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

[Guest guest]

i am sorry, but if it helps, i am in the same boat!

kate had her IEP last friday...what they see and what i and my family

see are 2 different things!

beyond frustrated and i wish i could offer words of advice, but alas,

i just want you to know that you are NOT alone....right now i am

trying to get kate SSI disability so we can pay for extra therapies

OUTSIDE of school...she is in a class w/ 13 other speech kids!!!!

incredible....how is she going to get the help she needs? and then on

top of everything, they " baby " her...there are certain behaviors she

will not be allowed to do at home, but they let her slide, because she

is small and coddled!

i'll keep you in my thoughts, and feel free to email me, maybe we can

chat on the phone....i am distraught...and i feel your pain....i am in

a deep depression because i just don't know what else to do for her

without selling our house, living under a bridge to pay for the things

she needs and what the school won't provide!

apraxic kid in group therapy? i am at a loss for words...kate gets 1

hour of private, 1 hour of group at school...we pay for 1 hour of

private at home, but she needs more!

please contact me so we can vent with someone who is in the same boat!

no-one understands me here!

my sympathies,

kris justice

>

> Sorry, but I need to vent... My son had his transition IEP meeting

> today. I was originally told that he would have the same teacher as my

> daughter (different class), with the same SLP, and that the SLP

> mentioned 2 individual sessions a week, 1 group. The OT recommended (in

> writing) 1 group OT/ week.

>

> Today I found out that

> 1> they changed his teacher.

> 2> They changed his SLP. The 'new' one was not at the meeting today,

> and we haven't met her. (The original SLP has seen Nick many times on

> parent days).

> 3> They offered him ST 2x/ wk group and 1x/ indiv.

>

> How the *% & # can they expect an apraxic child to do well in a group

> when he can barely speak!? They told me that since they hadn't eval'ed

> him (I brought in an eval from June), they want to work with him before

> offering more sessions, and that I can call a meeting in Feb to discuss

> my concerns. They agreed to put the potential Feb meeting into the IEP.

>

> In their defense, they took another district's IEP for my daughter and

> within a month, called me to offer her an additional session a week.

> I'd like to believe that they'd do the same, but I also know the system

> better. Another plus is that they already signed him up for Extended

> School Year.

>

> I just don't know what to do about the group sessions. On top of all of

> this, I got into an argument with my husband. I mentioned pulling Nick

> off of fish oils with little regression last time, but after a week it

> kicked in at full force. He couldn't round his lips, lost some sounds,

> and on his worst day was starting to close-mouthed speak again. If you

> corrected, he spoke properly, but not on his own. Even the SLP said she

> was nervous seeing it. (However, his sensory issues totally

> disappeared). He's back up to 2 EFAs a day (almost no difference on 1),

> and you can see a huge improvement, but not where he was on 4 with 2

> EPAs. I told my husband that in order for the school SLP to see Nick as

> he really is, I'd have to pull him off the oils again, and my husband

> freaked. I swear, he sees my son an hour a day, tops. It hurts me a

> thousand times more to not understand Nicky all day, to be the one to

> go to the therapies, meetings, and doctors, to make the decision to

> start fish oil, and the much harder decision to stop the oils

> (especially after seeing what happened the first time!). He really is

> great at supporting me, but sometimes I still feel alone, ya know?

>

> And just for the punch line to this whole story, I got dx'ed with

> hypertension yesterday. There's some irony to all this going on on the

> first day I have to take blood pressure meds.

>

> Sorry to vent, especially because I know there are people out there in

> much harder situations than me. Thanks for any advice that you can

> offer me.

>

>

>

[Guest guest]

Have you asked how many are in the Group? My daughter has one Group

for OT and they said- a group is 2 kids. It may not be that bad.

>

>

[Guest guest]

**my computer just freaked out and sent my last email before I was finished -

here's the rest**

 

Oh .  I feel your pain.  I went to 's preschool for his very

first IEP meeting this year (he hadn't even turned three).  I was so excited to

hear what type of speech help he would be getting.  They gave him 10 minutes a

week!  At the time, I had no idea I was supposed to negotiate with educators, so

like an idiot, I signed it!!!!!!  Then I went home and told my husband that I

felt like we were totally getting screwed.  He suggested that I call my friend

who is a kindergarten teacher. I did and she told me that I was basically

supposed to counter offer them.  Huh?  Counter offer?  You can do that?!?! 

