Stuttering, Stuttering, Employment Employment and the ADAand the ADA

prohibits employment prohibits employment discrimination against discrimination against

qualified individuals with qualified individuals with disabilities.disabilities.

ADA (1990)ADA (1990)

Did not “list” dis-abilities Did not “list” dis-abilities by name as not to limit by name as not to limit

scope of the Act. scope of the Act.

ADA (1990)ADA (1990)

Definition:Definition:1. a physical or mental1. a physical or mental impairment that impairment that substantially limits one substantially limits one or more major life or more major life activities.activities.

““Individual with a Individual with a disability”disability”

2. A record of such an 2. A record of such an impairmentimpairment

3. or is regarded as having 3. or is regarded as having such an impairmentsuch an impairment

““Individual with a Individual with a disability”disability”

StutteringStuttering Fulfills definition of a Fulfills definition of a

““physiological disorderphysiological disorder”” or or ““conditioncondition” that affects the” that affects the

“ “speech organsspeech organs” and that limits ” and that limits an individuals ability to an individuals ability to participate in the “participate in the “majormajor lifelife activityactivity” of “” of “speakingspeaking” and ” and

in some cases “in some cases “workingworking”.”.

Has “disability” Has “disability” if:if:

““regardedregarded”” as having such as having such an impairmentan impairment

Columbus,Ohio Columbus,Ohio vs Liebhartvs Liebhart

History:History:• 10 years part-time auxiliary 10 years part-time auxiliary

firefighterfirefighter• extensive experienceextensive experience• rated as “excellent” by co-workersrated as “excellent” by co-workers• applied for full-time jobapplied for full-time job•denied due to stutter during denied due to stutter during oral examoral exam

Columbus,Ohio Columbus,Ohio vs Liebhartvs Liebhart

History:History:• 10 years part-time auxiliary 10 years part-time auxiliary

firefighterfirefighter• extensive experienceextensive experience• rated as “excellent” by co-workersrated as “excellent” by co-workers• applied for full-time jobapplied for full-time job• denied due to stutter during oral denied due to stutter during oral

examexam•Sued and wonSued and won

ADA applies to:ADA applies to:

•private employers, private employers, •state and local governments, state and local governments, •employment agencies andemployment agencies and •labor unionslabor unions

ADA does not ADA does not apply to:apply to:

•federal government, federal government, includingincluding–military servicesmilitary services

Principle ofPrinciple ofReasonableReasonable

AccommodationAccommodation•May include job May include job “restructuring”“restructuring”

Determining Determining qualifications qualifications

for a jobfor a job2 Steps2 Steps 1. Education, work 1. Education, work

experience, training, experience, training,

skills, licenses, certificates,skills, licenses, certificates,

etc.etc.

Determining Determining qualifications qualifications

for a jobfor a job2 Steps2 Steps 2. Whether individual can perform 2. Whether individual can perform

essentialessential f functionsunctions of the job, with or without a of the job, with or without a

reasonable accommodationreasonable accommodation

Essential functionEssential functionTask that the employees in the Task that the employees in the

position actually do, and position actually do, and removing that task removing that task fundamentally changes the job.fundamentally changes the job.

ADA does not require employers ADA does not require employers to develop or maintain written to develop or maintain written job descriptions.job descriptions.

Free money if you Free money if you stutterstutter

NSP Advocacy NSP Advocacy CommitteeCommittee

Provides informationProvides information will write to employers to educate will write to employers to educate

themthem will work with attorneyswill work with attorneysContactContact

• NSP Advocacy CommitteeNSP Advocacy Committee

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

1. ADA requires some 1. ADA requires some employers to provide employers to provide devices, and then devices, and then reimburses some of these reimburses some of these employers 50%employers 50%

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

2. Telephone companies in 2. Telephone companies in several states provide the several states provide the Desktop Fluency System Desktop Fluency System free to customers free to customers

3. State vocational 3. State vocational rehabilitation programs rehabilitation programs should provide an should provide an electronic device if you’re electronic device if you’re looking for a job.looking for a job.

