Re: Re: IEP meeting did NOT go as planned. ;(

December 28, 2008

What is the recommended teacher to student ratio for students with disability,

in a mainstream class. Is the teacher to student ratio affected by each

student's disability or disabalities? What reading resources can I look at to

further answer my inquiries? Does the teacher to student (with disabilitiy)

ratio differ for each grade level? I am particularly interested in the second

grade, where I have a daughter who has PDD-NOS.

She is one of 10 students with disability/disabilities, in a mainstream

classroom with a total of 20 students. There is a special ed teacher and a

regular ed teacher, and a temporary " student teacher " who is counted as one of

three adults in the classroom. The teacher to student ratio became an issue when

I requested for a paraprofessional for my daughter who recently manifested an

increase in behavioral challenges.

Thanks...

rhea

________________________________

From: kiddietalk <kiddietalk@...>

Sent: Thursday, December 18, 2008 9:51:42 PM

Subject: [ ] Re: IEP meeting did NOT go as planned. ;(

Here's some archives about one on one therapy!

Just in case you have not seen the one on one info at Speechville

and/or CHERAB:

One on One Therapy

A Review of Apraxia Remediation

The Cherab Foundation gratefully acknowledges permission to print

the following, cited by Hecker, a parent advocate for her

apraxic son, .

" The type of treatment appeared to influence whether patients

improved. More patients improved and improvement was greater in

Group A, individual stimulus-response treatment, than in Group B,

group treatment. These result imply the way to treat AOS (Apraxia Of

Speech) is to treat is aggressively by direct manipulation and not

by general group discussion. This is consistent with what has been

recommended (Rosenbek, 1978).

The type of treatment appeared to influence whether improvement

occurred or not. Four of the five patients who did not improve

received group treatment with no direct manipulation of their motor

speech deficit. " Apraxia of Speech: Physiology, Acoustics,

Linguistics, Management. Rosenbek et al. 1984

" The frequency of professional speech assistance is critical in the

habilitation of children with developmental apraxia of speech. This

disability call for all-out attention and deserve serious

instruction to the limits of the child's attention and motivation.

When normal children begin their formal education, they do not go to

school two or three times a week for just a half-hour at a time,

even in kindergarten. Thus, I do no expect to provide special

education for children with developmental apraxia of speech on a

cursory basis, for it may be the most important part of the entire

education. " Current Therapy of Communication Disorders, Dysarthria

and Apraxia. H. Perkins 1984

" They use the term developmental apraxia to describe a disorder that

is not confined to the phonologic and motoric aspects of speech

production, but includes difficulty in selection and sequencing of

syntactic and lexical units during utterance productions. Most

clinicians agree that planning the appropriate treatment approach

and methods is crucial to the efficacy of intervention. A variety of

factors can facilitate treatment of DAS. DAS is often characterized

as being resistant to traditional methods of treatment. Group

therapy decreases the potential of responses per session for each

child and therefore, the motor practice needed by children with

apraxia and dysarthria. " Treatment of Motor Speech Disorders in

Children by Edythe Strand in " Seminars of Speech and Language " Vol.

16, No. 2. May 1995

" Early stages of treatment need to be carried out on a one-to-one

basis for it is only in this way that the patient can learn to

develop his own particular strengths and adopt compensatory measures

for weaknesses. " Disorders of Articulation, Aspects of Dysarthria

and Verbal Apraxia. Margaret 1984 " These children do not seem

to make good progress with the usual approaches to clinical

treatment of articulation problems. Carefully structures programs

that combine muscle movement, speech sound production, and sometimes

even work on grammar seem to get better results. " " Developmental

Verbal Dyspraxia " on Healthtouch Online, ASHA website

" Children must be seen one-on-one, at least in the early stages of

treatment. " Kaufman, author of the Kaufman Speech Praxis Test

and expert on Apraxia, on The Kaufman Children's Center for Speech

and Language Disorders website .

