McCabe (1983)
79
80
Talk about how different sounds are made with your mouth.
Associate the sound with an object, action, or noise to help practice it in a fun way. (“The “P” is
the popping sound, because it’s made when we pop our lips.”)
Play word game such as ”I’m thinking of a word that starts with: st, sp, thr,” (identify pictures in
books).
Make matching picture cards with the sounds to play Go Fish, Memory, or Lotto.
Find objects with the sound/start a collection.
Play “I’m thinking of a word that starts (or ends) with ______ (make the sound).”
Go on a treasure hunt for objects that begin with the sound.
81
Appendix G: Articulation Impact in the Classroom
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_____ Reading errors, explain:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_____ Reluctance to participate in oral activities, explain:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
What interventions have you put in place to support the social/emotional concerns?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
3. What other variables may interfere with the development of the student’s articulation skills?
_____ Oral motor difficulties _____ Dental concerns _____ Hearing concerns
4. Other comments:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
82
Appendix H: Disfluency/Fluency Checklist
Student: ______________________________________ DOB: _______________ Date: ________________
Please complete this checklist based upon observation of behavior over the past 30 days.
1. How frequently does the student demonstrate disfluencies in speech?
_____ Occasionally _____ Often _____ Consistently (most instances when the student talks)
Rate of speech:
_____ slow _____ average _____ fast _____ very fast
Organization of verbalizations:
_____ poor _____ a few concerns _____ average _____ good
4. Types of disfluencies observed in the student’s speech: (check all that apply)
_____ revisions (stops and starts over) _____ repeats sounds/words/phrases
_____ prolongations (stretches a sound) _____ blocks (airflow/sounds stop during speech)
_____ eye blinking _____ facial grimaces
_____ head nods _____ avoids eye contact
_____ other: _____________________________________________________________________________
5. Explain how the student’s disfluencies negatively impact academics and/or socialization in the
educational environment:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
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Appendix I: Language Skills Checklists
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits Average Below Significantly
strengths and weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken
language)
1. Knows and uses vocabulary appropriate for age (i.e.,
shapes, colors ,names of common objects)
2. Understands that some words have multiple meanings
3. Understands age-appropriate concepts
4. Demonstrates concepts of print
5. Uses age-appropriate phonological awareness skills
6. Demonstrates adequate phonics skills
7. Follows one- to two-step directions
8. Recognizes rhyming words
9. Comprehends Stories
a. Identifies main ideas
b. Sequences events using pictures
c. Understands “WH” questions
d. Predicts story events, identifies cause/effect
e. Understands characters and setting
f. Identifies beginning, middle, and end of story
g. Identifies story problems and solutions
h. Retells, summarizes events
10. Categorizes colors, shapes, size, function
11. Solves simple problems
Oral Expression (Use of spoken/language to
communicate)
1. Verbally expresses wants and needs
2. Speaks appropriately with peers and adults
3. Recites short patterned songs, stories, and poems
4. Communicates when relating experiences
5. Communicates when retelling stories
6. Uses complete sentences when speaking
7. Uses subject-verb agreement and tense correctly
8. Takes up to three conversational turns on one topic
Are there any additional factors to consider regarding the student’s educational background?
84
Language Skills Checklist: Grade 1
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits Average Below Significantly
strengths and weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken language)
1. Knows and uses vocabulary appropriate for age (i.e.,
shapes, colors ,names of common objects)
2. Recognizes grade-level antonyms, synonyms, homonyms
85
Language Skills Checklist: Grade 2
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits Average Below Significantly
strengths and weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken language)
1. Knows and uses vocabulary appropriate for grade level
(including synonyms, antonyms, homonyms, etc.)
2. Understands age-appropriate concepts
3. Classifies and categorizes vocabulary words
4. Understands prefixes, root words, and common suffixes
5. Reads grade-level material fluently
6. Demonstrates adequate phonics skills
7. Follows multi-step directions
8. Comprehension of grade-level fiction/non-fiction
j. Identifies/infers main idea and supporting details
a. Distinguishes fact from fiction
b. Sequences events
c. Identifies/infers cause/effect relationships
d. Makes predictions and draws conclusions
e. Identifies characters, setting, and plot
f. Identifies beginning, middle, and end of story
g. Identifies story problems and solutions
h. Retells, summarizes events
9. Recalls and infers facts
10. Compares and contrasts words/pictures
11. Asks and answers questions before, during, after reading
12. Interprets information from diagrams, charts, graphs
13. Uses problem solving strategies
Oral Expression (Use of spoken/language to communicate)
1. Begins to inform, persuade using oral language
2. Uses curriculum vocabulary in classroom discussions
3. Uses increasingly complex language sentence patterns
4. Uses common rules of conversation with adults and
peers
5. Uses descriptive language
6. Retells stories including main idea and details
7. Uses correct verb tense and plural nouns
Are there any additional factors to consider regarding the student’s educational background?
