Re: how did you get appropriate therapy from EI or school?

[Guest guest]

For me the biggest problem was not about getting the therapy he needs but " how

much " and " one on one " .  Most of the time the school district has so many kids,

that they are only able to give group therapy.

When I asked his private therapist what I could do about the school district,

she said I have to have a medical diagnosis from a doctor stating that he has

Apraxia and that he needs " these " services. 

So I made an appointment with a developmental pediatrician in hopes that even if

he is not able to make a diagnosis, he will be able to give me a letter stating

exactly what my son needs.

The problem is that my son is only 3 1/4 years old and no one wants to give him

a " diagnosis " .  They are only saying that he is showing " signs " of Apraxia and

that only time will tell.  However, they are treating like it is Apraxia.

You will have to fight for your child but don't be to demanding or you won't get

what you want.  You have to work the system with firmness and charm : )

Good Luck!

From: lucy4gets <lucy2max@...>

Subject: [ ] how did you get appropriate therapy from EI or

school?

Date: Sunday, October 18, 2009, 11:15 PM

 

Can someone please tell me how I can have EI or my school district (when he

turns 3) give my son the appropriate therapies?

I was thinking of going to a top SLP and get a written diagnosis for verbal

apraxia (and maybe oral apraxia), if in fact he has it, he is not diagnosed with

these yet. We have codes we have now are for motor planning and such, with only

suggested speech therapy of oral-motor.

Once I get the eval- can I ask for appropriate speech therapy from Early

Intervention? Can I only ask appropriate speech therapy from my school district?

How does one do this?

Let's say in our disabled school they only offer " regular speech " therapy and I

want PROMPT and Kaufman cards being used and it was written in the eval that my

son needs this......then will I have a big battle on my hands trying to get this

for him?

Thank you for helping,

Iveta

[Guest guest]

If you decide to wait until he's 3 you must write a letter to the school

district asking for an eval.

I did this but also my dd automatically qualified at birth since she was a 23

weeker.

Yvette A.

[ ] how did you get appropriate therapy from EI or

school?

Can someone please tell me how I can have EI or my school district (when he

turns 3) give my son the appropriate therapies?

I was thinking of going to a top SLP and get a written diagnosis for verbal

apraxia (and maybe oral apraxia), if in fact he has it, he is not diagnosed with

these yet. We have codes we have now are for motor planning and such, with only

suggested speech therapy of oral-motor.

Once I get the eval- can I ask for appropriate speech therapy from Early

Intervention? Can I only ask appropriate speech therapy from my school district?

How does one do this?

Let's say in our disabled school they only offer " regular speech " therapy and

I want PROMPT and Kaufman cards being used and it was written in the eval that

my son needs this......then will I have a big battle on my hands trying to get

this for him?

Thank you for helping,

Iveta

[Guest guest]

A diagnosis is the best way to get the appropriate Apraxia therapy. that has to

come from a doctor---a Ped Neurologist or Dev Pediatrician. An SLP can tell you

that they suppose your child has it--but cannot write scripts, which are needed

for the school district once EI is done. A recommendation from a doctor will

get all the 1-1 services you need in a good school district.My district has

never offered her any group sessions in the four years she's been in-district!

When is your child turning 3?

My 8dd was receiving 1-1 speech therapy in a special needs preschool. When she

was 4yrs old==the Ped Neurologist dx her with Severe Apraxia. Within a week--the

SLP at her preschool had signed up for an Apraxia workhshop and ended up buying

all the books and material that was suggested at the workshop! My dd got some of

the benefits of her dx from prek but most of it came in our school district.

what is regular speech therapy?

>

> Can someone please tell me how I can have EI or my school district (when he

turns 3) give my son the appropriate therapies?

>

>

[Guest guest]

Iveta,

everyone wants to pass the buck, so getting an early official diagnosis from an

independent third party is critical.� We wasted a full year with EI--one h per

week and no words gained at all--she actually lost some words during those 11

months of EI.� Finally when I confronted the SLP with the apraxia possibility

she admitted it but said she was no expert in motor planning----Duh!!!--and

recommended a private eval before starting with the school district.�

Well, it turns out I should ahve done that before starting with EI--and they

would have given me all paid /covered sessions with the same PROMPT trained SLP

we go to now--had I only known to demand it, had I only nown she had apraxia,

etc etc...

