Getting EI to Give Speech Therapy in the IFSP - Mothering Forums

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Old 03-25-2008, 11:12 PM - Thread Starter
 
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I'm having problems with our EI Coordinator giving us weekly speech therapy. He says the skills trainers we have for 2 year old DD, who has diagnosis of PDD-NOS and is "high-functioning", are doing speech therapy. I don't agree. DH doesn't agree. The skills trainers don't agree. I've written to EI and we're having a meeting in the near future. My EI Coordinator says speech therapy is articulation and making sounds and neither of these are issues for my daughter. DD is verbal though she has a mild delay. She can say simple sentences 3-4 word sentences if she is so inclined. A lot of stuff though has to be prompted otherwise she'll say " milk" when she means "I want milk". I think what the skills trainers are doing is related to speech therapy but it's NOT speech therapy. DD can't say "yes" to questions though she will say "no". She can't answer "OR" questions. She doesn't ask any questions. There's still a lot of room for improvement.

I've been doing my own speech therapy using material from Hannen. But I feel like EI should be helping us more.

What can I say to get this EI Coordinator to understand my daughter needs regular speech therapy, especially pragmatic speech therapy? I don't know if he's clueless or just dragging his feet until we transition to our school district in a few months and I'm off his hands for good. Dh thinks it's a resource issue for EI. Anyway, I want someone to help my daughter with the speech difficulties kids on the spectrum have but I'm not sure what I can give him or say to the Coordinator to get that point across. And I have a feeling he's dragging feet because the SLP on staff doesn't know much about kids on the spectrum. She might know about apraxia, articulation issues, etc.

Our insurer had a complete speech evaluation done on my daughter and it was recommended that she have speech therapy. I gave a copy of that report to EI. The EI Coordinator says that those speech goals are supposed to be covered by the skills trainers.

The skills trainers are willing to come to the next IFSP meeting to help me state my case. They know they don't do speech therapy.

Anyone have any ideas of what I might not be doing or should be doing? Thanks.

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Old 03-25-2008, 11:18 PM
 
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I think you need to call this LANGUAGE therapy instead of speech. That makes all the difference in the world when you have a child with decent articulation and pronounciation but who needs actual language help.
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Old 03-25-2008, 11:59 PM
 
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UGH... when you figure this out let me know because I've now carried it into the district with my 4yo and they are BEYOND clueless. They actually acknowledged the issue, but their idea of how to handle it is just ridiculous!!!

ETA: our son had "communication" therapy in EI--not speech therapy, but with an SLP. That might help.

From my limited research, I get the concept that this country is a bit behind on pragmatic speech problems.

In the meantime, I'm doing WAY more reading with my son (and I did a LOT with him before) in the hopes that this is just a small thing to help him learn language usage. His verbal/language scores are beyond the testing ceiling... so it's hard to even get them to see a problem (the tests don't really catch pragmatic issues).

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Old 03-26-2008, 05:00 AM - Thread Starter
 
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Thanks. Perhaps reframing my request as "language therapy" might work. It's certainly worth a shot. Is there such a thing as language therapy? I wonder if he'll ask "so what is language therapy?"

Heatherdeg - I do much the same thing. I read a lot to DD. I think we must go through 20 books a day. Thank god for the library. Reading a lot has made a big difference in DD's vocabulary.

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Old 03-26-2008, 09:38 AM
 
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'Language therapy' is the sort of thing you are doing with her now. Speech is the sounds of the language - can she say 'n' in 'can' and all that. Language is made up of the words, grammar, and use, more what your dd needs helps with. EI can be great, but some EI groups are very hesitant to send out anyone but an educator to do everything from PT to OT to Speech. EI does not have to accept a prescription or report from anyone, since it is supposedly a team decision and they can decide it isn't needed, despite whoever else says it is. It likely is a resources issue, especially since there are not many SLPs working in EI right now.

I would ask for language therapy again, document that you asked for it, and if you sign the IFSP check that box that says something like "I agree with the following exceptions" and write in that you don't want the skills trainers to be responsible for language goals.
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Old 03-26-2008, 10:04 PM
 
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It really does sound like you are getting what you need now. My DD has a Speech delay and recives ST - but to be honest at this point ( at 2yo) there really is little they do for articulation and sound formation. Really our SLP is doing a modified ST that covers a little play thearpy to break her selctive mutism, some OT and just general socialization and familirazation. I was told that toddlers under 2.5 for the most part are to young for active ST but when there are issues such at DD (cleft palate, PRS, suspect 22del) then they start much younger with a modified program. HTH.
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Old 03-27-2008, 01:34 AM
 
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Language therapy is MUCH different than speech, yes. My son gets weekly language, where he works on pronoun usage, spatial concepts, sentence organization, etc. To give an example of his speech, he's AHEAD in expressive but BEHIND in receptive, and this is not the norm. He also has word finding problems, so for example, today when we used rythym sticks in playgroup and the sound bothered him, he said "that noise is afraid to me". Speech therapy will not address is stuff, but language therapy will.