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

4. IRS allows you to deduct 4. IRS allows you to deduct speech therapy equipment speech therapy equipment on Schedule A, if your total on Schedule A, if your total medical expenses exceed medical expenses exceed 7.5% of your adjusted gross 7.5% of your adjusted gross income.income.

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

5. Federal Supplemental 5. Federal Supplemental Security Income helps low Security Income helps low income children with income children with disabilities. They send you disabilities. They send you a check every month, but a check every month, but don’t pay for devicesdon’t pay for devices

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

6. Health insurance 6. Health insurance programs usually only programs usually only pay for a device if you pay for a device if you have neurogenic have neurogenic stuttering (stroke or head stuttering (stroke or head injury)injury)

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

7. IDEA (Individuals with 7. IDEA (Individuals with Disabilities Education Act) Disabilities Education Act) helps children with helps children with disabilities…ask school disabilities…ask school principal or slpprincipal or slp

Help paying for an anti-Help paying for an anti-stuttering devicestuttering device

IDEAIDEAPresentation at ASHA Convention, 2000Presentation at ASHA Convention, 2000Chamela et alChamela et al

Commitment to improving Commitment to improving quality of services to children quality of services to children with disabilitieswith disabilities

IDEA RegulationsIDEA Regulations Created changes in Created changes in

• who will qualify for speech and language who will qualify for speech and language servicesservices

• how IEP’s are developed andhow IEP’s are developed and• manner in which services will be manner in which services will be

delivereddelivered• qualified children for service based on qualified children for service based on

educational impact (including non-educational impact (including non-academic and extracurricular activities)academic and extracurricular activities)

Specified that clinicians may Specified that clinicians may advocate for preferred practicesadvocate for preferred practices

Included parents as providing input Included parents as providing input into the evaluationinto the evaluation

IDEA EligibiltyIDEA Eligibilty Entrance/exit Entrance/exit

criteria must criteria must coincide with the coincide with the impactimpact that the that the disorder has on disorder has on educational educational performanceperformance

Discrepancies Discrepancies exist among exist among districts/states in districts/states in definitions, definitions, assessment and assessment and eligibility criteriaeligibility criteria

ADVERSE IMPACT IS NOT DEFINED IN THE LEGISLATION

Adverse Educational Adverse Educational Impact (AEI)Impact (AEI)

Cannot be limited to discrepancy in Cannot be limited to discrepancy in age/grade performanceage/grade performance

Must be determined on an individual Must be determined on an individual basisbasis

Includes academic and nonacademic Includes academic and nonacademic areasareas• General curriculum General curriculum • Nonacademic curriculumNonacademic curriculum• Extracurricular activitiesExtracurricular activities

Determining educational Determining educational relevancerelevance

Academic: ability to benefit from Academic: ability to benefit from the curriculumthe curriculum

Social: ability to interact with peers Social: ability to interact with peers and adultsand adults

Vocational: ability to participate in Vocational: ability to participate in vocational activitiesvocational activities

Academic impact Academic impact documented by:documented by:

Academics below grade levelAcademics below grade level Difficulty with language based Difficulty with language based

activitiesactivities Difficulty with auditory Difficulty with auditory

comprehensioncomprehension ****Difficulty communicating ****Difficulty communicating

information orally****information orally****

Social ImpactSocial Impact

Interference with listeners’ Interference with listeners’ understanding***understanding***

Difficulty maintaining or terminating Difficulty maintaining or terminating verbal interactions***verbal interactions***

Student experiences teasing from Student experiences teasing from peers***peers***

Demonstrates fear/embarrassment***Demonstrates fear/embarrassment*** OtherOther

Vocational ImpactVocational Impact

Impact on job related Impact on job related skills/competenciesskills/competencies

Difficult following directionsDifficult following directions Inappropriate commentsInappropriate comments Difficulty asking/answering Difficulty asking/answering

questions***questions*** Other***Other***

IDEA Assessment IDEA Assessment Requirements & StutteringRequirements & Stuttering

