Evaluation and Eligibility of Students with Communication Disorders in Public Schools in the United States

Research output: ThesisDoctoral Thesis

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Communication is an essential human right that, beginning early in a child’s life, provides the foundation for interaction with others. Communication is the underpinning for success in school and untreated communication disorders may impact children’s futures. In the United States, students with disabilities in public schools receive free speech and language evaluations and, if needed, services from speech-language pathologists (SLPs). In U.S. public schools this process is regulated by the Individuals with Disabilities Education Act (IDEA) and services are only available to students who meet specific eligibility criteria. An educational disability must result in an educational impact and is decided by a team that includes SLPs. Private speech-language pathology services are also available using a fee for service model decided by individual service providers. As parents and some educators may desire free services for students under IDEA, there is pressure to identify students as disabled who do not meet eligibility criteria. Misidentification due to cultural or linguistic differences also occurs. There are potential negative consequences to inappropriate disability identification such as: segregation from typically developing peers, violating the child’s rights with decreased expectations or limited educational opportunities, increased caseloads for SLPs resulting in recruitment and retention issues, and violation of state and federal regulations. While service options exist outside of IDEA, inconsistency in evaluation practices and eligibility decision-making has been documented and creates tensions for families, educators, and SLPs.
This thesis presents work for a PhD by Prior Publication to explore and describe evaluation and eligibility of students with communication disorders in U.S. public schools using quantitative and qualitative research and publications (presented as chapters) over the span of a career drawn together through an exegesis. Part 1 includes 7 chapters and provides an introduction and literature review that examines the SLPs’ practice patterns and documents the unique requirements for public-school practice in the United States. Chapter 2 reviews public policy and Chapter 3 discusses educational requirements and provides the context of public policy in the United States. A review of evaluation and eligibility requirements under IDEA and research on evaluation practices focusing on students from diverse backgrounds, test accuracy, and state differences are included in Chapter 4. Clarification regarding regulations, guidance and information to support understanding of guidelines and severity rating tools used by states as they implement IDEA is presented in Chapter 5. Options for services to support students with language differences, not disorders, outside of IDEA are detailed in Chapter 6. Chapter 7 integrates research and policy in the United States and addresses the implementation of research on children with speech sound disorders in the context of IDEA.
Part 2 includes six chapters and addresses the complex activity system involving team decision-making regarding evaluation and eligibility for speech-language pathology services in U.S. schools. Chapter 8 presents the theoretical framework that was used as the unifying approach to this thesis and for the study reported in Chapter 9. The chosen theoretical framework, Cultural-Historical Activity Theory (CHAT) by Engström (1987, 2015), was used to explain the complex activity system of speech-language pathology services in U.S. schools. Chapter 9 investigates the team decision-making activity system for determining student eligibility for speech or language services in U.S. schools and documents nine major tensions related to the team decision-making activity system. Chapters 10, 11, and 12 document SLPs’ use of evidence-based practices and language sample analysis techniques.
Variations in evaluation and eligibility decision-making often are attributed to the SLP, rather than the team decision-making system. The impact of differences in state and local regulations and policy, input from other members of the team, and variations in requirements for use of specific tools for evaluation were identified. Knowledge of the individual elements within the team decision-making activity system and the interactions and tensions that arise between elements may assist in understanding practice patterns of SLPs in U.S. schools. There are common tensions experienced by school SLPs regarding evaluation and eligibility of students. Using the CHAT framework enables acknowledgment of the interplay of elements within the broader activity system (beyond the SLP) and promotes the importance of teamwork and advocacy by SLPs at the local, state and national level.
Inconsistency and tensions in school team decision-making are well documented in the research literature. Once identified, information on inconsistency and tensions can be used to develop strategies to improve practice. The findings identify needs and solutions to strengthen school teams’ and SLPs’ knowledge of the regulations, research, and advocacy to address challenges in the school setting. Use of evidence-based practices for evaluation and compliance with IDEA regulations for data collection and decision making will reduce mis- and overidentification and protect students’ civil rights. Improving consistency by school decision-making teams will enable all students to receive quality evaluations and appropriate decision-making regardless of where they live or attend school. Consistency in evaluation and eligibility processes is essential to advance SLPs’ professional practice and build or maintain trust between families, students, and public-school professionals across the United States.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Charles Sturt University
  • McLeod, Sharynne, Principal Supervisor
  • Verdon, Sarah, Co-Supervisor
  • Crowe, Kate, Co-Supervisor
Place of PublicationAustralia
Publication statusPublished - 2024


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