Lewis

1. & Lewis Lewis

2. Program for students with disabilities • Lewis & Lewis has the statewide contract to provide specialist assessments for the DEECD to determine student eligibility for consideration for the PSD categories of: • Intellectual Disability • Severe Language Disorder with Critical Educational Needs • The DEECD’s Resource Coordination Group has the responsibility of reading applications and determining eligibility for the PSD

3. Program for students with disabilitiesReferral Category n = 4750

4. Program for students with disabilities The assessments can be for: • New referrals for currently enrolled students not supported by the PSD (annual round) • Referrals for Prep entry • Transfers from other systems, interstate or overseas (previously funded) • Year 6 (or age equivalent) transition reviews • Time-limited funding reviews

5. Program for students with disabilitiesReferral type

6. Referral issues Pre-referral processes • Due to the increase in inappropriate referrals to Lewis & Lewis in 2011 we are encouraging more rigorous pre-referral information gathering BY SCHOOLS in 2012

7. Referral issues Collecting evidence to support referrals to Lewis & Lewis Schools should endeavour to provide Lewis & Lewis with detailed information regarding the student’s presenting difficulties, and evidence of significant and ongoing learning difficulties.

8. Referral issues The following questions may assist schools when collecting information to support a referral to Lewis & Lewis: • Are the student’s parents aware of any delayed developmental milestones, such as crawling, walking, talking, and toilet training? • Has there been any involvement of early intervention services, external specialists and/or Student Support Services? • Have there been any previous formal assessments administered, and if so, what were the results? • Does the student have any medical conditions, or receive prescribed medication? • Is there a family history of similar problems?

9. Referral issues • Is the student delayed across a range of academic and/or developmental areas (i.e. not just literacy)? • Are there any specific measures of academic performance that may indicate significant delay in comparison with age peers? • Have observations of the student been made in order to make comparisons of his/her daily functioning and social maturity, in comparison with age peers? • Have there been any school interventions, targeted supports, or repeated years?

10. Referral issues Examples of supportive pre-referral information • Milestones • Comparison to peers and/or siblings • NAPLAN results • Academic progress issues across all areas • Early Years screening • Preschool/Early Intervention attendance/ Reports • ESL or refugee background • Previous assessments • Speech Pathology intervention/Reports

11. Referral issues Examples of supportive pre-referral information (cont.) • Family History • Genetic Testing (results) • Pediatrician involvement/Reports • Occupational Therapy/Physiotherapy Report • Agency involvement • Screening Tools eg. K-BIT, Ravens, Peabody • Age appropriate behaviour/self care • Experience of trauma • School attendance • School Interventions/support programs in place

12. Referral issues Things to remember • The DEECD requires 2 years between cognitive assessments (including WPPSI to WISC) and 12 months between language assessments • Vineland should not be older than 12 months • The Vineland is one of the criteria for the diagnosis of intellectual disability. It is an official document and must be completed accurately • Often specific Vineland information is placed into PSD reports • Lewis & Lewis do not keep DEECD files therefore it is important to provide copies of previous assessments.

13. Referral issues Things to remember • Students are unlikely to have an intellectual disability if previous assessments were in the low average to above range. • Literacy or behaviour difficulties in isolation are not necessarily indicative of an intellectual disability • Lewis & Lewis through their contract with the DEECD do not conduct assessments for learning disabilities

14. Referral issues Completion of referral forms • All referral forms are expected to be completed and signed • Before allocation to a psychologist or speech pathologist we will be looking for evidence of ongoing ‘severe difficulties’ • The stronger the evidence provided on the referral forms regarding current presentation the stronger the evidence is for your ENQ • Forms with ‘no’ or ‘n/a’ or ‘fine’ written in questions asking about a students adaptive ability do not support an intellectual disability and in the absence of supporting documentation may be screened out • Do not write ‘refer’ to speech pathology assessment report when discussing language difficulties. Provide specific example of difficulties within the classroom/school environment • At busy times of the year, anything that delays the process will hold up your assessment

15. Referral issues Completion of referral forms – Current Presentation • Social Skills e.g. Interactions with peers and adults, parallel play, friendships, etc. • Behaviour e.g. Specific examples of behaviours such as oppositional behaviour, aggression and violence, withdrawal and isolation, dealing with transitions and change, dealing with failure, need for routine & structure • Receptive & Expressive Language e.g. Echolalia, ability to follow instructions, do they require visual prompts, PECS, visual timetables. Intelligibility of speech, sentence structure, word knowledge, vocabulary, grammar, correct usage of pronouns, word associations, etc.

16. Referral issues Completion of referral forms – Current Presentation • Fine motor e.g. Pencil grip, legibility of writing, ability to colour within lines, use of scissors • Safety e.g. Following rules, leaving school grounds, road safety, close supervision on excursions • Sensory e.g. Hearing and vision difficulties • Self Care e.g. Specific examples of level of support required for toileting, dressing, eating, personal hygiene. Frequency of accidents.

17. Referral issues Completion of referral forms – Current Presentation Strategies and Curriculum Modifications Reading, literacy, numeracy, hand writing interventions. Small group/1:1 supports. Modified curriculum, individual learning plan, behaviour modification plan. Language programs. Use of visual timetables. Modified presentation of material. Aide support

18. Referral issues Completion of parental consent form • It is important that parents are aware of the true purpose of the referral to Lewis & Lewis and the potential outcome of diagnosing their child with a disability

19. Referral issues Vineland - Instructions IMPORTANT: PLEASE READ THIS FIRST • The following guidelines are provided by Lewis & Lewis to assist you to complete this form correctly and to provide an accurate indication of the referred child’s ability. • A referral has been made for this child because it is suspected that he or she may have an intellectual disability. Keep this in mind when scoring each item and always compare their ability to their same age peers. • Begin each section from Item 1. Ignore the ‘Start Ages’ in the left column although consider the age at which a normal child would be able to achieve the item before circling 0, 1 or 2.

