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Purpose Speech-language pathologists (SLPs) encounter many challenges in the school environment. We sought to identify school-based SLPs' needs in the areas of training and research to support school-based practice. Method We collected surveys from 145 school-based SLPs practicing in Wisconsin. Respondents were asked to describe aspects of preservice training that most and least prepared them for school-based practice. Respondents next described training needs for early-career SLPs and desired topics for general professional development. Respondents then described research topics that require further study to advance school-based practice. After completing this series of open-ended questions, the respondents completed a series of preferential-ranking questions about general needs for training and research. We employed mixed methods to analyze the data, using grounded theory for the qualitative analysis. Results During preservice training, respondents most valued the applied aspects of their training. Respondents noted that early-career SLPs require significant support, particularly with the professional responsibilities of school-based practice (e.g., individualized education programs, interprofessional practice, and scheduling). When describing general professional development and research needs, the respondents placed high value on practical topics that have clear implications for school-based practice. Conclusions Understanding the perceived needs of school-based SLPs can assist in designing training supports and ensuring that the developing evidence base is relevant to SLPs practicing in the schools. This exploration-stage study established a foundation for future testing of implementation initiatives to fill gaps in school-based practice.

Purpose This lead article of the Clinical Forum focuses on the research that supports why speech-language pathologists (SLPs) are an integral part of the overarching curriculum for all students in schools. Method Focus on education has shifted to student performance in our global world, specifically in college and career readiness standards. This article reviews recommendations on best practice from the American Speech-Language-Hearing Association on SLPs' roles in schools, as well as data on school-based services. Implementation of these practices as it is applicable to school initiatives will be explored. Methods of interventions available in schools, from general education to special education, will be discussed based on national guidelines for a Response to Intervention and Multi-Tiered System of Support. Research regarding teacher knowledge of the linguistic principles of reading instruction will be explored, as well as correlation between teacher knowledge and student performance. Results The implications for how SLPs as the linguistic experts offer unique roles in curriculum and the evidence available to support this role will be explored. Implications for future research needs will be discussed. Conclusion The demands of a highly rigorous curriculum allow SLPs a unique opportunity to apply their knowledge in linguistic principles to increase student performance and achievement. With the increased focus on student achievement, growth outcome measures, and value-added incentives, it is critical that SLPs become contributors to the curriculum for all students and that data to support this role are gathered through focused research initiatives.

Purpose This study examined the extent to which children born preterm (< 37 weeks) and/or who have low birth weight (< 2,500 g) catch up with their full term peers in terms of their language abilities at early school age (≥ 5 to < 9 years). Method A systematic literature search identified empirical studies that fit the inclusion criteria. Data from the tests/questionnaires used for meta-analysis spanned the following language categories: total language score, expressive language, receptive language, pragmatics, phonological awareness, and grammar. The means (standard deviations) were extracted from the studies and were converted to mean difference and 95% confidence intervals to test for overall effect. Results Sixteen studies met the inclusionary criteria, for a total of 2,739 participants, of which 1,224 were born full term and 1,515 were born preterm. It is important to note that the preterm cohort represented very preterm infants who have a very low birth weight. The meta-analysis found that preterm infants scored significantly worse on total language ( p < .001), receptive language ( p < .001), expressive language ( p < .001), phonological awareness ( p < .001), and grammar ( p = .03) than their full term peers. However, preterm infants did not score significantly worse than their peers on their pragmatics ( p = .19). Conclusions Children born VPT and who have VLBW perform worse than their peers on their total language, receptive language, expressive language, phonological awareness, and grammar abilities by early school age. This information is important for speech-language pathologists to consider as children born prematurely reach school age.

Purpose Displaced talk, or talk about past or future events, is a common form of interaction for social closeness. Some school-age children with autism spectrum disorder are restricted in their use...

Introduction Many more children are surviving premature birth and complex medical diagnoses than in the past. Children with autism and genetic disorders are being diagnosed more effectively. These ...

Purpose As a means of addressing bias against speakers of African American English (AAE) that is prevalent within the ethos of too many K–12 educators, this article aims to challenge speech-languag...

This study used a multiple-baseline-across-participants design to measure the effect of sentence-combining treatment provided to 6 school-age students who were identified by their teachers as being...

Purpose Speech-language pathologists (SLPs) have a unique opportunity to engage diverse youth and adults in developing their authentic voices and sharing experiences. Although they may not necessar...

