Survey Says! Results of Entrance and Exit Criteria Survey
Well only 5 people responded to this survey. I can conclude three things from that. Either it isn’t as big of an issues as I thought (or hasn’t become one yet), the survey was too long or no one is looking at my blog. More than likely it is the last one. Even though it was only 5 people responding I received some very interesting feedback that I would like to share and comment on.
The basic question was…..Does you school have entrance and exit criteria? Only one out of the 5 respondents said they had entrance and exit criteria. Apparent this was done in an attempt to standardized services throughout a very large school system. They went on to say that it was put in place in 2011 after a year long study by a group of SLPs. Their criteria was based on state law and ASHA guidelines. Basically they see students who fall in the 7th percentile or lower up to age 8, then 2nd percentile or lower after that. They are also able to use their professional judgment in some situations. Based on the responses from this therapist I was under the impression that these guidelines were working well in their setting. However, the therapist commented that she wished that she could serve the students that score much higher and be closer to private therapy standards.
I was actually glad to hear that one person out there was happy with the guidelines set up by their school district and that speech language pathologists actually put the guidelines together. I think they probably developed guidelines that work well in a large urban setting. Using percentile rank is interesting. It is more difficult for people unfamiliar with statistics to understand percentile rank. Kids functioning at the 7th-2nd percentile rank are really low, the standard scores on any of our tests reflecting those percentile ranks would be in the just below to below average range and age scores would be years below. I could hear the parents in our meetings now, “My kid is below average but not below average enough?” I am not totally sure if the same guidelines would be accepted in more suburban communities.
That statement about wishing she were able to service students closer to private therapy standards made me think. And I believe this is the crux of the conflict for me. I know we are a public school, we have to compromise on groupings, time, scheduling and caseloads are huge but should we as school therapists strive for a different level of service than a private therapist? Shouldn’t school therapies in general strive to be as good if not better than private therapies? Shouldn’t our goal focus be the same.? Shouldn’t the administration support this? This is an issue I will have to delve into another time because there is history here.
Over half of the respondents said that entrance and exit criteria has been questioned in their school. I’ve worked in many schools and in at least one meeting a year the special education director or some other administrator mentions developing E and E criteria. Their motivation of course is to see numbers go down. The development of the criteria never happens. I feel this is basically because we’re not give the time to do look at this issue critically, research and study. I also think this is a next to impossible task because our special needs students are so different. Most of us seem happy using the guidelines set up on formalized testing to aid our professional judgements. Any way wouldn’t we? We put our trust in tests that have been through trials and have the data to prove it. In this data driven world, therapists and educators have become notorious for creating their own measures to collect data which could or could not be consider reliable and valid.
In schools we also have that pesky guideline of wether or not the student is making effective progress. That is a double edge sword and makes writing recommendations/accommodations/modifications tricky in an evaluation report. The student may score poorly on many measures but is making effective progress (or passing the state mandated testing because lets be honest that is all the kids need to do these days) or the student may score in the low average or even high average range, exhibit other behaviors or an atypical manner of performance that impact learning/social skills but still making effective progress in academics. Then we have those who are not making effective progress with low scores (and not passing state testing). The first two kids don’t get picked up but the last one does. I think we have lost our focus on who needs our language services because of this. This drives us further away from being able to address underlying language skills that effect learning and life and attributes to increasing our caseloads.
Sorry, I know I got off topic a little here. As you can tell I am passionate about this subject. Most of the therapists who responded would like to have some E and E criteria, the reasons stated included, to be on the same page as other SLP’s and to take the subjectivity out of decision making. One therapist was adamantly opposed to developing criteria based on test scores only, pointing out that in a school system we have to look at other factors when determining speech and language needs. This is very true, that’s where professional judgement come in.
No one was able to come up with the ideal E and E criteria. My survey was more skewed toward entrance questions. However, exit criteria is probably a bigger factor. How much therapy to give and when to discharge a student from therapy are the two main questions I’ve been asked over the years. In the old days discharging a student from therapy was easy. We could determine if the student was meeting their goals (yes we usually wrote more than one), functioning in the classroom, plateaued, not receptive therapy to therapy, not willing to work in therapy or just not getting anything out of it. We could sit down with parents and explain. With the new laws we can’t do that anymore. Every student has to be tested before we can discharge them from therapy. Lets face it, students with low language skills (maybe low cog too), no matter how much quality therapy they have over the years are never going to score really well on our tests. It is the rare student that does that. They will improve but like IQ scores their test pattern will likely not change. We can strengthen areas of language, work on transferring skills to natural context and give them strategies. Our students will always struggle with language or even just be a beat behind the rest of the crowd.
