Would like a formal dx/ transition from EI

[Guest guest]

Hi All!

It's time for me to pick your brains! I haven't done it in a while!!

LOL!! Okay, here goes.... My son, 2.8, will be aging out of EI

in August and going into the school system. Before that happens I would

really like to get a formal dx. It seems to me that you get better

services that way. (correct me if I'm wrong!) My insurance, which has

been good in every other way, does not foot the bill for a dev. ped.

eval. Where else can I get a dx? He has speech delays (I think he's

mildly apraxic) and sensory issues (waiting for OT eval. right now) but

his behavioral problems that are getting worse by the day are what

REALLY worry me. I'm sure some of it is sensory but I'm not sure how

much. Today we had 10 meltdowns by 3:00 pm. (Argh!!) I don't have almost

$1000 to shell out for an evaluation. Would one of the Neurologists that

take my insurance give a dx? Also, I noticed that many of you get

private services in addition to EI or CPSE. Currently he receives

speech/feeding 1hr 2x/week, sped 45min. 2x/week and a child psych. has

just started coming 2x/month. I would really like to increase his speech

by at least one more session a week and depending on what they approve

for OT I'm sure more would be better. Where do I even begin to try and

get additional services privately? Is it mostly clinic based or in-home

similar to EI? I've also been reading with much interest on the board

about listening/music therapy that some of your children receive and

would like to know more about it. Is it a private service? One more

thing...When he's done with EI does he have to go on to CPSE or will the

county pay for a private preschool with services (either all or partial

tuition)? Okay ladies (and gentlemen, of course!) start your brains!!! I

know you have this info in there somewhere, you've never let me down

before!!!! I cannot convey to you all how much this list has done for

me, all I can say is.......THANKS!

TIA for any info,

Happy Earth Day,

~Dani~

Farmingdale, NY

Mom to

1.9 (31 weeker, torticollis (resolved), plagiocephaly, reflux,

fine motor delays, sensory issues, receptive language delays, etc. etc.)

2.8, (speech/feeding delays, hypotonia, DSI??? and who knows

what else!!!)

7.2 (a JUST FINE, happy first grader!)

(private e-mails okay)

[Guest guest]

Hi Dani,

Welcome to the world of IEPs!!

Regarding a diagnosis, you can get one from a neurologist? Will they

pay for that? 's first diagnosis was by a neurologist but to be

he wasn't too up on apraxia but maybe some members can recommend one

on Long Island. Perhaps Long Island jewish or North Shore has someone

there. There was a Dr. Joan Sheppard who spoke at a Cherab meeting

awhile ago but I don't know exactly what type of Dr. she was. I do

know she is big on feeding issues, which I learned from an SLP who

has worked with her.

I do believe you get more services from the school system when you

have independent evaluations and letters from a Dr. You will also get

more from insurance with neurological insurance codes as opposed to

those that indicate developmental delays.

In terms of private therapy, call the Promptinstitute or send them an

e-mail on their web site www.promptinstitute.com. If they have

certified SLps in your area that would be a great starting point.

Also contact the ASHA, they usually have therapists on their web site

which would be a good starting point. Usually they don't come to the

house. In our case this was better to get my son off his home turf!

You can have them pay for services in a private pre-school but it is

a tough battle. It depends on your district. My experience in-

district has been positive but there are horror stories out there! Go

observe now before school is finished for the year to get an idea of

their program!

I'll also froward this to another parent from Long Island who has an

older child.

Good luck and write anytime!

denise

Mom to almost 4

> Hi All!

> It's time for me to pick your brains! I haven't done it in a while!!

> LOL!! Okay, here goes.... My son, 2.8, will be aging out of

EI

> in August and going into the school system. Before that happens I

would

> really like to get a formal dx. It seems to me that you get better

> services that way. (correct me if I'm wrong!) My insurance, which

has

> been good in every other way, does not foot the bill for a dev. ped.

> eval. Where else can I get a dx? He has speech delays (I think he's

> mildly apraxic) and sensory issues (waiting for OT eval. right now)

but

> his behavioral problems that are getting worse by the day are what

> REALLY worry me. I'm sure some of it is sensory but I'm not sure how

> much. Today we had 10 meltdowns by 3:00 pm. (Argh!!) I don't have

almost

> $1000 to shell out for an evaluation. Would one of the Neurologists

that

> take my insurance give a dx? Also, I noticed that many of you get

> private services in addition to EI or CPSE. Currently he receives

> speech/feeding 1hr 2x/week, sped 45min. 2x/week and a child psych.

has

> just started coming 2x/month. I would really like to increase his

speech

> by at least one more session a week and depending on what they

approve

> for OT I'm sure more would be better. Where do I even begin to try

and

> get additional services privately? Is it mostly clinic based or in-

home

> similar to EI? I've also been reading with much interest on the

board

> about listening/music therapy that some of your children receive and

> would like to know more about it. Is it a private service? One more

> thing...When he's done with EI does he have to go on to CPSE or

will the

> county pay for a private preschool with services (either all or

partial

> tuition)? Okay ladies (and gentlemen, of course!) start your

brains!!! I

> know you have this info in there somewhere, you've never let me down

> before!!!! I cannot convey to you all how much this list has done

for

> me, all I can say is.......THANKS!

