Long, but beyond frustrated with DD's speech therapist/suggestions. WWYD?

Love My Lil Princess 509

DD is 3 1/2 now and in speech therapy for an articulation delay. She also fronts and drops off the endings of words. She started last April, had no therapy over the summer and started again in Septemebr. I'm very friendly with her ST on a personal level and DD loves her, but I'm thinking I need to look at this from beyond the point. I've seen 0 improvement on any articulation issues, fronting, dropping or any of the letter sounds that she can't pro-nounce. I'm still her translator though some of the new phrases come out clear.

I took some suggestions and spoke with the ST about asking her for homework to do with her (why wasn't this given to me in the first place?) and finding out what the hell they are doing in there besides artwork and crafts. Well, I didn't say it that way lol.

I saw the ST today and ask what I can go over with her at home, she says "Um, nothing really." Ok? She's been a ST for 20 years I wanted to add. Then I ask what did they work on and get vague answers that she gives every week "We did the gingerbread girl worksheet." Again, that's not really an answer? What letter is she working on? Are they doing any kind of drills? How is this getting her articulation? I'm just getting beyond frustrated with the 0 feedback I'm getting from her therapist and no idea of how I can help her at home. She did give me word drills on flash cards to do with her, but DD has a hard time paying attention for 20 min. or so to do them. The therapist even said how hard they are to do and she has 4 year olds who can't get through them.

She then comes out of left field after I say I concerned that "I'm really concerned she's not where she should be with her language."  Um DUH lol, maybe bc she had made 0 progress with ANYTHING on her IEP she was given from the school system. Her speech is about as unclear as it was when she started. Then she starts saying how sometimes she's so quiet during her sessions. She's never expressed any concern about this before. DD just started having her sessions with the ST at the preschool office where the ST works full time bc it's closer to my home, so it's a new environment for her. And DD can sometimes take time getting used to someplace new. She went from a very shy 2  1/2 year old to a 3 1/2 year old now who doesn't stop talking and LOVES preschool though.

The ST seems to STILL not believe that DD is a chatter box at home, school, with family, strangers we meet, etc. So perhaps it's whatever strategies she is using, it's not getting DD to talk. Or better yet, work on the issue, her articulation. Then she starts saying her "teacher friend" at the school suggested maybe DD attend their 5 day a week intergrated preschool program. I'm now completely confused where this convo is going. DD is already enrolled in a 2 day a week program I'm, and she's very happy yet. It's play based and the ST was the one that suggested I enroll her in preschool at 3, otherwise I would have kept her home until 4 for unviversal pre-k. I have 0 desire to pull her out mid year to put her in another program. Nor can we afford this pricey school she works at

During her evaluations last year, she actually scored high on the educational part. She then says "Oh, well you have an education background, where do you feel like she's at with her numbers and such?" DD can count to about 15 or so, but sometimes she goes wonky after 7 or so, and she's better counting with actual objects in front of her. I am not least bit concerned with this as kids learn at their own pace IMO.

Part of me feels like she was trying to deflect the fact that her speech therapy is doing 0 for DD and maybe trying to make it like it's DD's fault that she's not "Getting" what the ST is doing with her. Whatever that is. Or is she passively telling me there is something else wrong with DD, which according to her evals, she's not, and she has no right to determine either. Perhaps her therapy just isn't "good" for my child. I get feedback that doesn't do anything for me from Sept to now, except "Oh she's doing good, or we worked on fire safety and then a scholastic handout to read. She'll gets sent out with a worksheets matching pictures totally unrelated to the activity she said they did. She goes from telling me how DD pays such good attention during their sessions to today, "DD looks around sometimes." She goes on to say she thinks she's leaving the agency DD gets her speech from bc its too far a commute for her, parents are canceling with her, but DD can still get speech with her. But how would that be possible then?

Her final suggestion is that I contact my case coordinator to tell them I'm concerned about her language. DD gets re-evaluated, she will suggest in her evaluation that she gets an additional half hour (big whoopie) and also get it over the summer. But that means she goes through another 3 long drawn evaluations so they can say she's at the same point she was at last year with any of her goals.

I also felt like she was kind of saying that her current pre-school isn't adequate enough bc she doesn't know her numbers or letters perfectly. But isn't she with her for speech therapy? I'm think she even had her "teacher' friend test DD or something?

Anyone think it's time to contact my case coordinator with the school system and request a new therapist? Stick with her? WWYD?

