Speech Therapy
michelle_m29
My seven year old has some severe speech issues. He talks in complete, complex sentences with a huge vocabulary and correct grammar....but there are something like 40 sounds that he's not capable of making. As I understand it, the muscles in his mouth and tongue just aren't able to do it yet.
For the past three or four years, he's been in speech therapy. First, it was with a therapist through our HMO who pretty much wrote him off because we were limited to 20 visits over his lifetime and she felt that he was going to wind up getting services through the school district anyway. That lasted about a year, with me spacing out the appointments as far as I could get away with and working with him at home. We spent the entire time working on the letter P, with no results.
After that, we changed insurance and started getting therapy through a private children's therapy center. Our current insurance coverage (which is awful for everything else) allows for unlimited speech therapy, so we've been going every week for the past two years. His second speech therapist was fantastic. Instead of telling him how to shape his lips and expecting him to do it, she had him doing all sorts of oral motor development -- blowing bubbles, chewing on stale licorice, sucking applesauce through thinner and thinner straws... he adored her, and she was great with him. If I thought I heard him making a new sound and asked her if she heard it too, she'd drop her plans for the day and switch sounds to take advantage of his new ability.
Last month, she quit without warning because her husband had accepted a new job offer across the country. So now we have a new speech therapist, the one the children's therapy center just hired. We've had three appointments, and I've been biting my tongue through all of them. I'm the only parent they have who sits in on every single session (as far as I know, I'm the only one who sits in on Any appointment -- most seem to drop their kids off and head to the grocery store) so I'm trying to tread lightly.
Quinn still seems to be enjoying his appointments, but thinks she treats him like a baby. Which she does. They're playing with actual baby/toddler toys. She seems to be adjusting that a bit, so I'm being patient about that.
She doesn't seem to be listening to him. They were doing a puzzle with farm animals and she was having him name each animals. When it was a pig, he called it "bacon"...the sheep was "wool for a sweater"....the fish was "sushi" It seemed to me like she was listening for the "P" sound in pig, so she tuned out what he did say. To be fair, Quinn can be really hard to understand, but it seems like if he's telling her something when she wants another answer, she hushes him and gets along with her own agenda. So I've been translating for him. If she's trying to listen, I keep my mouth shut, but if she's ignoring something he actually said, I repeat it.
My other concern...frustration...whatever... is the way she tells him not to do things. Not that she tells him not to do it, but the way she does it, which Quinn seems to take as a personal challenge. On our second appointment, he'd been gluing pieces of paper to a larger piece of cardstock. When he handed it to me to take home with us, he tried to toss it like a Frisbee to see if it would fly. The speech therapist launched into a lecture about how the edge of the paper could have cut my cheek...and Quinn launced into an argument about how paper can't cut people's skin.... Last week it was about not tipping back in his chair because he could get hurt....so he took that as a challenge and laid the chair on his back and sat on the front edge of the seat, and then she had to get him to stop doing that.... (And yes, I told him not to do it myself, but telling my son not to do something is almost a guarantee that he'll need to do it six or eight more times)
I'm trying to figure out how to handle it. I don't think he should be throwing things in her office (since that's her rule) or tipping chairs back (because it probably won't hurt the kid, but I've repaired enough chairs to prove what it can do to the furniture and I don't want him tipping my chairs at home or anyone else's either), but the way she's trying to get him to stop won't work with him. She'd stand a better chance by just saying "don't tip the chair" or "don't throw anything."
Do I stay out of it and let the two of them work it out? Pull him into my own lap and physically prevent chair tipping? Suggest she talk to him a different way? (His last speech therapist would've moved him to the floor on a beanbag, but this one seems to have a definite agenda in mind and not be willing to deviate from it, even when an easy change would make things go more smoothly) I'm going to remind him before his appoinment that tipping chairs and throwing things really upsets M, which I hope might help with those two problems, but he's likely to come up with some new and unexpected way to break the rules.
(His father wants him in speech therapy, so quitting isn't an option. And, so far, Quinn has really enjoyed his appointments, even with the awful therapist we first started out with. This is the only provider covered by our insurance, so I can't switch therapists. It's in our best interest to make this work out the best I possibly can.)
