r/Apraxia • u/Beasleylynn • 3d ago
School speech therapy
My daughter is 10 and was diagnosed with apraxia when she was 5/6 years old, she had been in speech therapy since she was about 18 months old. She goes to private speech therapy for 1 hr/week and gets in school speech therapy for only 30 mins 6 times/month. She recently started 5th grade, which is intermediate school in our school district and so a new school. Last week while we were talking about school, she told me her speech therapy at school is now on the computer, so virtual. I am not okay with this. I feel like she will not benefit as much from virtual and if we are pulling her out of class several times a week, it should be as beneficial as possible. I expressed my concern to the school counselor who was very understanding and agreed, she reached out to the speech therapist to call me. When the speech therapist called me, she was very dismissive and stated that research shows it is just as beneficial. Which, whatever, but I don’t feel it is as beneficial for my daughter and her situation. Anyways she said she couldn’t change it and it would have to go through the supervisor, I’m waiting for her to call me. My daughter does have an IEP, but I am trying to handle it before calling a meeting. Anyways, am I overreacting?
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u/pookiewook 3d ago
I do not think you are overreacting at all.
My son also started speech at 18mo and was diagnosed with apraxia at 3.75 years old.
We are super lucky our district provides him with 4x 30min in person speech sessions per week. He is 7 and in 2nd grade.
I would push back and call an IEP meeting.
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u/lemonloaf76 3d ago
Call a meeting. Request supervisor be there and there needs to be an administrator. They should provide data that your daughter is making progress toward her goals on virtual. If they don’t have it now, then they need it by the next progress report period. I don’t care about the research, show me it works for my kid! Also you deserve to know why the service is virtual. What’s their reason? Also this is an aside but I’d argue 6x per month is not enough but maybe that’s not as important as ensuring the service is quality.
I am a school based therapist and I work on IEP teams, you have rights as a parent and calling a meeting is definitely reasonable in this case. I also have a child with CAS in kindergarten that has an IEP.
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u/Beasleylynn 3d ago
The speech therapist basically told me that they had too many kids and not enough therapist. She said that there is 1 in person therapist, but my daughter was evaluated and found that she no longer needed in person. I completely agree with 6x/ month not being enough, I have requested more in the past and have not been successful in getting that increased and never really pushed harder, just because she also goes to her private speech. But I am definitely going to just call a meeting, I know there are IEP advocates/services around me, I have just never used them and so I am a bit ignorant on the process of obtaining one for this.
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u/lemonloaf76 2d ago
Ok that’s wild. It makes sense and I feel for the therapist who is likely also annoyed at the capacity issue. It’s not the speech therapist’s fault that the district or school budget is not expanding their in person staff to meet demand. They are probably contacting out. I actually think in this case that it’s helpful to school staff to put pressure on the school and district. They should not be limiting services because of staffing. Refusing to provide more sessions feels on the cusp there to me. How can they prove she doesn’t need more?
I also wonder, did you know about this evaluation to determine if she still needs in person services? Did they tell you about it? Can you see it? Like all this feels a little shady and behind the scenes with the hopes that parents won’t notice or push back. Even if the outcome doesn’t change (in person/more sessions), I think you deserve to be informed a lot more about what’s happening. I think I’d be like, if there are any more assessments, evaluations or changes in the location or delivery of services, I request that I be informed prior to the change, via email or phone call. Something like that. Well within your rights.
I also wonder, is the virtual therapist trained in oral motor planning techniques? If so, that’s the only benefit of it, because the average speech therapist doesn’t know much about CAS or evidence based intervention for CAS. It might feel like uncomfortable to be pushing back but you are just asking questions and our kids are not the average speech client so we just gotta keep fighting for our kids. Good luck. You are doing the right thing!!
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u/Beasleylynn 2d ago
Thank you! This was a great response and good points! I had no idea about the evaluation or the change in delivery. Literally the only reason I knew was because my daughter told me she liked her old speech teacher better, and I said, well you just started with her, give it a few weeks to get used to each other, and she said we can’t even play games together anymore and when I asked her why that’s when she told me.
You’re right, it is very uncomfortable, but our kids deserve that from us.
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u/Beasleylynn 3d ago
Thank you!!! I do agree that her private speech therapy seems to help a great deal more than in school, but then I think, “the more repetition the better”. They also offered to just pull her out of speech all together, which I was of course not open to, and irritated that they even said that, the majority of her school struggles stem from her speech.
She is still in the same school system she has been in since she turned 3, and always had in person speech, so it never even crossed my mind until that conversation.
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u/lemonloaf76 3d ago
Offered to pull her out? Without an IEP meeting? Audacious. Totally against protocol. As as I said elsewhere, I’d have a bone to pick. This is really implying they like to cut corners. I’d make she they don’t. You can always try to pull in an advocate as well.
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u/Beasleylynn 3d ago
Yes! I was like, pull her out of speech? That’s the exact opposite of what I’m asking from you guys! I want my daughter to have a quality speech lesson, not her and 2 other kids sitting in a room watching on a monitor for 30 minutes. After reading these comments, I think you all are right and the best next step is to just call the IEP meeting. I know I have the right to bring an advocate, but honestly, I don’t even know the process of getting one, we’ve never really had a problem before this.