Really a private eval is critical, and then once you know more or less what you

are delaing with you can make sure the school district does their best. Now, a

warning, the school district has a different budget and they may just not have

therapists trained to work with apraxia, so depending on a lot of things the

battle may not even be worth it.

If you have private insurance push that to the max and the school will do what

they can but they are overburdoned and undertrained and even if you fight for

appropriate services and get them--very unlikely unless you have an

advocate/lawyer and are prepared to spend a lot of money, time, effort and risk

losing it all or just not gaining much because they simply are not

equipped/trained to deal with apraxia---well, this has been our experience.�

She's now in kindergarten and because the school district dragged their feet for

a year offering NOTHING--we won� out of district--private reimbursement for

what insurance doesn't cover for the 3 years.�� We're due for another eval

next Spring and my daughter has made so much progress that they won't even

recognize her.� i am not sure I will push for 1:1 motor planning etc. becuse

they ar esimply not capable of providing it --even if I win it on paper. They

cna't and it's an uphill battle i've learned. i no

longer have the mistakes they made as leverage to negotiate outsourced

services, and she really has come such a long way that I feel I will accept what

ever they offer --more language and even group is fine, provided she doesn't

lose too much classroom time.� Also her class has a few ESL kids--completly

monolingual, and working with ESL is very different than working with motor

pllanning problems, so it just may not work out even for language problems which

are becooming more and mor eapparent now that hse has speech, but in her case it

is not that she doe snot know how to say it correctly--she does, but can't--her

motor planning gets stuck or she simply cannot do it, plan out a full sentence

and remember or be able to say all the connecting words, the right verb tense

etc.� She definitely needs language help now along with speech, but the school

may still not be equipped to do it, and there is no way to really know what they

are doing with the child

in school. We get 4 speech a week privately, and it's been going great, there

is just no way i would give that up to leave it up to the school even if it did

mean we could start contributing to our retirement account again.�

So with the school district --since outsourcing is not an option usually--not

unless they make major mistakes or you have very correct people there who admit

their limitations and want what is best for the child--not likely, really--- you

are stuck with the SLP in school who has over 80 kids to see per week and

there's no way she can even begin to give an apraxic child what s/he needs.

There are exceptions, but not in our district, not with that case load, and not

when most experienced SLPs go into private practice to be able to really do

their job and not just go through the motions.�

So I'll ask for as much as they cna give, but I'm not holding my breath and will

now focus on identifying strengths and weaknesses to implement learning

strategies, testing techniques etc that work for her. i'm trying to see if the

developmental pediatrician will suffice, if not I'll have to bite the bulet and

get an educational psychologist to evaluate and make recommendations in a full

report and that's pricey--but may be worth it.� In general, never leave evals

up to the school or EI.� EI can offer better services than the school district

because they typically outsource so it is just a matter of knowing what the

child needs and finding the SLP to do it withing their network.� Much easier

to do than with the school district.

Hope this helps.� And really Ivetta, I see people keep talking about their

doctors, I'm sure there are doctors who are great and can diagnose apraxia, but

most may not have even heard of it in the pediatric population and the point is

they do not treat it, they do not know all the ins and outs, the varying degrees

etc. They ar eneeded to confirm the diagnosis for insurance purposes and to

evaluate the child, make sure other things are not also off hearing, etc.�

many evaluations are needed and as the child improves new problems may surfice,

neurologicla disorders are never clear cut and easily treated, but if you take

each piece at a time, and work with it, you'll see much progress and the key is

the good SLP--they treat your child, they know if it is apraxia or not more

often than a doctor who has text book info or not even that from what I've

experienced, apraxia in kids is a relatively new --just little over a

decade--diagnosis.

�SLPs are the best trained to diagnose and treat apraxia and the best motor

planning experts are in private practice so you have to carefully evaluate your

resources and figure out where it is worth battling because as I said, everyone

wants to pass the buck and not offer the much needed services for an apraxic

kid. Take care,

Elena

[Guest guest]

Iveta:

Please dont let others discourage you who have not had a good experience with

their school district or who have not given it a chance to work because their

children have not been in school for very long. My daughters Ped Neurologist dx

her four years ago--I do bring her to him for treatment--he knows that the SLP's

are the ones who do the actual therapy. that is a given. Its sad that some have

no faith in SLP's who work in the schools because of their experience.