Beth.1212

Take this with a grain of salt, as I'm no expert. I'd get on the phone with your case coordinator tomorrow and start the process to get someone new. Your therapist should be about to effectively communicate with you, and she should have some sort of explanation as to your daughter's (lack of) progress, IMO. Even if it's just, "we are trying techniques XYZ, sometimes it takes many months and then there's rapid progression" or something. Based on what you've said, I'm not at all convinced that this therapist is making any progress at all. With the case coordinator, I'd probably phrase it as "she is very nice, but based on the discussions that we've had and the very small amount of progress we've seen, I'm concerned that she's not a good fit for my daughter." 

On a sort-of related note: my DS started seeing a developmental specialist for a language delay once a week through EI when he was, oh, 15 months or so. At least, I think her title is developmental specialist. I did wonder at the time why he was assigned an overall developmental person rather than a speech person, but I figured the EI folks knew what they were doing. He made some progress, but not much. As his 6 month evaluation approached, I expressed a concern about his lack of progress and the developmental person admitted that she was at a bit of a loss on what else to do. We switched to a speech therapist around 21 months, and the progress he's made since starting with her about 3 months ago is AMAZING. Maybe it's a coincidence and he was just at that point where the timing was right and he was ready to learn, but I really think it was the change to a different specialist that made the difference. All this is my long, roundabout way of saying that I think that finding the right teacher can make all of the difference. 

Keeptruckin

Hi! My daughter is receiving speech therapy but entirely for social communication due to autism. Honestly, it sounds like you need someone new. The current slp isn't giving you good information and sounds just scatter brained, what does her moving, or commute have to do with your daughter, etc.
Our issues are very different of course but the SLP will tell me, okay we are working on xyz. Her is where she is at, here is where I would like to see her at in 2 months. Here is what I'm doing with her, and here are exercises you can do. The exercises are very concrete things we can work on.

PrimRoseMama

I'd say do.something new because you are frustrated. However, I also think you are not having reasonable expectations of therapy. Especially when it's not consistent (3 months off can make a big difference).

Try something new-- but realize that this entire situation is a process. DD has been in SLT since 16 months old & is just now stringing sentences. She 3 & clarity is our next hurdle.

It's not an immediate gratification type thing & there is no quick fix.

Love My Lil Princess 509

Thanks ladies. I agree with all of you. I know this is a process and last year she told me she didn't qualify for summer speech nor would she recommend it bc you had to have a delay like autism or ADHD to qualify. Now yesterday she's telling me she's going to recommend her for that too. Also, I don't get why she's suggesting we switch preschools to the one she works at. She even said "oh, I don't want you to feel like I'm pushing my school on you." She was making it like dd is soo far behind bc she gets confused here or there with her numbers. Sometimes she just clams up. And I was not asking her to have her teacher friend meet with dd either. She's a very nice person, even gave me paperwork to try to sub at her school, but I'm just feeling like maybe she's not the right fit. Like she's trying to make it like dd is the issue and not that maybe she needs to do something new. She's been a st for 20 years to btw.

chickaboo1974

So your daughter is 3.5.... are her speech services being offered by the school district then?  I ask because my son is 4 and since he was 3 he receives speech services thru the school district.  We could have just took the speech services and sent him to a private preschool, but my school district runs a 5 day a week intergrated preschool program.  If your child qualifies for the program it is free.  They also have tuition students- which only attend 3 or 4 days.  I have found that my son has done so well, that this year we put his twin in the school as a tuition student 3 days a week.  I can't say how impressed I am with the school.  They evaluate every student to make sure they are reaching milestones both academically and  physically.

And while I think since you are not happy with the speech therapist, you should call the case coordinator and request someone new.  But also be aware that speech therapy is not an easy fix- my son has been in speech therapy for over 2 years.  He is talking in complete sentences and more- but he still has his articulation issues which might mean that he will be in speech for many more years.

StacyJYay

I'm not an expert in this area, but it sounds like a new ST is in order.  Consider cross-posting this on the Special Needs board -- seems like a group that's very knowledgeable in this area (not that the folks here aren't!).  Best of luck to you and LO! 

Love My Lil Princess 509

I've actually already been in contact with her case coordinator already and a switch is in the process. I contacted the 2 other agencies our school system worked with and after speaking with one and getting a lot of helpful info, I requested she be switched to that agency with a new therapist. Pretty certain it is a fast process too, so I'm crossing my fingers she will be with someone new the beginning of the new year.

 

Yes, she gets speech from our school system but does not qualify for an intergrated pre-school. Next year she will go to a universal Pre-K at 4 and I guess go to the agency for her therapy. I'm going to mention to the new therapist about getting her more hours and speech over the summer.

