Thursday, July 21, 2016

Therapy Tip: Can I ask my SLP that?

Welcome to Therapy Thursday! This is the day that I share some of my experience based as a pediatric speech-language pathologist and a mother of a child with special needs.

Today's topic is:

Can I ask my Speech-language pathologist that?

Having been a speech-language pathologist (SLP) since 2004 and Jaycee's mom since 2006, I can say that I have had many experiences on both sides of the table. I have performed evaluations, conducted therapy sessions, counseled families, and participated in meetings. I have also watched my child in therapy sessions, read through professional reports, and been the parent at meetings to discuss my child's progress. (My daughter has Down syndrome, severe childhood apraxia of speech, and is minimally verbal).

Some parents are very vocal and ask questions to communicate with me as an SLP. Others are quiet. Some of Jaycee's professionals have been very forthcoming with me and have had open lines of communication. Other professionals never seem to feel the need to communicate with me nor do they seem pleased when I ask questions. Since, I have experience in dual roles, here are some questions you may have for your child's SLP but may not know if you can ask.

Can I ask the SLP if my child can receive more speech therapy?
Yes, but let me explain something. This is probably the question I am asked the most at work. Determining how much therapy a child receives is based upon many, many factors. The first being the program rules. Right now, anything more than 1 visit a week in my state's birth-3 system isn't necessarily illegal, but it is highly discouraged. So, the child who receives more than one session a week must have a very good reason for it.

Other than policies, the important things I consider are:
-if the child has a diagnosis other than just a speech-language delay
-if the child is exhibiting red flags that might result in slower progress
-pertinent medical history
-the child's age
-the other services the child is already receiving
-test scores
-the amount of progress made on the current frequency/duration of speech sessions

If you are asking your child's SLP this, first consider why you want more speech therapy. Instead of just asking for more therapy, state your case. Tell the SLP your concerns, tell them how the delays are impacting your everyday life, and talk to them about what you hope to attain by increasing services. Sometimes, more therapy is appropriate. Sometimes, it is not! Asking for more therapy because you feel they need it won't get you far. You need to be specific with your concerns. If you ask this question, please be open to the SLP's answer and perhaps you two can come to an agreement or some timelines/expectations.

Can the SLP give me regular updates on my child's progress?
Here's the simple answer: yes, yes, yes!! Again, there should be a policy in place regarding how you are notified of your child's progress. If your child has home therapy or private therapy, then you are probably getting verbal updates regularly. In schools, it may be harder. However, there should be a spot on the IEP which will tell you how often the progress towards your child's goals will be assessed. Usually this is quarterly. Hopefully, the SLP is communicating this progress with you. If not, you could and should ask how your child is doing. I personally would not ask a therapist to update me after every session or even weekly. Yes, that would be ideal. However, school SLPs have huge caseloads. I think you will get better information if you ask for an update monthly or quarterly. This can be in the form of a call, written note, communication notebook, or email.

Can I ask the SLP to give me homework ideas?
Yes! You should know what your child is working on and why. Hopefully your SLP is giving you some ideas of ways you can help your child at home. It is so important that skills your child is learning in therapy generalizes over to the home environment, so you need to know some quick little activities to do with your child. Again, I would not ask for daily or weekly homework if your SLP is not giving you any ideas. But let them know you are more than willing to help at home and would love to know how to do that on a regular basis.

Can I ask the SLP for information on my child's future and prognosis?
Being a parent of a child with some fairly significant delays, I know many parents are worried about their child's future early on. I often asked my child's therapists early on how they felt Jaycee was doing and basically fished for information that may give me a glimpse into the future. I bet they hated those questions!

As a SLP, I am sometimes asked questions like: Will my child ever talk? Do you think they will be in special education forever? Do you think he will live independently one day? Do you think my child will outgrow this problem?

I don't have a crystal ball, and I can't possibly know the child's future, especially at the young age of 2. However, I know why the parents are asking those questions. I do know some basic information and experience that allows me talk to the parents about the red flags or concerns I have with their child and why/why not these may cause problems. Some parents don't need to be worried about their child needing special education or speech forever, and I can easily calm their fears. Other parents have reasons to worry, and I can't deny those reasons.

A better question to ask your SLP may be: Do you think these delays will be long term? What are the biggest concerns you have with my child and why? What's a reasonable expectation for my child 1 year or 6 months from now?

I really hope you have a good relationship with your child's SLP. If not, I hope you can develop one so that the two of you can work together to help your child.

Have a question not listed here? Comment below, and I will answer it. (Comments are moderated so they will not immediately appear.)

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