PERRY PUBLIC SCHOOLS

SPECIAL EDUCATION DEPARTMENT

GUIDE TO SPEECH AND LANGUAGE SERVICES
2010

A GUIDE TO
SPEECH AND LANGUAGE SERVICES
IN PERRY PUBLIC SCHOOLS

The Perry Public Schools are committed to responding completely and professionally to
the special needs of all its students. Speech and Language services are a vital part of
special education. Under the Chapter 766 regulations, a child in need of special education
is one who is “unable to progress effectively in a regular education program due to
temporary or more permanent adjustment difficulties or attributes arising from
intellectual, sensory, emotional or physical factors, cerebral dysfunction, perceptual
factors, or other specific learning impairments.”

The Speech and Language Pathologists in the Perry Public Schools are part of the Special
Education Team which services children identified as having communication disorders
which are determined to impede the education progress. The Speech and Language
Pathologist is one who is trained to provide individual and group remediation, either
outside the classroom, or within the classroom setting through teacher consultation or
group lessons. The Speech/Language Pathologist is called upon to perform diagnostic
and therapeutic services to children displaying significant need in the areas of
articulation, language, voice, fluency, phonology, and voice disorders. “Significant
need” is thought to be such that a child is considerably difficult to understand when
attempting to communicate verbally to either adults or peers or is encountering academic
failure due to poor communication skills, which adversely effect oral or written language
performance.

SERVICE DELIVERY MODELS

UTILIZED BY THE
SPEECH AND LANGUAGE DEPARTMENT

1. CONSULTATION
 The consultation model involves collaboration with the classroom teacher and
other professionals working with the student, and/or the parent to develop
activities which will facilitate further language development and improve
classroom participation and performance.

Consultation will be provided for all students with a Speech/Language IEP. In

addition, consultation will be provided for those students who have demonstrated
an emerging weakness in one or more language areas. This may not necessitate
the writing of a formal I.E.P.

2. CLASSROOM

Some students may benefit from class-oriented activities unless they present with
interfering behaviors.

The extent of whole group services is dependent upon each student’s level of
language/articulation development. Activities will focus on motivating students
to use their language/articulation skills in developmentally appropriate tasks.
These services may be a minimal portion of total delivery, or for mild
difficulties/carry-over it may be the only appropriate delivery mode.

3. SMALL GROUP THERAPY

Children may be seen in a small group if the problem is moderate to severe in

nature: articulation / phonological process disorders, language delays, voice and
fluency difficulties.

4. INDIVIDUAL THERAPY

Individual therapy may be recommended based on the nature and severity of the
communication disorder.
Examples may include:
a) Severe to profound functional communication skills
b) Within a known context, speech intelligibility is judged to be
approximately 50%. Within an unknown context, intelligibility is judged
to be approximately 20%. Included are motor planning deficits(apraxia),
dysarthria (oral musculature weakness), and phonological difficulties.
c) Use of alternative systems (e.g., AAC devices)
d) Voice or fluency disorders
 e) Due to variations in attending, distractibility and compliance, 1:1
therapy may be necessary
f) Children with low cognitive skills may be serviced until skills increase.

LANGUAGE

Language disorders may be defined as the impairment or deviant development of

comprehension and/or use of a verbal/nonverbal symbol system involving:

a) The form of language, i.e. morphology, syntax

b) The content of language, i.e. semantics
c) The function/use of language, i.e. pragmatics

MAJOR LANGUAGE AREAS

A. Receptive Language

1.) Semantics: comprehension of vocabulary, basic concepts and linguistic

concepts.
2.) Language Comprehension: following oral directions, comprehension of
information from a short paragraph.
3.) Syntax and Morphology: comprehension of the structures of language

B. Expressive Language

1.) Word Retrieval: formulating and expressing appropriate vocabulary within

an appropriate amount of time.
2.) Classification: the ability to classify concepts according to category,
attributes, functions.
3.) Syntax and Morphology: the expression of sentence structure and/or
grammatical form.
4.) Sequence: the ability to sequence words and/or sentences into events or
ideas appropriately when describing or retelling information.
5.) Being able to give oral directions.
6.) Problem-Solving: asking/answering “wh” questions.
7.) Narrative: oral or written.

