Is it really “speech only?”

What is a multidisciplinary evaluation?

A multidisciplinary evaluation is a team evaluation involving several disciplines and method of gathering information to capture a better picture of the whole child. No child is just their reading ability, just their speech development, just their behavior. A multidisciplinary evaluation strives to see how strengths and challenges in all areas influence each other to determine a child’s ability in a given environment. Disciplines involved in a multidisciplinary evaluation might include: Speech Language Pathologist, Occupational Therapist, Physical Therapist, Special Educator, School Psychologist, School Adjustment Counselor, etc.

Conversely, a “speech only” evaluation would only look at a child’s speech and language skills.

The Problem with The Speech Only Evaluation

Consider Scarborough’s Reading Rope analogy. Skilled reading is a rope made of many component skills woven together. The two main components are word recognition (phonological awareness, decoding, and sight recognition) and language comprehension (background knowledge, vocabulary, syntax, semantics, verbal reasoning, and literacy knowledge). Viewing this model, you can see that written language, including reading and writing, are really just skills on the continuum of speech and language development. Only assessing a child’s speech language skills and not evaluating or at the very least monitoring their literacy development is a huge omission in their development as a learner.

Now, not every child with a speech-language disorder will experience challenges with literacy development. So, how do we know when to advocate for more than just a speech-language evaluation? We can turn to the research to support our decision for when to refer our “speech only” students.

Speech Sound Disorders & Reading Disabilities

Jin et al. (2020) found poor speech intelligibility in preschool nearly doubled a child’s likelihood of reading disability at age 8. Their research indicated predictive factors of which children may develop a reading impairment included concomitant language impairment, family history of reading or language disability, SES, and being female.

Several studies have found that approximately 25% of children receiving speech therapy for a Speech Sound Disorder meet the criteria to be at risk for a reading disability (Tambryraja et al., 2020). Furthermore, of those children identified as at-risk for a reading disorder, a statistically small percent made improvement with speech therapy alone over the course of one school year.

Language Impairment & Reading Disabilities

McArthur et al. (2000) found that greater than 50% of students identified with Specific Language Impairment met the criteria for reading disability.

Murphy et. al. (2016) concluded that the risk for reading difficulty in children with language impairments can be reliably determined in preschool. They identified poor alphabet knowledge, phonological awareness, name writing, and oral language abilities as the key predictors of later literacy development. These differences in ability were present before any formal reading instruction.

The Bottom Line

Children with language impairments and speech sound disorders are at greater risk for reading disabilities. Even more so for those students with both language impairment and speech sound disorder. Understanding this risk is important for early identification, especially since children who enter school with reading difficulties are very likely to remain on that path!


Gosse, C. S., Hoffman, L. M., & Invernizzi, M. A. (2012). Overlap in speech-language and reading services for kindergartners and first graders.

Jin, F., Schjølberg, S., Eadie, P., Nes, R. B., & Røysamb, E. (2020). Preschool Speech Intelligibility and 8-Year Literacy: A Moderated Mediation Analysis. Journal of Speech, Language, and Hearing Research63(10), 3380-3391.

McArthur, G. M., Hogben, J. H., Edwards, V. T., Heath, S. M., & Mengler, E. D. (2000). On the “specifics” of specific reading disability and specific language impairment. The Journal of Child Psychology and Psychiatry and Allied Disciplines41(7), 869-874.

Murphy, K. A., Justice, L. M., O’Connell, A. A., Pentimonti, J. M., & Kaderavek, J. N. (2016). Understanding risk for reading difficulties in children with language impairment. Journal of Speech, Language, and Hearing Research59(6), 1436-1447.

Tambyraja, S. R., Farquharson, K., & Justice, L. (2020). Reading risk in children with speech sound disorder: Prevalence, persistence, and predictors. Journal of Speech, Language, and Hearing Research63(11), 3714-3726.

Thanks for reading!

Summer 2021 Continuing Education Opportunities for SLPs

I hope that we spend most of this summer relaxing, but it is a great time to earn some CEUs or build up knowledge in an area of growth. Here is a list of current summer 2021 continuing education opportunities for SLPs.

