Therapy question - long

[Guest guest]

Here I am again with issues over Nick's therapist! Sorry everyone

but I don't know where else to turn. Here's the low down.

Nick was diagnosed by a ped. neurologist as verbally appraxic. She

then sent us to The Center for Communication in Sanford Maine which

is an hour and a half from us for an evaluation. Two SLP's

evaluated him using the VMPAC. Here are the results

Global Motor Control - 100%

Focal Oral Motor Control - 46%

Sequencing - 0%

Connected speech and language .08%

Speech characteristics - 100%

The report indicates given the ranges that " presents with

severe verbal apraxia "

They then went on to recommend PROMPT and PECS. The problem is

there is only one PROMPT cert. therapist in my area and she is the

one that restrained Nick within 15 minutes of meeting him. She also

has no time slots to see him (I wasn't upset by that given her rough

manner!). One of the SLP's that preformed the VMPAC was WONDERFUL

with Nick! They were laughing and she handled him SO well! In a

follow up meeting they agreed that the SLP that handled him roughly

would not be the best choice and offered to see him one time a

week.

But there is more (sorry!) The SLP that is seeing him (3 x's per

week 45 minute)is not a good mix and at first said she would go get

PROMPT trained and is now saying she hates NY and NJ so why can't we

use this other motor cueing method that she has a book on. She has

tried for two 45 minute sessions to get Nick to cue on himself or

me. He is resisting terribly. He wants to play pretend fire truck

and she will say, " No we are doing this now and wants him to look at

a Kaufman card (that I introduced her to) say the word and cue on

himself. It is getting into a battle! I told her I didn't think it

was a good idea given that we wanted PROMPT and the different cues

might be confusing, she said it wouldn't be. Then I told her I

wanted to wait to hear what the people from the center said because

I felt she was presenting too many cues in a session as many as 4 or

5 (I didn't say that part out loud). She kept right at it! Never

mind that she asked to back bill my insurance and that she would pay

back the E.I. program and I found out she has a contract stating

that she can't do that. I worry about her being unethical but

haven't reported her because we have no other therapist to go to and

I don't want her treatment of Nick to be affected.

Now to make matters worse I had high hopes we could switch to

another SLP that was recommended by another mother and an OT, but

she called me yesterday and told me MAYBE she could see him one hour

a week.

I am BESIDE myself! Nick turns three this Saturday and he has not

had good therapy yet! The Sanford people can see him once, maybe

twice a week but they are not contracted with the E.I. program plus

it would be three hours in the car. Then the recommended therapist

can possibly see him once a week. Do I bounce him around like

that? What will three hours in a car once or twice a week do to his

feelings about wanting to go there (silly question! Although we did

think of getting one of those portable VCR things - great MORE

T.V.!)

I also am fighting an eval done by the E.I. people and must go

before their board. I am tired and frustrated and don't know which

way to go. The Sanford people say I should force the E.I. people to

pay for a SLP to get PROMPT trained. They say they will push them

to contract with them for Nick. PLUSSSSS they want a list of words

Nick can't say for the PECs book and I don't think in negatives, I

think in what he CAN say! No wonder I have head aches!

ANY suggestions, feed back, advice, Tylenol will be gladly

accepted

McCann

SAHM to Birthday boy turns three on Sat April 24th!

[Guest guest]

hi sarah,

I'm sad hearing your plight. do you have agencies that you work with to give

you therapist? Or is just your EI dept. I know here in ny I had several

agencies to choose from.

It may seem like I am sticking up for the SLP but Prompt workshops are very

expensive and it takes a long time to be completly certified. I have looked

into Prompt therapist and they only had the 1 st workshop. there are 3 to be

certified. sooo they may know some things but they are not experienced.

now in defense of you, it seems like ego is getting in the way of this

therapist. you can certainly give suggestions as a parent, she just does not

want to follow.

another thing is REPORT her. talk to her supervisor and explain your situation

but being that you don't haveany choices for SLP's then wait to do it until you

do. or try to way out the situation, is her therapy worth to wait to report her

or just report her and have no services. I'm a professional and let me tell you

I would like to know if I were not a doing a good job with my client. believe

me it would hurt and I had it happen to me. but i got into this job because of

the kids and need negative feedback as well as good. sooo if your therapist is

for the kids, this reporting would be good for her. (I'm trying to make you

feel better about reporting her.)

about the words he can't say well they prob want to get him to some words he

can't do yet. that's ok as long as he not pressured alot and its not alot of

words.

You poor thing fighting the system is hard but know in the end it'll pay off. I

think after everyhting is said and done you need a vacation!!!!

I hope I didn't make you mad and shed some light

good luck

chris

srmccann2003 <smccann@...> wrote:

Here I am again with issues over Nick's therapist! Sorry everyone

but I don't know where else to turn. Here's the low down.

