Selective Mutism

The school nurse plays a pivotal role in the assessment and treatment of selective mutism (SM), a rare disorder found in elementary school children. Due to anxiety, children with SM do not speak in uncomfortable situations, primarily the school setting. Diagnosis of SM is often missed in the formative years because the child does speak at home. Early diagnosis and treatment provide the key to addressing this rare disorder. The school nurse plays a critical role as a member of the Instructional Support Team (IST). The school nurse, as team liaison, provides communication between parents, school staff, and medical personnel. School nurses make a difference by advocating for the child with SM and possessing the necessary knowledge to effectively intervene. This article discusses a team approach to the assessment and treatment of SM and the role of the school nurse in the school setting.

A Year in the Life of RtI: The First Year

A speech-language pathologist in a public elementary school (grades K-5) was asked to become a participant in reviewing a district design of Response to Intervention (RtI) services, while initiating a building based RtI program for speech-language therapy. The instructional support team (IST) would serve as an initiator and facilitator for the SLP, RtI process and the targeted struggling learners. The purpose of this article is to review the development and changes made to an RtI program during the first year of enactment.

High Versus Low Implementation of Instructional Support Teams

In 1990, the Commonwealth of Pennsylvania implemented a statewide instructional support team (IST) process to provide prereferral assessment and intervention for at-risk students in 500 school districts. The current study examined the academic performance of students affected by this process as contrasted with other at-risk students who did not have access to it. The dependent measures were academic learning time (time on task, task completion, and task comprehension). The results indicated that students supported by ISTs had greater levels of academic performance only when their schools implemented the IST process to a high degree. Low IST implementation produced no differences in academic performance in schools that had not implemented IST. The importance of implementing a promising program according to critical design features is discussed.