 

I def. understand speech can take years. I was in an out in under a year, dh was in for close to 6 years, but at the same time when I feel like someone isn't doing all they could be doing and I'm not being given any useful feedback, why continue wasting time, you know. I'm hoping everything goes easily with the switch. Thanks ladies!!

chelseymat

Has your DD seen an ENT? When DS2 was referred for speech therapy our pedi suggested we also see an ENT while we wait for his speech eval. They did a number of simple tests to check for fluid on the ears and to assess his hearing. He can hear fine but maybe this is part of your daughters problem? 

Also, find out if your insurance pays for any type of speech therapy. Ours doesn't pay for the therapy but it did pay for a private eval which took less than 1 hr for DS2 to complete with the speech therapist. This might help your case with the school district.

And to give you an idea, I sat in on DS2 first speech therapy session this week. She worked on his 'w' sound and every time he pronounced it correctly he got a part to the toy they were assembling. SHe also had him do some breathing exercises. Specifically he was blowing through a straw to try to move a cotton ball across the table. She explained to me this helps his facial muscles. She also told us to practice this for 'homework'

sorry you are having such a hard time with speech therapy. its been a super frustrating process for me too. We just want help for our littles! I would be very concerned with the therapists inability to answer your questions or provide you with direct feedback about your LO

Love My Lil Princess 509

Her therapist has already been changed. Fast right? Her old ST texted me saying she was sorry to see us go, when her IEP eval is and that she needs her flash cards back that she lent me lol. I actually still feel bad that we switched bc DD adores her. She talks about her daily and well she was really nice to me to, but I had to do what I had to do. I don't even know how I'm going to tell DD she won't be seeing her again.

 

I don't know what her therapist was suggesting, and I didn't really appreciate her having her "teacher" friend meet my daughter either. She's supposed to be there for speech, not having random people with my daughter doesn't sit well. I'm certified to teach too, and IMO, knowing numbers and letters perfectly at 3 is a non-issue to me. I could read a book to her once, open the book again weeks later and she'll point to a picture I showed her and know that "He's the bad lion." or whatever. DH even thought maybe she is getting some sort of financial kick back on getting "new people" into her preschool or even how she was trying to get me to sub at her school. After her telling me I should I put DD in the preschool she works at, she even said "Oh, I don't want you to feel like I'm pushing my school on you."

Her receptive language was just fine during her last evaluation and her ability to understand what I ask, do something, is fine and was never mentioned to be a problem. But it couldn't hurt to mention it to her new ST. When I get a ton of " Oh, she listens so well, it's amazing or she did good.", but no mention of what they did other then "Fire safety or The holidays", what kind of answers are these. Soo frustrated.

 

fitmom82

I haven't read though all the responses, but I'd look into a new speech therapist.

My nephew also has a speech delay and some issues.  He was in a daycare until just before 2 and then went to a stay a sitter with 2 other children, who also had speech delays.  At 3 he really wasn't saying much.  In September he started preschool, 5 days a week 8-3, it's amazing how much his speech has improved in just 3 months.  He still doesn't speak clearly and I believe his mom is slowly working on getting him some help, but it might be worth putting her in school a few more days a week.   Atleast of my nephew it's made an amazing improvement.  DD goes to preschool 5 days and it seems like the kids there a few days are much quietier and uncomfortable, I guess they feel left out in some ways. 

mama2bornot2b

I am an SLP, now SAHM, and you needed a new therapist. You have a right to know exactly what your DD is working on each session and you should be given examples of ways to target her goals at home during your day. You should be able to observe sessions too. Your DD will not make progress with ST alone, they are only with the SLP a short time each week. Your DD's sessions should be play based at her age. That said, each child is different and she will need consistent therapy with carry over and goals addressed at home to see progress...and even then it can take 6 months to a year to see some progress...not goals met, but progress. In the meantime there are good and bad online resources for parents. www.ASHA.org and www.teachmetotalk.com have good info for parents.

Love My Lil Princess 509

That's the thing, I've ALWAYS wanted to help her at home. But like I said, I was never given the opportunity to other then reading magazines and books she'd come out with or doing coloring sheets. I did do the word cards she gave me, but I don't even think the ST was doing the drills with her, at least she never mentioned doing them with her again. I always correct her when she speaks, but I guess that's not enough.

I called my insurance company yesterday and the good news is, something must have changed in our plan bc they will cover speech 80% after our deductible is met, but only 24 sessions per calendar year. Last year our deductible was met in May, so maybe we can start private speech over the summer along with her speech from the school system. Not sure if the private speech practice will have an issue with DD going for only 24 sessions though

 

mama2bornot2b said:

I am an SLP, now SAHM, and you needed a new therapist. You have a right to know exactly what your DD is working on each session and you should be given examples of ways to target her goals at home during your day. You should be able to observe sessions too. Your DD will not make progress with ST alone, they are only with the SLP a short time each week. Your DD's sessions should be play based at her age. That said, each child is different and she will need consistent therapy with carry over and goals addressed at home to see progress...and even then it can take 6 months to a year to see some progress...not goals met, but progress. In the meantime there are good and bad online resources for parents. www.ASHA.org and www.teachmetotalk.com have good info for parents.

