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Question for teachers/therapists

amc80

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My BFF and her family (husband, 3yo, and 15mo) are coming to visit next week (YAY!). Her kids are the same ages as my kids (my older one is about 6 months older than her eldest, and my younger one is 5 weeks older than her baby). Her 3yo, C, has significant speech delays, both in terms of expression and comprehension. She shared his most recent evaluation with me, and he's somewhere in the 18-22 month range for both. This causes some behavioral issues, since he doesn't really understand what people are saying to him, nor is he able to communicate his feelings.

My 3yo, B, will be 4 in August. Is there any way to explain to him that C might not be a good sharer or listener or whatever, but that it's okay and he needs to be patient? I was thinking of talking to him in terms of playing with his baby brother, who obviously (at 15m) isn't a great listener or sharer. I'm not sure what I can expect from B being so young, if anything, but I'd like to sort of prep him for what to expect. He's fairly sensitive and in tune with moods and the way people are feeling. Any advice would be appreciated.
 

purplesparklies

Brilliant_Rock
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Can you use another example of a recent time when another kid he knows learned to do something before or after he did? Just talk about how every child learns different skills at their own time and sometimes friends learn things at different times and it can make them feel sad or grouchy or frustrated. Then gentle reminders just before the visit and even during as he is only 3 and it will be hard for him to remember during any frustrating moments.

Also, I would strongly encourage your friend to use some simple sign language with her son. Sign language skills can be developed much earlier than speech and can really help alleviate the frustration that comes from communication challenges.

Just some basics to start:
More
Help
Eat
Drink
Sleep
Hurt
Please

Just a few signs will help him communicate his wants/needs and that will help tremendously with behavior.

Enjoy your visit!


Sent from my iPhone using Tapatalk
 

momhappy

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That's a tough one. I don't know that I would say anything to "prep" my child, but I would talk openly (and in very simple terms) if my child asked questions about the other child. If my child asked, I might reply with something like "Everyone is different and so-and-so has some difficulty speaking and listening, but we can still try to play and be friends." You may even want to ask the other mom for some suggestions and/or let her explain to your child since she has more experience with the issues.
 

packrat

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Our kids at preschool don't even notice when kids are different. We don't tell them anything beforehand when new kids come. We play w/them and watch their interactions together and if we need to intervene, if one takes a toy from the other and screaming/hitting ensues, we step in. If something like that happened and the other child is non verbal, we would say "so and so is working on words right now and he doesn't know how to tell you what he wants. What do you think he is trying to say?' and go from there. We just help facilitate things for them.

We just last Monday got a new student, autistic, non verbal, lots of behaviors, foster child who has been bounced around like a tennis ball. We do a lot of sign language here (we have one deaf student), and we use it w/all the kids at some point. It doesn't take very long if a child is "eh eh eh" and reaching for the milk to sign milk and say "milk", and we will hand over hand to help them sign. Today we got "more peaches" signed and a verbal "pees" for please...tho it was yelled like bloody murder, he still said it! It's surprising how fast they catch on.

Kids don't think "Oh well he's my age, he should be on the same level as me". they think "Oh another kid for me to play w/"
 

momhappy

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^I agree. Preschool children probably aren't at a level where they are comparing their level of development with that of their peers. Having said that, I think OP might be concerned with the potential behavioral outbursts that might occur as a result of the frustration the child experiences with being unable to communicate effectively. Again, I probably wouldn't go into detail with a preschooler about how so-and-so has developmental delays, but I think it would be fine to guide a child (in simple terms) so that they can continue to play/be friends. Maybe there are some coping strategies the mother of the child can share with you to make the visit easier for everyone.
 

packrat

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yep, that's why we facilitate the way we do. We do what we can to ask the kids questions-why do you think he did that? what do you think he wants? what do you think he is trying to say to you? What could we do? A lot of the times it's the absolute basic bare bones conversation, but 9 times out of 10 it's something they're able to figure out on their own with help to talk through it. It's just a way to help them put themselves in the other child's shoes.

