Speech and Education of individuals with Language Impairment
Communication skills are the foundation of academic and social performance. The ability to participate in active and interactive communication with peers and adults in the educational setting is essential for student success in school. Problems with speech or language development can lead to difficulties learning to listen, speak, read, or write. As a result, children with communication disorders may perform at a poor or insufficient academic level, struggle with reading, have difficulty understanding and expressing language, misunderstand social cues, avoid attending school, show poor judgment, or have difficulty with tests. Speech and language services can help children become effective communicators, problem solvers, and decision makers, allowing them to benefit from a more successful and satisfying educational experience as well as improved peer relationships.
The History of Speech and Language Services
Since their inception in the early twentieth century, speech and language services in the schools have undergone profound fundamental changes in scope and focus. Initially, speech correctionists, speech specialists, or speech teachers worked primarily with elementary school children who had mild to moderate speech impairments in the areas of articulation, fluency, and voice. Children with more severe disabilities were placed in private schools or institutions, or were not provided services at all. That is no longer the case, however, due to a number of social, political, and professional influences.
During the 1960s a number of state and federal laws were passed addressing the responsibility of public schools to provide an education to children with disabilities. Although a vast number of children with disabilities remained unidentified or inadequately educated according to Taylor, these laws served as the foundation, both legally and philosophically, for legislation passed in the 1970s that brought about profound and widespread changes in the responsibility that schools must accept in educating children with disabilities.
The Rehabilitation Act of 1973 was civil rights legislation that prohibited discrimination on the basis of disability in public or private programs and activities receiving federal financial assistance, including public education. This was followed in 1975 by the Education for All Handicapped Children Act (Pub. L. 94-142), requiring that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs. The act was amended in 1986 to ensure services for children from birth through age two, and to place that responsibility with public agencies. This expansion of special education services was accompanied by the Regular Education Initiative calling for a partnership between general and special education to eliminate barriers between disabled and nondisabled children.
In 1990 the act was reauthorized once again, this time as the Individuals with Disabilities Education Act (IDEA), with a renewed focus on free appropriate public education in the least restrictive environment. In the same year, the Americans with Disabilities Act was passed, mandating reasonable accommodations for disabilities across all public and private settings, including private and public schools.
The IDEA Amendments of 1997 (IDEA 1997) is designed to retain the basic rights and protections that have been in the law since 1975 while strengthening the focus on improving results for children with disabilities. The primary focus of IDEA 1997 is to establish an educational process that promotes meaningful access to the general curriculum for each student with a disability.
While landmark legislative initiatives were being enacted during the 1970s, an equally significant shift occurred in the professional domain with the expansion of scholarship in all language-related fields. This stimulated increased attention to disordered language as well as normal language acquisition, with a concomitant shift in the relative proportion of students receiving special services in the schools for language problems, as differentiated from speech problems. At the same time, there was an increase in awareness of the central role that language plays in academic achievement. The expanding learning disability movement had a significant impact on language services in schools, as a large proportion of services to students with learning disabilities focused on strengthening language skills. This was typically viewed as being within the purview of the speech-language clinician who was based in the school.
During the 1990s there was an increased awareness of the relationship between language and literacy (i.e., reading and writing). Language problems are both a cause and a consequence of literacy problems in children and adolescents. Spoken and written language have a reciprocal relationship–each builds on the other to result in general language and literacy competence, starting early and continuing through childhood into adulthood. Because of this, speech-language clinicians play important roles in ensuring that children gain access to appropriate instruction in reading, writing, and spelling. These roles include early identification and assessment, intervention, and development of literacy programs.
U.S. demographics have undergone rapid changes since the 1970s. It is now estimated that nearly one of every three Americans is African American, Hispanic, Asian American or Native American. In addition, according to the American Speech-Hearing Association's 1999 study, the limited-English-proficient population is the fastest growing population in America. This increase has resulted in a student population that is culturally and linguistically more diverse than ever before, and requires attention to such issues as nonbiased assessment and intervention considerations related to this diverse population.