Purpose This article reports out on the development of a university/school district partnership to augment speech and language therapy services provided to schoolchildren in the partner district wh...

Objectives To outline the prevalence and disparities of hearing problems among school-aged urban minority youth, causal pathways through which hearing problems adversely affect academic achievement, and proven or promising approaches for schools and parents to address these problems. Methods Literature review. Results Most school-aged youth will experience a temporary, fluctuating hearing loss at least once and about 20% of U.S. adolescents have some kind of permanent hearing problem. When nationally representative samples of hearing loss among youth under age18 were conducted, those from lower socioeconomic families were more likely to have a hearing loss (23.6%) than those from families above the poverty threshold. Hearing screening is widespread in schools, but the benefits are jeopardized by non-standardization, inadequate methods for commonly occurring losses, and lack of follow-up. Conclusions Hearing problems are disproportionately prevalent among school-aged urban minority youth, and have a negative impact on academic achievement through sensory perceptions, cognition, and school connectedness. Effective practices are available for schools to address these problems. To better realize the benefits of current investments in screening, programs will require improved prevention efforts and follow-up/coordination between agencies conducting screening, school nurses, teachers, speech-language pathologists (SLPs), audiologists, parents, and in some cases, physicians and community resources.

Purpose Although language samples and standardized tests are regularly used in assessment, few studies provide clinical guidance on how to synthesize information from these testing tools. This study extends previous work on the relations between tests and language samples to a new population—school-age bilingual speakers with primary language impairment—and considers the clinical implications for bilingual assessment. Method Fifty-one bilingual children with primary language impairment completed narrative language samples and standardized language tests in English and Spanish. Children were separated into younger (ages 5;6 [years;months]–8;11) and older (ages 9;0–11;2) groups. Analysis included correlations with age and partial correlations between language sample measures and test scores in each language. Results Within the younger group, positive correlations with large effect sizes indicated convergence between test scores and microstructural language sample measures in both Spanish and English. There were minimal correlations in the older group for either language. Age related to English but not Spanish measures. Conclusions Tests and language samples complement each other in assessment. Wordless picture-book narratives may be more appropriate for ages 5–8 than for older children. We discuss clinical implications, including a case example of a bilingual child with primary language impairment, to illustrate how to synthesize information from these tools in assessment.

Rural school districts report high rates of job openings for speech-language pathologists (SLPs). Telepractice is a viable service delivery model for addressing personnel shortages in rural schools. Yet, SLPs are graduating with minimal training in this technology-driven service delivery model. In response to the lack of personnel preparation, Linking Kids to the Speech-Language Pathologists (LinKS) program was developed. LinKS trains eight graduate students a year to use telepractice within the context of the school setting. Participating graduate students complete two didactic courses, two telepractice experiences, and one externship in a rural school setting in addition to the requirements of an accredited master's program in Communication Sciences and Disorders (CSD). In Year 1 of LinKS, program completers collectively accrued 180 hours of experience using telepractice including delivery of speech-language services to children presenting with a variety of communication disorders located in the home and school environment. A digital library housing therapy plans and materials is described. Recommendations for CSD programs seeking to develop a similar model are provided.

In this article, the author discusses how communication is impaired in learners with autism. In addition, evidence-based strategies to utilize when working to help increase a student's language level are also discussed. A case study of the implementation of these strategies in a collaborative and systematic model is discussed in depth.

Purpose This research attempted to replicate Hoffman's 2009 finding that the proportion of narrative utterances with semantic or syntactic errors (i.e., ≥ 14% “restricted utterances”) can differentiate school-age children with typical development from those with language impairment with a sensitivity of 83% and specificity of 88%. Method Methods similar to Hoffman (2009) were used to evaluate an existing set of narratives from 16 age-matched pairs of 8- to 9-year-old children, half with known language impairment. Transcripts were segmented into T-units; a code of [RESTRICTED] was assigned to any utterance with semantic or syntactic errors. Results A Welch's t test for independent samples revealed a statistically significant difference in the mean proportion of restricted utterances between the two groups after accommodation for an outlier with typical development. A cutoff of ≥ 14% restricted utterances replicated Hoffman's (2009) sensitivity but not specificity. Post hoc analysis of specific error types found sensitivity and specificity rates similar to Hoffman's as well as a significant difference in means when using a proportion of sentence–internal morphosyntactic errors. Conclusion Results support further exploration of utterance-level error coding for diagnostic purposes and future development of this approach to meet clinical assessment needs.