AAC in the Cloud

AAC in the Cloud is a massive free online conference focused on spreading the knowledge of best practices in AAC so families, teaching staff, practitioners and AAC users themselves can learn and improve. AAC in the Cloud just concluded on June 24, 2021, but all of the sessions are available hosted through YouTube. Best of all, past AAC in the Cloud conference sessions are also available.

Click here to check out the AAC in the Cloud schedule.

From Speech to Print: The Role of the SLP for Literacy – Free Course from

As SLPs, we often question our role for students with literacy issues including dyslexia. Each domain of language plays a vital role to move from speaking and listening to reading and writing. This session concentrates on morphology, phonology, and syntax. Evidence-based practices and specific strategies are provided that link speaking and listening with reading and writing.

This webinar is available for .1 ASHA CEU with ASHA reporting included. Click here to check it out.

If you are not a member already you can take one free course on using promo code 1FREECourse.

Presence Learning

Building Better Readers Through Early Collaborative Partnerships is a one-hour webinar available on-demand on Presence Learning.

Description: Progress in creating literate learners is the cornerstone of education and a high-stakes yardstick by which academic performance is measured. Silos of school-based services are how we’ve traditionally helped students with special needs who are at-risk for reading failure. But now, there’s a new collaborative and results-oriented approach: parents and educators working together to provide individual early reading experiences that develop literacy skills for every learner. During this webinar, we’ll explore why, how, and what we read in shared reading interactions with young children and how to develop critical foundation skills for reading success. You’ll see examples of books, techniques, and practical ways to help young learners succeed.

Click here to check it out.

Leaders Project

The Leaders Project offers self-study courses for 0.5 ASHA CEUs. Current topic offerings include Grammar Fundamentals for a Pluralistic Society, Differential Diagnosis in Preschool Evaluations: A Case Study, Disorder, Difference, or Gap?: A School-Age Disability Evaluation, Culturally and Linguistically Appropriate EI Evaluations, and Evaluation and Treatment of Speech Impairments Due to Cleft Palate.

Check them out here.

Pearson Assessments

Check out the webinars available by Pearson to help improve your assessment skills. Click here to check it out.

Ethical Decision-Making: A Public Health Emergency and Unprecedented Challenges by Theresa H. Rodgers, MA, CCC-SLP, ASHA Fellow

Course Description: Response to the COVID-19 pandemic evolved rapidly with the public health emergency forcing speech-language pathologists to change the very manner in which services are delivered. Regulatory agencies and professional organizations provided needed guidance including information on changes to long-standing professional practice standards precipitated by the pandemic. Personal protective equipment (PPE), billing and reimbursement, informed consent, supervision, telepractice, confidentiality, and Individualized Education Plan (IEP) compliance are some of the topics which presented dilemmas and potentially ethical challenges for speech-language pathology professionals. This session will highlight information on these topics including scenarios that will be analyzed and deliberated by participants.

Available for .1 ASHA CEU. Click here to check it out.

Power Up SLP Literacy Conference August 5-6, 2021

The Lavi Institute is offering 1.4 live ASHA CEUs or 14 professional development hours sharing the latest EBP clinical tools from the field’s leading experts in literacy. The conference videos are available to watch for free. To receive ASHA reporting you would need to sign up for the Lavi Institute CEU Hub ($125/year), which includes 40 additional pre-recorded webinars available for ASHA CEU Reporting.

Check the conference out here.

SLP Summit July 26 – 29, 2021

Free practical continuing education delivered by SLPs. SLP Summit offers 8 one-hour webinars available live or on-demand for a limited time. The specific webinar lineup has not yet been announced, but the following topics were listed on the website: caseload management, stuttering, family-centered intervention, dynamic assessment, service delivery, AAC, anti-ableist practice, narrative intervention. The webinars are available for free with certificates. ASHA reporting is usually available for an affordable price.

Click here to sign up for updates as more information is released.

Unbelievable Deal: Unlimited CEUs with ASHA Reporting from

If you need to get a lot of high-quality CEUs with ASHA reporting this summer, make sure you check out has over 1148.5 hours of courses with new live and interactive courses being added weekly. Enjoy automatic CEU reporting and a huge variety of courses presented in different formats for a super reasonable yearly cost.

Check out all that has to offer by clicking here.

Let me know if you check out any of these CEU opportunities! Thanks for reading!