86
Language Skills Checklist: Grade 3
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits Average Below Significantly
strengths and weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken language)
1. Knows and uses vocabulary appropriate for grade level
(including synonyms, antonyms, homonyms, etc.)
2. Classifies and categorizes vocabulary words
3. Understands prefixes, root words, and common suffixes
4. Reads grade level material fluently
5. Demonstrates adequate phonics skills
6. Follows multi-step directions
7. Comprehension of grade-level fiction/non-fiction
a. Identifies/infers main idea and supporting details
b. Distinguishes fact from fiction
c. Sequences events
d. Identifies/infers cause/effect relationships
e. Makes predictions and draws conclusions
f. Identifies characters, setting, and plot
g. Identifies beginning, middle, and end of story
h. Identifies story problems and solutions
i. Compares and contrasts elements between plots
8. Retells /summarizes events
9. Recalls, interprets & summarizes information
10. Asks and answers questions before, during, after
reading
11. Interprets information from diagrams, charts, graphs
12. Uses problem solving strategies
Oral Expression (Use of spoken/language to communicate)
1. Begins to inform, persuade using oral language
2. Adapts oral language to fit the situation
3. Expresses ideas appropriately and effectively for grade
level
4. Uses new vocabulary/descriptive language in
discussions
5. Speaks and writes in complete coherent sentences
6. Demonstrates knowledge of when to use formal and
informal language exchanges (i.e., slang, idioms)
Are there any additional factors to consider regarding the student’s educational background?
87
Language Skills Checklist: Grade 4
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits Average Below Significantly
strengths and weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken language)
1. Understands and acquires new vocabulary appropriate for
grade level (including synonyms, antonyms, homonyms,
etc.)
2. Identifies the meaning of common root words and prefixes
to determine the meaning of unfamiliar words
3. Reads grade-level material fluently
4. Demonstrates adequate phonics skills
5. Follows multi-step directions
6. Narrative elements in stories read and written:
a. Summarizes main idea and supporting details
b. Distinguishes fact from opinion or fiction
c. Relates themes in works of fiction and nonfiction to
personal experience
d. Distinguishes cause from effect in context
e. Identifies similarities & differences between characters,
events, or themes in literary work
f. Identifies characters, setting, and plot
g. Make predictions and draw conclusions
h. Compares and contrasts elements between texts
7. Uses and identifies the four basic parts of speech (noun,
adjective, verb, adverb)
8. Recalls, interprets & summarizes information
9. Identifies sensory details and figurative language
10. Interprets information from illustrations, diagrams, charts,
graphs
11. Uses problem-solving strategies
Oral Expression (Use of spoken/language to communicate)
1. Begins to inform, persuade using oral language
2. Adapts oral language to fit the situation
3. Expresses ideas appropriately and effectively for grade
level
4. Demonstrates appropriate social language skills with peers
5. Speaks and writes in complete coherent sentences
6. Demonstrates knowledge of when to use formal and
informal language exchanges (i.e., slang, idioms)
7. Retells and summarizes stories heard
8. Solicits another’s opinion and offers own opinion
appropriately
Are there any additional factors to consider regarding the student’s educational background? (Use back of
form)
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Language Skills Checklist: Grade 5
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits strengths and Average Below Significantly
weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken language)
1. Understands and acquires new vocabulary appropriate for
grade level (including synonyms, antonyms, homonyms, etc.)
