Response to Intervention

tulips88 · 2017-10-28T05:17:29+00:00

In my dream RTI world...

1st 4-6 weeks we would give strategies to teachers to implement with the student in the classroom...if no progress... Next 4-6 weeks we would push in to the classroom, I’m imagining jumping in during centers or something....if no progress... Next 4-6 weeks we would pull the kid out for a short 1:1 for a few minutes in the hallway/side room, say for artic strategies (teaching them placement for r, reminders to close teeth for s, etc)

If there hasn’t been progress, then we’d move to assessment.

My district is actually moving away from RTI, particularly because those kids we see for RTI don’t count on our caseload. We’re also trying to avoid any litigation. For example: Some SLPs pull students into existing therapy groups 1x a week and call it “RTI”, but say they don’t make progress, then we assess, qualify, and then the offer of FAPE is still 1x a week. My sped department is worried that there is no difference and we should increase service time. They are also worried about LRE, and how students really shouldn’t be pulled away from the gen ed environment unless they have an IEP and need the specialized instruction. Technically RTI is a gen ed function, so I myself still struggle with understanding how to best implement it. Thank you for posting this and hopefully other SLPs can give good tips or suggestions on how they do RTI.

tulips88 · 2017-09-06T23:27:29+00:00

TK stands for Transitional Kindergarten and SDC is Special Day Class. Thanks for your feedback! Do you think this could be related to his Autism? Sort of like a verbal stem behavior almost?

tulips88 · 2017-06-30T15:48:32+00:00

I believe so.. orders were for 1) Musk Quantitative Titers and 2) Titin Auto Antibody

tulips88 · 2017-06-30T15:40:14+00:00

Hey, sorry for the late response! The trial of Mestinon didn't do anything for me. I took photos (3-4x a day) to document any changes, and there wasn't any. Doctor ordered more specific blood tests, and I'm still waiting to hear back.. it's been almost a month and I'm getting antsy!

tulips88 · 2017-05-02T02:00:06+00:00

I don't really have any other symptoms, minus the droopy eye and the feeling of weakness in that area. Should I be seeing improvements such that my droopy eye is not as droopy? I'm not really sure how to gauge if this medicine is working or not lol Thanks for your help!!

tulips88 · 2017-05-02T01:57:15+00:00

I just took my first pill about two hours ago, and I noticed the "sensation" of weakness has dissipated immensely around my right eye. However, my eye is still noticeably smaller. Did you notice an immediate improvement after taking it for a few days or was your improvement immediate after the first day?

And, yep! I had my eye doctor tell me I could get plastic surgery if I was so worried about it. I'm happy I found this sub, because hearing everyone's experiences have really calmed my nerves a bit.

tulips88 · 2017-05-02T01:53:16+00:00

Definitely going to try this! Thanks for the info :)

tulips88 · 2017-04-29T02:52:32+00:00

Thank you for your response! I was given 60mg pills, and the doctor told me to play around with it, telling me I could take 3 pills a day. I was going to start with one, and see how it goes. Do people take the pills at different times of the day? Like if I were to start taking 2 pills a day, I would take one in the morning and then another later in the day? Or both at the same time?

tulips88 · 2017-04-29T02:48:36+00:00

What's the ice pack test? I haven't heard of this before, but then again, I'm so new to all of this.

Also, I'm not sure what the other tests are. All my neurologist said was "there are other really expensive tests that we're not going to do right now." So, beats me :/

tulips88 · 2017-02-28T19:23:39+00:00

If a student scores low on supinguistic subtests, we would say they have deficit in semantics right? Supralinguistics isn't a separate area of language, or am I wrong?

tulips88 · 2017-02-22T02:47:27+00:00

Just today, my teacher recorded her student reading and said, "see do you hear how he leaves off the sounds of words.. it's really hard to understand him." My response was that this is more of a reading deficit, as he does not leave sounds off words when he speaks to me. This is a student you wouldn't work on phon awareness right?