Read with Me PD: Drive by Daniel H. Pink

Synopsis: “Most people believe that the best way to motivate is with rewards like money—the carrot-and-stick approach. That’s a mistake, says Daniel H. Pink (author of To Sell Is Human: The Surprising Truth About Motivating Others). In this provocative and persuasive new book, he asserts that the secret to high performance and satisfaction-at work, at school, and at home—is the deeply human need to direct our own lives, to learn and create new things, and to do better by ourselves and our world.

Drawing on four decades of scientific research on human motivation, Pink exposes the mismatch between what science knows and what business does—and how that affects every aspect of life. He examines the three elements of true motivation—autonomy, mastery, and purpose-and offers smart and surprising techniques for putting these into action in a unique book that will change how we think and transform how we live.”

The big focus of Drive is that all people are born curious, intrinsically motivated, and in desire of autonomy. It is the focus on extrinsic rewards that turns us into mice in a maze just seeking out that cube of cheese.

Below are my biggest takeaways as a pediatric SLP from Drive by Daniel H. Pink. If you see something interesting, please check this book out for much more information and specific research studies from which this information is derived.

Extrinsic Motivation: “if, then” reward systems

When an extrinsic reward is offered before a task has even begun, the task is immediately perceived as undesirable. Perceiving a task as undesirable before even attempting it takes away the autonomy of possibly finding joy, interest, or challenge in the task. If you are primed to view the task as undesirable, you are unlikely to meaningfully engage in the activity in the first place and you are less likely to pursue additional opportunities to engage in the task.

Lepper et. al (1973) conducted a study on preschool-age children, who demonstrated a personal preference for drawing. The children were divided into three groups. Group one was promised a reward after the study, group two was given a surprise reward after the study, and group three had no rewards mentioned. All children were asked to draw a picture and then given their reward or not depending on which group they were assigned. The children were then watched over several weeks to see how much they would continue to pursue opportunities to draw. The results of the study indicated that those children promised a reward showed a significant decrease in intrinsic motivation to pursue opportunities to draw. They actually chose to draw half as many times as they did prior to the study.

Several research studies demonstrated that offers of extrinsic reward narrowed the person’s focus, which negatively impacted their productivity, creativity, flexible thinking, and problem solving abilities. Offered a reward, the person simply rushes to reach the end result for the reward, which decreases their opportunity for long term learning and minimizes carryover of skills.

Intrinsic Motivation: “Now that” reward systems

“Now that” rewards are basically naturalistic consequences and specific positive feedback that follow completion of a task. “Now that we finished retelling the story, let’s pick out a new book.” “Now that you finished saying that word, I noticed you kept trying when it was difficult to place your tongue in the correct position to make the /r/ sound.”

In the Lepper et. al (1973) study referenced above, the children who were randomly given a reward after they finished drawing or who were given no reward showed no significant changes to their level of intrinsic motivation.

For “now that” rewards to be successful, they should arise naturally after the task has been completed. The consequence should be something that would naturally follow, like a break or a special interest, rather than a piece of candy or a small trinket. Specific feedback can also serve as a natural consequence. Feedback is most beneficial when it provides specific information about what the child did successfully. (For more information on providing specific feedback, check out this post!)

Have you read Drive by Daniel H. Pink? What were your takeaways?

Thanks for reading!

Professional & Student Learning Goals for SLPs

It is true that every work setting has its pros and cons. It is also true that working in the school setting is not for everyone (according to my advisor in graduate school, schools are where the less ambitious SLPs end up *exasperated sigh*). I personally LOVE working in the schools! What I do not love is being a part of the teacher evaluation process.

I believe it is important to continually be challenged and encouraged to grow in our field. I just wish the evaluation process for SLPs in the school was more specific to our particular area of expertise. Regardless, every October I find myself drafting the perfect professional goals.

When I started in the schools, my CF supervisor told me to set a professional goal that was realistic. Now I know, you are probably thinking that IS what the “R” in SMART stands for, but let me explain further. Realistic meaning, something you are already doing, but just need a little motivation to finalize or fine tune. Professional goal setting season is not the time to plan a lofty over-haul in your speech room. Please, be realistic with yourself!