C. Pragmatics
 Rules of use of oral language pertaining to social interaction such as:

1. Communicative intent
2. Ability to follow conversational rules: initiate, maintain and
close conversation appropriately, turn taking, awareness of
nonverbal cues, conversational repair, etc.

D. Auditory Processing

The ability to blend, discriminate and sequence phonemes.

This differs significantly from LANGUAGE PROCESSING which is

discriminating, assigning significance to, and interpreting spoken words, phrases,
clauses, sentences and discourse.

ENTRANCE CRITERIA:

LANGUAGE (Receptive, Expressive, Auditory)

KEY: Language Quotient= Language Age / Chronological Age or Mental Age

Mental Age= Intelligence Quotient / 100 X Chronological Age
Intelligence Quotient= Mental Age / Chronological Age X 100

To be placed in a language therapy program a student must manifest a discrepancy from

the norm in the comprehension and/or the expression of language.

1. Any student age 3-8:11 whose performance indicates a 50% delay in

developmental age functioning in one domain; OR a 25% delay in
developmental age functioning in two domains. (Domains: Adaptive,
Communication, Personal/Social, Motor, Cognitive)
2. Any student age 9 and older whose performance indicates a standard
deviation of 1.5 or more below the norm as measured by at least two
standardized tests and/or by the Speech/Language Pathologist may be
considered for treatment.

*Delivery Model will depend upon severity of language disorder.

Children whose sole or native language is not English exhibit specific linguistic
difficulties which are reflected in their academic functioning. It is essential that those
children be evaluated, using standardized measurements, to determine language
dominance. A student identified as English or non-English dominant will be evaluated in
his predominant language to determine if a language learning disorder in fact exists. In
the event that a child does exhibit specific language deficits, special needs will be
provided as required by the appropriate professional.
EXIT CRITERIA:

Our philosophy is to make exit criteria as individual as possible based on testing,

developmental norms, and current practices in the profession. Exit criteria cannot be
only general statements, as individuality would be sacrificed.
Based on the discretion of the Speech/Language Pathologist the students may exit the
Language Program based on one or more of the following criteria:

1. Successful completion of IEP goals

2. Age appropriate language skills for Mental Age, Intellectual Quotient or
grade placement
3. Lack of progress during a 24 month period
4. Students motivation is so low as to preclude therapeutic intervention
5. Student will no longer benefit from therapeutic intervention because of
physical, neurological, or intellectual limitations, which have resulted in a
performance plateau over a three year period
6. Speech/Language problems no longer interferes with academic performance

ARTICULATION

An articulation disorder is defined as the omission, substitution, distortion, or addition of

speech sounds in isolation, words and/or connected speech. The disorder is manifested
because of a failure to make the necessary movements of the lips, tongue, teeth and palate
for these sounds. The disorder is due to faulty learning, hearing impairment,
malformation of the oral structures and/or fine and gross motor impairment. The term
“articulation impairment” does not include students whose speech is characterized by
second language speakers.

1. Substitutions: These are most commonly developmental in nature, or the

result of a hearing loss. (i.e. won/run, thoup/soup)

2. Omissions: Often the result of immaturity or hearing loss. (i.e. wing/swing)

3. Distortions: Incorrect tongue or lip placement that produces a sound not

included in English phonemes. Lateralizations are the most common.

4. Additions: Including sounds within words that should not be there.

 5. Phonological: This speech/language pattern is characterized by speech in
which a phonological process affects a category of speech sounds. For
example, the process of “fronting” would be when a child says sounds in front
of his/her mouth, which are typically produced in the back of the mouth.

Sound development in children progresses in a similar manner to motor development.

Some children develop all sounds very quickly while other children require more time. A
child should not be expected to have perfect speech before age 7.

ENTRANCE CRITERIA

ARTICULATION

To be placed in an articulation treatment program, the student must meet the

following criteria: manifest a non-maturational, non-dialectical articulation
dysfunction characterized by one or more of the following omissions,
substitutions and distortions at the phonologic and/or syntactic level.
a) Any student below age 8 whose articulation is 50% delayed or is 25%
delayed with a 25% delay in another developmental domain OR who
has unintelligible speech 50% of the time during conversation.

b) Any student age 8 and above whose speech is characterized by one or

more non-developmental phoneme errors with or without reduced
intelligibility.