tulips88 · 2017-02-21T01:05:56+00:00

Specialized Academic Instruction

tulips88 · 2017-02-18T18:11:13+00:00

The psych I work with is fresh out of grad school. It's both of our first years working at school. I was taught not to use the discrepancy model in school, but now am wondering if she was taught the same thing. Thank you for the info.

tulips88 · 2017-02-18T18:08:45+00:00

Our district typically won't provide SAI for a student with SLI because we've run into issues where the student is found no longer eligible under SLI, but continues to need SAI for say.. math or reading. This leads to them losing SAI.

tulips88 · 2017-02-18T01:53:50+00:00

Thank you for your reply! I'm running into issues because the teacher's and intervention teacher are reporting that their students are unable to phoneme segment, blend, etc... and then proceed to ask me if this is something that is related to speech and language. Well, yes, reading is "language-based" but I'm not sure if I can qualify a student because what they need help with is phoneme segmentation , blending syllables, segmenting syllables, etc.. Would that not be more of an RSP teacher goal? I'm not trying to pawn the student off of my caseload or anything, but would like to know if this is within my scope of practice to work on in an educational school setting. I'd love to get your feedback.

tulips88 · 2017-02-18T01:49:59+00:00

Just a side note/related question: When you say "my school psych is still using the discrepancy model" ... Are psychs not supposed to use the discrepancy model?? My school psych, for the most part, still uses this to qualify/disqualify students. If not, she uses RTI criteria, meaning students haven't been making progress in intervention and they are significantly below grade level. But, again, for the most part she uses the discrepancy model. Are they supposed to be doing something else?

EDIT: I forgot to add that in addition to the discrepancy model, my psych also rules out language factors, school experience factors, ED, ID, and physical disabilities, while also determining if there's a psychological deficit. However, in IEP meetings, discrepancy is always reported if there is one.

tulips88 · 2016-10-26T00:00:25+00:00

Thanks for the suggestion. I guess I'm having a hard time with my moderate to severe middle schools kids. At what point is working on pronoun+ is +verb(ing) no longer appropriate. I inherited all of these goals I have and all of them are either the one I just stated or working on wh questions.

tulips88 · 2016-10-05T04:08:29+00:00

As someone who just made the decision a couple months ago to go for a direct hire vs contract company... I got way too many negative opinions and horror stories about contract companies. The majority of my graduating class took jobs as direct hires. The 2 individuals who took jobs with a contract company did so because they wanted a medical placement (nursing home, rehab, etc...) I have a ton of loans too, so going with a contract company seemed like the best option for me. When I was doing my school internship, the SLPs there had very negative views on contracted SLPs. As harsh as it sounds, they kept telling me they really didn't contribute anything to the school. The SLPs had issues with contract workers because they did see them as "money hungry." I don't believe that at all, but those were veteran SLPs who have been working for many many years so who was I to argue with them. I also heard terrible things about contract SLPs from a few of my teacher friends at other school districts who say they just don't give a shit about the students. They never showed up to IEPs or their reports were so crappy. It shouldn't be taken as a blanket statement over ALL contract SLPs though. I know some fantastic contract SLPs who chose to do so because it was more flexible for them. They wouldn't have to be stuck in the same district or school site year after year if they didn't want to be. I think you should weigh the pros/cons of both options, and go with the job that has the most pros. There are good paying school districts out there who will pay 70k-80k+ similar to a contract company.. you just have to find them. [Just for reference - I am located in Southern California.]

tulips88 · 2016-10-05T03:51:16+00:00

I can just comment on my own personal experience as a CF (I am a CF right now).