Nick was diagnosed by a ped. neurologist as verbally appraxic. She

then sent us to The Center for Communication in Sanford Maine which

is an hour and a half from us for an evaluation. Two SLP's

evaluated him using the VMPAC. Here are the results

Global Motor Control - 100%

Focal Oral Motor Control - 46%

Sequencing - 0%

Connected speech and language .08%

Speech characteristics - 100%

The report indicates given the ranges that " presents with

severe verbal apraxia "

They then went on to recommend PROMPT and PECS. The problem is

there is only one PROMPT cert. therapist in my area and she is the

one that restrained Nick within 15 minutes of meeting him. She also

has no time slots to see him (I wasn't upset by that given her rough

manner!). One of the SLP's that preformed the VMPAC was WONDERFUL

with Nick! They were laughing and she handled him SO well! In a

follow up meeting they agreed that the SLP that handled him roughly

would not be the best choice and offered to see him one time a

week.

But there is more (sorry!) The SLP that is seeing him (3 x's per

week 45 minute)is not a good mix and at first said she would go get

PROMPT trained and is now saying she hates NY and NJ so why can't we

use this other motor cueing method that she has a book on. She has

tried for two 45 minute sessions to get Nick to cue on himself or

me. He is resisting terribly. He wants to play pretend fire truck

and she will say, " No we are doing this now and wants him to look at

a Kaufman card (that I introduced her to) say the word and cue on

himself. It is getting into a battle! I told her I didn't think it

was a good idea given that we wanted PROMPT and the different cues

might be confusing, she said it wouldn't be. Then I told her I

wanted to wait to hear what the people from the center said because

I felt she was presenting too many cues in a session as many as 4 or

5 (I didn't say that part out loud). She kept right at it! Never

mind that she asked to back bill my insurance and that she would pay

back the E.I. program and I found out she has a contract stating

that she can't do that. I worry about her being unethical but

haven't reported her because we have no other therapist to go to and

I don't want her treatment of Nick to be affected.

Now to make matters worse I had high hopes we could switch to

another SLP that was recommended by another mother and an OT, but

she called me yesterday and told me MAYBE she could see him one hour

a week.

I am BESIDE myself! Nick turns three this Saturday and he has not

had good therapy yet! The Sanford people can see him once, maybe

twice a week but they are not contracted with the E.I. program plus

it would be three hours in the car. Then the recommended therapist

can possibly see him once a week. Do I bounce him around like

that? What will three hours in a car once or twice a week do to his

feelings about wanting to go there (silly question! Although we did

think of getting one of those portable VCR things - great MORE

T.V.!)

I also am fighting an eval done by the E.I. people and must go

before their board. I am tired and frustrated and don't know which

way to go. The Sanford people say I should force the E.I. people to

pay for a SLP to get PROMPT trained. They say they will push them

to contract with them for Nick. PLUSSSSS they want a list of words

Nick can't say for the PECs book and I don't think in negatives, I

think in what he CAN say! No wonder I have head aches!

ANY suggestions, feed back, advice, Tylenol will be gladly

accepted

McCann

SAHM to Birthday boy turns three on Sat April 24th!

[Guest guest]

,

I am assuming you live in Maine. Will your son be aged out of the E.I. program

on his 3rd birthday? In NJ our school district is responsible for children ages

3 and up. My son went into the preschool disabled program and I used his ST who

worked only with preschoolers. She came to my house 2x week.

You may find someone you like in the school system and inquire as to private

therapy, and if not them, who can they recommend. I also talked to quite a few

parents who also supplemented their child's IEP with private sessions.

My son did not like the prompt technique but I did try it. He did not like his

face touched and I did not like the restraining part. He smacked the one

therapist in the face when she tried to squeeze his lips together. That was my

last visit. His OT was the missing link to the motor planning issues. I had an

integrated 45 minute session with the ST and OT for social skills. Both the ST

and OT told me they enjoyed that session because they both learned from one

another different techniques to use for apraxic children. In the long run it is

benefiting other children they have in their caseload.

My son also sounds like your child. He is a physical learner and needs to be

playing with an object during his speech sessions. I did not have to explain to

the therapist to allow him to play while therapy was going on. Her sessions

were so age appropriate that after awhile he would stop playing with his toys to

engage in her therapy toys. She was an amazing therapist. Too bad she only saw

him until he was 5.

Below is a link of 3 speech centers in Maine I found on the ASHA site. Maybe

one of them is closer than 90 minutes.

http://www.asha.org/proserv/finalresults.asp

Also is their a teaching college/university in your area that has a speech

department? Another option is a hospital/clinic.

Hope this helps.

Joanne

[ ] Therapy question - long

Here I am again with issues over Nick's therapist! Sorry everyone

but I don't know where else to turn. Here's the low down.