EXIT CRITERIA

Remediation is considered to be complete when:

a) The student has achieved 80% accuracy of previously misarticulated
sounds in conversational speech within the treatment setting.
b) In the event that remediation has not been successful after 3 years, the
student will be considered as a possible candidate for discharge from
the program.
c) The student’s articulation problem no longer interferes with the
student’s academic performance as measured by grades and teacher
reports or the problem no longer causes the student frustration and/or
other emotional or social difficulties.
d) The student’s motivation is so low as to preclude therapeutic
intervention.
e) The student’s misarticulations result from orthodontic prostheses or
temporary dental conditions.
 CONTRAINDICATIONS TO SPEECH THERAPY

1. Nonstandard Articulation of a cultural or dialectical nature is not basis for articulation

therapy.

2. When a tongue thrust is present and speech is free of misarticulations it is the

recommendation of the Speech and Language Department that Speech/Langauge
Pathologists not engage in management procedures designed to modify swallowing
patterns.

DEVELOPMENTAL ARTICULATION NORMS

AGE THREE
Delay (C.A.)
/p/ 90% of children have acquired this sound by the age of 3 years
4 years
/m/ 90% of children have acquired this sound by the age of 3 years
4 years
/h/ 90% of children have acquired this sound by the age of 3 years
4 years
/n/ 90% of children have acquired this sound by the age of 3 years
4 yeas
/w/ 90% of children have acquired this sound by the age of 3 years
4 years

AGE FOUR
/k/ 90% of children have acquired this sound by the age of 4 years
5 years
/g/ 90% of children have acquired this sound by the age of 4 years
5 years
/d/ 90% of children have acquired this sound by the age of 4 years
5 years
/f/ 90% of children have acquired this sound by the age of 4 years
5 years
/j/ 90% of children have acquired this sound by the age of 4 years
5 years
/t/ 90% of children have acquired this sound by the age of 4 years
5 years
 AGE SIX
/ing/ 90% of children have acquired this sound by the age of 6 years
7 years
/l/ 90% of children have acquired this sound by the age of 6 years
7 years

AGE SEVEN
/r/ 90% of children have acquired this sound by the age of 7 years
8 years
/s/ 90% of children have acquired this sound by the age of 7 years
8 years
/ch/ 90% of children have acquired this sound by the age of 7 years
7.5 years
/sh/ 90% of children have acquired this sound by the age of 7 years
7.5 years
/dz/ 90% of children have acquired this sound by the age of 7 years
7.5 years

AGE EIGHT
/z/ 90% of children have acquired this sound by the age of 8 years
8.5 years
/v/ 90% of children have acquired this sound by the age of 8 years
8.5 years
/th/voiced
90% of children have acquired this sound by the age of 8 years
8.5 years
/th/unvoiced
90% of children have acquired this sound by the age of 8 years
8.5 years

In using the norms listed above, the speech/language pathologist should consider speech sound error to be a problem when the error
persists one year beyond the chronological age when 90% of the students sampled have typically acquired the sound.

(From the Massachusetts Speech and Hearing Association Entrance and Exit Criteria Guidelines)

AUDITORY PROCESSING

Central Auditory Processing Disorder is a term applied to children with auditory

processing which is reflected in poor performance on auditory tasks involving attention,
discrimination, figure-ground discrimination, memory, closure, temporal sequencing, and
generalizing.
 SEVERITY RATING SCALE

1) WNL - Within Normal limits

2) MILD -Childs’ auditory perceptual abilities fall

within one standard deviation below the
mean. Reading and spelling abilities may be
affected. Child may be inattentive or
distractible in a noisy environment, but
classroom function with modifications is
possible.

3) MODERATE - Childs’ auditory perceptual abilities fall

between one and two standard deviations
below the mean, overall academic
functioning is affected, functions best in
quiet surroundings and small groups.

4) SEVERE - Childs’ auditory perceptual abilities fall

between two and three standard deviations
below the mean, limited ability to learn
auditorally presented information and need
to be reinforced, functions best in quiet
surroundings in small groups.