I know when I started out, I turned to some of my favorite SLP bloggers for ideas. So, I wanted to log my goals here, for future reference and to help others:


Student Learning Goal 

By the end of the 2017-2018 school year, my K-3 students will demonstrate at least moderate growth in using attributes to describe familiar nouns in a structured therapy setting.

  • By the end of September, 2017, I will administer a pre-test to all K-3 students on my caseload with objectives on their IEP pertaining to describing to determine their individual baselines in providing attributes when describing a given noun.
  • Throughout the 2017-2018 school year, I will implement a multi-sensory, systematic method of describing items by attributes. During once or twice weekly language therapy sessions, students will receive direct instruction, guided practice, and independent opportunities to utilize targeted strategies in order to improve their describing skills.
  • By November 17, 2017, I will document student progress towards meeting their describing learning objectives on their progress reports.
  • By March 16, 2018, I will document student progress towards meeting their describing learning objectives on their progress reports.
  • By June 1, 2018, I will administer a post-test to the same set of students to determine their growth in providing attributes when describing a given noun.

Professional Practice Goal

By the end of the 2017-2018 school year, I will build up Tier I speech/language interventions in the kindergarten general education classrooms as part of the Response to Intervention (RTI) model to provide universal support to all students in foundational speech and language skills and improve early identification of students in need of more targeted interventions.

  • In Fall, 2017, I will send out a survey to all of the kindergarten classroom teachers to identify the areas of speech/language development (e.g., following 2 step directions, wh-questions, story re-tell, turn-taking/topic maintenance, phonological awareness, basic concepts, vocabulary, early grammar) in which most of their students will benefit, and which day/time would work best for their schedule.
  • By November 30, 2017, I will collaborate with two kindergarten classroom teachers to plan and implement one universal language lesson in each classroom.
  • By December 7, 2017, I will meet with the kindergarten classroom teachers to evaluate the strengths and weaknesses of the universal language lesson and identify changes that can be made to increase its educational efficacy moving forward.
  • By March 2, 2018, I will collaborate with the kindergarten classroom teachers to plan and implement at least one universal language lesson per classroom during the second term of the school year.
  • By March 9, 2018, I will meet with the kindergarten classroom teachers to evaluate the strengths and weaknesses of the universal language lessons, discuss the impact of the lessons on the students’ speech and language skills, and offer carry-over strategies for the classroom.
  • By May 25, 2018, I will collaborate with the kindergarten classroom teachers to plan and implement at least two universal language lessons per classroom during the third term of the school year.
  • By June 1, 2018, I will meet with all of the kindergarten classroom teachers to evaluate the strengths and weaknesses of the universal language lessons, discuss the impact of the lessons on the students’ speech and language skills, and select topics for the beginning of the 2018-2019 school year.


Student Learning Goal 

By the end of the 2018-2019 school year, my students will demonstrate at least moderate growth in knowledge and understanding of speech/language goals by stating their individualized targets at the end of each session with 80% accuracy in four out of five sessions.

  • At the start of the school year, I will create goal visuals in student-friendly language specific to each student to be displayed in front of the student during sessions as a visual reminder of their speech-language targets. During each therapy session, I will review which goals we will be working on, and then at the end of the session each student will tell what was targeted.
  • After initial familiarization with speech/language targets, I will have each student fill out an individual profile that lists his/her general goal areas and why these areas are important. These will be displayed in the therapy room and reviewed periodically throughout the year as needed.
  • I will have my students working on articulation, phonology, and/or fluency fill out a self-rating scale at the beginning and end of the school year to help them think about why working on speech is important and monitor the emotional impact of these disorder types.
  • I will use progress monitoring checks at least once per trimester to assess student progress with their individual goals. I will review progress individually with each student, and he/she will review their goals and then update their personal goal graph sheet with their progress each trimester.

Professional Practice Goal 

During the current school year, I will increase my collaboration with other school professionals and explore new therapy approaches to help provide the least restrictive environment for my students.

