by Rend Al-Mondhiry
ASHA's state advocacy team recently worked closely with the Rhode Island Speech-Language-Hearing Association (RISHA) after the state's Board of Regents proposed new special education regulations that would curtail the provision of speech-language pathology services in schools. The collaboration is part of the state advocacy team's new state outreach model, which is designed to improve communication between state speech-language-hearing associations and ASHA, and to provide direct assistance to state associations with immediate legislative or regulatory needs.
Despite RISHA and ASHA efforts, the Rhode Island Board of Regents adopted new regulations that will restrict the availability of speech-language pathology services for some children with disabilities. Scheduled for implementation by July 1, the new regulations are intended to bring the state into compliance with federal mandates required under the Individuals with Disabilities Education Improvement Act of 2004.
Opposition
After contacting other state associations and reviewing special education regulations throughout the country, ASHA staff met with members of the RISHA board and submitted comments to the Board of Regents in opposition to the regulations.
ASHA strongly opposes regulations that would define speech-language pathology and audiology services as related services only. In support of ASHA's position, Alexa Posny, former director of the Office of Special Education Programs at the U.S. Department of Education, stated in a letter to ASHA that, "whether a speech and language impairment adversely affects the child's educational performance must be determined on a case-by-case basis, depending on the unique needs of a particular child and not based only on discrepancies in age or grade performance..."
In addition, setting such a precedent may create severe problems for the children—and their families—who would no longer qualify for speech, language, and hearing services, and may prompt legal action by parents.
In the final Rhode Island regulations, the definition of "special education" includes "speech-language pathology services for students through 8 years of age (up to the child's 9th birthday)." Therefore, after age 9, children would no longer be eligible for stand-alone speech-language pathology services.
The Rhode Island regulations define speech-language services for children ages 9 and up as a "related service," meaning that speech-language treatment must be attached to an existing individualized education plan (IEP). Consequently, speech-language pathology and audiology services cannot be provided as a stand-alone service to children whose primary disability is speech or language-related. Only those children with speech impairment in addition to another disability can receive speech-language pathology and audiology services (as a service "related" to the primary disability).
The changes will drastically reduce the delivery of speech, language, and audiology services in schools to children with primary disorders of articulation, fluency, voice, language deficits related to hearing loss, and singular language deficits. In addition, providing speech and language services only as "related" services may significantly reduce Medicaid reimbursement to schools.
Unique Definition
No other states have proposed or adopted regulations that would limit the provision of speech-language pathology and audiology services to related services only. In fact, other state regulations either include the services under the definition of "special education" or define special education broadly enough to encompass these services.
The proposed regulations were made available for public comment by the Rhode Island Board of Regents on Sept. 27, 2007, and at four public hearings and four work sessions. RISHA board members, speech-language pathologists, and parents attended the hearings—approximately 400 at the first hearing alone—to oppose the proposed rules.
Following the example of RISHA, state associations are encouraged to alert members, promote attendance at public hearings, and encourage members, parents, and families to testify on the severe impact of limited speech-language and audiology services in schools.
Rend Al-Mondhiry, director of state and regulatory advocacy, can be reached at ral-mondhiry@asha.org or 301-296-5665.