Problem is, if you end up with an evaluator or an slt who just doesn't have enough experience with more complicated language problems, they'll miss it. With kids this age, they might just count words, ask a few very basic questions and not really catch the full problem.

Be prepared for EI to tell you that they don't have an slt for you. And they might be telling the truth - a qualified slt can be a longer wait and harder to find than a good ot.
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Old 03-27-2008, 06:29 AM
 
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My son is receiving "Speech Therapy" but after reading this thread, I really should call it "Language Therapy". He can articulate fine, or as fine as any almost-three year old. Yet Jayce doesn't know how to use language in conversations or to make requests. His receptive language is also behind. He is definitely benefiting from his ST.

Does your EI have a director? If my EI doesn't listen to me, I would have a huge problem with that.
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Old 03-27-2008, 04:51 PM - Thread Starter
 
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Thanks mamas.

Aridel and BDDavis - Your posts were helpful. I need them to help DD with her language not speech. Everyone says her articulation is fine and I agree. My child's expressive speech is ahead of her receptive speech and of course typical kids are the reverse of that.

Our EI Coordinator does have a supervisor. I've been introduced to that person. I hate to go above the Coordinator's head but if we don't get satisfaction I might consider going to the director.

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Old 03-27-2008, 07:10 PM
 
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Something I would consider in the whole going above the head thing is that if a child has been receiving specific therapies in one program then it will be much easier to ask for the same therapies in another program... basically if she's been receiving X from EI and you transition to school it's pretty much guaranteed that she would continue to receive X through the school, not saying that if she has never received X from EI that she won't be able to get it through school, but if you wait to fight the battle with the school (if there happens to be one) then your looking at possibly making those folks your enemies that you will have to work with for a really long time whereas if you start your battle now you will only have to actually deal with this agency for a short time.

Also look through your intial paperwork with them and find conflict resolution steps or greivance procedures, make sure you are going through the proper steps so they can not come back and say you contacted someone out of the chain of command. Start keeping a running notebook of all coversations with everyone, date, time, what was talked about, what you and they are susposed to follow through with and a time when this should be done. Don't let anyone drag their feet hoping that time passes and age limits are passed before things get settled. If you feel that your child's development is being greatly hindered because she is not receiving these services "NOW" tell them that and insist that this issue be resolved in the quickest possible manner so your daughter can reach her fullest potential.

Hopefully by just rewording your request to language will get the services for your daughter...

(Back to my corner unruffling my feathers - hope I don't sound too agressive with thinking you should just hit them head on)
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Old 03-27-2008, 11:07 PM - Thread Starter
 
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Lightheart - No, I like what you had to say. Thanks.

I don't want to see them as my enemies either. I think my problem is for a long time I thought of them as friends and now I've come to realize perhaps I've allowed my personal feelings to cloud my objectivity as far as the quality of services they're giving us.

And I have started keeping a log. I keep a log for everything concerning DD ever since we got the diagnosis. I have several binders set up and a whole email address just devoted to emails that have to do with DD's treatment and progress.

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Old 03-28-2008, 12:52 AM
 
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I dont know what state youre in, but its not Texas!! Our EI programs actually have tons of slt...its PTs we cant get!!!

I work for the early childhood intervention program in texas as an EIS (early intervention specialist) which Im guessing is what a skills trainer is? There are things that I do with kids that if you had a speech therapist,they would be doing exactly the same and thats probally what the caseworker thinks is the case. However, since Im NOT a speech therapist, there are things that are beyond my scope and then I would definetly bring in someone else! Here, I am a servic provider AND The caseworker so you would never have that issues. All I can offer is what I know about programs in texas, but yes, if you have stated what you want and been told no, it is time to go over his head (another way I know youre not in tx, we seem to have only women in this field here!) In texas, if you cant get resolution, there is a 800 number to the state office you can call.

The trick is getting it in the IFSP, if its there they HAVE to provide it. I dont understand the idea that the team can just say no...beause the team consists of your skill trainers and yourself and you have all said yes.

Ive done this job for ten years and never heard of "language therapy". I guess we call it all "speech therapy" if its for speech, language, artic or feeding. But the SL in slp or slt stands for speech language so I cant understand you being told that an slp doesnt do what your dd needs when what she needs is language help. Thats weird to me.

It totally could be a resource issue. Ive had HUGE issues with kids really needing PT and not being able to get it. They want ME to go out and "cover" it but I cant! Again, there are some skills I can work on that are the same thing a PT would be doing, but there are those out of my scope or experiance and in those cases...I STILL cant get a PT to my families! My director admitts its an issue but one we cant seem to do anything about. Apparently PT"S want way more than an EI program (at least here) can pay. BUT....while I understand its a real problem, its not an excuse. If she needs it and they cant provide it....thats a real problem. As a parent, I'd start thinking about threatening lawsuits!

Ok, heres a tip when you get to school, if you have an independant eval taht says you need st, and they cant/wont give it, they have to pay someone who can/will. You may have to seriously push the issue though, they would never volunteer that info. The EI program only has to pay someone else when they cant provide iti f its in the IFSP. But you need to remind them that you are ALSO a team member and you want it on there!

I wish I could be more help. Good luck!

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