Speech and language services were always a mystery for us when our son was in school. Even as he struggled with written composition, our school’s Speech and Language Pathologist would end her evaluations with the statement that “services are not recommended at this time.” We assumed that since he did not have an audible problem with his speech, that he didn’t need any of her services.
We now know that this is a typical reaction of many parents, who like ourselves, don’t understand the wide range of services that a Speech and Language Pathologist can and should provide to students in a school setting. In this article, we want to review some of the most important of these services, describe our experiences with schools attempting to limit them, and make suggestions about how you can advocate for your child to have the services that he or she needs.
The Role and Responsibility of a Speech and Language Pathologist*
A Speech and Language Pathologist evaluates children to determine if there is a communication disorder in areas related to speech, the use of language, and sensory issues that impact communication and interfere with attaining educational goals.
Though there are many detailed aspects to what a Speech and Language Pathologist can evaluate, for the purpose of this article we have simplified them into the following categories:
- Speech: This includes expressive speech (the quality of audible sounds such as articulation and voice volume and quality), receptive speech (how a person understands and processes verbal communication), and pragmatic language (social communication skills).
- Language: This includes the comprehension and expression of written language, sequencing of thoughts, syntax and grammar, and understanding symbols and their meanings.
- Sensory Issues: These include social and emotional deficits that impact communication and even difficulty swallowing pills.
In addition to diagnosing disorders in these areas, a Speech and Language Pathologist provides therapy to help children communicate with their peers, teachers, and families. Therapy can also teach children who are nonverbal how to use communication devices to express themselves.
In other words, speech and language services are not just about speech, they are about learning how to communicate with others in many different ways, with both expressive and receptive language, speaking, writing, and assistive technology. The professional organization for Speech and Language Pathologists in the United States takes the position that it is the responsibility of its members to provide a full range of these services to improve the “literacy achievement of… those who struggle in the school setting.” For more detailed information about this organization and what it expects from its members, visit the website of the American Speech-Language-Hearing Association.
Eligibility for Speech and Language Services
Given the wide range of speech and language services that are available, it is no exaggeration that they are often key to providing an appropriate education to many children with disabilities. Getting schools to provide these services as part of special education, however, isn’t as simple as you might think. In fact, we have found that schools may limit what speech and language services they will provide.
Our school district, for example, claimed that its Speech and Language Pathologists were available only for obvious expressive language deficits, like significant articulation problems or stuttering. We believe that the reason for this is that speech and language services can be intensive and therefore expensive for schools to deliver.
This is a concern for parents, because more and more children, especially those on the autism spectrum, need speech and language services to help with the less obvious, but no less important, pragmatic language or written expression deficits. Because most parents don’t fully understand the nature and importance of pragmatic language, or the connection between written and expressive language, it is easy for schools to convince parents that their child doesn’t need these services. After all, for a child with multiple learning disabilities, what parent wants to hear that there is yet another therapy to schedule for their child?
How Schools Take Advantage of Parents’ Ignorance
This was the situation we found ourselves in during one of our Team meetings in elementary school. Although testing had indicated that our son had difficulty with pragmatic language and written expression, the school’s Speech and Language Pathologist concluded her report by stating that since he didn’t have a noticeable problem speaking, she could not recommend any speech and language services. We actually felt relief that this was one area we didn’t have to worry about, and focused the rest of the meeting on occupational therapy and reading instruction. Unfortunately, the school let our ignorance relieve them of the cost of providing services that our son clearly needed and that they were obligated by special education law to provide.
By the time our son was in high school, we had an independent Speech and Language Pathologist evaluate him. She produced a very detailed report that said he needed intensive and frequent services with a Speech and Language Pathologist to help with pragmatic language and writing skills. We submitted this independent report to our director of special education, who then held a meeting with us and the school’s Speech and Language Pathologist.
During this meeting, which lasted over an hour, the school’s Speech and Language Pathologist reviewed our independent report (she hadn’t done her own testing), and once again we heard the phrase “services are not recommended at this time.” While giving her report, we noticed that she never made eye contact with us, but looked directly at the director of special education as if to make sure that she was saying only what was expected of her.
During another meeting, which the director also attended, we brought up the issue of pragmatic language instruction and she told us that the school’s Speech and Language Pathologist wasn’t necessary because “the students teach each other pragmatic language skills.” In her mind, it seems, our town’s high school was full of certified Speech and Language Pathologists.
Schools Warned by the Department of Education
Diverting students away from speech and language services is apparently becoming a common practice with schools. In 2015, the US Department of Education issued a guidance letter that alerted schools to reports that a growing number of children with Autism Spectrum Disorder may not be receiving needed speech and language services. The letter also said that some schools were not including Speech and Language Pathologists in evaluation and eligibility determinations or in meetings to develop IEPs.
The letter goes on to remind schools that when they conduct an initial evaluation for special education eligibility, the school must assess in all areas of the suspected disability, including “communicative status,” if appropriate, and that IEP meetings must also “include an individual who can interpret the instructional implications of evaluation results,” in other words, a properly trained Speech and Language Pathologist.
What Can You Do?
From all of the above, it may seem that the deck is stacked against parents. We can’t disagree, so we have the following suggestions to help you obtain needed speech and language services for your child:
- Be aware of possible communication disorders your child may have beyond obvious expressive speech problems. Consider having an independent speech and language evaluation performed to confirm the full range of your child’s needs. If appropriate, have your independent Speech and Language Pathologist attend a Team meeting to interpret the data and advise on his or her recommendations.
- When any speech and language evaluation is performed, especially the school’s, it should be comprehensive in all areas of a suspected disability according to Part B of IDEA. This should include an assessment of the communicative status of your child. See the US Department of Education guidance letter of July 2015.
- Think about your child’s sensory needs and how they affect communication. If swallowing is a problem, for example, a Speech and Language Pathologist should be able to help with that. This type of service is included under IDEA.
- If speech and language services are in your child’s IEP, make sure that the service delivery grid specifies a Speech and Language Pathologist to provide them. “Sped. Staff” is not acceptable, as it could be anyone. Neither is a “Speech and Language Assistant,” who in many states is not required to have formal training. The Speech and Language Pathologist should be certified by your state department of education as well as by the American Speech-Language-Hearing Association (ASHA).
Obtaining appropriate speech and language services for your child is not an easy task. Determining what your child needs through testing and knowing what a properly trained speech and language pathologist can do, however, are important steps in the process. Remember that your research and advocacy now will pay big dividends for your child’s education in the future.
Judith Canty Graves and Carson Graves
* The inspiration for the subhead title and much of the content of this section comes from a document published by the American Speech-Language-Hearing Association (ASHA): Roles and Responsibilities of Speech-Language Pathologists in Schools. This document is considered an official policy statement of the ASHA, the professional organization for certified Speech and Language Pathologists in the United States.