20. Referral issues Vineland - Instructions • 0 = Never achieved, 1 = sometimes or partially achieved and 2 = usually achieved. An item should not be scored 1 if the child cannot perform the task independently without assistance. • A response for EACH item MUST be provided. Forms with blank sections have to be returned to you as they cannot be scored. • If you place a tick in the ‘Est’ box, this indicates that the response is estimated NOT established. You are still required to circle 0, 1 or 2. • You do not need to complete the ‘Motor Skills Domain’ sections if the child is over 7 years of age.

21. Referral issues Vineland Although the Vineland is used as a screening tool, scores on the Vineland do not predict scores on an IQ assessment

22. Referral issues FSIQ VS ABC n = 4035 FSIQ ABC

23. Referral issues FSIQ VS ABC FSIQ 55% Eligible 70 70 ABC

24. Referral issues FSIQ VS ABC FSIQ ABC = 117 FSIQ = 117 ABC

25. Referral issues FSIQ VS ABC ABC = 51 FSIQ = 118 FSIQ 19% ABC

26. Severe Language Disorder with Critical Educational Needs 5 Criteria to account for • Language Assessment • Elimination of confounding factors • History and Evidence • Intelligence Testing • Critical Educational Needs

27. Severe Language Disorder with Critical Educational Needs a) A score of three or more standard deviations below the mean for the students age in expressive and/or receptive language skills on two of the recommended tests • 3 Standard Deviations = score of 55 or lower • Language profile must be consistent across two tests eg: Expressive <55 on first test should also be expressive <55 on second test

28. Severe Language Disorder with Critical Educational Needs a) First test Second test First test Second test < 55 < 55 < 55 < 55 EL EL RL RL EL EL RL RL

29. Severe Language Disorder with Critical Educational Needs b) the severity of the disorder cannot be accounted for by hearing impairment, social emotional factors, low intellectual functioning or cultural factors • SLD is considered a pure disorder • Students may be diagnosed with a language disorder but not be eligible for the SLD-CEN program

30. Severe Language Disorder with Critical Educational Needs c) a history and evidence of an ongoing problem with an expectation of continuation during the school years • Early intervention • School programs in place • Specialist reports • Speech pathology involvement

31. Severe Language Disorder with Critical Educational Needs d) A non-verbal score at or above one standard deviation below the mean on one recommended intellectual test, with a statistically significant (P<0.05) difference between the verbal and non verbal functioning > 85 Statistically Significant PIQ/PRI VIQ/VCI

32. Severe Language Disorder with Critical Educational Needs In addition to language difficulties students must also demonstrate critical education needs in order to attract at least level three funding

33. Severe Language Disorder with Critical Educational Needs In order to meet CEN criteria, the student must demonstrate high ratings on several scales listed on the Educational Needs Questionnaire. Supporting evidence can include: • Current descriptive reports from the teacher outlining support or modifications required in specific areas of difficulty such as learning needs, mobility or fine motor skills • Examples of incidences that have or are occurring during the day relating to behaviour or safety concerns

34. Severe Language Disorder with Critical Educational Needs • Support programs (e.g. Psychology intervention for behaviour) and/or Individual Learning Plans currently in place • Details of supervision or assistance the student requires in specific areas such as self care • Current reports from specialists such as Speech Pathologists, Psychologists, Occupational Therapists, Physiotherapists, Medical specialists, Mental Health Workers, Psychiatrists, Audiologists etc

35. Childhood Apraxia of Speech - Dyspraxia • CAS in children may be known by various names: Developmental Verbal Dyspraxia; Verbal Apraxia; Apraxia of Speech; Apraxia • CAS is a childhood speech sound disorder in which children have difficulty programming, sequencing and initiating movements required to make speech sounds. • Although characteristics may overlap, CAS is a motor speech planning disorder and should not be confused with other speech sound disorders. Due to the complexity of its nature diagnosing CAS can be very difficult and requires a very detailed assessment that includes analysing speech movements, sounds, patterns and rhythms

36. SLD – CEN What is Supportive evidence? SPEECH PATHOLOGY • Speech & Language Assessments completed including test scores • Intervention Summary outlining therapy outcomes • For a CAS referral (formal or informal) measures regarding the student’s overall communication difficulties e.g. sound errors, intelligibility ratings, other characteristics which may be consistent with a presenting CAS

37. SLD-CEN Applications n = 165

38. SLD-CEN Applications n = 250

39. Referral Procedure

40. Referrals received per week 2011 500 n = 6517 400 300 200 100 0 Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec

41. STATEWIDE Distribution of IQ scores for students referred for ID assessment- 2011 n = 4570 ...

42. www.lewisandlewis.com.au

43. Main points • Lewis & Lewis is contracted to provide assessment for the categories of ID and SLD-CEN only • To make a referral, call us • When you call, make sure you know the student and their relevant details

44. Main points • Diagnosing a student with a disability is significant • Last year the number of inappropriate referrals increased • This year we are aiming for better screening of referrals

45. Contact Lewis & Lewis 9380 5742 9380 6883 info@lewisandlewis.com.au  www.lewisandlewis.com.au