Speech, Language, and Hearing Treatment - The type and level of treatment services are a direct outcome of the assessment.

Assessment - Assessment refers to the process of determining the need, nature, frequency, and duration of treatment; deciding the needed coordination with others involved, and documenting these activities.

Evaluation - The speech, language, and hearing evaluation includes the assessment of articulation and language (receptive, expressive; form, content, and use) as measured by a standardized/norm-based instrument (i.e., criterion-referenced measures including clinical observations). The evaluation may also include an assessment of oral motor functioning (oro-pharyngeal function), voice quality and speech fluency.  Results of the evaluation may identify a significant delay or disorder in one or more of the following areas:

• Articulation skills
• Speech fluency
• Oral motor/feeding
• Voice quality
• Hearing
• Language

Direct Service - Includes treatment, support and rehabilitation services to ameliorate:

Articulation - Articulation disorders (misarticulated phonemes) with stimulability of at least two phonemes and decreased intelligibility of conversational speech.

Fluency - Speech dysfluencies, and to ameliorate a child's struggle with behavior and concerns about his/her dysfluencies.

Voice - Voice pathology and/or abnormality of vocal quality, pitch or volume.

Language - Improve a child's language skills which fall outside averages ranges, and exhibit significant weakness in a single area such as auditory memory or vocabulary.

Auditory Training - Sound discrimination tasks (in quiet noise), sound awareness, sound localization, support services for hearing aid use/wear.

Audiologist Treatment - Support and rehabilitation services to hearing impaired children and their families, including ongoing assessment of hearing aid function, adjustment/modification of hearing aids, repair of hearing, aids, recommendation for new hearing aids, counseling to child and parents regarding proper care and use of amplification.

Case Consultation - The role of consultation is monitoring, supervising, teaching and training of professionals, paraprofessionals, parents and student in the educational environment, home and/or community environment.  (Reimbursable as a treatment service for the time of the therapist only and pertain specifically and completely to an individual student.)  Case consultation includes:

• Providing general information about a specific student's handicapping condition
• Teaching special skills necessary for proper care of specific student's hearing aid
• Development/maintenance/demonstrating use and care of adaptive/assistive devices for a specific student
• Recommendations for enhancing a specific student's performance in education environments.

Billable Service Procedures - In accordance to 4.2.2.3 of the School-Based Health Services Policy Manual, the following service procedures are included for reimbursement purposes: Speech, language, and hearing assessment

• Speech, language and hearing assessment
• Individual speech and language therapy - one therapist to one student
• Individual hearing therapy - one therapist to one student
• Group speech and language therapy - one therapist to five or fewer students
• Individual speech and language co-treatment therapy - tow therapists to one student
• Individual hearing co-treatment therapy - two therapists to one student
• Group speech/language co-treatment therapy - two therapists to five or fewer students
• Services may be reported by student name, type, three-point date, and therapist signature - units are no longer required.

Treatment Plan Requirements - An assessment and treatment plan are required annually.  The treatment plan must be based on an evaluation of the speech, language, hearing and/or audiologist therapist.  Further, the treatment plan must indicate goals/objectives and level of service (type and frequency of service).

• A progress note is required approximately every six months or at a reasonable interval to document the student's progress and the continuing need for service. Quarterly progress reporting in IEP Plus is acceptable when dated and signed by the provider.
  • Indicate where the student is in relation to the treatment plan goals
  • Indicate if the treatment plan requires changes in the goals and/or objectives and
  • Indicate if the type or frequency of the treatment requires modification

Authorized Personnel - Speech, language, and hearing services, when provided by the State of Delaware, licensed speech-language pathologist, or a licensed audiologist holding a Certificate of Clinical Competence in Speech-Language Pathology.

At a minimum, the records must contain the following on each client for any related service:

• Full assessment(s) in the appropriate discipline area(s) with pertinent documentation such as tests, evaluations, and diagnosis (updated at least every 3 years), and an annual reassessment documented in a written format including narrative information summarizing the child's status and the continuing need for treatment.
• A treatment plan (IEP) prepared by the respective therapist(s) that describes the goals/objectives and level of service(s) (i.e., type and frequency of service) needed. The treatment plan is required annually and must be signed by the provider.
• A progress note is required approximately every six months or at a reasonable interval to document the student's progress and the continuing need for service. Quarterly progress reporting in IEP Plus is acceptable when dated and signed by the provider. A progress note should:
  • Indicate where the student is in relation to the treatment plan goals
  • Indicate if the treatment plan requires changes in the goals and/or objectives and
  • Indicate if the type or frequency of the treatment requires modification.
  • Each occurrence of the student's service, including the date (three-point), type, length, and scope of professional services provided.
  • Any significant contacts made in relation to the student.
  • All records must contain the full signature of the professional providing the services and/or supervision.