> TIA for any info,

> Happy Earth Day,

> ~Dani~

> Farmingdale, NY

> Mom to

> 1.9 (31 weeker, torticollis (resolved), plagiocephaly,

reflux,

> fine motor delays, sensory issues, receptive language delays, etc.

etc.)

> 2.8, (speech/feeding delays, hypotonia, DSI??? and who knows

> what else!!!)

> 7.2 (a JUST FINE, happy first grader!)

> (private e-mails okay)

[Guest guest]

Hi Dani- I don't know alot about Nassau or Suffolk County EI vs CPSE,

but I am finding out alot about the city ones so it may be similar.

Our CPSE is paying for some of the best special ed pre schools

around. I don't know if you would find a private preschool that

would be geared towards language and his special needs. All of the

schools that I looked at in the Bronx (9) and in Manhattan (5)- that

had the services we were looking for and the special ed- and the OTs

that know SI, and the speech therapists that know oral motor therapy,

etc, were the ones that are funded by the city. I would speak to the

preschool that you are thinking of. When we applied for our CPSE

evaluation package- they gave us a very long list of sites that could

do the evaluations, many of these were also schools that we looked

at. If you haven't chosen a school yet- I would do it ASAP! Many

schools make their choices, and the good ones get full around now

(March, April)... You could also ask your EI therapists to make

recommendations. Many of the homecare therapists work in the

preschool programs also. We are considering paying the speech

therapist who sees my daughter at home for EI privately in the fall-

depending what the school board approves at her IEP meeting. We are

hoping for 4x speech per week, the school we chose also does home

services so we could split those.

You could try the pediatric neurologist that your insurance plan

covers- we didn't have much luck with that avenue. The EI doctor has

been the most helpful but we are planning to spring for the $1000

anyway and go for the developmental pediatrician- just trying to

decide which one. I think a diagnosis would be helpful- not

necessarily to get the services- the school board officials probably

don't know the diagnoses any more than the pediatricians do. I think

the diagnoses are helpful to get the most appropriate treatment.

I.e. for apraxia PROMPT therapy is said to work well, vs if the

problem is more the muscle tone- then an oral motor approach may be

most effective (likely a combo of many approaches)- anyway- as a

therapist (not speech) I know that having an accurate diagnosis

certainly helps to guide my treatment and makes it much more

effective. Hope any of that is helpful...

Oh p.s. we started music therapy in Manhattan 1x/week this month...

she loves it so far.

Ann Marie

Mom to Jenna (2.8) and probably apraxic- definitely low tone and some

SI stuff...and to Luke 1 year old and doing great!

>Where do I even begin to try and

> get additional services privately? Is it mostly clinic based or in-

home

> similar to EI? I've also been reading with much interest on the

board

> about listening/music therapy that some of your children receive and

> would like to know more about it. Is it a private service? One more

> thing...When he's done with EI does he have to go on to CPSE or

will the

> county pay for a private preschool with services (either all or

partial

> tuition)? Okay ladies (and gentlemen, of course!) start your

brains!!! I

> know you have this info in there somewhere, you've never let me down

> before!!!! I cannot convey to you all how much this list has done

for

> me, all I can say is.......THANKS!

[Guest guest]

Dani -- we faced the evaluation issue and wound up paying ourselves.

However, if you want to pursue it with your insurance company you

have to have the backing of your pediatrician, time for phone calls,

and time/patience (this is where they wore me down).

The first step is to have your pediatrician on board with the need

for the evaluation by the " right " type of specialist. (Not all

pediatric neurologists focus on the same areas, we saw one who looked

at gross motor only and recommended a separate speech eval. for the

delay).

Next, contact your insurance company for a list of providers who

perform the necessary service. Call them, ask around. There has to

be a reason why they are not acceptable (you might be surprised and

find someone in the first list). If no one works for you, ask the

insurance company how to get an approval for an " out of network "

or " out of area " provider because they don't have anyone for the

patient's needs. Usually, the pediatrician/primary care doctor needs

to make a case. Then you will get another list. etc.

On the IEP process, I went into 's with service recommendations

(and incremental evaluations) from his EI service providers. This

was very helpful. His EI team wrote up goals as if they were

providing the services and then I could ask the district why they

were suggesting different things and had different goals.

Good luck!

Margaret...'s Mom

>Where do I even begin to try

and

> get additional services privately? Is it mostly clinic based or in-

home

> similar to EI? I've also been reading with much interest on the

board

> about listening/music therapy that some of your children receive and

> would like to know more about it. Is it a private service? One more

> thing...When he's done with EI does he have to go on to CPSE or

will the

> county pay for a private preschool with services (either all or

partial

> tuition)? Okay ladies (and gentlemen, of course!) start your

brains!!! I

> know you have this info in there somewhere, you've never let me down

> before!!!! I cannot convey to you all how much this list has done

for

> me, all I can say is.......THANKS!

>