Tennessee Regulations for Speech/Language Services in Schools

The following excerpts have been taken from the state website. Please refer to this website - www.tennessee.gov/education/speced - for full disclosures of the following topics. Copies of the Speech & Language Evaluation Report; the Severity Rating Scales for Articulation, Language, Fluency and Voice; as well as other school-based S/L forms/ resources can be reviewed and downloaded from the state’s website.

Both state (TN) and IDEA 97 (federal) law requires the IEP to be implemented in the least restrictive environment (LRE). The IEP team determines the most appropriate services needed for meeting each individual student’s communication needs. When pull-out services are deemed the most appropriate service delivery model for students, the IEP team may be required to demonstrate that the communication needs of eligible students cannot be met in the regular classroom to support a determination to serve students via the ‘traditional clinical direct pull-out therapy model’. Once the appropriate service model has been determined, the SLP is legally responsible for overseeing the design, implementation and supervision of S/L services.

IDEA ’97 provides for the inclusion of speech and language impairments that adversely affect the educational performance of students. If the student’s challenges do not adversely impact the student’s academic performance, the student is not eligible for services under IDEA. S/L assessments and intervention plans for students must be educationally relevant.

Speech/Language Therapy services include the provision of speech or language services by a Speech/Language Pathologist or Specialist. A minimum of two (2) contacts per month are required by the state. Services can be direct or indirect. Indirect services are generally consultative.

Definition/Eligibility Standards

Definition (State Board of Education Rule 0520-1-9-.01)

• Speech or Language Impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment or voice impairment that adversely affects a student’s educational performance.
  
• Deafness means a hearing impairment that is so severe that the student is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance.

Eligibility Standards

• Articulation Impairment – a significant deficiency in the ability to produce sounds in conversational speech which is not consistent with the student’s chronological age.
  
• Deafness – involves the student’s inability to communicate effectively due to deafness; inability to perform academically on a level commensurate with the expected level because of deafness; and, delayed speech and/or language development due to deafness.
  
• Fluency Impairment – abnormal interruption of the flow of speech by repetitions or prolongations of a sound, syllable or by avoidance and struggle behaviors.
  
• Language Impairment – a significant deficiency which is not consistent with the student’s chronological age in one or more of the following areas: receptive language skills; expressive language skills; and/or auditory perception skills.
  
• Voice Impairment – an excess or significant deficiency in pitch, intensity or quality resulting from pathological conditions or inappropriate use of the vocal mechanism.
  

Evaluation Procedures

Speech/Language Pathologists are required to implement traditional, professionally recognized standardized assessment instruments when evaluating students for deter- mining if the student meets the TN state’s criteria for eligibility as speech or language impaired. Information from the parent/s or legal guardian; general education classroom teacher; licensed audiologist and/or otolaryngologist (where applicable); and other appropriate professional personnel should be gathered as part of the evaluation process.

Pre-referral and Early Intervention

The state of TN regulations require that alternative procedures and early intervention programs in the general education curriculum/classroom be explored and implemented before a child is referred to special education. The early intervention process is critical in distinguishing students who may benefit from general education interventions from stu- dents who may need speech and language services in the traditional pull-out model or an alternate evidence-based S/L therapy service delivery model. The Student Support Team (S-Team) serves as the pre-referral agent, providing support for the classroom teacher in the implementation of appropriate early intervention strategies. When a student fails to respond to the early intervention strategies, the S-Team initiates the referral process which begins with the formal assessment.

(please refer to the diagram outlining the required pre-referral/referral process at the end of this section)

Evaluation Guidelines

IDEA ’97 specifies the following circumstances that require evaluation (formal or informal) of a student:

• The student is suspected of having a speech and/or language impairment.
  
• Prior to the initial provision of speech/language services as special education or as a related service.
  
• At least every three years, or if conditions warrant a reevaluation or if the teacher or parents request a reevaluation.
  
• Before determining that a child no longer has a disability, except when termination of eligibility is due to graduation with a regular high school diploma or the student exceeding age eligibility for a free appropriate public education.