All kids are going to have issues communicating with another at some point, and behaviors because of it. Heck I don't like to share all the time even now haha! Just go into it w/an open mind and do what you can. When the kids are playing, if something comes up, the mom might say something to help guide it along "So and so, remember, we say please before we take the truck" and then sign the word please. And then the other mom could say "X, so and so wants to play with your truck. He said please. Can you show him how you share your truck? Look! Your blue car and the truck can drive on this road together, see?"

She's your BFF, so you have that as a plus--it's not a play date w/some random stranger and you have that to deal w/as an unknown. You'll be able to work thru it and figure it out together, how to handle things as they come up!
 

amc80

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momhappy|1463518626|4032898 said:
Having said that, I think OP might be concerned with the potential behavioral outbursts that might occur as a result of the frustration the child experiences with being unable to communicate effectively.
This, exactly. B is a rule follower by nature (he gets it from me!). If someone is doing something they aren't supposed to, he tells us. DH said a bad word the other day and B wanted to put him in time out. Or if someone isn't sharing or taking turns, he gets pretty upset because he knows he gets in trouble for that sort of thing.

I do appreciate all of the advice. I think we will just see how it goes. If something comes up and there's an incident, I will pull him aside at that time. Hopefully the kids are all happy and get along and it isn't an issue.
 

Tuckins1

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I have a young child (5 years old) and have to refrain from being the "school psychologist mommy" all the time... Most of the time, kids will understand and accept the differences in others without any prep from parents. But I agree with others that perhaps a conversation that mentions how everyone is different, and highlights the ways that they are the same (they both like to color, they both like to dig in the sand, etc...) is likely to elicit the best results. I have held my tongue and refrained from over-prepping my son, or trying to interpret situations for him, and he amazes me every time. Kids are amazing, resilient, understanding little creatures! I hope you all enjoy your visit!!
 

madelise

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packrat|1463510260|4032829 said:
Our kids at preschool don't even notice when kids are different.
+1. Don't even stress it. Children naturally know how to figure out when someone doesn't know yet/ doesn't talk yet. My little kiddos all accommodate each other, despite different cognitive levels and different disorders. Actually, most student in my school do, up to even the 5th grade. They all know that "Johnny" "can't talk", and will play with him but not expect him to give verbal responses (even though his cognition is absolutely fine, and he's really just selectively mute). They will even "interpret" for their classmates.

purplesparklies said:
Also, I would strongly encourage your friend to use some simple sign language with her son. Sign language skills can be developed much earlier than speech and can really help alleviate the frustration that comes from communication challenges.
A child with low cognition and receptive language won't be able to magically communicate with sign. If the child is physically incapable of producing speech, sure, learning ASL can make the communicate easier (e.g., in toddlers when their oral mechanism is not yet able to produce the fine motor movements). But this child is past the age where that's the issue. This child sounds like it's just receptive and expressive language disorder.

I would not recommend making any recommendations to the parents. I'm betting the child is seeing a properly licensed speech-language pathologist, who only he or she alone can be making clinical judgments about how to best treat the child and/or have the child develop. Not every kid can or should use ASL.



Signed,
Speech Language Pathologist.
 

amc80

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madelise said:
+1. Don't even stress it. Children naturally know how to figure out when someone doesn't know yet/ doesn't talk yet. My little kiddos all accommodate each other, despite different cognitive levels and different disorders. Actually, most student in my school do, up to even the 5th grade. They all know that "Johnny" "can't talk", and will play with him but not expect him to give verbal responses (even though his cognition is absolutely fine, and he's really just selectively mute). They will even "interpret" for their classmates. A child with low cognition and receptive language won't be able to magically communicate with sign. If the child is physically incapable of producing speech, sure, learning ASL can make the communicate easier (e.g., in toddlers when their oral mechanism is not yet able to produce the fine motor movements). But this child is past the age where that's the issue. This child sounds like it's just receptive and expressive language disorder. I would not recommend making any recommendations to the parents. I'm betting the child is seeing a properly licensed speech-language pathologist, who only he or she alone can be making clinical judgments about how to best treat the child and/or have the child develop. Not every kid can or should use ASL. Signed, Speech Language Pathologist.
That was my exact thought about using ASL. And yes, he's seeing a speech pathologist (same one who did the assessment my friend shared with me).