2. Determines the meaning of unfamiliar words using knowledge
of common root words, prefixes, & suffixes
3. Reads grade-level material fluently
4. Determines the meaning of unfamiliar words using context
clues
5. Follows multi-step directions
6. Narrative elements in stories read and written:
a. Summarizes main idea & supporting details
b. Distinguishes fact from opinion or fiction
c. Relates themes in works of fiction and nonfiction to
personal experience
d. Distinguishes cause from effect in context
e. Identifies similarities & differences/analogies
f. Identifies characterization, setting, and conflict in plot
g. Makes predictions and draw conclusions
h. Compares and contrasts elements between texts
7. Uses and identifies the eight basic parts of speech (noun,
adjective, verb, adverb, pronoun, conjunction, preposition,
interjection)
8. Recalls, interprets, and summarizes information
9. Identifies common idioms and figurative language
10. Interprets information from illustrations, diagrams, charts,
graphs
Oral Expression (Use of spoken/language to communicate)
1. Begins to inform, persuade using oral language
2. Adapts oral language to fit the situation
3. Expresses ideas appropriately and effectively for grade level
4. Demonstrates appropriate social language skills with peers
individually and within small groups
5. Speaks and writes in complete coherent sentences
6. Demonstrates knowledge of when to use formal and informal
language exchanges (i.e., slang, idioms)
7. Retells and summarizes stories heard
8. Solicits another’s opinion and offers own opinion
appropriately
9. Asks relevant questions and responds to questions
appropriately
Are there any additional factors to consider regarding the student’s educational background? (Use back of
form)
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Language Skills Checklist: Middle School
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits strengths Average Below Significantly
and weaknesses in the following areas: Average Below Avg.
Comprehension (ability to understand spoken language)
1. Understands and acquires new vocabulary appropriate for
grade level (including synonyms, antonyms, homonyms, etc.)
2. Determines the meaning of unfamiliar words using knowledge
of common root words, prefixes, and suffixes
3. Uses strategies to learn meaning of an unfamiliar word
4. Determines the meaning of unfamiliar words using context
clues
5. Follows multi-step directions to complete a product
6. Narrative elements in stories read and written:
a. Summarizes main idea and supporting details
b. Distinguishes fact from opinion or fiction
c. Relates new information to prior knowledge
d. Distinguishes cause from effect in context
e. Identifies similarities and differences/analogies
f. Identifies characterization, setting, and conflict in plot
g. Make predictions and draw conclusions
h. Compares and contrasts presented information
7. Uses problem-solving strategies
8. Recalls, interprets and summarizes information
9. Identifies common idioms and figurative language
10. Interprets information from illustrations, diagrams, charts,
graphs
Oral Expression (Use of spoken/language to communicate)
1. Communicates ideas that persuade, describe, and inform
2. Adapts oral language to fit the situation
3. Oral presentations for various purposes is organized
4. Demonstrates appropriate social language skills with teachers
and peers individually, and within small groups
5. Confirms understanding by paraphrasing and clarifying
6. Demonstrates knowledge of when to use formal and informal
language exchanges (i.e., slang, idioms)
7. Retells and summarizes stories heard
8. Solicits another’s opinion and offers own opinion
appropriately
9. Asks relevant questions and responds to questions
appropriately
Are there any additional factors to consider regarding the student’s educational background? (Use back of
form)
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Language Skills Checklist: High School
Student____________________________________________________ Date____________________
Evaluator_____________________________________ Primary Home Language____________________
Compared to students of similar age, this student exhibits Average Below Significantly
strengths and weaknesses in the following areas: Average Below Avg.
Vocabulary
1.Understands and acquires new vocabulary in content areas
2.Determines the meaning of unfamiliar words using
knowledge of common root words, prefixes, and suffixes
3. Uses strategies to learn meaning of an unfamiliar word
4. Determines the meaning of unfamiliar words using context
clues
Comprehension (ability to understand spoken language)
1. Reads content fluently in class
2. Identifies abstract/figurative language
3. Understands different points of view
4. Employs group decision-making techniques (brainstorming)
5. Compares and contrasts presented information
6. Uses problem-solving strategies
7. Recalls, interprets, and summarizes information
8. Interprets information from illustrations, diagrams, charts,
graphs
Oral Expression (Use of spoken/language to communicate)
1. Communicates ideas that persuade, describe, and inform
2. Adapts oral language to fit the situation
3. Gives oral presentations for various purposes is organized
4. Demonstrates appropriate social language skills with
teachers and peers individually, and within small groups
5. Clarifies, illustrates, or expands on a response when asked
6. Demonstrates knowledge of when to use formal and
informal language exchanges (i.e., slang, idioms)
7. Retells and summarizes stories heard
8. Solicits another’s opinion and offers own opinion
appropriately
9. Asks relevant questions and responds to questions
appropriately
10. Applies appropriate interviewing techniques
11. Expresses ideas using descriptive and precise language
12. Participates in discussions, initiates, and contributes ideas on
content area topics.
