School SLPs vs. Private SLPs: Do They Really Target Different Oral Language Goals?

Recently I was in an IEP meeting for an elementary-aged student. During the meeting, I raised concerns regarding several non-evidenced-based oral language goals for the student and suggested modifying them to meet the student’s extensive academic needs better. To my surprise several IEP team members pushed back, emphasizing the supposed differences between school and private therapy. While there are certainly distinctions between these settings, particularly regarding the scope of services related to literacy, it is essential to recognize that both school and private SLPs are responsible for creating functional, evidence-based oral language goals that support the student’s real-world communication needs.

Key differences in what private and school-based SLPs can address with respect to literacy:

• Private SLPs often have the flexibility to provide direct intervention for reading and writing disorders, working explicitly on decoding, reading comprehension, spelling, and written expression.
• School-based SLPs may often be restricted from directly treating reading and writing in some states and/or districts, depending on their role and how their state interprets SLP involvement in literacy. Their primary responsibility is to support language skills that impact academic success.

However, when it comes to oral language, both private and school-based SLPs are expected to establish evidence-based, functional goals that address the student’s ability to communicate effectively in academic settings.

Functional speech-language goals are relevant to the student’s communication needs and facilitate their participation in learning and social interactions whether in or out of school. In contrast, non-functional goals focus on isolated skills that lack meaningful application for the student in ANY setting.

Examples of Non-Functional Language Goals:

• Student will increase auditory memory by repeating nonwords
• Student will follow multi-step directions of increased length and complexity with embedded concepts
• Student will repeat sentences of increased length and complexity
• Student will rapidly name words based on semantic categories/beginning with a particular letter, etc.
• Student will listen to orally presented stories and answer listening comprehension questions.

These goals lack functionality because they focus on isolated skills without clear connections to the student’s real-world needs or communication contexts. Auditory memory tasks, such as repeating nonwords, will not translate into meaningful communication skills for daily life. Similarly, following multi-step directions or repeating increasingly complex sentences, while important for assessment purposes, is not directly tied to someone’s ability to effectively speak, read, write, interact with peers, express needs, or engage in social contexts. Rapid naming tasks, which assess processing speed, do not reflect functional communication treatment goals, as nothing will come of them if they are repeatedly done in therapy. Finally, listening comprehension goals that focus solely on answering questions about presented stories overload the student’s already restricted cognitive capacity resulting in highly limited retention of information. By repetitively following the above goals in therapy sessions, the students will merely memorize select information but that information will never effectively generalize to functional academic outcomes. In other words, students will be able to execute these particular tasks in isolation during therapy time but as time passes they will forget that information very quickly and not become better listeners, speakers, readers, and writers because the above goals are non-functional in the least.

What makes language intervention for school-aged children functional?

According to studies, intervention with school-aged students should be contextually based and educationally relevant (Whitmire, 2002). SLPs must target academic language goals that will produce “robust and generalizable impact on educational outcomes” (Kelley & Spencer 2021, p. 102). Targeting academic language in intervention “produces meaningful effects on academic performance” (Kelley & Spencer 2021, p. 102) Instead of focusing only on short-term, situation-specific isolated intervention session skills, EBP interventions aim to accomplish long-term, situation-independent, generalizable skills learning (Kamhi, 2014). Furthermore, targeting language in meaningful contexts increases saliency and allows the students to better integrate new information with what they already know (background knowledge), which in turn promotes deeper vs. shallow knowledge and greater retention of information (Gillam, Gillam, & Reece, 2012).

So what skills can we meaningfully measure in language therapy? What is worth functionally measuring and what is best left alone?

We can effectively measure contextual expressive language output (vocabulary breadth and depth, semantic flexibility skills, etc.), syntax and grammar, pragmatic strengths and weaknesses (comprehension of irony and sarcasm, perspective taking, etc.), as well as story grammar elements knowledge and use (narratives), just to name a few measurable skills. Targeting these areas will functionally result in improved academic gains.

What is not recommended to be measured?

Anything related to receptive language and listening skills. For example, it is not functional to read a story to the student and then ask the student questions without any visual support. This will create a very quick cognitive overload situation and will not result in functional carryover of outcomes. Research indicates that therapy with a focus on standalone listening comprehension goals such as following directions, repeating words and sentences, as well as answering listening comprehension questions without the benefit of visual or written support will not functionally carry over into either therapeutic or academic language gains (Rinaldi et al, 2021). That is because poor listening comprehension occurs secondary to oral language deficits in the areas of (including but not limited to) vocabulary knowledge, background knowledge, inferencing abilities, as well as syntactic, morphological, and lexical deficits in comprehending the presented information. These abilities will functionally improve in the context of contextualized language therapy focused on measurable oral language and literacy goals. Hence, it is much better to use a picture book, a video, or have the student read themselves if they can. This will result in far more functional information delivery and allow the student to effectively use visual support to answer questions, define vocabulary, etc.