FLUENCY

Dysfluency is defined as a disturbance in the rate or flow of speech, characterized

by one or more of the following:
audible or silent blocking, sound, syllable, or whole word repetitions, sound
prolongations, interjections, hesitations,
broken words, circumlocution, and word substitutes. These primary
characteristics may be accompanied by struggle
behaviors. Dysfluencies are so numerous that they exceed the normal number or
degree for the individual’s age, sex,
or speaking situation.

CHARACTERISTICS

a) Frequent use of interjections. i.e. “um,” “uh”

 b) Avoidance of certain speaking situations. i.e. telephone conversations,
answering aloud in class.

c) Use of facial grimaces, body contortions, and signs of frustrations while

talking.

d) Stuttering not present when singing or participation in choral reading.

e) Sounds as if talking while holding breath.

SEVERITY SCALE:

1. WNL - Within normal limits

2. MILD – Dysfluency Index is 2% with no visible tension or

secondary characteristics. Dysfluencies are less than one second
in duration and usually are enforced repetitions. Student is
unaware of or unconcerned with the interruptions in speech.

3. MODERATE – Dysfluency Index is 7% with clear indication

of tension or effort. Speech may be accompanied by distracting
associated behavior. Dysfluencies are one to two seconds in
duration and repetitions, prolongations, and interjections may
now be apparent.

4. SEVERE – Dysfluency Index is 15% with definite tension or

effort. Speech is accompanied by conspicuous distracting
sounds, facial grimaces and other associated movements.
Dysfluencies are two – four seconds in duration and are
characterized by more struggle behavior.

5. VERY SEVERE- Dysfluency Index is 25% with considerable

effort. Speech is accompanied by
vigorous musculature activity, facial or otherwise. Dysfluencies
are five seconds or more with
consistent repeat attempts.

ENTRANCE CRITERIA
FLUENCY

As a result of a comprehensive speech and language evaluation, done by a certified

Speech/Language Pathologist, the child may be eligible for speech and language
treatment services if the student manifests dysfluent speech within the MODERATE to
SEVERE rating scale range.
EXIT CRITERIA

1. Successful completion of IEP goals

2. Lack of progress during a 12 month period
3. Home carryover program

VOICE

A voice disorder is defined as the absence or abnormal production of voice, characterized

by inappropriate vocal quality, pitch, loudness, and/or rate of speaking. A voice disorder
occurs when a student exhibits a breathy, harsh, hoarse, hyper nasal, or denasal voice
quality which persists over a period of time. A voice disorder may be due to a functional
cause (i.e. vocal abuse, depression) or a structural cause (i.e. disease, paralysis). In some
cases misuse of the voice can develop organic pathology (i.e. vocal nodules or polyps).
Therefore, a medical evaluation MUST be completed in all cases and a written
recommendation for voice therapy obtained from the physician prior to the evaluation of
voice therapy.

ENTRANCE CRITERIA

Voice

To be placed in a voice therapy program, the student must manifest disordered pitch,
volume, prosodic patterning, hyper-or hypo-nasality or other vocal qualities inappropriate
to the students’ age and sex. Evaluation by a medical specialist, and his/her
recommendation for therapeutic intervention is mandatory before placement of a student
by categorization of voice disorder alone. Voice problems which are a direct result of an
existing medical condition such as vocal nodules or ulcers will not be considered for
therapy.

The evaluation by the Speech/Language Pathologist must indicate that one or more of the
following criteria is met:

1) Any student who manifests phonation breaks (actual disruption or stoppage of

phonation/aphonia).
2) Any student who manifests pitch breaks (continuation phonation with abrupt
pitch changes higher or lower than the student’s optimum pitch).
3) Any student who displays a phonation time less that five or six seconds
 4) Any student with a history of a hoarse, raspy, husky voice as reported by teachers
and/or parents.
5) Any student with vocal behavior inappropriate to the student’s age and sex, as
determined by clinician judgment or professionally recognized scale or checklist

EXIT CRITERIA

Voice
1) Successful completion of IEP objectives
2) Dismissal based on follow-up of Otorhinolaryngologist examination with a
medical report
3) Dismissal based on lack of progress in a six month period
4) Dismissal based on unsuccessful completion of home modifications

HEARING

A hearing impairment refers to altered auditory sensitivity and/or damage to the

integrity of the physiological auditory system. A hearing impairment may impede
the development, comprehension, production, or maintenance of language,
speech, and/or interpersonal communication. Hearing impairments are classified
according to difficulties in detection, perception, and/or processing of auditory
information.