Here is the link to ASHA’s Admission/Discharge Criteria in Speech-Language Pathology. Like most ASHA documents it is pretty basic. Maybe it has to be. After all it has to be a one size fits all document. It also leaves a lot of room for professional judgement. It also appears a little dated considering how much service delivery in the public schools has changed since 2004.
I asked a question about push back from administration when they didn’t like your recommendations. Half of the therapists said they have received push back from administration an one time or another. I was glad to see it wasn’t more. No one eluded to this being a chronic problem. It hasn’t been a huge issue in my career with only a couple of incidences over almost 30 years.
Sorry, I wasn’t able to draw any big conclusions or share any good information. I don’t know if there is an answer to the question of Entrance and Exit Criteria. Caseloads are growing and a lot of kids are qualifying for services. Why is this happening? We have been using the same tests for years. If more kids are qualifying using these tests than they did 10 years ago well then something else is wrong. Personally I think it is more a reflection of our society and lack of a good basic consistent curriculum in schools. Also our hands are really tied when it come to Exit criteria. It is almost impossible to discharge a student these days. Every year I pick up more than I discharge.
When it comes to developing entrance and exit criteria be careful what yo uwish for. I am not sure that we want administrators, who don’t understand what we do, telling us who to pick up and who not to pick up. It could happen. I don’t want to pick up kids just they are not passing a state mandated exam. I don’t want to pick up the slack for poor curriculums, void of phonics, critical thinking and I believe memory tasks. I don’t qualify kids so I can go into classes for a 30 minute session with less that 10 minutes of direct intervention. I do want to work with students who need specific help developing the underlying language skills they need to access the curriculum on their own. I do want to teach language strategies to aid overall success. I do want to introduce students who need it to higher order language functions. I don’t have faith that specific Entrance and Exit Criteria will allow me to do that. Although I would like to be open minded about it so if you feel your school has very good entrance and exit criteria please share.
One final thought:
The last question on my survey drew the most response. Do you feel too many students are qualifying for speech and language services? Why do you think this is happening? Here are the response verbatim.
1. Yes, this is happening at all levels. With little ones they’re picked up too soon for language and learning issues that they are not developmentally expected/or ready to do, curriculum does not address many important and higher level language areas any more so kids get little practice of skills and do not know how to apply them. Also teachers and administrators do know what we do or how we do it.
2. Yes. I don’t feel many of the students truly have language disabilities. I feel that they have low language skills, the curriculum is more demanding, the teachers have less time to work with the students, the background knowledge and overall language experiences of the kids have affected their language development. In my district, whether they test low or not, we are told to start dropping kids after grade six. They tell us to figure out a way to make it happen. I thing the overall need for kids with autism an Aspergers is definitely growing……… And the tests we have for them stink.
3. I think we qualify too many ELL students. Our district needs to work harder to
appropriately assess them and identify language differences versus a language disorder.
4. I feel like too many students are staying on the caseload in upper grades….middle school and not being exited despite scores not changing by the time of their 3year re eval. I think some SLPs are more LD based and service kids differently than others. Idk if this is right or wrong. I struggle in this area.
5. Yes… so many more children seem to appear to be \”on the spectrum\” with language concerns.
I have to admit this survey raised more issues and questions for me to ponder. Thanks to everyone who took the time to respond.
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I just found your website/blog and am reading with high interest as I’m now working for middle/high after 16 years with preK-6th grade. Now that I’m taking over another therapist’s caseload, I’m realizing that a huge part of the issue re: entry and exit has to do with “professional” input. When intellect is low, or autism is in the mix, at some point, “functional ability” has to be the focus [rather than standardized measures]. It’s such a grey area. I’ve already done a lot of narrative, “dynamic” assessments and believe that’s what I’m being paid for: my expertise. I’m still supporting these students, by pushing in to their classrooms, but I’m not recommending direct service all the time. It’s almost like we need a rubric, rather than standardized testing, to establish the level of support. In many ways, I’m developing my own rubric in order to deliver a thought out, well developed opinion in my IEPs.