 

Since that initial meeting - has formally been diagnosed with verbal

apraxia by an SLP and a Developmental Pediatrician.  When I contacted the school

district to have his IEP changed, they informed that it was not necessary. 

 

It's been an uphill battle ever since.

 

My other peeve - the district has no one trained in PROMPT!  That's the therapy

we are using privately.  So I have basically come to rely on our private SLP for

help with  speech and I use the preschool for the fabulous environment and I

love 's teacher who is sensitive to kids with speech problems.

 

That all said - I have a great blog for you to read. 

 

http://gwendomama.blogspot.com/ - click on apraxia and IEP if you want to read

about her adventures.  She is one brave lady who seems to get a lot of activity

on her page, so she must be doing something right!

 

WARNING - Gwendomama is prone to profanity, but man...the gal can rant.  Enjoy!

From: <cp_mistyrose@...>

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

Date: Wednesday, December 17, 2008, 1:48 PM

Sorry, but I need to vent... My son had his transition IEP meeting

today. I was originally told that he would have the same teacher as my

daughter (different class), with the same SLP, and that the SLP

mentioned 2 individual sessions a week, 1 group. The OT recommended (in

writing) 1 group OT/ week.

Today I found out that

1> they changed his teacher.

2> They changed his SLP. The 'new' one was not at the meeting today,

and we haven't met her. (The original SLP has seen Nick many times on

parent days).

3> They offered him ST 2x/ wk group and 1x/ indiv.

How the *% & # can they expect an apraxic child to do well in a group

when he can barely speak!? They told me that since they hadn't eval'ed

him (I brought in an eval from June), they want to work with him before

offering more sessions, and that I can call a meeting in Feb to discuss

my concerns. They agreed to put the potential Feb meeting into the IEP.

In their defense, they took another district's IEP for my daughter and

within a month, called me to offer her an additional session a week.

I'd like to believe that they'd do the same, but I also know the system

better. Another plus is that they already signed him up for Extended

School Year.

I just don't know what to do about the group sessions. On top of all of

this, I got into an argument with my husband. I mentioned pulling Nick

off of fish oils with little regression last time, but after a week it

kicked in at full force. He couldn't round his lips, lost some sounds,

and on his worst day was starting to close-mouthed speak again. If you

corrected, he spoke properly, but not on his own. Even the SLP said she

was nervous seeing it. (However, his sensory issues totally

disappeared). He's back up to 2 EFAs a day (almost no difference on 1),

and you can see a huge improvement, but not where he was on 4 with 2

EPAs. I told my husband that in order for the school SLP to see Nick as

he really is, I'd have to pull him off the oils again, and my husband

freaked. I swear, he sees my son an hour a day, tops. It hurts me a

thousand times more to not understand Nicky all day, to be the one to

go to the therapies, meetings, and doctors, to make the decision to

start fish oil, and the much harder decision to stop the oils

(especially after seeing what happened the first time!). He really is

great at supporting me, but sometimes I still feel alone, ya know?

And just for the punch line to this whole story, I got dx'ed with

hypertension yesterday. There's some irony to all this going on on the

first day I have to take blood pressure meds.

Sorry to vent, especially because I know there are people out there in

much harder situations than me. Thanks for any advice that you can

offer me.

------------------------------------

[Guest guest]

Don't even get me started on " services " through the school system.

Through his IEP, our son goes to pre-school five mornings per

week.... in a six and six class (six typical/six delayed). He gets

pulled out twice per week for " treatment " from the county SLP. She

has 65 kids, so she has to double-up. So, gets speech w/ another

kid who's speech issues are very different from my son's. Imagine how

affective this all is... NOT! I did not even know her NAME until our

son was already in school for six weeks. I still don't have a way to

contact her... and she doesn't send us any notes or recommendations.

So... since the county is completely worthless... we get speech and

OT privately. Our insurance has no problems w/ OT... but speech is a

constant battle. In fact, we have an appointment w/ 's

Developmental Pediatrician tomorrow to ask her to plead our case

(write a letter) to our insurance company.

I'm sure all of you know how hard it is to get an emergency appt. w/

a Developmental Peditrician. It took me three weeks of calling every

number I could find to finally get a supervisor on the phone to help

me. And STILL.. there is no guarantee anything the Developmental

Pediatrician will say/do will help. Our insurance only covers

congenital anomoly (sp?), autism, speech impediment and stroke. Not

sure what things fall under the congenital anomoly category... and

the DP has always been insistant that our son doesn't have autism...

don't know if we can stretch the apraxia thing to be a speech

impediment... or not....