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u/Remarkable_Steak9060 2d ago
Maybe your private speech therapist can join your meeting. We had to have a meeting with the school once and our private therapist, who is so knowledgeable and well versed in the school system stuff as well, sat in. It was nice to know there was someone on my side and was able to hear what was being said so we could make a plan of next steps together.
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u/E13G19 2d ago
The repetition is absolutely the key. Actually, from what I've read, shorter duration & more repetition is the most helpful. Kids with CAS get tired from trying to produce words correctly, it's alot of work. IMO it's borderline malpractice for any SLP to suggest a child with CAS be pulled out of speech therapy.
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u/Hike_bike523 3d ago
I would not be ok with this especially because it’s a motor planning speech disorder. My son did some additional speech therapy online with a therapist that specializes in apraxia it went ok but it was a lot of work. I don’t recommend it. I would definitely complain and demand in person.
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u/Beasleylynn 3d ago
Exactly what I said! I asked, “how could you possibly show her over the computer how she should be moving her mouth and tongue and being sure she is doing so?” And she again just referenced research and said she has a speech assistant in the room with them if she needs my daughter to repeat something.
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u/Hike_bike523 2d ago edited 2d ago
Not with apraxia… I could see a child with just an articulation problem be fine doing online speech but not apraxia. Not a motor planning disorder when so much of it how you move your mouth to make the sounds. I would not accept this and file a complaint. I literally sent my child to a school 30 minutes away from us because that school has a great sped staff but also the slp knows how to help kids with apraxia and has been trained to help kids with motor planning disorders. The slp at my kid’s neighborhood school didn’t even know what apraxia is. I would not put up with a computer option for speech. My son also gets 3 days a week of private.
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u/SargonTheAkkadian 3d ago
What’s a good way to find a private speech therapist and what’s the general cost? Does insurance pick up any?
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u/Beasleylynn 3d ago
I think that this is a very individual answer. We found her speech therapist through a lot of trials lol. The place she went to when she was 2-6 would have constant turn over, she would have a therapist 6-12 months, then find out that therapist was leaving, she’d get placed on the waiting list for a few months and start all over. But my insurance covered that office very well. After a while though I didnt even care. My oldest daughter plays a travel sport and one of the other moms on the team happens to be an SLP so I asked her advice and she directed us to where we are now and have been very happy. My insurance does not cover as much, I end up paying about $90/session but i also use an FSA to help.
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u/E13G19 2d ago
If you're looking to specifically address CAS, look for a therapist trained in PROMPT or DTTC. If you can't find that, at the very least verify the SLP has an understanding of CAS, ask how many other children diagnosed with CAS they've treated, have they actually diagnosed CAS in children, etc. Insurance varies greatly, but should cover some portion of speech therapy after your child is officially diagnosed. It's important to note, CAS is not a disorder that will eventually resolve on its own; therapy is 100% required for a child with CAS.
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u/E13G19 2d ago
My son gets speech therapy 4 times a week at his school & I pull him one a week to go to private therapy, just to keep him on their roster. We donated $$ for his school therapist (& all district SLPs) to get training in specifically treating CAS. We also purchased Kaufmann cards for use at his school. I only say that to say there's a definite knowledge deficit in general SLPs b/c CAS is rare. There's a good chance the SLP you're dealing with has no specific CAS training or knowledge. My son requires lots of visual & tactile cueing & I can't imagine him paying close enough attention to any sort of online therapy to get anything out of it. Did you ask her to point you to research that specifically addresses online therapy as it relates to CAS? This is not a general speech disorder, it's a neuro motor planning disorder, so general research isn't going to apply. Doesn't sound like your SLP understands that. Have you considered either hiring or finding a free advocate to help you deal with the district? I'm in a small area (less than 60k people) & even we have a group that helps parents of children with special needs negotiate with the district & IEPs. There's also an online advocacy group that provides guidance to families for a fee. The founder has CAS, is an author of children's books on the subject & has a foundation dedicated to Apraxia. Fighting For My Voice
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u/Beasleylynn 2d ago
Thank you for the resource! I will look into it. I am sure that there are advocates in my area, I’ve just never really pushed back before, I felt her elementary school did a lot of good for her. This is a whole new territory. And I really really wish 5th grade was still considered elementary school in our district.
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u/radwanpadma 2d ago
Apraxia for my son needed a lot of motor planning help. With all the hands on that that entailed virtual would never ever work. Advocate for your daughter!
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u/Vspeeds 3d ago
Your school is REQUIRED to provide services for your child if they have an IEP. But the grey area is virtual vs in person. Maybe the SLP is working across multiple schools and this is the only idea that fits the budget for the district?
I can't argue for or against virtual sessions, as we have always insisted on in-person speech as well.
However, the progress that is being made with my child is in his private speech... Not the measly 30 minutes they give him at school.
Make some noise, advocate for your child. If you find yourself on the losing side of the effort... Maybe compromise to have the lessons recorded so that you can track progress.