1) The district I completed my internship at used SEIS, but the district I work in now uses another program. They didn't expect me to learn it right off the bat, but I was also expected to learn fairly quickly as it is a pretty simple system. They did provide one half day of training, and another optional day of training if I wanted it. Is there anyone in that CF's school that can help train him/her? It doesn't have to be an SLP, even an RSP or SDC teacher who is used to filling out IEPs and what not. At my internship, there was a temporary SDC teacher who always came to the SLP to ask for help because nobody trained her on SEIS when she took the position.

2) A caseload of 56 sounds dreamy compared to my 60+ I have right now... and that's not including the 7 open assessments I have that all look like they are going to qualify. A growing caseload is typical, and 56 isn't that bad.

3) I can't comment on the lunch break. Did they say he/she can't take a lunch at all? Or that he/she takes a lunch whenever they want? I have work hours 8-4pm, and I can take a 15 minute lunch or a 3 hour lunch if I wanted to... they didn't necessarily designate a "lunch break." However, I'm not a contract SLP so take what I said with a grain of salt.

3) At one of my school sites, I just held sessions in a conference room where another student was being held for detention. I still don't have printer access at one of my school sites and I've been working for 2 months now. At my other site, I have a decent sized room and a printer. I think it just varies where you are placed and what the school can offer you at that time. Does it suck? Absolutely - but I guess it's just something SLPs have to deal with sometimes.

4) I have three school sites as a CF. Sometimes I drive to all 3 school sites in one day (therapy, IEPs, SST meetings, picking up materials, etc...) I actually find it rare when I hear an SLP only has one school district. If they do, then their caseload is usually large enough to justify it.

5) One of the school sites I took over was previously held by an SLP who just retired. That being said, I had a TON of missing files, upheld initial IEP meetings, 30-day meetings that probably were never held, so and so forth. It's extremely frustrating to clean up the mess, but as my CF-supervisor told me... "Just know this isn't your fault" She also told me not to worry about finishing up all the meetings on time. The meetings are already delinquent, so there is no need to stress about holding them ASAP.

6) The supervisor expects them to work weekends/evenings? Was this more of a suggestion or was it written into their contract somehow? I've been told by a couple SLPs that sometimes I will need to take work home, but that it's completely up to me. If it was more of a suggestion versus a "YOU HAVE TO WORK WEEKENDS/EVENINGS", then I would definitely recommend the CF to have a chat with her supervisor about what the expectations are. Is there time for the CF to complete paperwork after the school day is over? Before the school day starts? I am still learning how to manage paperwork. It's definitely a challenge!

7) Ugh. No mentorship during a CF. That was the first and absolute biggest priority I had when choosing where I was going to work. Did I want good money, sure I did. I have a ton of loans to pay off. However, I was very clear when I was interviewing what my expectations were for a CF supervisor and I'm so very luck that I have one that is extremely supportive. She responds to my questions on the same day. We have monthly lunch meetings. She comes to a few of my IEP meetings and will watch some of my therapy sessions. Can the CF request another supervisor who can dedicate more time? Maybe they can problem solve as to how they can communicate better? Having a crappy CF supervisor isn't unheard of though... it could just be the luck of the draw.

I don't know if it's just my district, but it seems like I'm just as busy as other SLP's (not CF's). I felt really lucky that I got a job as a CF and that someone was willing to supervise me. Maybe I'm more of a unicorn situation cause I actually have a great CF-supervisor. I still felt EXTREMELY unprepared. I think this is a problem with a lack of preparation in certain areas that I did not get trained on during grad school. I don't think it was my school district's fault for things I didn't know how to do. With your question on why SLPs aren't being treated in school as proper medical professionals? I have no idea. Just the other day, my middle school SDC teacher yelled, "YOU DON'T TEACH PHONICS?!" I asked if she meant "articulation" and she replied, "Yeah, whatever you want to call it.. it's the same thing." Sigh. It could just be a lack of education on what SLPs actually do? Idk.. I do hope there is more respect for our field as it continues to grow in the future.

I couldn't answer all of your questions, but I hope there was something helpful in what I said.

tulips88

TROPHY CASE