So how can parents ensure that their children have functional oral language therapy goals? For starters, they can ask questions regarding goal functionality. Here are some questions that could help guide the conversations:

1. How do these goals relate to my child’s real-life communication needs?
   • Parents should inquire whether the goals are focused on communication skills that will help their child function successfully both in the classroom and in social settings outside of school.
2. Will these goals help my child participate in classroom activities and social interactions?
   • Ask if the goals will allow the child to interact meaningfully with peers and teachers, addressing specific barriers to participation (e.g., challenges with conversation, following classroom instructions, or expressing themselves in writing).
3. Are the goals measurable and tied to academic outcomes?
   • Parents should check if the goals can be tracked with clear, measurable benchmarks that will demonstrate progress in academic settings. For example, improving vocabulary comprehension or using specific grammatical structures in writing or speech.
4. How will progress on these goals translate into improvements in my child’s academic performance?
   • Ask how the therapy goals will lead to academic success, such as improving reading comprehension, writing, or speaking in a way that supports learning across subjects.
5. Are the goals based on evidence-based practices (EBPs)?
   • Parents can inquire whether the therapy methods used to reach the goals are supported by research, ensuring they are aligned with effective, proven strategies for language development.
6. How will these goals help my child apply language skills in different contexts?
   • Ask how the goals will generalize to different settings, not just during therapy sessions, but also in class, social interactions, or daily life situations.
7. Do these goals address my child’s strengths and needs in a balanced way?
   • It’s important to ask whether the goals focus on both areas of challenge and areas where the child shows strengths, promoting a holistic approach to language development.
8. Are the goals age-appropriate and aligned with my child’s developmental level?
   • Parents can check whether the goals are suitable for the child’s age and developmental stage. For example, goals should align with their grade level in terms of the complexity of language tasks (e.g., understanding figurative language, expressing complex ideas).
9. How do these goals integrate with other aspects of the IEP (e.g., social skills, emotional support)?
   • It’s useful to ask how the language goals work together with other aspects of the IEP to ensure that the child’s social, emotional, and cognitive needs are all being addressed in a comprehensive way.
10. How will the goals be adjusted if my child does not make progress?

• Parents should ask about the plan for revisiting and revising goals if the child does not show the expected progress. This will help ensure flexibility in the approach to meet the child’s evolving needs.

11. How often will my child be assessed on these goals, and how will the results be shared with me?

• Ask how frequently the child’s progress will be measured and communicated to parents. Regular updates ensure parents are involved in the process and can advocate for necessary adjustments.

By asking these questions, parents can ensure that the goals outlined in the IEP are not only focused on measurable outcomes but also truly functional in supporting the child’s success in both academic and real-world communication.

In conclusion, as part of the IEP team both parents and school professionals as a cohesive whole should:

1. Advocate for Contextualized Goals: Develop goals that target the child’s communication needs in real-world settings. This means focusing on how the child communicates in academic, social, and everyday contexts, rather than abstract or isolated tasks. For example, instead of goals like “repeat nonwords” or “follow complex directions,” aim for goals that promote real communication, such as expressing ideas clearly in academic discussions or using appropriate social language in peer interactions.
2. Prioritize Evidence-Based Practices (EBPs): Rely on research-backed methods for improving oral language. This includes targeting skills that contribute to academic success, such as vocabulary development, sentence structure, and comprehension in a meaningful context (e.g., through storytelling, reading, or interactive activities). The goal should be for the child to use these skills across settings.
3. Focus on Generalization: Functional goals should not just be about performing well during therapy sessions but should also emphasize the ability to use language effectively in various environments. Goals should be designed to help the child transfer what they learn in therapy to real-life situations, such as participating in class discussions, understanding complex instructions, and interacting socially.
4. Incorporate Visual and Written Supports: Given that poor listening comprehension can often be linked to oral language deficits, the team can advocate for the use of visual aids, books, or videos during therapy. This supports the child’s understanding and retention of information. For example, rather than just answering listening comprehension questions after a story is read aloud, encourage therapy strategies that incorporate both visual and auditory supports.
5. Set Measurable and Functional Targets: Ensure that therapy goals are measurable, focused on areas that can realistically lead to academic improvement. These include vocabulary expansion, understanding complex grammar and syntax, as well as pragmatic skills like understanding sarcasm, perspective-taking, and using language appropriately in social contexts.
6. Evaluate the Relevance of Goals: Ensure that goals are specifically tied to the child’s needs. If a goal doesn’t contribute to the child’s functional communication abilities or academic progress, it may be worth re-evaluating. For instance, goals focused solely on repeating sentences or naming items rapidly may not support real communication growth, while goals centered around understanding and applying language in context will yield more meaningful benefits.

By advocating for and supporting these strategies, the IEP team can help ensure that the student receives functional, evidence-based language therapy goals that support their academic success and overall communication abilities in everyday life.

References:

1. Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: Results of an early efficacy study. Language, Speech, and Hearing Services in Schools, 43, 276–291.
2. Jensen de López, K. M., Kraljević, J. K., & Struntze, E. L. B. (2022). Efficacy, model of delivery, intensity, and targets of pragmatic interventions for children with developmental language disorder: A systematic review. International Journal of Language & Communication Disorders, 57(4), 764-781.
3. Kamhi, A. (2014). Improving clinical practices for children with language and learning disorders.  Language, Speech, and Hearing Services in Schools, 45(2), 92-103.
4. Kelley, E.S., & Spencer, T.D. (2021). Feasible and Effective Language Intervention Strategies that Accelerate Students’ Academic Achievement. Seminars in speech and language, 42 2, 101-116 .
5. McGregor, K. K. (2020). How we fail children with developmental language disorder. Language, Speech, and Hearing Services in Schools, 51(4), 981-992.
6. Rinaldi, S., et al, (2021). Efficacy of the treatment of developmental language disorder: A systematic review. Brain Sciences. 11(3), 407
7. Whitmire K. (2002) The Evolution of School-Based Speech-Language Services: A Half Century of Change and a New Century of Practice. Communication Disorders Quarterly. 23(2):68-76