Michelle
For the past three or four years, he's been in speech therapy. First, it was with a therapist through our HMO who pretty much wrote him off because we were limited to 20 visits over his lifetime and she felt that he was going to wind up getting services through the school district anyway. That lasted about a year, with me spacing out the appointments as far as I could get away with and working with him at home. We spent the entire time working on the letter P, with no results.
After that, we changed insurance and started getting therapy through a private children's therapy center. Our current insurance coverage (which is awful for everything else) allows for unlimited speech therapy, so we've been going every week for the past two years. His second speech therapist was fantastic. Instead of telling him how to shape his lips and expecting him to do it, she had him doing all sorts of oral motor development -- blowing bubbles, chewing on stale licorice, sucking applesauce through thinner and thinner straws... he adored her, and she was great with him. If I thought I heard him making a new sound and asked her if she heard it too, she'd drop her plans for the day and switch sounds to take advantage of his new ability.
Last month, she quit without warning because her husband had accepted a new job offer across the country. So now we have a new speech therapist, the one the children's therapy center just hired. We've had three appointments, and I've been biting my tongue through all of them. I'm the only parent they have who sits in on every single session (as far as I know, I'm the only one who sits in on Any appointment -- most seem to drop their kids off and head to the grocery store) so I'm trying to tread lightly.
Quinn still seems to be enjoying his appointments, but thinks she treats him like a baby. Which she does. They're playing with actual baby/toddler toys. She seems to be adjusting that a bit, so I'm being patient about that.
She doesn't seem to be listening to him. They were doing a puzzle with farm animals and she was having him name each animals. When it was a pig, he called it "bacon"...the sheep was "wool for a sweater"....the fish was "sushi" It seemed to me like she was listening for the "P" sound in pig, so she tuned out what he did say. To be fair, Quinn can be really hard to understand, but it seems like if he's telling her something when she wants another answer, she hushes him and gets along with her own agenda. So I've been translating for him. If she's trying to listen, I keep my mouth shut, but if she's ignoring something he actually said, I repeat it.
My other concern...frustration...whatever... is the way she tells him not to do things. Not that she tells him not to do it, but the way she does it, which Quinn seems to take as a personal challenge. On our second appointment, he'd been gluing pieces of paper to a larger piece of cardstock. When he handed it to me to take home with us, he tried to toss it like a Frisbee to see if it would fly. The speech therapist launched into a lecture about how the edge of the paper could have cut my cheek...and Quinn launced into an argument about how paper can't cut people's skin.... Last week it was about not tipping back in his chair because he could get hurt....so he took that as a challenge and laid the chair on his back and sat on the front edge of the seat, and then she had to get him to stop doing that.... (And yes, I told him not to do it myself, but telling my son not to do something is almost a guarantee that he'll need to do it six or eight more times)
I'm trying to figure out how to handle it. I don't think he should be throwing things in her office (since that's her rule) or tipping chairs back (because it probably won't hurt the kid, but I've repaired enough chairs to prove what it can do to the furniture and I don't want him tipping my chairs at home or anyone else's either), but the way she's trying to get him to stop won't work with him. She'd stand a better chance by just saying "don't tip the chair" or "don't throw anything."
Do I stay out of it and let the two of them work it out? Pull him into my own lap and physically prevent chair tipping? Suggest she talk to him a different way? (His last speech therapist would've moved him to the floor on a beanbag, but this one seems to have a definite agenda in mind and not be willing to deviate from it, even when an easy change would make things go more smoothly) I'm going to remind him before his appoinment that tipping chairs and throwing things really upsets M, which I hope might help with those two problems, but he's likely to come up with some new and unexpected way to break the rules.
(His father wants him in speech therapy, so quitting isn't an option. And, so far, Quinn has really enjoyed his appointments, even with the awful therapist we first started out with. This is the only provider covered by our insurance, so I can't switch therapists. It's in our best interest to make this work out the best I possibly can.)
Michelle
Sandra Dodd
-=-Last month, she quit without warning because her husband had accepted a new job offer across the country. So now we have a new speech therapist, the one the children's therapy center just hired. We've had three appointments, and I've been biting my tongue through all of them. I'm the only parent they have who sits in on every single session (as far as I know, I'm the only one who sits in on Any appointment -- most seem to drop their kids off and head to the grocery store) so I'm trying to tread lightly. -=-
Wouldn't it be cool if you could occasionally have a session with the old therapist by skype? :-) I'm serious, even if you had to pay her directly, a few times a year. But maybe your insurance would pay for it.