Are there any additional factors to consider regarding the student’s educational background? (Use back of
form)
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Appendix J: Teacher Pragmatics Checklists
Teacher’s Checklist and Rating Scale: Pragmatic Language Skills Grades K–3
Please complete this form in ink. It will be included in the student’s final report.
This will help determine the role communication plays in educational/social development.
Sometimes
Usually
Always
Never
Nonverbal Communication Skills
1. Understands others’ use of body language/uses appropriate body language
2. Understands and uses appropriate physical space boundaries
General Conversation Skills
3. Responds to greetings/says goodbye
4. Tells of wants, needs, and preferences
5. Asks appropriately for help, assistance, and permission
6. Starts and maintains friendships
7. Initiates topic
8. Joins an ongoing conversation appropriately
9. Maintains topic
10. Provides relevant answers to questions
11. Interrupts appropriately
12. Gives sufficient information for listener comprehension
13. Revises messages when listener misunderstands
14. Demonstrates and shares feelings appropriately
Comments/Questions:
What are the problems that concern you the most?
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Teacher’s Checklist and Rating Scale: Pragmatic Language Skills Grades 4–12
Sometimes
Usually
Always
Never
1. Observes turn-taking rules
2. Introduces appropriate topics of conversation
3. Maintains topics of conversation (nods, responds with “hmm”)
4. Makes relevant contributions during conversation/discussion
5. Asks appropriate questions
6. Avoids use of repetitive/redundant information
7. Asks for/responds to requests for clarification
8. Participates appropriately in structured group activities
9. Uses appropriate strategies for gaining attention
10. Asks for help appropriately
11. Asks for permission appropriately
12. Agrees/disagrees using appropriate language
13. Responds appropriately when asked to change his/her actions
14. Responds to teasing, anger, failure, disappointment
appropriately
Comments/Questions:
What are the problems that concern you the most?
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Appendix K: Fluency Questionnaire for
Parents/Caregivers
Student: _____________________________________ DOB: _________________ Date: ____________________
Teacher: _____________________________________ Grade: _________________________________________
Parent completing the form: ____________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
At what age did you first notice the concerns? __________
2. Have the concerns improved or worsened since that time? (please circle)
4. Below are some examples of stuttering/disfluencies (check all that you observe in your child)
_____ blocks, or gets stuck, and is not able to get the sounds/words out
_____ unusual face or body movements when speaking, or just prior to speaking
5. Have there been any changes at home which correspond to the start or increase in
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Is there a family history of stuttering? _____ Yes _____ No
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Appendix L: Voice Checklist
Student: ___________________________________ Date: ____________________
*Please complete the checklist based upon observation of your student’s vocal quality over the past 30
days.
1. Does the student’s voice stand out as being different from peers?
If yes, circle all that apply: hoarse, breathy, hypernasal, hyponasal, Yes/No
Other:
2. Does the student’s voice interfere with his/her ability to communicate effectively
in the educational setting? Yes/No
3. Are you observing the student excessively using any of the following behaviors?
Loud talking
Yelling/screaming Yes/No
Throat clearing Yes/No
Coughing Yes/No
Making unusual noises Yes/No
Talking too much Yes/No
Yes/No
4. Please check how frequently you are observing the student demonstrating any of the behaviors
listed in question 3:
6. Describe any changes in the way his/her voice has sounded since the start of the school year:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
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Appendix M: Vocal Habit Chart
Directions: Choose a time each day where unhealthy vocal habits are most likely to occur. Count the
number of times the student engages in the habits/behaviors. Complete the chart for one week in
order to establish a baseline. Involve the student in charting his/her habits. Complete this form again
as needed for progress monitoring.
Comments:_______________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
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Appendix N: Permission to Screen Language Skills
Address: __________________________________________________________________________________
This form constitutes a request for screening, with parent/guardian permission, to determine whether areas of concern
can be addressed within the student’s regular education environment or if a special education referral is needed. This
screening will include a review of the student’s communicative abilities and can address language comprehension and use,
articulation, fluency, or voice. Results and recommendations will be reviewed with the parent and teacher to determine a
plan of action.