" However, many of the theories, principles, and hierarchies

described for adult apraxics are potentially helpful to the

clinician designing motor-programming remedial program for an

individual child. (We stress the word individual since the program

development for children with DAS must meet the individual, and

often unique, needs of each child.) " " Intensive services are needed

for the child with DAS. Children with DAS are reported to make slow

progress in the remediation of their speech problems. They seem to

require a great deal of professional service, typically done on an

individual basis. Therefore, clinicians working with DAS must

accommodate this need and schedule as much intervention time with

the child as the child and/or his/her schedule can allow. The

definition " intensive " varies from clinician to clinician and from

work setting to work setting. Rosenbek (1985), when discussing

therapy with adult apraxics, defines the word as meaning that the

patient and the clinician should have daily sessions: Macaluso

Haynes (1978), Haynes (1985), and Blakeley (1983) also advocate

daily remediation sessions. " Also, " our experience has been that the

overall outcome has been best for those children with DAS who were

identified as possibly exhibiting DAS and received services as very

young children. " Developmental Apraxia of Speech, Theory and

Clinical Practice. Penelope Hall et al. 1994

" We recommend therapy as intensively and as often as possible. Five

short sessions (e.g., 30 minutes) a week is better than two 90

minute sessions. Regression will occur if the therapy is

discontinued for a long-time (e.g. over the summer). Most of the

therapy (2-3/week) must be provided individually. If group therapy

is provided, it will not help unless the other children in the group

have the same diagnoses and are at the same level phonologically. "

Velleman, authority and published author on Apraxia, on her

website (velleman.html) . " Our clinic has had tremendous success with

the half-hour format, we find these session to be very intense,

packed with therapy, and have little

down time. The earlier and more intensive the intervention, the more

successful the therapy. Group therapy can be effective for

articulation disorders and some phonological processing disorder,

but children with Apraxia really need intensive individual therapy. "

Lucker-Lazerson, MA, CCC-SLP, and Clinic Coordinator for the

ish Rite Clinic for Childhood Language Disorders San Diego, on

the Apraxia Kids website.

" A few major principles in particular have direct relevance to the

treatment of motor speech disorders. The most obvious, yet

surprisingly often disregarded, is that of repetitive practice.

Pairing of auditory and visual stimuli is included in most

approaches, and intensive, frequent, and systematic practice toward

habituation of a particular movement pattern is suggested instead of

teaching isolated phonemes. It is important to

consider the treatment needs of each child and attempt to find

creative solutions that

> allow frequent individual treatment for children that will most

benefit. "

Childhood Motor Speech Disorders Edythe Strand

" Given the controlled conditions stipulated in the studies..., it is

clear that speech dyspraxia can respond to therapy. All approaches

involved an intensive pattern of therapy. Even if not seen daily by

a therapist, patients carried out daily practice. " Acquired Speech

Dyspraxia, Disorders of Communication: The Science of Intervention.

Margaret M. Leahy 1989

" Consistent and frequent therapy sessions are recommended. The

intensity and duration of each session will depend on the child. At

least three sessions per week are recommended for the child to make

consistent progress. " Easy Does it for Apraxia-Preschool, Materials

Book. Robin Strode and Chamberlain

" In stark contrast, the children with apraxia of speech whose parent

stated that three quarters of their child's speech could be

understood following treatment, required 151 individual sessions

(ranging from 144-168). In other words, the children with apraxia of

speech required 81% more individual treatment sessions than the

children with severe phonological disorders in order to achieve a

similar function outcome. " Functional treatment outcomes for young

children with motor-speech disorders by in Clinical

Management of Motor Speech Disorders A.J. Caruso and E.A. Strand

1999.