(Oh� later you you wrote: "This is the only provider covered by our insurance, so I can't switch therapists." It's possible you could write and appeal.)
-=- On our second appointment, he'd been gluing pieces of paper to a larger piece of cardstock. When he handed it to me to take home with us, he tried to toss it like a Frisbee to see if it would fly. The speech therapist launched into a lecture about how the edge of the paper could have cut my cheek...and Quinn launced into an argument about how paper can't cut people's skin�. -=-
And what did you say?
Paper absolutely can and does cut people's skin.
-=- Last week it was about not tipping back in his chair because he could get hurt....so he took that as a challenge and laid the chair on his back and sat on the front edge of the seat, and then she had to get him to stop doing that.... (And yes, I told him not to do it myself, but telling my son not to do something is almost a guarantee that he'll need to do it six or eight more times) -=-
Is that kind of behavior possibly the reason the therapist is using baby toys? (You don't need to tell us, I'm just suggesting that it's not so cool, especially if he does that with his mom there.)
-=-I'm trying to figure out how to handle it. I don't think he should be throwing things in her office (since that's her rule) or tipping chairs back (because it probably won't hurt the kid, but I've repaired enough chairs to prove what it can do to the furniture and I don't want him tipping my chairs at home or anyone else's either), but the way she's trying to get him to stop won't work with him. She'd stand a better chance by just saying "don't tip the chair" or "don't throw anything." -=-
He shouldn't be throwing people in anyone's office, ever again, in his whole life, whether it's a rule or not.
And she shoudln't need to say "don't throw anything." He should be prepared to go to an office by now (if he's been going for years) and know not to tip chairs or throw things.
Maybe he just doesn't want to be there, but maybe you could figure out a different way to coach him on courtesy and safety and taking care of furniture and such.
-=-I'm going to remind him before his appoinment that tipping chairs and throwing things really upsets M, which I hope might help with those two problems, but he's likely to come up with some new and unexpected way to break the rules. -=-
Exactly. Make it about principles and not about rules. Make it about the kind of person he is being, not about the things he's doing or not doing. http://sandradodd.com/rules
Sandra
[Non-text portions of this message have been removed]
Wouldn't it be cool if you could occasionally have a session with the old therapist by skype? :-) I'm serious, even if you had to pay her directly, a few times a year. But maybe your insurance would pay for it.
(Oh� later you you wrote: "This is the only provider covered by our insurance, so I can't switch therapists." It's possible you could write and appeal.)
-=- On our second appointment, he'd been gluing pieces of paper to a larger piece of cardstock. When he handed it to me to take home with us, he tried to toss it like a Frisbee to see if it would fly. The speech therapist launched into a lecture about how the edge of the paper could have cut my cheek...and Quinn launced into an argument about how paper can't cut people's skin�. -=-
And what did you say?
Paper absolutely can and does cut people's skin.
-=- Last week it was about not tipping back in his chair because he could get hurt....so he took that as a challenge and laid the chair on his back and sat on the front edge of the seat, and then she had to get him to stop doing that.... (And yes, I told him not to do it myself, but telling my son not to do something is almost a guarantee that he'll need to do it six or eight more times) -=-
Is that kind of behavior possibly the reason the therapist is using baby toys? (You don't need to tell us, I'm just suggesting that it's not so cool, especially if he does that with his mom there.)
-=-I'm trying to figure out how to handle it. I don't think he should be throwing things in her office (since that's her rule) or tipping chairs back (because it probably won't hurt the kid, but I've repaired enough chairs to prove what it can do to the furniture and I don't want him tipping my chairs at home or anyone else's either), but the way she's trying to get him to stop won't work with him. She'd stand a better chance by just saying "don't tip the chair" or "don't throw anything." -=-
He shouldn't be throwing people in anyone's office, ever again, in his whole life, whether it's a rule or not.
And she shoudln't need to say "don't throw anything." He should be prepared to go to an office by now (if he's been going for years) and know not to tip chairs or throw things.