Apraxia has never been mentioned, but I have started to panic and googled stuff on it. I guess it could be a possibility, though her errors her pretty consistant and most of the info I found confusing for a parent to understand. Should I request her to be re-evaluted then or just bring up all of these zillion concerns to my new ST and see what her take is? I also set up a hearing test for DD, which has never been done since birth, to rule out that issue. DH thinks I'm crazy lol.

Unfortunately, we can't afford anymore preschool then the 2 days we have her in now. DH did ask the teacher how she's doing, if she was interacting with the other kids, etc, and she told him she was.

EWBauer29

Hello! I am new to this board but had to chime in also - I am a licensed Speech-Language Pathologist (currently a SAHM) with six years of experience working in the public school system with children 3-12 (preschoolers being a bulk of my caseload). You absolutely should look into finding another therapist. Since your child is 3 1/2 - I would recommend calling your local Board of Education and learning about services through the public school system. They are free services that your child is entitled to as long as she qualifies for an IEP. I'm not sure who mentioned apraxia of speech above, but only an SLP (or pediatrician- though they aren't too great at making the diagnosis in my opinion) can diagnose CAS. It is VERY rare - I believe less than .75% of all diagnosed speech and language cases. It's a label that in my opinion is thrown around much to easily. From your description - your child demonstrates a Phonological Disorder- different from a simple articulation error. I like to tell parents that phonological process errors are speech errors that encompass whole CLASSES of sounds whereas an articulation error is a mistake at the single sound level - think of Barbara Walters who can't say her r's or a child with a lisp - these mistakes are not so significant and do not impact the MEANING of what is being said - whereas a phonological process error can impact the meaning of the child's language. Your SLP should know this and was possibly trying to explain this in some roundabout way. For example if a child is reducing consonant blends at the beginning of words; plane may come out as "pain" and you are then worried that the child is in pain because the meaning of the word was changed based on how they are saying it. I also like to explain to parents that phonological process errors are more all encompassing and do take more time in general to fix as opposed to an articulation error (in general - not always though - some of those darn r"s take a while to fix!). I would also ask what approach your therapist is using. I personally prefer the cycles approach or the complexity theory. I have found that some children benefit from one and not the other so much. If she is using the cycles approach she would be cycling through your child's errors and may not get to mastery level for a while. For example, she would working on fronting for 2-3 weeks and then work on ending sounds for another 2-3 weeks and then goes back to fronting. Like the previous SLP stated - asha.org is our national accreditation body and has an excellent website. I also really like Mommy Speech Therapy too (Google it). Your SLP may not be giving you worksheets because much of what she is doing is play based. Your little girl is not going to sit and do drills at 3 1/2 - ask your SLP what sounds you should be targeting and try to incorporate them into everyday life and routines. Make sure you have her look at your mouth when you are saying her sounds. So you said she is fronting - which means she is taking a back sound (k or g) and producing it in the front of her mouth instead so "cookies" become "tookies" and "cat" becomes "tat/dat." So sounds you will want to make sure to target at home are k & g. When you are at the grocery store point out the carrots - see if she can say carrots. Talk about what color they are and that bunnies like to eat them. This builds her language skills and targets her sound production. Another tip I can give you to help at home that I give to all of my parents is called "conversational recasting " - when your little lady says "look mama tat" - say it back to her and expand on her language - so she is getting the correct model of the sound and again building those beautiful language skills. So you might say "Yes Sarah! Look the brown cat is playing with a ball." Wow - who is missing her job?!? Haha! I hope these suggestions help and that you are able to find someone who better suits your families needs. Look into the public school system and you can always look into private practices or hospitals for outside services that would be covered by your insurance. Best of luck to you and your little lady!

3litttlebirds

I am an SLP (well, I'm a SAHM now). I agree you need a new therapist (started skimming the messages, but looks like you have found one). I know it's hard when you feel like you and your child connect with a therapist on a personal level, but you are paying them to help your child with communication. If progress is not being made, you have to move on at some point. And a good therapist should understand that and not take it personally. Different children respond to different methods/people better. Speech therapy is a process and sometimes it can take quite awhile for progress to be seen, but usually less so with something like articulation (unless it is a more involved issue than "just" articulation delay). But, in this case, it does seem time to move on if you feel that the ST is not communicating properly with you and not providing you with homework (which a child definitely needs...progress shouldn't be made in the speech session for a short time each week). Best wishes to you and your daughter!