I mean, (insert favorite curse word), my son is 4... and he only uses

sentences to request ( " I want juice. " ) The rest of the time its just

single words and noises. Sounds to me like there is an impediment

keeping him from speaking!

Good luck! We've all been there!

[Guest guest]

Hi :

Sorry your meeting didn't go well. Did you sign the IEP? If you

aren't happy with what the school offered, perhaps you can have

another meeting to discuss it before you sign it. Did you take

recommendations from SLPs, private evaluations, printed material for

what type of therapy is recommended for apraxic children? Group

therapy wouldn't be bad if it is one other child working on the same

goals. My son was 4 years old when he started a group session and it

was with one other girl working on the same speech errors and letter

sounds. You said the school is changing your SLP, if you can have

the " old " SLP that has worked with your son write up a recommendation

and go to the meeting that might also be helpful-If she was the one

that recommended 2 private-1group. I am in GA, and the assitant

director did a dev. evaluation before transition. If that is a

problem for them, ask the school to do an evaluation along with a

private evaluation.

Good luck to you,

Tina

[Guest guest]

> They told me a group could be " up to 5 kids, but we've never

seen it go that high, and it probably never will " .

Gretchen> I can't believe they offered 10 minutes! Thankfully I have a

sis-in-law who worked for EI and told me not to agree with their first

offer (for my daughter, where they tried to tell me she needed nothing

on an over 33% delay). In that case, first they told me that they'd

never had a preschool disabled in the district, then that " there's a

lot of children here who need speech, they're no different than your

daughter " (actually, they could all speak just fine, just not speak

English...), then they wanted her in a group... They said she needed

spec. ed. if they were going to offer speech, but the SE teacher worked

with the entire class at once. If you live in Garfield NJ and you need

a PSD class, my advice is MOVE ANYWHERE ELSE! They told me what they

agreed to, and said something like " here's the IEP, if you'd like to

sign it today, we can start immediately " . If I didn't know better, I

would've signed, and I've heard from a few moms who were not told they

had the option not to sign. As far as reviews go, I believe (definitely

in NJ) you have the right for a review at least once a year.

> >

> >

>

[Guest guest]

I have a huge amount of archives below because I don't even

know where to start as I went through what you are going

through (minus the hypertension)

Are 'you' on the fish oils? Please consider it for you.

Also read some Chicken Soup for the Soul books for 'you' -in general

take care of . Your son needs you but the most important

person for you to take care of first is you. OK relax -take a deep

breath (yes now) Hold it....a bit longer....OK now breath out. Do

that when you get a bit too stressed- it's always worked for me.

(Either that or yelling about what is pissing me off to one of my

friends!) Are you a member of a support group -in person one that

is? Not that this isn't good but it will be great if you can find at

least one other parent to hang out with -go through this together

with. What state are you from?

Anyway -below are just a few archives to show you that I relate -many

of us do. As stressed as the IEPs used to make me as time went on I

really started to have fun with them...really.

Yes out of district evaluations from neuroMD/SLP/OT

Yes use the severity intervention matrix

http://cherab.org/information/speechlanguage/therapymatrix.html

Yes -use the documentation on reasons for one on one therapy that I

will archive and post next.

Here's the first half of archives. Grab a cup of tea. It will

reduce stress- just posted about that thanks to one of Gabby's

messages! And don't stress out about all of this.

This too shall pass.

From: " kiddietalk " <kiddietalk@...>

Date: Fri Feb 11, 2005 6:17 pm

Subject: Re: Am I being naive? SLP/OT issue kiddietalk

Hi !

You don't mention -but I'm going to assume the SLP and the OT are

school based? I mean otherwise the obvious advice for private is -

" Next! "

(there are tons of other professionals out there)

I found myself in the same situation as you with the school back

when Tanner was three. You don't even have to 'be' naive to know

it's fun to just 'act' naive when you are dealing with people that

are messing with your baby! (was going to say idiots but thought

I'd be nice)

Just remember the average person has average IQ -so just outsmart

them -and even use their lame info to help advocate for your child.