_____Other____________________________________________________________________
Comments (Please provided specific examples supporting the request for a screening):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
___________________________
__________________________________________ ___________________
Parent/Guardian Signature Date
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Appendix O: Examination of Oral Peripheral
Mechanism
Name: ___________________________________________ Date: ____________ Examiner: ____________________________________________
2. Lips
Appearance ___________________________________________________________
4. Tongue
Appearance at rest: ________________________________________________________
6. Diadochokineses
Papapa – (avg. =3-5 ½) _____________ kakaka – (avg. = 3 ½ - 5 ½) ___________
Tatata – (avg. =3-5 ½) ______________ putuku – (avg. = 1-1 ¾) ______________
7. Tongue Thrust
Does s/he swallow with teeth apart? Yes No
Can you see the tongue when s/he swallows? Yes No
If s/he swallows with the lips closed,
Comments ______________________________________________________________________________________________________________
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Appendix P: Language Severity Rating Scale
Student ____________________________ School ____________________ Grade ____ Date of Rating _________ DOB __________ Age ____ SLP _______________________________
FORMAL ASSESSMENT 0 2 3 4
< 1.5 SD below the >1.5 SD below test mean >2 SD below test mean >2.5 SD below test mean
Comprehensive language mean (standard score between 70-77) or (standard score between 62– (standard score below 62) or
score, and/or composite (Standard Score* of 78 2nd - 6th Percentile 69) or 1st –2nd Percentile below 1st Percentile
receptive/expressive scores or above) ☐ Standard error of measured used
because____________________________
___________________________________
At least one of the following areas are At least two of the following At least three of the following
deficient areas are deficient areas are deficient
INFORMAL ASSESSMENT 0 2 3 4
Language skills are Check areas of weakness: Check areas of weakness: Check areas of weakness:
Check descriptive tools used: within expected range. Sentence length/complexity Sentence Sentence
Language/communication Word order/syntax length/complexity length/complexity
sample Vocabulary/semantics Word order/syntax Word order/syntax
Checklist(s) Word finding Vocabulary/semantics Vocabulary/semantics
Observations Word form/morphology Word finding Word finding
Other: _______________ Use of language/pragmatics Word form/morphology Word form/morphology
Auditory perception Use of Use of
language/pragmatics language/pragmatics
Auditory perception Auditory perception
0 2 3 4
FUNCTIONAL/ACADEMIC Functional/Academic The student uses language skills Due to language deficits, the The student does not use
LANGUAGE SKILLS language skills are effectively most of the time with student needs more cues, language skills effectively
within expected range. little or no assistance required. models, explanations, or most of the time despite the
assistance than the typical provision of general
student in class. education accommodations
and supports.
1. Circle score for the most appropriate description for each category. Do not include regional or dialectal differences when scoring.
2. Circle the total score on the bar/scale below and compute the total score and record below to determine severity rating.
Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range for Speech Sound Production on
the rating scale for Speech Sound Production. Disability standards for Phonological Processing require ratings at the Moderate, Severe, or
Profound Levels of Severity. Yes No
There is documentation/supporting evidence of adverse effects of the Speech Sound Production on educational performance. Yes No
(BOTH STATEMENTS ABOVE MUST BE CHECKED YES)
Determination of eligibility as a student with a Speech and/or Language Impairment is made by the IEP Team.
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Appendix R: Fluency Severity Rating Scale
Student _______________________ School ____________________ Grade ______ Date of Rating _______ DOB _______ Age _________ SLP ___________________________
0 1 2 3
Frequency Frequency of disfluency Transitory disfluencies Frequent disfluent Habitual disfluent
is within normal limits for are observed in speaking behaviors are observed in behaviors are observed in
age, sex and speaking situations and/or many speaking situations majority of speaking
situation and/or 3-4 stuttered words per and/or situations and/or
≤ 2 stuttered words per minute and/or 5-9 stuttered words per More than 9 stuttered
minute and/or 5% to 11% stuttered minute and/or words per minute and/or
≤ 4 % stuttered words words 12% to 22% stuttered ≥23% stuttered words
words
0 1 2 3
Descriptive Assessment Speech flow and time Whole-word repetitions Whole-word repetitions Whole-word repetitions
patterning are within Part-word repetitions Part-word repetitions Part-word repetitions
normal limits. and/or and/or and/or
Developmental disfluencies Prolongations are Prolongations are Prolongations are
may be present present with no secondary present. Secondary present. Secondary
characteristics. Fluent symptoms, including symptoms predominant.
speech periods blocking avoidance and Avoidance and frustration
predominate physical concomitants may behaviors are observed.
be observed.