On another note, I find it so ridiculous that speech therapy isn't generally covered by insurance. They are paying $600/month for his sessions.
 

momhappy

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^Depending on where they live, there are many state programs that offer testing, evaluation, and treatment for certain delays/disabilities at no charge (these are not programs designed for low-income families, they are programs intended to work hand-in-hand with public school systems). Many issues/delays are identified during the preschool years and the state programs were designed to perform testing and get services in place so that by the time a child is in school, they already have help.
 

amc80

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momhappy|1463682638|4033652 said:
^Depending on where they live, there are many state programs that offer testing, evaluation, and treatment for certain delays/disabilities at no charge (these are not programs designed for low-income families, they are programs intended to work hand-in-hand with public school systems). Many issues/delays are identified during the preschool years and the state programs were designed to perform testing and get services in place so that by the time a child is in school, they already have help.
There is therapy available through the school district, but it's just winding down for the year and won't start again until the fall. They are already kicking themselves for starting a little later than they should have, so they don't want to wait another 3 months. Thus the $600/month.
 

madelise

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amc80|1463686077|4033670 said:
momhappy|1463682638|4033652 said:
^Depending on where they live, there are many state programs that offer testing, evaluation, and treatment for certain delays/disabilities at no charge (these are not programs designed for low-income families, they are programs intended to work hand-in-hand with public school systems). Many issues/delays are identified during the preschool years and the state programs were designed to perform testing and get services in place so that by the time a child is in school, they already have help.
There is therapy available through the school district, but it's just winding down for the year and won't start again until the fall. They are already kicking themselves for starting a little later than they should have, so they don't want to wait another 3 months. Thus the $600/month.
Then he's not that severe. Insurance requires him to be at least 1 standard deviations below the mean; schools require him to be at least 1.5 standard deviations below the mean. All of my super severe clients qualify for free services year round throughout the summers, too.

Edit: $600/month isn't that bad. There is a huge lack of SLPs, so I get to name my price. I work with just one private client, and I get paid $600/week.
 

purplesparklies

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I suggested a few basic signs, not ASL, not as an all encompassing solution but rather one tool to attempt to help alleviate frustration. From the description, it may well not work but I have used it and have seen it used in similar situations with some success. I tend to be one who will try such simple things as there is no harm in the attempt. If this were an acquaintance, I would not make such suggestions but OP says this is her BFF. I absolutely would do what I could to help my BFF consider all options. Sounds like they are fairly early on in the process so it could help bridge the gap as they work toward long-term progress. It is so simple to just to add in a few signs as they go about regular life. Worth a shot in my book. Although, I have worked with Speech Pathologists who are opposed to introducing signs as it is regarded by some as enabling a child to refrain from speech. As an educator who has taught children who are deaf, hearing, autistic and some who have behavior disorders, I am happy to try any method which may be successful at giving a child an opportunity to communicate and experience language. Of course, there is much more to consider than is noted in a brief post. Best of luck with your visit and I hope your friend is able to find answers for her child.