Maybe he just doesn't want to be there, but maybe you could figure out a different way to coach him on courtesy and safety and taking care of furniture and such.
-=-I'm going to remind him before his appoinment that tipping chairs and throwing things really upsets M, which I hope might help with those two problems, but he's likely to come up with some new and unexpected way to break the rules. -=-
Exactly. Make it about principles and not about rules. Make it about the kind of person he is being, not about the things he's doing or not doing. http://sandradodd.com/rules
Sandra
[Non-text portions of this message have been removed]
Robin Bentley
> My seven year old has some severe speech issues. He talks inI don't get this. If the muscles in his mouth and tongue aren't able
> complete, complex sentences with a huge vocabulary and correct
> grammar....but there are something like 40 sounds that he's not
> capable of making. As I understand it, the muscles in his mouth and
> tongue just aren't able to do it yet.
>
to do it yet, why is he getting therapy?
If it's a matter of maturation (muscles growing and getting stronger
with age), then will therapy make that happen faster?
A huge vocabulary and correct grammar at 7 is a big deal. So maybe
he's behind in some things and ahead in others. Very common.
-=- His father wants him in speech therapy, so quitting isn't an
option.-=-
His father wants him in speech therapy, because he thinks he'll never
get better? will never be intelligible? Your son's still really young.
Quinn's behavior indicates to me that he's not especially happy being
at therapy. Sandra's advice about coaching is sound, though, if it's a
"have-to" and there is no choice for him.
Robin B.
Pushpa Ramachandran
>I know that Maine and New Hampshire have a law that requires insurance to
>
>
> >>>Wouldn't it be cool if you could occasionally have a session with the
> old therapist by skype? :-) I'm serious, even if you had to pay her
> directly, a few times a year. But maybe your insurance would pay for it.
>
>
cover telerehab/ telespeech. But I have also heard of insurance
reimbursement in other states.Sometimes coverage is on a case by case
basis. If you could contact your insurance case manager (write a letter
requesting coverage) and get a supporting letter from the SLP of your
choice, you might stand a good chance to get some coverage- if not all..
Thanks,
Pushpa
[Non-text portions of this message have been removed]
michelle_m29
> Wouldn't it be cool if you could occasionally have a session withThat -would- be cool, and paying directly for an appointment a few times a year would probably be do-able. But she's not going to be working as an SLP in her new home state, so I'm not sure if it's a possibility. I wonder if ethics would allow her to make some non-professional suggestions for money?
> the old therapist by skype? :-) I'm serious, even if you had to
> pay her directly, a few times a year. But maybe your insurance
> would pay for it.
Our insurance is terrible to deal with, even when we're playing by their rules, so I don't have much hope of them paying for an out-of-network provider.
>***snipped the part about him throwing paper like a frisbee***
> (Oh later you you wrote: "This is the only provider covered by our insurance, so I can't switch therapists." It's possible you could write and appeal.)
> And what did you say?I told him not to throw the paper again. I do know that paper can and does cut skin, but I doubt it would have happened in those circumstances. Is trying so see if a piece of paper will fly like a Frisbee really the same as throwing a toy or other object? Especially when they've just been blowing feathers with straws and had other small, light things flying through the air....I see the difference, but I can understand the lines blurring for him.
>
> Paper absolutely can and does cut people's skin.
> Is that kind of behavior possibly the reason the therapist is using > baby toys? (You don't need to tell us, I'm just suggesting thatShe had the baby toys out and was using them with him before he did any acting up. And I -totally- agree with you that it's not so cool for him to tip chairs. But if that's the worst thing he does in her office, he's acting WAY better than he did a year ago. Not in speech therapy appointments - he's usually fairly good there - but in general.
> it's not so cool, especially if he does that with his mom there.)
> He shouldn't be throwing people in anyone's office, ever again, in his whole life, whether it's a rule or not.Thank you for helping me sort this out in my own head, Sandra. I think he was, mostly, prepared to follow the old speech therapist's expectations. She wouldn't have objected to the flying sheet of paper. And there were different chairs that weren't so invitingly tippy...
> And she shoudln't need to say "don't throw anything." He should be prepared to go to an office by now (if he's been going for years) and know not to tip chairs or throw things.
We've got an appointment this morning. I'm hoping it goes better than the last one.
Thanks!
Michelle