Behavior and the SLP — Enough is Enough

At what point can the SLP say "enough is enough". This student's behavior difficulties are not because of their communication.

“Ms. C, please report to room 10! Ms. C, please report to room 10!”

This was not a call for me to report to a meeting after school. This was not an urgent telephone call. This was an interruption to my therapy session to go help with a behavior blow out in room 10. And why would the speech pathologist be interrupted from therapy to deal with a child destroying a room? Because I was his case manager. So then you naturally then assume that the behavior was a manifestation of the child’s disability. But what if I told you that the child in question was seeing me for /r/ sounds, or for fluency, or for irregular grammar. Now what are your thoughts?

I know many SLPs have this dilemma. Thankfully, I am no longer ever called out of therapy groups and have a lot more support than I did when I started working at my school. But there are still many unanswered questions in regards to SLPs and behavior. At what point can an SLP put down her foot and say, “Enough is enough! This child’s behavior is not due to their communication disorder.”

If I were in charge of the special education world, here are the questions I would always ask before putting the SLP in charge:

What is the child’s communication disorder?
I realize that some students with articulation difficulties may have behaviors out of frustration that no one understands them, or because they are being teased. I think it is pretty safe to assume that minor or one sound articulation errors are not directly correlated with significant behavior difficulties.

On the other hand, a child with autism or other social pragmatic difficulties may be demonstrating behavior challenges because of their communication disabilities. Likewise, a young child with apraxia that is not understood at all, may also react with strong behaviors when they are unable to communicate.

How often does the speech pathologist work with the child?
In my district, the policy is that the IEP case manager is selected by the child’s primary eligibility. This means that if a child works for 30 minutes a week with the SLP because of an expressive language disorder, but 300 minutes per week with the special education teacher because of how that language disorder impacts her reading… the SLP is still the case manager. The logic in this still completely puzzles me. I once had a child that I only served 30 minutes per MONTH and was seen for 90 minutes per day by the special education teacher. And yet because another school had labeled him as having a communication disorder, I had to facilitate weekly behavior meetings and FBAs.

If, however, the SLP works with the child on a very regular basis and understands his/her behaviors well, then they are a great person to be in charge of the child’s behavior management. I have one non-verbal student that I work with daily. Although I am not her case manager, I routinely step in and fill the role of behavior problem solver for her because I know her better than the other specialists.

Who would be the most appropriate person to manage the behaviors?
In an ideal world, there would be a behavior specialist at every school working with students with and without IEPs. But let’s face it, that is not the reality for most. For every child with significant behavior difficulties, the team should really ask not “what is the rule for who case manages this kid?”, but instead “who would help this student most with their behavior?” It may be that the special education teacher works with the student often, and they would be the best one to work on behavior. Possibly, the school counselor or psychologist should be the one calling the behavior meetings and creating the FBAs. This decision should be based on skill level and knowledge of the student, not just the primary eligibility.

But maybe the SLP is highly skilled in behavior management based on their years of working with students with communication based behaviors? And maybe they are amazing at creating visuals and reinforcement systems? Possibly they are even in the building every day and can check in every morning with the student. In these cases, it is appropriate for the SLP to be managing the behaviors.

When will the student be graduating from speech?
I’ve heard it said that everything was under control because the SLP was helping little Billy with his behaviors. They were creating point cards, sensory breaks, behavior plans, and meeting weekly with the teacher and parent. And then… Billy masters his /r/ sounds and no longer qualified for speech. And we’re back to the drawing board. The team needs to consider that if the child is eligible because of a communication disorder, they may graduate. They may even graduate soon. What will happen then?

 

Is this an issue in your district as well? At what point do we SLPs yell out, “Enough is enough!”

 

This post is part of a series entitled “Behavior and the SLP”. To see all of the posts in this series click here.

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7 Comments

  1. Marla Bailey says:

    In our school district in Utah, if a student is in resource for reading the case manager is always the resource teacher. The classification would have to be something other than SLI for them to even have resource reading and I am on the IEP as a related service provider, regardless of language impacting reading. In other words resource services trumps speech/language service for case manager on the file.

    1. You are lucky!!

    2. that makes a lot of sense. Here we have a lot of kids with “communication with add on services”

  2. The way your school district handles that DOES seem baffling. Our school district (and most of them like it in Kansas), the predominant service-provider (not just by label) is the case manager. Most often, that is the Resource Teacher. They spend an inordinately larger amount of time with X-student than the SLP in a given day/week or month. Therefore, it makes the most sense for that person to hold case-management responsibilities.

    It’s a team, and I help when/where I can (eg. parent scheduling, making sure my part of the paperwork is done and proofing others as I can, etc.)

    1. that makes so much more sense!!!

  3. In my district, the case manager is determined by the primary category of eligibility. Children identified as speech language impaired will not be eligible for services with a resource teacher.
    On this subject, I find pragmatics tricky. I’ve had several high functioning AU kids at our school & children with other mental and behavioral diagnoses that don’t have a deficit of understanding but have trouble self regulating or don’t really have empathy. They can explain another’s point of view they choose not to consider it. To me this is not a pragmatics deficit, it’s a behavioral or mental health issue. I wondered if anyone else has dealt with this.

    1. I have had many kids like that. Even kids that I know have ASD and can tell me exactly what others are thinking, what they should do, etc. It has been quite a challenge for me as well!!

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