Changes in the medical arena have also affected our nation's demographics. Medical advancements have led to more children surviving neonatal and early childhood traumas and illnesses, yet those who survive are often physically or medically challenged. Additionally, with health-care reform, many patients are released earlier from hospitals or rehabilitation centers; those who are school age may enter or reenter public schools requiring intensive speech-language services.
Programs in the Twenty-First Century
More than 1 million children receive services for speech or language disorders in public schools as of 2001, representing a 10.5 percent increase from the previous decade. In fact, speech-language intervention is the most common service provided for school children with disabilities. Caseloads include a wide range of disorders such as learning disabilities, autism, attention deficit disorder, stuttering, hearing loss, traumatic brain injury, specific language impairment, and cerebral palsy. Some children are medically fragile, have rare syndromes, or experience feeding and swallowing difficulties. In addition, children with speech or language disorders represent many racial and ethnic groups. The focus of intervention may include any or several components of speaking, listening, reading, or writing–language, voice, fluency, articulation, and/or swallowing.
Speech-language services are provided in the schools by approximately 35,000 speech-language clinicians. The credentials required of these professionals vary across states. These credentials may be teacher permits, teaching certificates, teacher licenses, or clinical service credentials. Also, credentials required for schools may differ from a state license that is required to practice speech-language pathology in nonschool settings. In addition, many school-based speech-language clinicians choose to obtain the certificate of clinical competence granted by the American Speech-Language-Hearing Association. Some states allow the use of speech-language pathology assistants under the supervision of fully qualified speech-language clinicians.
School-based clinicians have a range of roles and responsibilities. Although the majority of their time is spent providing direct intervention services to children, they must also conduct screenings and diagnostic evaluations, write reports and documentation, plan and prepare sessions, meet and/or consult with teachers and parents, and conduct classroom observations of students. The scope of their responsibilities includes prevention of communication disorders as well as assessment and intervention.
Speech and language services involve cooperative efforts with others, including parents, audiologists, psychologists, social workers, special education teachers, classroom teachers, guidance counselors, physicians, dentists, and nurses. Speech-language clinicians work with teams to provide comprehensive language and speech assessments, and to develop and implement intervention plans. Intervention services may be provided in individual or small group sessions, in classrooms, in teams with teachers, or in a consultative model with teachers and parents. To be effective, communication goals should be educationally relevant, that is, integrated with academic and social activities. The ultimate outcome is to help children overcome their disabilities, achieve pride and self-esteem, participate fully in major life activities, and find meaningful roles in their lives.
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION. 1999. Guidelines for the Roles and Responsibilities of the School-Based Speech-Language Pathologist. Rockville, MD: American Speech-Language-Hearing Association.
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION. 2000a. 2000 Omnibus Survey Caseload Report: SLP. Rockville, MD: American Speech-Language-Hearing Association.
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION. 2000b. 2000 Schools Survey Executive Summary. Rockville, MD: American Speech-Language-Hearing Association.
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION. 2000c. IDEA and Your Caseload: A Template for Eligibility and Dismissal Criteria for Students Ages 3 to 21. Rockville, MD: American Speech-Language-Hearing Association.
COUNCIL FOR EXCEPTIONAL CHILDREN. 2000. Developing Educationally Relevant IEPs: A Technical Assistance Document for Speech-Language Pathologists. Reston, VA: Council for Exceptional Children.
MOORE-BROWN, BARBARA J., and MONTGOMERY, JUDY K. 2001. Making a Difference for America's Children: Speech-Language Pathologists in Public Schools. Eau Claire, WI: Thinking Publications.
TAYLOR, JOYCE S. 1992. Speech-Language Pathology Services in the Schools, 2nd edition. Needham Heights, MA: Allyn and Bacon.
U.S. DEPARTMENT OF EDUCATION. 2000. Twenty-Second Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act. Washington, DC: U.S. Government Printing Office.
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