Let them say he's got a thin upper lip -instead of giving them a fat

upper lip. Get all of their " professional " reports in writing. In

addition -document their comments about why they disagree or won't

even consider the diagnosis already given to your child. Then use

that to go above their heads, superintendent of schools, to prove

that they don't have a clue about your child's condition, no less

how to provide appropriate therapy for him to give him a chance to

be mainstreamed as soon as possible. Be nice -not emotional. You

can even say " I'm sure they are wonderful professionals in dealing

with children that have conditions that they know about -like simple

delays and all " Use their documentation to prove just how clueless

they are in dealing with 'your' child. Back up what you say not

with what you believe -but with what the private professionals that

worked with him for __ years say. And add " I myself for example am

not a pediatric neurologist, I'm just a parent, but I believe when

Dr. ____ states that my child is not ____ and instead has _____ and

that _____therapy is appropriate, that the type of therapy the

school based SLP and OT want to do is highly inappropriate. By the

way I'm just curious -neither of them are going to medical school to

first become neurologists are they? " " Oh just wondering because

they seemed to disagree with everything that a respected pediatric

neurologist had to say and I wondered why " " My husband and I (or my

wife and I) have checked into appropriate out of district placements

for my child where he will be able to receive appropriate therapies

and placement with professionals who are knowledgeable about my

child's condition and who respect the neuro medical doctors and

private SLPs who work with him "

Request " out of district " placement immediately, follow up in

writing.

So yes -we were in that situation -and yes -Tanner was put into " out

of district " placement at The Summit Speech School for the hearing

impaired in New Providence, NJ. Most all of the apraxic children

that attend there from our group have no hearing problem 'at all'

Kanter (we miss you) let our kids in to this school because

she felt all kids had a right to have a voice -not just hearing

impaired. I hear today that's not the case for many of you. I say -

fight it - would have! just in case you don't know

since for some strange reason it's not mentioned anywhere anymore -

is the one that started the school -and made it what it is today.

passed away of cancer.

http://www.oraldeafed.org/schools/summit/

http://www.summitspeech.com/

's on this page from when we were on Inside Edition

http://www.cherab.org/news/insideedition.html

I myself did not use my own views of Tanner to advocate for him in

school to get him out of inappropriate placement in his preschool

through the town school. Yes of course my husband Glenn and I let

them know what we saw in Tanner, but understand that I knew that

they would view most that I said about Tanner as a " parent in

denial " if they viewed him as anything different than us. So when

Tanner was three and they wrote in his IEP that he was manipulative

and would speak more as his self esteem " increased greatly " , and

when the preschool teacher told me " you have to forget this apraxia

thing and treat Tanner like a normal child " and the lack of any

mention of motor planning, DSI, hypotonia in his IEP -it read like

they viewed Tanner as an elective mute with psychological problems -

and from feedback -due to possible emotional abuse from us! Just

like you, my husband Glenn and I were of course horrified by this,

and didn't agree one bit, and didn't sign the IEP -neither of us

did. They lied -it does matter if you sign it.

Tanner always had an incredible self esteem, and he was far from

manipulative. Tanner as most of you now know from The Late Talker

had not a clue he had apraxia -we treated him like any other child -

and acted like it was normal to go to speech therapy because after

all " everybody learns to talk " All Tanner's private therapists

described Tanner as " so sweet " In fact Tanner's Early Intervention

therapist Zimet CCC SLP who now works with EI in Georgia was

just as horrified as us at what went on. loved Tanner.

is still a special person in our lives -and is part of this

group. She may not read every email however so I'll have to

remember to call or email her for input.

So just want you to know Kathy that it's expected to be emotional

and upset, and even outraged! -and OK to cry, but that's not the

face you want to show the school -you need to show you are not just

an emotional parent. You also need a plan.

My brother is a partner in a law firm -and he advised us to separate

emotions from facts. I'll let you know what we did and fill in

Kayla's name instead. Create a paper trail, write down Kayla's

history up till now and each event that happens now, phonecalls with

date and time and who you spoke with, letters or emails. Hard copy

every conversation by following up with a fax, email or letter.

Secure documentation to support an accurate diagnosis and placement

for Kayla.

We had signed a report to get Tanner into the preschool summer

program, he turned 3 June 11th -and somehow that became his IEP that

fall even though it's all questionable how that even happened if you

check the paperwork. What we then did however is request a meeting

to immediatly reopen Tanner's IEP based on " change in diagnosis " and

state we didn't agree with is current placement due to documentation.