Nick was diagnosed by a ped. neurologist as verbally appraxic. She

then sent us to The Center for Communication in Sanford Maine which

is an hour and a half from us for an evaluation. Two SLP's

evaluated him using the VMPAC. Here are the results

Global Motor Control - 100%

Focal Oral Motor Control - 46%

Sequencing - 0%

Connected speech and language .08%

Speech characteristics - 100%

The report indicates given the ranges that " presents with

severe verbal apraxia "

They then went on to recommend PROMPT and PECS. The problem is

there is only one PROMPT cert. therapist in my area and she is the

one that restrained Nick within 15 minutes of meeting him. She also

has no time slots to see him (I wasn't upset by that given her rough

manner!). One of the SLP's that preformed the VMPAC was WONDERFUL

with Nick! They were laughing and she handled him SO well! In a

follow up meeting they agreed that the SLP that handled him roughly

would not be the best choice and offered to see him one time a

week.

But there is more (sorry!) The SLP that is seeing him (3 x's per

week 45 minute)is not a good mix and at first said she would go get

PROMPT trained and is now saying she hates NY and NJ so why can't we

use this other motor cueing method that she has a book on. She has

tried for two 45 minute sessions to get Nick to cue on himself or

me. He is resisting terribly. He wants to play pretend fire truck

and she will say, " No we are doing this now and wants him to look at

a Kaufman card (that I introduced her to) say the word and cue on

himself. It is getting into a battle! I told her I didn't think it

was a good idea given that we wanted PROMPT and the different cues

might be confusing, she said it wouldn't be. Then I told her I

wanted to wait to hear what the people from the center said because

I felt she was presenting too many cues in a session as many as 4 or

5 (I didn't say that part out loud). She kept right at it! Never

mind that she asked to back bill my insurance and that she would pay

back the E.I. program and I found out she has a contract stating

that she can't do that. I worry about her being unethical but

haven't reported her because we have no other therapist to go to and

I don't want her treatment of Nick to be affected.

Now to make matters worse I had high hopes we could switch to

another SLP that was recommended by another mother and an OT, but

she called me yesterday and told me MAYBE she could see him one hour

a week.

I am BESIDE myself! Nick turns three this Saturday and he has not

had good therapy yet! The Sanford people can see him once, maybe

twice a week but they are not contracted with the E.I. program plus

it would be three hours in the car. Then the recommended therapist

can possibly see him once a week. Do I bounce him around like

that? What will three hours in a car once or twice a week do to his

feelings about wanting to go there (silly question! Although we did

think of getting one of those portable VCR things - great MORE

T.V.!)

I also am fighting an eval done by the E.I. people and must go

before their board. I am tired and frustrated and don't know which

way to go. The Sanford people say I should force the E.I. people to

pay for a SLP to get PROMPT trained. They say they will push them

to contract with them for Nick. PLUSSSSS they want a list of words

Nick can't say for the PECs book and I don't think in negatives, I

think in what he CAN say! No wonder I have head aches!

ANY suggestions, feed back, advice, Tylenol will be gladly

accepted

McCann

SAHM to Birthday boy turns three on Sat April 24th!

[Guest guest]

thank you for responding to my post. NO! I am not mad! I'm

all for that suggested vacation too )))

I was surprised to hear that it takes more than one PROMPT training

session to get certified. That makes it almost impossible then. So

much of this just makes me want to beat my head against a wall! I

am honestly begining to wonder if we need to move so he can get a

better services.

BTW, that's interesting that you had other agencies to work with.

To the best of my knowledge our CDS is the one and only. It's that

or doing it through private funding. I did find out today that we

do have access to other case managers though. So I can have a

seperate case manager from a non-profit agency to act as an advocate

and to possibly help find us a different therapist.

I'm going to keep plugging! Thank you again for " being there " !

> hi sarah,

> I'm sad hearing your plight. do you have agencies that you work

with to give you therapist? Or is just your EI dept. I know here in

ny I had several agencies to choose from.

> It may seem like I am sticking up for the SLP but Prompt workshops

are very expensive and it takes a long time to be completly

certified. I have looked into Prompt therapist and they only had

the 1 st workshop. there are 3 to be certified. sooo they may know

some things but they are not experienced.

> now in defense of you, it seems like ego is getting in the way of

this therapist. you can certainly give suggestions as a parent, she

just does not want to follow.

> another thing is REPORT her. talk to her supervisor and explain

your situation but being that you don't haveany choices for SLP's

then wait to do it until you do. or try to way out the situation,

is her therapy worth to wait to report her or just report her and

have no services. I'm a professional and let me tell you I would

like to know if I were not a doing a good job with my client.

believe me it would hurt and I had it happen to me. but i got into

this job because of the kids and need negative feedback as well as

good. sooo if your therapist is for the kids, this reporting would

be good for her. (I'm trying to make you feel better about

reporting her.)

> about the words he can't say well they prob want to get him to

some words he can't do yet. that's ok as long as he not pressured

alot and its not alot of words.

> You poor thing fighting the system is hard but know in the end

it'll pay off. I think after everyhting is said and done you need a

vacation!!!!

>

> I hope I didn't make you mad and shed some light

> good luck

> chris

>