Sent from my iPad using Tapatalk
 

amc80

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madelise said:
Then he's not that severe. Insurance requires him to be at least 1 standard deviations below the mean; schools require him to be at least 1.5 standard deviations below the mean. All of my super severe clients qualify for free services year round throughout the summers, too. Edit: $600/month isn't that bad. There is a huge lack of SLPs, so I get to name my price. I work with just one private client, and I get paid $600/week.
The assessment said moderate to severe delay. But I'm not sure what that translates to in terms of S.D.s. My friend has her official results/evaluation/meeting with the school district next week, so maybe something will come out of that.
 

amc80

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purplesparklies said:
I suggested a few basic signs, not ASL, not as an all encompassing solution but rather one tool to attempt to help alleviate frustration. From the description, it may well not work but I have used it and have seen it used in similar situations with some success. I tend to be one who will try such simple things as there is no harm in the attempt. If this were an acquaintance, I would not make such suggestions but OP says this is her BFF. I absolutely would do what I could to help my BFF consider all options. Sounds like they are fairly early on in the process so it could help bridge the gap as they work toward long-term progress. It is so simple to just to add in a few signs as they go about regular life. Worth a shot in my book. Although, I have worked with Speech Pathologists who are opposed to introducing signs as it is regarded by some as enabling a child to refrain from speech. As an educator who has taught children who are deaf, hearing, autistic and some who have behavior disorders, I am happy to try any method which may be successful at giving a child an opportunity to communicate and experience language. Of course, there is much more to consider than is noted in a brief post. Best of luck with your visit and I hope your friend is able to find answers for her child. Sent from my iPad using Tapatalk
I will mention it. I use signs with my kids, and have found them to be very helpful for the first couple of years.
 

madelise

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amc80|1463715816|4033855 said:
madelise said:
Then he's not that severe. Insurance requires him to be at least 1 standard deviations below the mean; schools require him to be at least 1.5 standard deviations below the mean. All of my super severe clients qualify for free services year round throughout the summers, too. Edit: $600/month isn't that bad. There is a huge lack of SLPs, so I get to name my price. I work with just one private client, and I get paid $600/week.
The assessment said moderate to severe delay. But I'm not sure what that translates to in terms of S.D.s. My friend has her official results/evaluation/meeting with the school district next week, so maybe something will come out of that.

That's bizarre. Insurance usually will cover kids before schools will. There are many kids that don't qualify via the educational model but do qualify via the medical model. In the schools, we have to prove it negatively effects their access to education. So there are kids who are delayed and/or disordered, but aren't having trouble accessing.... So they don't get school speech therapy. But they qualify with their insurances.

Hm...
 

packrat

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We don't have much access to services around here. And the funding for services provided in the school districts have been cut, so the kids get less that way again. I know the person who works w/my cousins deaf child will be providing limited services over the summer-on her own time, she doesn't get paid for working over the summer.
 

madelise

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packrat|1463748056|4033945 said:
We don't have much access to services around here. And the funding for services provided in the school districts have been cut, so the kids get less that way again. I know the person who works w/my cousins deaf child will be providing limited services over the summer-on her own time, she doesn't get paid for working over the summer.

I would do some research into the legalities. Special education services like speech, OT, etc. are legally mandated. They aren't allowed to cut it based on funding. It's illegal.
 

amc80

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madelise|1463718903|4033879 said:
amc80|1463715816|4033855 said:
madelise said:
Then he's not that severe. Insurance requires him to be at least 1 standard deviations below the mean; schools require him to be at least 1.5 standard deviations below the mean. All of my super severe clients qualify for free services year round throughout the summers, too. Edit: $600/month isn't that bad. There is a huge lack of SLPs, so I get to name my price. I work with just one private client, and I get paid $600/week.
The assessment said moderate to severe delay. But I'm not sure what that translates to in terms of S.D.s. My friend has her official results/evaluation/meeting with the school district next week, so maybe something will come out of that.

That's bizarre. Insurance usually will cover kids before schools will. There are many kids that don't qualify via the educational model but do qualify via the medical model. In the schools, we have to prove it negatively effects their access to education. So there are kids who are delayed and/or disordered, but aren't having trouble accessing.... So they don't get school speech therapy. But they qualify with their insurances.