0 1 2 3
Speaking Rate Speaking rate not Speaking rate affected to Speaking rate affected to Speaking rate affected to
affected mild degree. Rate moderate degree. Rate severe degree and
difference rarely notable to difference distracting to distracting to
observer, listener and/or observer, listener and/or listener/observer and/or
82-99 WSM 125-150 60-81 WSM 150-175 <60 WSM > 175 WSM
WSM WSM
Instructions: 1. Circle the score for the most appropriate description for each of these categories: Frequency, Descriptive Assessment, Speaking Rate.
2. Compute the total score and record below.
3. Circle the total score on the rating bar/scale below.
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Appendix S: Voice Severity Rating Scale
Student _________________________ School ________________________ Grade ______ Date of Rating _______ DOB _______ Age ___ SLP __________________________
Pitch 0 1 3
Pitch is within normal limits. There is a noticeable difference, There is a persistent, noticeable
which may be intermittent. inappropriate raising or lowering of
pitch for age and sex.
Intensity 0 1 3
Intensity is within normal limits There is a noticeable difference in There is persistent, noticeable,
intensity, which may be inappropriate increase or decrease
intermittent. in the intensity of speech or the
presence of aphonia.
Quality 0 1 3
Quality is within normal limits. There is a noticeable difference in There is persistent, noticeable,
quality, which may be intermittent. breathiness, glottalfry, harshness,
hoarseness, tenseness, stridency or
other abnormal quality.
Resonance 0 1 3
Nasality is within normal limits. There is a noticeable difference in There is persistent, noticeable cul
nasality, which may be intermittent. de sac, hyper or hyponasality, or
mixed nasality.
Instructions: 1. Do not include regional or dialectal differences when scoring.
2. Circle the score for the most appropriate description for each category, i.e., Pitch or Intensity.
3. Compute the total score and record below.
4. Circle the total score on the bar/scale below.
Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range Voice Disorder. Yes No
There is documentation/supporting evidence of adverse effects of the Voice disorder on educational performance. Yes No
(BOTH STATEMENTS ABOVE MUST BE CHECKED YES)
Determination of eligibility as a student with a Speech and/or Language Impairment is made by the IEP Team.
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Appendix T: Evaluation Report Template
SPEECH-LANGUAGE EVALUATION REPORT
I. Purpose of Evaluation
☐ This speech and language evaluation was requested to determine if the student meets the Tennessee
Department of Education eligibility standards for disability.
☐ This is a re-evaluation in order to determine if the student meets the Tennesee Department of Education
eligibility standards as speech and/or language impaired. (See re-evaluation summary in student’s special
education file.)
☐ A speech and language evaluation was requested to gather more information to be used in planning the IEP.
☐ This assessment is part of a comprehensive evaluation involving other disciplines, which includes:
☐School Psychologist ☐Special Educator ☐Occupational Therapy ☐Physical Therapy
II. Background Information and Assessment Observations (all fields must be completed)
Relevant Developmental and Medical History: (please summarize information from the parent-completed case history
form)
☐ Test results should be viewed with caution, as they may not indicate an accurate current level of communicative
abilities.
Comments:
If the student failed the most recent screening, please provide current communication with parents/guardians:
If the student failed the most recent screening, please provide current communication with parents/guardians:
V. Speech Assessment
A. Articulation Test:
Articulation error sounds/patterns which were produced, and which are considered below normal limits for a child this
Initial
Medial
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Final
☐ Initial consonant deletion (up for cup) ☐ Final consonant deletion (do for dog)
☐ Weak syllable deletion (tephone for telephone) ☐ Intervocalic deletion (teephone for telephone)
☐ Cluster reduction (sove for stove, cown for clown) ☐ Voicing/Devoicing (bear for pear, koat for goat)
☐ Stopping (tun for sun, pour for four) ☐ Backing (kable for table)
☐ Fronting (tup for cup, thun for sun) ☐ Stridency deviation (soe for shoe, fumb for thumb)
☐ Liquid simplication (wamp for lamp, wed for red) ☐ Deaffrication (tair for chair, dump for jump)
Are the conversational speech errors consistent with errors in formal testing?
If no, explain:
The same norms were used for sounds in words/sentences/conversation, and consistently across the district?