TYPES OF HEARING LOSS

A. Conductive Hearing Loss

Outer and middle ear are affected. Hearing loss is characterized by
a reduction of loudness, however quality is usually preserved.
Words may sound faint or muffled.

B. Sensori-Neural Hearing Loss

Inner ear and auditory nerves are affected. Hearing loss is
characterized by a distorted quality as well as a reduced intensity.
Words may sound slurred or unclear.

C. Mixed Hearing Loss

A combination of conductive and sensori-neural hearing loss,
which combines the characteristics of both.

SEVERITY RATING SCALE

 1.) WNL -10 to 15 dB

2.) SLIGHT HEARING LOSS 16 to 25 dB

3.) MILD HEARING LOSS 26 to 40 dB

4.) MODERATE HEARING LOSS 41 to 55 dB

5.) MODERATELY SEVERE HEARING LOSS 56 to 70 dB

6.) SEVERE HEARING LOSS 71 to 90 dB

7.) PROFOUND HEARING LOSS 91+ dB

EXIT CRITERIA
HEARING

Our philosophy is to make exit criteria as individual as possible based on testing,

developmental norms, and current practices in the profession. Exit criteria cannot be
only general statements as individuality would be sacrificed.

ALTERNATIVE COMMUNICATION SYSTEMS

In 1981, The American Speech and Hearing Association adopted a position

statement on non- speech
communication. In this statement the nonspeaking population is operationally
defined as “a group of individuals for
whom speech is temporarily or permanently inadequate to meet all of his or her
communication needs, and whose
inability to speak is not due primarily to a hearing impairment” (1981,p,.577).
Although these persons may have some
vocal skills, they are not adequate to meet all of their communication needs.

Some handicapping conditions which may make adequate speech difficult include
Cerebral palsy, apraxia, dysarthria,
emotional disturbance, and mental retardation. Physical conditions such as the
loss of the tongue or larynx also can
be factors.
A variety of communication systems have been devised for the non-speaking
person. Some of these systems include
manual/gestural (i.e. signing), non-speech, nonverbal, alternative, augmentative,
prosthetic, and/or assistive devises
such as individual or electronic communication board systems.

A “non-speech” communication method does not necessarily replace speech.

Speech is not inhibited; rather, it is
enhanced. For those who will always be nonverbal, a non-speech communication
system may become their “speech”,
whether they are able to communicate complex thoughts, ideas, and feelings, or
simply a basic need.

THE SPEECH/LANGUAGE PATHOLOGIST’S ROLE IN

AUGMENTATIVE COMMUNICATION SYSTEMS

The speech/language pathologist most likely will be the person to initiate the
recommendation for an augmentative
communication system and coordinate the services of the multidisciplinary team
involved with the nonverbal child.

The American Speech and Hearing Association, in the 1981 “Position Statement
on Non-speech Communication,”
outlined the professional role of the speech/language pathologist in providing
services to non-speaking persons. These
services include:

1. Continual evaluation of the communication/interaction behaviors and needs

of the nonverbal.
2. Assisting in the selection of appropriate communication techniques.
3. Developing speech vocal communication as much as possible.
4. Developing and evaluating procedures to teach the necessary skills for
optimal use of an augmentative system.
5. Selecting the symbol system to be used with the selected technique.
6. Providing information regarding assessment and use of the program to other
Professionals and parents.
7. Training those who interact with the nonverbal
8. Coordinating augmentative communication services
9. Advocate for acceptance and use of nonverbal communication modes
Source: TOTAL Curriculum Guide, by Beth Witt and Jeanne Boose, 1984, pp. 53,60

This document was adapted from those criteria written by the Gardner Public Schools.

Revisions were made by the following Speech/Language Pathologists of the Perry Public
School System especially for the Perry Public School System.

Tiffany R. Hiner, M.S., CCC-SLP

Alicia Bynum, M.S., CFY-SLP