(In addition to the information on this page, a great page on 1:1

therapy is at Apraxia-Kids)

1:1 Therapy Question Sent To Children's Apraxia Network:

Advice From our nonprofit's SLS/MA/ EDUCATIONAL CONSULTANT, Cheryl

- SLS/MA (Hi Cheryl you quiet little cutie you!

http://www.cherab. org/about/ cheryl.html )

It is interesting to note that when a child is receiving Early

Intervention services in the home, therapy is 1:1. It is also

interesting to note that children as young as 6 months of age have

received 1:1 services. Every apraxic child is different, with a

diagnosis of severe apraxia, the child would benefit from 1:1

therapy. What data is the school SLP (Speech Language Pathologist)

presenting indicating that the age of 5 is too young for 1:1

services?

Remember when a request for services is not given as requested, the

denying party must give a written rationale as to why. The IEP

(Individualized Education Program) is an individualized Education

Program. How will the SLP (Speech & Language Pathologist) address

the severe oral motor needs of the child within the group setting?

What are the short and long term goals and objectives that are

specific to the nature of this child's severe apraxia? Does the SLP

plan to devote x amount of minutes providing 1:1 therapy to your

child within the group setting? Your child's disability of apraxia

affects his involvement and progress in the general curriculum and

access to nonacademic and extra curricular activities due to the

fact that he is not able to communicate appropriately to school

personnel when needed and communicate effectively through speech

and/or writing to class- mates and teachers. The severity of his

disability warrants 1:1 speech therapy intervention. Your child's

disability of apraxia of speech affects his ability to engage in age

relevant behaviors that typical students of the same age would be

expected to be performing or would have achieved {IDEA-Code of

Federal Regulations (C.F.R.): 34 C.F R.300.347 (a)(1)(i) Statue 20

United State Code (U.S.C.) 1414 (d)(1)(A)(i) (1).

I am requesting that the parent draft a letter to the Dr. of the

Child Study Team including the information listed above. Indicate

that you are not in agreement with the type /amount/duration of the

speech therapy services that will be provided to your child. State

that you are seeking 1:1 therapy services for your child because...

Send the letter certified receipt return requested. Send a copy to

the SLP, the District Superintendent of Schools, and Board of

Education President. Severe Apraxia requires the parent to advocate

for 1:1 services in the area of speech therapy.

http://www.cherab. org/information/ speechlanguage/ therapyintensity .html

Here's some more from Speechville including one quote from apraxia

kids the website that originally built and hosted for over 7

years.

http://www.speechvi lle.com/diagnosi s-destinations/ apraxia/speech-

therapy-frequenc y.html

It's also worked for people to bring in The Late Talker book which

of course has in it the severity intervention matrix. (we also were

granted permission to put this up on the CHERAB and Speechville

websites) And as Kathy from this group always says -you can let

them know you know the authors and that we are interested in what

the outcome for our next book.

" Literature Review: Frequency and Intensity of Therapy for Children

With Apraxia of Speech. Click here to print a " text only "

http://www.speechvi lle.com/printer- friendly/ frequent- speech-

therapy.html copy of this page for personal use when advocating for

appropriate services from your child's school or appealing an

insurance denial. "

http://www.speechvi lle.com/printer- friendly/ frequent- speech-therapy. html

Recommendations of Frequency and Intensity of Speech Therapy for

Apraxia

" For use when advocating for increased frequency of therapy sessions

from insurance or school "

http://www.speechvi lle.com/diagnosi s-destinations/ apraxia/one-

on-one-therapy. html

Apraxia: Researchers' Websites and Citations

Researchers with an interest in developmental apraxia:

http://www.speechvi lle.com/diagnosi s-destinations/ apraxia/research .html

The Late Talker Book

Chapter 6: Getting the help you need (pgs, 70 to 89)

http://www.speechvi lle.com/late. talker.html

=====

December 28, 2008

Hello,

What price range should I expect to pay for an " educational evaluation " . My

second grader with autism, expressive and receptive language disorder, CAPD, and

PDD-NOS, was recommended to have one done by the neuro-developmental MD, I

mentioned that I do not think the current IEP is meeting her needs. The

psycho-educational evaluation done last May, showed her IQ ranges from below

average to aproaching genius. What should I expect to learn from an educational

evaluation?

thanks,

Rhea