This article focuses on the influence of historical trauma (Brave Heart, Chase, Elkins, & Altschul, 2011) on the health and education of contemporary Native American (NA) communities. It is crucial that educators and health care professionals understand how events in American history have manifested as attempts to forcefully assimilate NAs into mainstream Euro-American culture. These attempts, which included relocation of NA communities onto reservations, enrollment of young NA children in government boarding schools and forcing these children to stop speaking native languages, and delivery of inadequate medical services (Adams, 1997) have resulted in psychological trauma that has negatively impacted multiple generations of NA families (Walker, 1999). These traumas have been found to be related to the high incidence of chronic health conditions and low academic achievement in NA communities (Whitbeck, Adams, Hoyt, & Chen, 2004; also see article by Gillispie, this issue). Understanding historical trauma as it has occurred in NA communities is a first step in our attempt to best serve NAs as speech-language pathologists (SLPs) in health care and educational settings. Knowledge and a deeper awareness of this historical trauma allows professionals to better understand negative attitudes toward formal education and medical service delivery systems that are not responsive to the rich cultural and linguistic diversity of NA people.

This manuscript will focus on the value of a growth mindset, the belief that our abilities are not static, rather, those abilities can be developed upon and improved while utilizing hard work, dedication, and effort. In this article, we describe the value of a growth mindset for speech-language pathologists in schools who support language and literacy skills of students with disabilities and strive to increase academic success in the general education classroom. Speech-language pathologists in a school-based setting can use the principles of growth mindset, putting in into practice for themselves and to foster growth mindset within their students. We present recommendations and examples of implementing a growth mindset during the school year. Additionally, resources are provided for further understanding of growth mindset and the research behind growth mindset principles.

Student clinicians find goal writing and progress monitoring to be difficult tasks to learn, especially when children on the caseload have complex communication needs (CCNs). School-based externship supervisors play an important role in developing students' understanding and competence in these skills. This article provides supervisors with strategies for instructing student clinicians to write goals and evaluate the effectiveness of services for children who use augmentative and alternative communication (AAC). Additionally, the authors adapt the Continuum of Supervision Model (Anderson, 1988) for supervisors who train students to write goals and monitor progress for children who use AAC.

Post-school outcomes for individuals with disabilities have been persistently poor. The Bureau of Labor Statistics (2014) found only 18% of individuals with disabilities were active in the labor force, and Newman et al. (2011) found only 41% have completed a post-secondary education program. Research in secondary transition has identified 64 practices that are effective with and 16 predictors that improve the post-school outcomes for this population. Many of these are compatible with the services speech-language pathologists (SLPs) provide. This article reviews the evidence-based practices and predictors relevant to SLPs by defining, describing, and providing examples of how to use them.

It is critically important that speech-language pathologists understand the difference between educational identification of a speech-language impairment under the Individuals with Disabilities Education Act (IDEA) and the procedures used for a clinical determination of speech or language impairment. The authors review variations in terminology, federal and state regulations, and state, local, and professional guidance. Federal evaluation requirements and examples of differing state requirements are provided along with evidence-based recommendations for comprehensive assessment of students.

Oklahoma has a large population living in rural areas where it is difficult to fill school speech-language pathologist (SLP) positions. To meet this need, telepractice has been used in rural Oklahoma school districts since 1999. Medicaid policies have allowed schools to receive reimbursement for speech therapy provided by onsite therapists; however, reimbursement for speech telepractice was excluded. The current project measured the effectiveness of a speech telepractice program so this policy could be revised. Speech and language skills of 578 children, grades PreK–12, were followed over one of two school years and were rated using Functional Communication Measures (FCM) established by the American Speech Language and Hearing Association (ASHA). Our data show that 67–87% of the children advanced by one or more levels on three common FCM scales. These changes are similar to, or greater than, what was reported in a large sample of students compiled by ASHA's National Outcomes Measurement System (NOMS) with clinicians who worked onsite in schools. Average weekly treatment time was also less in our teletherapy practice than what was reported in the reference database. Therefore, the current study demonstrates that speech telepractice is an effective and efficient method of delivery for the school age population.