For Tanner, as upset as I was my brother (the lawyer) said

something that I really enjoyed to pass on " Actually based on their

own IEP which so greatly deviates from documentation and history

about Tanner through Early Intervention and his private therapists

and doctors reports -they in their own writing have proven that

their own program is in fact so highly detrimental to Tanner that he

regressed substantially within two weeks in it and needs to be

removed from this environment and placement immediately. "

Each time something inappropriate happened at school -like when they

punished Tanner for not doing something he did the day before and

blamed it on him being " manipulative " and let him sit on the floor

and cry for hours (!) and ignore him -I would take Tanner to another

neuromedical doctor for his or her views and present that instead of

our own outrage.

I didn't stop with just an evaluation from Dr. Agin at that time

because back then I felt like we were drowning, Tanner was drowning -

and didn't know how to save him. Tanner went to see a slew of

doctors and therapists -each writing up reports. If in fact Tanner

was MR or autistic or an elective mute we would have loved him just

the same, so we wanted to know for sure what the reasons were for

Tanner's lack of speech, etc. for reasons outside of his school

IEP. We wanted to know how best to help him. In fact each report

came back the same -that Tanner's placement and classification was

inappropriate, punishing an apraxic child for something that may be

beyond their abilities is inappropriate, and that Tanner was an

intelligent child with a severe to profound motor planning disorder

both verbal and oral, with mild global hypotonia and sensory

integration dysfunction. We used the professional reports to

advocate for Tanner's therapy and placement. I recommend the same

for Kayla. Then you are no longer presenting your opinion of Kayla,

you are presenting reports from various professionals on what their

professional views are on appropriate diagnosis and treatment.

For us, the approach we did for Tanner secured out of district

placement for Tanner's preschool years at The Summit Speech School

for the hearing impaired and deaf. The most awesome school you

could imagine for an apraxic child. Tanner was not the only apraxic

child that thrived there and then transitioned into a mainstream

kindergarten class at six. (because the school went up to six -and

for hearing impaired children they already appreciate the benefit of

the additional year developmentally for a child with an impairment -

they set up the children for success by keeping them in preschool

until 6. Most with speech impaired children don't appreciate this

concept yet)

From: " kiddietalk " <kiddietalk@...>

Date: Thu Jan 22, 2004 10:05 pm

Subject: Re: hearing impaired class for apraxics??

Hi Toni,

As you probably already know I believe these type of schools for

apraxic children are incredible. And yes Tanner went to one during

preschool and is not hearing impaired at all -and is now in a

mainstream academically advanced first grade class with straight A's

(still!) and he is both Mr. Social and Mr. Cool. Even though Tanner

doesn't have any hearing impairment at all, if he still has a

noticeable speech impairment when he " grows up " and society is still

as lame as it is now about verbal disabilities and how they judge

those who have even minor impairments of speech as cognitively

inferior -I've joked I'm going to buy Tanner some hearing aids he

can wear when he doesn't feel like being judged! (or he can borrow

his cousin's who is hearing impaired and has a speech impairment)

Here is an archive:

" Mild hearing loss in a child however is different. Ability to hear

is critically important while speech is still developing. My nephew

also attended the Summit Speech School in New Providence, NJ

http://www.oraldeafed.org/schools/summit/ where my son Tanner went.

Even though Tanner and many of the other apraxic children in the

school had normal hearing -all of our children were schooled with

professionals who were fully aware of the proper way to educate and

provide therapy to a child with the duel diagnosis (which is not

uncommon) of speech problem/hearing loss. Lots of multisensory

approaches. Hence the base for The Association Method School.

http://www.usm.edu/dubard/associat.html

As I posted here when I posted one of my first emails -I first

thought of this type of schooling for Tanner within days of his

diagnosis (and at the time was shot down by this one parent who at

the time ran the only grouplist for apraxia who also tried to shoot

me down on EFAs and the importance of neuromedical MDs) As it ended

up a few years after Tanner and many others in our group in NJ

started to succeed in the Summit Speech School -and the Lakedrive

School http://www.mtlakes.org/ld/ , Dr. Joan Sheppard from Columbia

University

http://www.cherab.org/news/meetings/eventsmay2001.html did a

presentation at the ASHA conference on " Teaching

hearing apraxic children at schools for the hearing impaired and

deaf " to talk about how successful this is. (ASHA -is that the

organization that is now calling it childhood apraxia of speech and

that blocks out all the information to the public so only CCC SLPs

can read the information....I guess it's a wash then. Who wants

anyone to start using that stupid name childhood apraxia of speech

for a condition one does not outgrow?!! Can we send them a link to

276 month old (or if we want to talk about it in years -23 year

old) 's talking page update to put on their childhood apraxia

of speech page?)