Use a variety of tools and strategiesUse a variety of tools and strategies Obtain relevant and functional Obtain relevant and functional

information about the childinformation about the child Information from parents & teachersInformation from parents & teachers No single criterion should be used to No single criterion should be used to

determine eligibilitydetermine eligibility Must include cognitive and affective Must include cognitive and affective

factorsfactors

Assessment Process Assessment Process (Schools)(Schools)

Stage I: Establish that a disorder is Stage I: Establish that a disorder is present without respect to severity or present without respect to severity or impactimpact

Stage II: Determine whether the Stage II: Determine whether the condition has an AEI condition has an AEI

Stage III: Decide whether student Stage III: Decide whether student needs services in order to participate needs services in order to participate appropriately in the general curriculumappropriately in the general curriculum

Review of entrance criteria Review of entrance criteria in 6 statesin 6 states

Found 44 different criteria, falling Found 44 different criteria, falling into one of 6 categoriesinto one of 6 categories• Cognitive: beliefs/perceptionsCognitive: beliefs/perceptions• Affective: emotionsAffective: emotions• Linguistic: linguistic units or behaviorsLinguistic: linguistic units or behaviors• Motor: form, frequency, duration, Motor: form, frequency, duration,

accessory behaviorsaccessory behaviors• Social: AEISocial: AEI• Other: age, chronicity, history etc.Other: age, chronicity, history etc.

RECOMMENDATIONSRECOMMENDATIONS

ENTRANCE CRITERIAENTRANCE CRITERIA Less emphasis on ONE (motor) behavior Less emphasis on ONE (motor) behavior Increased emphasis on affective and Increased emphasis on affective and

cognitive components of the disordercognitive components of the disorder Specifically require other measures beyond Specifically require other measures beyond

speech sampling/observation of speech speech sampling/observation of speech behavior across multiple environmentsbehavior across multiple environments

Document AEI beyond classroom Document AEI beyond classroom participationparticipation

RECOMMENDATIONSRECOMMENDATIONS

EXIT CRITERIA: Students should be EXIT CRITERIA: Students should be dismissed when…dismissed when…

All objectives have been met and no All objectives have been met and no additional intervention is warrantedadditional intervention is warranted

Parents request exitParents request exit Intervention no longer results in Intervention no longer results in

measurable benefitsmeasurable benefits Child is unwilling/unmotivated and Child is unwilling/unmotivated and

efforts to address motivation have efforts to address motivation have been unsuccessfulbeen unsuccessful

Extenuating circumstances Extenuating circumstances warrant discontinuationwarrant discontinuation

Disorder no longer impacts Disorder no longer impacts educational performanceeducational performance

Child no longer needs services to Child no longer needs services to participate in general curriculumparticipate in general curriculum

Developing Relevant IEP Developing Relevant IEP GoalsGoals

MUST (ACCORDING TO IDEA)MUST (ACCORDING TO IDEA) Consider child’s individual needsConsider child’s individual needs Change as child’s needs changeChange as child’s needs change Discuss present levels of performanceDiscuss present levels of performance Include Annual goalsInclude Annual goals Include benchmarks or objectivesInclude benchmarks or objectives Consider other factorsConsider other factors

Guidelines for Developing Guidelines for Developing IEP GoalsIEP Goals

Begin with teacher/administrator Begin with teacher/administrator education about nature of stuttering education about nature of stuttering problems in childrenproblems in children

Explore communicative competencies Explore communicative competencies with with individualindividual teachers teachers

Recognize nature of treatment child Recognize nature of treatment child currentlycurrently needs needs

Relate stuttering treatment to Relate stuttering treatment to curriculumcurriculum

Consider consultation from a Consider consultation from a fluency specialistfluency specialist

Integrate aspects of stuttering Integrate aspects of stuttering therapy into the classroom therapy into the classroom

Service Delivery IssuesService Delivery Issues

Service delivery is a dynamic conceptService delivery is a dynamic concept No one service delivery model should be No one service delivery model should be

used exclusively during interventionused exclusively during intervention All service delivery models should include All service delivery models should include

collaborative consultation with otherscollaborative consultation with others IDEA regulations should result in more IDEA regulations should result in more

integrated service delivery models. integrated service delivery models.