Make the Speech Referral Process Work for You Try these four steps to streamline the referral process and improve relationships with school staff. School Matters
Free
School Matters  |   October 01, 2017
Make the Speech Referral Process Work for You
Author Notes
  • Scott Prath, MA, CCC-SLP, is vice president of Bilinguistics in Austin, Texas, and serves a diverse caseload in school and early-childhood settings. He also serves as vice president of public relations for ASHA’s Hispanic Caucus. scott.prath@bilinguistics.com
    Scott Prath, MA, CCC-SLP, is vice president of Bilinguistics in Austin, Texas, and serves a diverse caseload in school and early-childhood settings. He also serves as vice president of public relations for ASHA’s Hispanic Caucus. scott.prath@bilinguistics.com×
Article Information
School-Based Settings / Professional Issues & Training / School Matters
School Matters   |   October 01, 2017
Make the Speech Referral Process Work for You
The ASHA Leader, October 2017, Vol. 22, 38-39. doi:10.1044/leader.SCM.22102017.38
The ASHA Leader, October 2017, Vol. 22, 38-39. doi:10.1044/leader.SCM.22102017.38
The speech-language referral process influences the size of our caseloads, as well as the tone of our interactions with teachers and other school staff. For many speech-language pathologists, a school’s referral process can generate more issues than it resolves. On one hand, many SLPs prefer not to participate heavily in the referral process, because this workload often isn’t reflected in our caseload. By assuming a greater role in the referral process, we take on added work.
On the other hand, not participating in the referral process often means we receive insubstantial evaluation requests. An evaluation can take anywhere from eight to 15 hours for observation, testing, writing the assessment, and meeting with parents and teachers. And, after this time investment, the student might not be found eligible for treatment. Teachers and parents wait a long time for these results and often expect the child to receive services.
If there is no diagnosis, SLPs often feel stressed about revealing that a student doesn’t qualify for services. Parents may feel disappointed and teachers might feel unsupported by the SLP. To prevent this sort of situation, our only choice is to participate in the referral process from the get-go—raising the time issue again.
But there are ways we SLPs can help streamline the process, saving time and improving relationships between SLPs and school staff.
The first question to ask: Are teachers referring the right students? Educators tend to over-identify students in general, and in many locations, disproportionately identify children from diverse backgrounds. National statistics on over-identification also don’t bode well for the 30-plus years since the implementation of the response to intervention (RTI) process, which provides services at increasing levels of intensity for students with learning issues.
To answer this question—and to help overhaul the referral process—try these four simple approaches.

If SLPs let teachers know exactly what we need for an adequate referral, everyone benefits.

Ask teachers for more details.
If SLPs tell teachers exactly what we need for an adequate referral, everyone benefits. So, what do the teachers tell us most often? “I can’t understand my student.”
To educators, this means a singular “speech issue.” To SLPs, this statement can mean 27 common speech and/or seven common language issues. Help narrow the gap by asking teachers for more details by making three lists—words the student says in error, unintelligible sentence examples, and descriptions of confusing social interactions. These lists can help us determine the nature of the difficulty and how best to proceed.
Use referral forms with explicit instructions in simple, jargon-free language.
When we created our online referral forms, we field-tested them on a group of kindergarten teachers and incorporated their feedback for final versions.
For example, the original instructions said: “Have the student model the sound…” A teacher asked: “What do you mean by model? Like a runway model?” “No, have the student say the sound,” I responded. “Why don’t you just put ‘say’ then?” she retorted, reasonably. Point taken.
Request only needed information.
I conduct evaluations across dozens of districts and see enormous variety in the amount and type of information requested for speech-language referrals. These forms create a perceived or real burden for many teachers, leading to negative feelings about the process. However, SLPs need only nine pieces of information to get the ball rolling: name, date of birth, grade, teacher, vision and hearing status, parent concern and history, teacher concern, and examples in two categories: “I can’t understand my student” speech examples and “My student doesn’t speak enough, is confusing, or can’t understand me” language examples.
Request facts directly informing your decision about whether or not the child needs testing. At this point, we need to know only if communication is typical for the child’s age and language background, and if can we make classroom improvements without providing direct services.

By the end of three or four 10-minute visits with a teacher, you geht great data on whether or not the child needs specific help beyond the classroom.

Manage time to your benefit.
Why do we allow our fall referrals to stretch into hectic spring semesters where they compete against academic testing, field trips and IEP meetings? Although evaluation timing must meet set requirements—often 45 or 60 days to complete—referrals usually don’t have such restraints. And I try not to let my evaluations take the full allotted time.
During the prior two school years, I completed referral and testing for all students by January. To accomplish this feat, I help get teachers going early in the school year with the following approach:
  • I schedule 10 minutes with each teacher who wants to refer students. When we meet, I ask them to gather the nine pieces of information listed above, then ask to meet again the next week at the same time to get the answers. I make sure to explain what I need and show the teacher how to collect the details. This may take 10 more minutes, but I immediately win a fan, reduce the teacher’s fears and provide precise instructions for future referrals.

  • Between meetings, I examine the initial results and return with a request to gather more information. Let’s say that the child could not say /s/ on the initial screening, for example. I return with a page of initial, medial, final and cluster /s/ words for the teacher to use when listening to the student repeat each sound. This gives me accurate percentage data. Lastly, I ask about topics the teacher is covering in class and look for a way for the student to practice challenging sounds during classroom activities.

  • By the end of three or four 10-minute visits with a teacher, you get great data on whether the child needs specific help beyond the classroom. I continue these brief weekly meetings for as long as the student makes progress in class.

You might have difficulty convincing teachers—or other faculty—to buy into a process that doesn’t produce immediate, visible results. With this more detailed referral process, however, as little as 30 minutes of effort at the beginning of the school year can save 10 to 15 hours at the end. And that’s a pretty good trade-off.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
October 2017
Volume 22, Issue 10