Hm...
Her insurance said they will only cover it if it's due to a medical condition (like autism). I read my insurance docs and it says the same thing. She is currently fighting them.
 

packrat

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packrat|1463748056|4033945 said:
We don't have much access to services around here. And the funding for services provided in the school districts have been cut, so the kids get less that way again. I know the person who works w/my cousins deaf child will be providing limited services over the summer-on her own time, she doesn't get paid for working over the summer.
Oh, they're available..just like..one part time speech pathologist for 5 school districts (and the nearest district is 5 miles away-some of the districts are 30+ miles away) type available. So our speech pathologist we get once a week for three hours and if she's gone for whatever reason, the kids don't receive services and time is not made up. She takes two kids at a time to help offset it when she can, but then they really aren't getting her full on attention those times either b/c they're sharing time w/another student. It's the Area Education Agency-the funding has been cut millions of dollars for the year. We're having huge issues here anyway w/our special education services so that adds insult to injury as far as I can see.
 

Puppmom

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I live in PA so it may be different but I just assumed all states/counties had early intervention programs. DS2 had gross motor delays. Our pediatrician was not concerned but said if we were we could contact early intervention. Four professionals - a case worker, a physical therapist, an occupational therapist and speech therapist came to our home. They performed an extensive evaluation. In our our county, you qualify for early intervention services if you are 25% behind. So, in our example, our son was 11 months old but in overall gross motor "scored" at 8 months so he qualified for services. In fine motor and speech he was on target (or within range) so didn't qualify. He received PT in our home twice weekly until he was on par with his peers. And, we were very involved in making that judgement call even though a formal evaluation was involved.

Where it gets tricky here is when you age out of early intervention (3 years old) but aren't school age. My sister lives in Colorado and has had a similar experience (her daughter is now 8 and has an IEP) but, although not diagnosed with a specific disability at the time, she has apraxia (which is a more generalized diagnosis I guess) and, because of this, she gets Medicare coverage. My sister pays very little out of pocket for my niece's expenses.

I think the key is to get into the "system". Our case worker was amazing and really acted as an advocate for us.

Back to the original topic - I don't think it'll be a problem for B's interaction with him. I hope you enjoy your visit! That's a whole lot of kids!
 

amc80

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puppmom|1463770110|4034091 said:
I live in PA so it may be different but I just assumed all states/counties had early intervention programs. DS2 had gross motor delays. Our pediatrician was not concerned but said if we were we could contact early intervention. Four professionals - a case worker, a physical therapist, an occupational therapist and speech therapist came to our home. They performed an extensive evaluation. In our our county, you qualify for early intervention services if you are 25% behind. So, in our example, our son was 11 months old but in overall gross motor "scored" at 8 months so he qualified for services. In fine motor and speech he was on target (or within range) so didn't qualify. He received PT in our home twice weekly until he was on par with his peers. And, we were very involved in making that judgement call even though a formal evaluation was involved.

Where it gets tricky here is when you age out of early intervention (3 years old) but aren't school age. My sister lives in Colorado and has had a similar experience (her daughter is now 8 and has an IEP) but, although not diagnosed with a specific disability at the time, she has apraxia (which is a more generalized diagnosis I guess) and, because of this, she gets Medicare coverage. My sister pays very little out of pocket for my niece's expenses.

I think the key is to get into the "system". Our case worker was amazing and really acted as an advocate for us.

Back to the original topic - I don't think it'll be a problem for B's interaction with him. I hope you enjoy your visit! That's a whole lot of kids!
You're right- the fuzzy area is between 3 and when they start school. They didn't even get him in for an assessment until a little before he turned 3. Another part of the problem is they live in SF, but their day care is like 30 minutes south (by her husband's work). So, while the school district will take care of therapy, it's not as easy as them sending a therapist to the day care, which they would do if it was inside the district limits.

Anyway, I really do appreciate the input. I'm hoping everything will go smoothly. If it doesn't, I'll just have a chat with B once it's an issue.
 

packrat

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early intervention is how we get a lot of our special ed preschool kiddos. They're not eligible until a certain age, they need to be 3 by whatever date to come to preschool as a gen ed 3. However, early intervention trumps that, so they can come whenever, sometimes they're just turned two.
 
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