My 8dd has had nothing less than 1-1 4x per week for the past four years. We

have four Apraxia-trained SLP's in our district. They are out there--they are

not overburdened and frazzled from too many kids on their caseload. The SLP in

my daughters school is the reason she is talking in full sentences now.She does

not give her a toy and tell her to go play alone--I've been in my dd speech

therapist office many, many times! Every time- I have to ask her--how do you sit

in that little chair all day long?? But its what she does to be able to work

closely with my daughter and the rest of the kids in the school. She does it to

be at their level. She never looks upset or frazzled at the thought of one more

child coming thru her door.

The head of the Speech department in our district gave my 4yr old son his 1-1

speech 2x week at the Preschool level and treated his articulation issues in

only five months of services. With a severe apraxic daughter at home==I was

relieved when he was discharged. We had the very best EI therapist in our county

for him too! This guy was truly amazing with what he accomplished with my son! I

recommend him to every parent starting on their EI journey to do everything they

can to get him on their team.

A lot of SLP's work in EI when their own children are young. Than they try to

get into the school district so they can have the same hours as their children.

As they get older--they might do some private stuff on the side. School district

SLP's are not settling and comprimising or giving up a lucrative private

practice. They are trying to take care of their families and want to be there at

home the way the rest of us do.

Hang in there!

>

> Can someone please tell me how I can have EI or my school district (when he

turns 3) give my son the appropriate therapies?

>

> I was thinking of going to a top SLP and get a written diagnosis for verbal

apraxia (and maybe oral apraxia), if in fact he has it, he is not diagnosed with

these yet. We have codes we have now are for motor planning and such, with only

suggested speech therapy of oral-motor.

>

>

> Once I get the eval- can I ask for appropriate speech therapy from Early

Intervention? Can I only ask appropriate speech therapy from my school district?

How does one do this?

>

> Let's say in our disabled school they only offer " regular speech " therapy and

I want PROMPT and Kaufman cards being used and it was written in the eval that

my son needs this......then will I have a big battle on my hands trying to get

this for him?

>

> Thank you for helping,

>

> Iveta

>

[Guest guest]

I do not bring her to him for treatment. Also, now that she has her dx-the

pediatrician is the one who writes her scripts for the school district for her

PT/OT and Speech services per her IEP. But he notes the amazing progress in her

speech every 6mos when we visit him! But we would not have the services we do

without a dx from a medical doctor. Here in NY--SLP's cannot make an Apraxia

dx---it does not matter if they are trained in Apraxia or not- nor does it

matter if they work in a school district or in private practice in after school

hours.

>

> Iveta:

>

> My daughters Ped Neurologist dx her four years ago--I do bring her to him for

treatment--he knows that the SLP's are the ones who do the actual therapy.

[Guest guest]

I thought we were here to encourage and support! this mom is asking about EI

Services--if I read correct he hasnt even turned three yet.

NY CPSE---Preschool level after EI--has a minimum of 2x per week for all

children who qualify for speech services. the head of the CPSE for our district

told me that when my son was receiving services.

So her need for services from the school district is still three years away.

Most of us have found that a true Apraxia dx is hard to come by before 4yrs old.

My daughter has multiple disabilities and they are all included in her IEP..I

dont know maybe thats why I have not had to fight for services. So when she got

an Apraxia dx--she was already receiving 3x per week individual at a private

special needs preschool. Maybe thats part of the fight parents have had to

endure is trying to get Apraxia services without a dx from a doctor qualified to

give an apraxia dx. I know lots of parents who have to fight for

services--parents in the district next door to ours have beautiful, huge,

gorgeous houses--but I feel sorry for anyone in that town that has a special

needs child---because I know from many parents that its all a struggle.

Iveta still has at least two years at the preschool level before she needs to

worry if services will be a fight or not.

Going thru insurance is getting more and more difficult. there are many parents

who need to purchase insurance for their families. we have it thru my husbands

job--but those without that kind of coverage may not be able to drain their

insurance to the max for every minute of speech therapy. My daughters doctor

recently suggested some additional PT outside of school. She wrote the script

for 12 and our insurance only approved 4 visits! The rest will be approved when

the therapist lets them know it is still very necessary in her case.

It does not seem fair to blast every school district and every school district

SLP when you have just started in K. You have no idea where you will be and what

services you may need or want three years from now---so not speaking from

experience really is not offering useful advice.