There are two types of schools for the deaf -I like the oral based

model due to the wonderful speech models Tanner had. I would have

liked a bit more sign -but in the end it didn't matter.

Summit Speech School is an oral based school that does not encourage

sign -even though they will acknowledge it if used. As

Kanter who we all loved and now miss once told me -the theory is

that a deaf child that does not speak verbally by the age of 5 most

likely will never speak, while one can learn sign at any age.

As we've gone into in the past -there is a huge amount of

controversy in the deaf world on cochlear implants. Those that are

just into sign " deaf culture " say it's " mutating " the child. I like

the response from one of the MD dads in Tanner's class to this

comment when a deaf man " told him off in sign " due to his son's

cochlear implants " So if my child had a heart defect you are saying I

should just allow him to die? Is that also a mutation to try to

fix that? "

I know apraxic children that were schooled at both types of hearing

impaired schools and did well. However again I prefer the oral

based model based on personal observations of my own son and the

many others in this group who attended the Summit Speech School with

him.

Here is a list of websites for schools for the deaf

http://clerccenter.gallaudet.edu/InfoToGo/schools-usa.html

Kanter always told me in regards to IEPs - " you have to play

the game with them " I say -if you are going to play a game -might

as well have fun. I'd love to share some of the fun things I've

said at IEP meetings. I do have fun with it. (some of it is in The

Late Talker -have you read that?)

THE " LELLOW " BREAKTHROUGH

Three-year-old Tanner, standing in the bathroom of his family's New

Jersey home picked up a pink comb, pointed to a yellow stripe that

ran through it, and said, " Lellow. " It was the first 'real' word he

had ever spoken and it came after just three weeks of

supplementation. " I almost fell over, " says his delighted mother,

[Guest guest]

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.speechville.com/diagnosis-destinations/apraxia/speech-therapy-frequen\

cy.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.speechville.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.speechville.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.speechville.com/diagnosis-destinations/apraxia/one-on-one-therapy.htm\

l

Apraxia: Researchers' Websites and Citations

Researchers with an interest in developmental apraxia:

http://www.speechville.com/diagnosis-destinations/apraxia/research.html

The Late Talker Book

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

http://www.speechville.com/late.talker.html

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[Guest guest]

Rhea after preschool special needs placement which is typically a

very small teacher to student ratio (Tanner's was almost a 1/1 in one

preschool!) if your daughter transitions to a mainstream K-12 class

(yay!) then the class is not a special needs placement and the ratio

can be high depending upon the school.

If nothing extra is needed in regards to ratio, thus written in the

IEP, then your daughter would most likely be in a regular

class/regular class size with just one teacher just like all the

other kids. My son for example since kindergarten has only had one

teacher -and the ratio of teacher to student here in Florida in the

one school was very high -around 27 kids to one teacher! (and Tanner

thrived as one of the " top students " ) We switched to a private

school where the class size went down to around 15 kids to one

teacher and Tanner continued to be a good student.

If you child needs a smaller teacher to student ratio you could have

a personal aid or " shadow " written into her IEP. Sometimes they try

to keep the aid to the side as if it's a " classroom " helper so the

child doesn't feel uncomfortable that s/he needs their own teacher.

Or that aid is there really for 2 or 3 kids in the class but will

help others if they ask for help. It sounds like your daughter

already has a number of extra professionals in the class. So she's

in a " mainstream class " but not really a typical one as they probably

call it mainstream but just stuck all the special needs kids in that

one class if they have that many aids. Can you find out why she's

having behavioral issues? Is it the teacher/student ratio or is it

possible it's something else? I know my son in his own way and on

his own asked for them to remove some of the accommodations when he

was in first grade as 'he' wanted to be just like the other kids.

It's a trick to know the best time to throw the baby bird from the

nest because the goal is to teach them to really be mainstreamed.

" The mother knows the time has come for the baby bird to leave the

next. The mother knows that any earlier the baby would have been

unprepared to fly and might have fallen to the ground. And the

mother knows that any later and the baby would resist leaving the

nest. So, with a firm nudge, the mother bird pushes the baby bird

out of the nest, having complete faith her baby is ready. And baby

bird does fly! "

~ Positive Pushing By Dr. Jim and

http://www.amazon.ca/Positive-Pushing-Raise-Successful-Happy/dp/0786868775

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