  • At the start of the school year, I will provide packets of information to each teacher, regarding each of their specific students on my caseload, their disorders and goals, and possible academic impact.
  • I will collaborate with at least one general or special education teacher to plan and execute at least one co-taught inclusion lesson or center time in each trimester of the school year.
  • I will collaborate with my IEP students’ classroom teachers to conduct at least one supplementary whole-class or small-group speech/language support lesson in each trimester. We will meet to determine which classrooms would benefit the most, which available times work best with my existing therapy schedule, and which topics would most benefit the students.
  • I will collaborate with the kindergarten teachers to conduct at least two supplementary whole-class speech/language support lessons per kindergarten classroom each trimester. We will meet before and after each lesson to discuss areas of concerns and students in need of more support.
  • I will trial the “5 Minute Articulation” approach with at least 5 different students this year in order to determine if shorter, more frequent sessions are more effective than being pulled out from the classroom for traditional, longer therapy sessions.


Student Learning Goal

By the end of the 2019-2020 school year, my K-3 students will demonstrate moderate growth in the area of following directions by participating in individualized intervention in which evidence-based strategies and targets for following directions are addressed (e.g., defining instructional verbs, expanding concept knowledge, improving sequencing, and developing auditory processing strategies).

  • I will research evidence-based intervention targets and strategies in the skill area of following directions.
  • I will generate a list of common instructional verbs and concepts used in K-3 classrooms to serve as functional targets during language intervention sessions.
  • At the beginning of the school year, I will assess each student’s baseline performance using a pre-test consisting of structured following directions tasks (e.g.,defining instructional verbs; identifying spatial, quantitative, and temporal concepts; sequencing procedural events; and application of auditory processing strategies).
  • By second term, I will provide the classroom teacher of each student with visuals and resources regarding the vocabulary, concepts, and strategies being taught in the language intervention sessions to support generalization.
  • Each trimester, I will assess student progress toward acquisition of all four foundations of following directions (i.e., instructional vocabulary, concept knowledge, sequencing ability, and knowledge of auditory processing strategies).
  • In May 2020, I will administer a post-test consisting of structured following directions tasks (e.g.,defining instructional verbs; identifying spatial, quantitative, and temporal concepts; sequencing procedural events; and application of auditory processing strategies) to assess student progress.

Professional Practice Goal

During the current school year, the speech/language department will improve communication with parents and guardians in order to encourage generalization of speech/language targets to the home and in the community.

  • By October 2019, we will create individual educator pages on the Schools website featuring our contact information and a description of my role.
  • Throughout the school year, we will send home monthly newsletters, which will include current focuses in the therapy room, thematic ideas for supporting positive communication skills at home, and a link to our individual educator page.
  • By mid-year, we will add parent-friendly resources and references to our educator pages providing information about speech/language disorders, accommodations, and classroom impact.
  • By mid-year, we will add home practice ideas for each area of speech-language pathology (i.e., articulation, receptive language, expressive language, fluency) to our educator pages.


Student Learning Goal

By the end of the 2020-2021 school year, my students with phonological IEP objectives will demonstrate moderate growth in the remediation of targeted phonological processes.

  • By September 2020, I will identify students on my caseload who are candidates for a phonological approach to speech sound intervention.
  • By October 2020, I will research two phonological approaches for speech sound intervention (e.g., complexity approach, cycles approach, multiple oppositions, minimal pairs, maximal oppositions, treatment of the empty set, etc.)
  • By November 2020, I will assign the most appropriate phonological approach to each identified student and collect baseline data using a standard articulation probe.
  • Every six weeks, I will assess student progress using their assigned phonological approach by readministering the standard articulation probe.
  • By February 2021, I will provide each identified student a home practice program to support generalization.
  • By June 2021, I will evaluate the effectiveness of the two new phonological approaches to speech sound intervention used during this school year by readministering the standard articulation probe and comparing the identified students’ performance to their performance on the baseline probe.

Professional Practice Goal

During the current school year, the speech/language department will expand knowledge and use of various technology resources and platforms for speech/language therapy in order to adapt and improve quality of intervention.

  • By September 2020, each SLP will complete ten hours of professional development in the area of telepractice.
  • By November 2020, the speech/language department will research five new technology resources and select at least three to implement in speech/language therapy sessions.
  • By March 2021, each SLP will use at least three new technology resources a minumum of three times each in direct or asynchronous speech/language therapy sessions.
  • By June 2021, the speech/language department will evaluate the effectiveness of each technology resource using a five-point scale for student engagement, ease of use, and range of use.

Thanks for reading!