The rules that apply to the evaluation and eligibility of students in public education may be found under IDEA: Evaluation Procedures [IDEA, Rules and Regulations, 1999-300.532, 20 U.S.C. 1412 (a)(6)(B), 1414 (b)(2) and (3)] [TN Rules and Regulations, 2000, Chapter 0520-1-9].

S/L Assessments

Articulation

When assessing articulation skills or phonological processes, the evaluation process must include the following:

• A norm-referenced articulation test or a test of phonological processes.
  
• An oral peripheral examination.
  
• A hearing and vision screening.

The assessment process should also include a completed Speech Sound Production Severity Rating Scale.

Deafness

The evaluation process for the hearing impaired student shall include the following:

• An audiological evaluation completed by a licensed Audiologist.
  
• An evaluation of speech and language skills.
  
• School history and levels of learning or educational performance.
  
• Documentation, including an observation of classroom performance, and assessment of how deafness adversely affects educational performance in the general education classroom or learning environment.

Fluency

When assessing for fluency, the evaluation process shall include the following:

• A formal/informal fluency measure for frequency, descriptive assessment and speaking rate.
  
• An oral peripheral examination.
  
• A hearing and vision screening.
  
• Information from two educators.

The assessment process should also include the completion of the Fluency Severity Rating Scale.

Language

Language assessments must be comprehensive in nature, including an appropriate balance of formal and descriptive assessment instruments. The comprehensive assessment should follow the professionally recognized testing procedures, including a minimum of two (2) measurements. The assessment should include a criterion and/or norm-referenced instrument; a functional communication analyses; and, a language/ communication sample.

Interpreting and reporting the evaluation results shall follow the Standards for Educational and Psychological Testing (AERA, APA, NCME, 1985):

To determine eligibility as a student with a language impairment, receptive, expressive and/or composite test scores shall fall at least 1.5 standard deviations below the mean (approximately the 7th percentile or a standard score of 77 or below) of the language assessment instrument/s administered. The cutoff shall be applied to composite scores of receptive and/or expressive measurements or to the overall test scores rather than to individual subtest scores. When assessment results indicate a significant weakness in any skill area (i.e. receptive, expressive, auditory perception, pragmatic language), and the obtained score is not 1.5 standard deviations below the test mean, further assessment in the deficit area is required. The Language Severity Rating Scale is to be used as a tool after a complete assessment of the student’s communication abilities and after the SLP has interpreted assessment results.

Voice

When assessing for voice, the evaluation process should include the following:

• A medical report from an otolaryngologist.
  
• An analyses of voice pitch, intensity and voice quality.
  
• An oral peripheral examination.
  
• A hearing and vision screening.
  
• Information from two educators.

The assessment process should also include the completion of the Voice Severity Rating Scale.

Cultural and Linguistic Diversity

ASHA stresses the importance of the SLP understanding the impact of culture and language on communication skills. Prior to assessing a student from a culturally or linguistically diverse background, the SLP should seek information pertinent to the culture of the student. The Center for Applied Linguistics in Washington, D.C.
(www.cal.org) is a useful resource about other languages and cultures, as is the National Clearing House for Bilingual Education (www.ncbe.gwu.edu).

To determine whether a student with limited proficiency in English has a speech/ language disability, differentiating a language disability from a cultural or language difference is crucial. In order to conclude that a student with limited English proficiency has a language disability, the assessor must rule out the effects of different factors that may simulate language disabilities.

Dismissal

The decision to dismiss a student from S/L services is based upon input from the IEP team that is initiated by the SLP or any other team member. The criteria for exit from services for speech and/or language impairments should be discussed with the IEP team members at the beginning of intervention. A speech and/or language evaluation should be administered as part of the dismissal process to assure that the appropriate determina- tion occurs.

The following guidelines should be followed whenever considering dismissal of a student from S/L services:

• S/L goals have been met. Speech and/or language skills are within normal limits.
  
• Continued lack of progress is shown after appropriate changes in intervention/ accommodations and goals have been considered and implemented.
  
• Acquisition of new skills would not greatly improve education-based speech and language skills of students with severely impaired communication or cognitive systems.
  
• Gains are shown to be general and not related to intervention.