This independent field experience in global health explores the application of health promotion and service delivery models from the field of public health to speech-language services through descriptive research of the case in southern Belize. This project explores first steps in global speech-language health outreach for children living in very limited resource settings. Global speech-language health outreach includes community-wide interventions, fostering collaboration in the community and internationally, health education, building on local resources to expand health services, and special education program development. This project makes the assumption that a rich language environment may be a determinant of speech-language health. Speech-language interventions that enrich the linguistic environment may be a strong starting point for regions with very limited access to speech-language services. Therefore, this project looks at targeting social and environmental factors that influence language and literacy skills. The aim is to raise awareness of pediatric speech-language disability in southern Belize, with the ultimate goal of increasing school and community participation of children with speech-language disabilities. The purpose of this project is to explore points of entry for population-wide, environment-enriching, and culturally relevant intervention targeting communication and academic growth, in a limited resource setting. Furthermore, this project describes barriers to speech-language services and interventions in southern Belize.

Addressing swallowing and feeding in a school system is a team effort. Working closely with parents is essential to the student's progress. This article profiles swallowing and feeding intervention by a school-based team with a 5-year-old Down's Syndrome student with dysphagia and behavioral feeding disorders. The team was able to work successfully with the parents which resulted in the student making significant progress both at school and in the home setting.

In addition to providing services to children who demonstrate speech and language impairments, it is within a speech-language pathologist's (SLP's) scope of practice to “recognize and hold paramount the needs and interests of individuals who may benefit from AAC [Augmentative and Alternative Communication]” (American Speech-Language-Hearing Association (ASHA), 2005, Position Statement section, para. 3). However, in spite of nearly one-half of all school-based SLPs reporting they provide services to nonverbal students who utilize AAC systems (ASHA 2012; Kent-Walsh, Stark, & Binger, 2008; Proctor & Oswalt, 2008) many SLPs across the country still do not feel adequately trained to assess and provide therapy services to these children (Costigan & Light, 2010; Kent-Walsh et al., 2008; Light, Drager, Currall, & Roberts, 2012). It is becoming increasingly necessary for all SLPs to assume responsibilities in the AAC process. The case study presented in this article illustrates the collaborative process of conducting an AAC assessment for a preschool-aged child.

Elevator speeches, or brief talks in which individuals pitch an idea, sell a solution to a problem, or raise awareness of an issue, have gained increasing popularity within the business world. While school-based professionals may not view themselves as having to “sell,” audiologists and speech-language pathologists are in the business of “selling” our ability to create change for students with communication disorders. Elevator speeches serve as a viable advocacy tool and can be used influence decision-makers and bring about meaningful change in our professions. This article equips readers with knowledge of how to craft a winning elevator speech, provides examples of instances in which school-based professionals could use elevator speeches, and presents information on how to assess the success of elevator speeches.

Purpose School-based speech-language pathologists (SLPs) are often asked to adopt new policies or practices at the school, district, or state level. Professional learning (PL) opportunities usually accompany these changes but are often delivered in a one-size-fits-all workshop format. The authors challenge school-based SLPs and district leadership to consider PL in a new light, guided by data-based decision making to ultimately improve student outcomes. Method This article discusses the research supporting the assessment and delivery of high-quality PL for school professionals, including SLPs, and a specific model for measuring change: the concerns-based adoption model (CBAM; Hall & Hord, 2015). An example of how CBAM was used to examine the adoption process with school-based SLPs in a large school district is provided. Conclusion Based on the review of the literature, the current approach to PL experienced by most SLPs is problematic. High-quality PL should target improvement in student outcomes and should be focused, ongoing, supported, and evaluated.

This article is intended to emphasize the importance of using a feature-matching process when identifying mobile technology systems for students with complex communication needs. The reader will be able to apply features of the needs and abilities of the student to the features of a mobile tech system (commercially available system with application) to determine if it is a match for the student. Case studies are used to illustrate the feature matching process in the school setting.

Communication access is a key component of 504, IDEA and Title II of the Americans with Disabilities Act (ADA). A November 2014 policy guidance from the U.S. Department of Education and U.S. Department of Justice clarified that, under Title II of the ADA, schools are required to ensure that students with disabilities receive communication with others through the provision of appropriate auxiliary aids and services. In other words, they are responsible for ensuring that communication access is as effective for children with hearing loss as it is for their typically hearing peers. Hearing loss is invisible and the impact is often mistaken for a learning disorder rather than performance issues secondary to decreased access to communication. Information in this article is presented to assist the educational audiologist, teacher of the deaf/hard of hearing, or speech-language pathologist in demonstrating the impact of hearing loss on access to classroom communication so that the question “Does this student have effective access to communication in school?” can be answered in an evidence-based manner.