If problem identified, summarize the adverse impact in the educational setting (i.e., grades, work samples, etc.):
105
C. Voice Test:
☐ Appropriate for sex and age
☐ Not appropriate for sex and age. Please explain:
If voice was found to be inappropriate, explain the adverse impact in the educational setting (i.e., grades, work samples,
etc.):
If not appropriate, has the parent/guardian consulted with their medical doctor?
D. Fluency Test:
☐ Appropriate for age
☐ Inappropriate for age
If fluency was assessed, provide detailed formal and informal test results below:
Student’s attitude towards stuttering: (include student and/or parent interview as an attachment)
If fluency was found to be inappropriate, explain the adverse impact in the educational setting (i.e., grades, work
samples, etc.):
additional standardized measure to support the comprehensive assessment. Pragmatics should be assessed if
Test:
Narrative: (Describe subtest scores, skills assessed, explanation of score in terms of normalcy and exceptionality)
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Test:
Narrative: (Describe subtest scores, skills assessed, explanation of score in terms of normalcy and exceptionality)
Test:
Narrative: (Define skills assessed, explanation of score in terms of normalcy and exceptionality)
Test:
Narrative: (Define skills assessed, explanation of score in terms of normalcy and exceptionality)
Test:
Narrative: (Define skills assessed, explanation of score in terms of normalcy and exceptionality)
Please explain the results is completed. If not completed, please explain why it was not necessary:
If inappropriate language is indicated, explain the adverse impact in the educational setting (i.e. grades, work samples,
etc.) :
107
VII. Effects on Educational Performance (Based on data collection)
☐ Does not adversely affect educational performance.
☐ Does adversely affect educational performance.
IX: Recommendations
This report is submitted to the IEP team for consideration when making decisions regarding placement and programming.
_____________________________________________________________
Speech-Language Pathologist
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References
http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935321§ion=Roles_and_Responsibilities
http://www.asha.org/public/speech/disorders/SpeechSoundDisorders/#signs_artic
http://www4.esc13.net/uploads/speech/docs/09-10/dec/RtIStrategies_Artic.pdf
http://www.oliviasplace.org/speech-and-language-strategies-for-parents-educators-articulation/
http://www.asha.org/public/hearing/Otitis-Media/
http://www.asha.org/uploadedFiles/PreventingSpeechandLanguageDisorders.pdf
Clark MK, Kamhi AG. 2010. Language Disorders (Child Language Disorders). In: JH Stone, M Blouin,
editors. International Encyclopedia of Rehabilitation. Available online:
http://cirrie.buffalo.edu/encyclopedia/en/article/31/
Evidence Summary: Speech and Language Delay and Disorders in Children Age 5 and Younger: Screening.
U.S. Preventive Services Task Force. July 2015.
https://www.uspreventiveservicestaskforce.org/Page/Document/evidence-summary30/speech-and
language-delay-and-disorders-in-children-age-5-and-younger-screening
Ruddy B, Sapienza C. 2004. Treating Voice Disorders in the School-Based Setting: Working Within the
Framework of IDEA. Language, Speech and Hearing Services in Schools, Vol. 35, 327-332
109
Speech Sound Assessment (taken from ASHA)
http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935321§ion=Assessment)
Bernthal, J., Bankson, N. W., & Flipsen, P., Jr. (2013). Articulation and phonological disorders. New York,
NY: Pearson Higher Education.
Boone, DR. McFarlane, SC., Von Berg, SL& Zraick, RI. (2009). The Voice and Voice Therapy. (8th). Boston,
MA: Allyn & Bacon.
Karnell, M.P, Melton, S.D, Childes, J.M, Coleman, T.C, Dailey, S.A, &Hoffman, HT. (2007). Reliability of
Clinician-Based (GRBAS and CAPE-V) and Patient-Based (V-RQOL and IPVI) Documentation of Voice
Disorders. Journal of Voice, 21(5), 576-590.
Lee, L., Stemple, JC, Glaze, L.; Kelchner, L.N. (2004). Quick Screen for Voice and Supplementary
Documents for Identifying Pediatric Voice Disorders. Language, Speech & Hearing Services in Schools,
35(4), 308-319.
Zura, KB, Cotton, S., Klechner, L., Baker, S., Weinrich, B., &Lee, L. (2007). Pediatric Voice Handicap Index
(PVHI): A new tool for evaluating pediatric dysphonia. International Journal of Pediatric
Otorhinolaryngology, 71(1), 77-82.
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