This paper will discuss the implementation of Proloquo2Go for a group of students in a specialist school. This implementation was planned by the school executive at Malkara School in consultation with a speech-language pathologist from Therapy ACT. During the first term of the implementation, the author was engaged as a literacy consultant by the school and began to consult around this classroom as well from Term 2. This paper will discuss what occurred both before and after the author's involvement.

Purpose This study aimed to determine the relative strengths and weaknesses in language and verbal short-term memory abilities of school-age children who were adopted from Eastern Europe. Method Children adopted between 1;0 and 4;11 (years;months) of age were assessed with the Clinical Evaluation of Language Fundamentals—Preschool, Second Edition (CELF–P2) and the Clinical Evaluation of Language Fundamentals, Fourth Edition (CELF–4) at age 5 and ages 6–7. Language composites and subtests were compared across time. Results All CELF–P2 and CELF–4 mean scores fell in the average range. Receptive composites were 102.74 and 103.86, and expressive composites were 100.58 and 98.42, at age 5 and ages 6–7, respectively. Age of adoption did not correlate to test scores. At ages 6–7, receptive language, sentence formulation, and vocabulary were areas of strength, with subtest scores significantly better than test norms. Verbal short-term memory and expressive grammar subtest scores were within the average range but significantly worse than test norms. A high percentage of children scored 1 standard deviation below the mean on these 2 subtests (27.3%–34.1%). Conclusion Eastern European adoptees had average scores on a variety of language tests. Vocabulary was a relative strength; enriching the environment substantially improved this language area. Verbal short-term memory and expressive grammar were relative weaknesses. Children learning a language later in life may have difficulty with verbal short-term memory, which leads to weaknesses in expressive syntax and grammar.

The proliferation of mobile technology (commercially available systems, such as the iPads, iPad Minis, Androids, and Windows tablets) has decreased barriers and put communication systems into the hands of many of our persons who use augmentative and alternative communication (PWUAAC). Because there are so many benefits with the advent of mobile technology, so too are there challenges that can come up as a result of this technology (McNaughton & Light, 2013). Moreover, the speed of innovation and the commercial availability of these devices can put teachers, therapists, and families at odds. In the past, devices were harder to obtain, but we had a strong process and assessment protocol to support device acquisition and implementation (Gosnell, Costello, & Shane, 2011). A key component of our role in this new and changing environment is to restructure the discussion and process in order to recapture the type of teamwork and collaboration we previously experienced. This article will discuss issues, strategic ideas, as well as success stories from one clinician's perspective, related to AAC implementation utilizing mobile technology, across home, school, and community settings.

Purpose The need for speech-language pathologists (SLPs) to consider an academic talk (AT) register in addition to an everyday casual talk (CT) register of oral language with children beginning in the preschool years is presented, the AT and CT registers are distinguished in a comprehensive manner, ideas regarding AT language assessment are proposed, and suggestions for fostering children's skills with the AT register are offered. Method Extant research and scholarship from a wide variety of disciplines are integrated and organized. Results The author discusses the role of the SLP in supporting AT skills beginning in the preschool years and the added risk of difficulties with the AT register for children with language impairment who are from diverse backgrounds. Two broad categories—social-interactive and cognitive—that give rise to linguistic features that differentiate between the CT and AT registers are deduced from extant scholarship. Conclusions SLPs should consider children's competence with the AT register as they work to prepare preschoolers and older children for the language demands of school.

This article discusses feeding and swallowing (dysphagia) services in schools. As we know, students spend six to seven hours a day in school with time scheduled for snacks and lunch. These meal and snack times can be challenging and put students with feeding and swallowing issues at risk for aspiration, choking, or inadequate intake. This article will address factors that influence service delivery to these students. The terms dysphagia and feeding and swallowing disorder will be used interchangeably throughout this article.

In a time of limited resources and increased accountability, speech-language pathologists (SLPs) are asked to broaden their roles resulting in efforts to continually redefine and refine service delivery options. SLPs in schools have to be creative as we manage and shift toward a more formidable role in prevention, while still providing educationally relevant services to students who receive special education services. This article shares benefits for one SLP who embraces supervision of SLP assistants as one method for increasing service delivery options.