We had some issues with our last speech offer. My daughter has severe speech issues, called apraxia of speech , which requires a lot of speech therapy. The recommended amount is from 30-60 minutes per day, five days per week, for someone with her severity of the condition. All therapy, at least at first should be individual. Last spring it was recommended that she receive two thirty minute individual sessions, and one thirty minute group session. Below are some of the questions I wrote down to ask at the IEP meeting in order to make the point that the SLP may not really be recommending what was needed.
How important is speech to education?
How do Speech-Writing-Reading tie together?
How do you determine how much time to spend with a child who has the need for speech therapy?
Is what you're recommending within the standards suggested by your professional guidelines?
What are those guidelines?
Do you have a copy of those recommendations available?
All I have been able to find in the literature (published by ASHA) is that children with apraxia should receive between three and five hours per week of individual speech therapy, but you have recommended only one hour of individual speech therapy, do you have any specific clinical justification for that offer?
You have never worked with Megan or evaluated her, how do you justify making ANY recommendations for her with so little knowledge of her?
In your report you state that "based on the assessment results, the structure and function of the speech mechanism does not appear to be adequate for speech production" yet therapists who have actually spent time with her and done a thorough evaluation have recommended that she be taught to speak, how do you explain that?
In addition, she is able to say many words, you even state this in your report, she is just not able to communicate effectively, so this seems to be contradictory. How do you explain this contradiction?
What types of speech therapy are recommended for apraxia?
ASHA (on their web site) recommends only individual, no group for apraxia, yet you recommend group therapy for Megan.
Is your recommendation based on what is recommended by the standards of your profession or is your recommendation based on what the school district is telling you to offer?
Does offering far less than the standard of care conflict with the ethical guidelines of your profession?
Also, in your report I see you state that you did a direct assessment, what direct assessment was that?
I could find no report of any kind of actual test or assessment given in your report?
You report that Megan was "slow to engage", I have seen her be slow to engage with some people and engage rather quickly with others.
Of course slow and quickly are rather subjective statements, do you remember what you considered "slow"? Was this slow for a typical child?
Slow for a child with Down syndrome?
Slow for a child with autism?
Slow for a child with Down syndrome and autism?
You also report that she kept her body turned and did not readily engage in play. Have you observed her to be the same with others?
Have you observed her to behave the same with people with whom she is familiar?
In your report you state that "her communication is disrupted by her non-compliant behavior and difficulty expressing her wants and needs in an effective way." p.4
BUT, on p.5 in the conclusions you do not mark the box that says "Student behavior during evaluation" would have been a factor that appears to have affected the results of this evaluation. So, was her behavior a problem or was it not a problem?
You also write "Megan's progress in the classroom is limited by the inconsistency of her communication aids and by the lack of generalization to the classroom setting". It sounds like you are saying that the communication aids were not kept up?
Who was supposed to have kept those communication aids in workable order?
Didn't her IEP include goals for assistive communication?
Shouldn't the person who was working with her from the district been keeping her communication aids in working order?
If not them, then who?
The final paragraph of your report states that "Megan's behavior had been described as increasing in non-compliance since the beginning of this school year. Most of her school day is spent dealing with her refusal to complete her school work. This is seen as a decline from last year."
Who was responsible for helping Megan to manage her behavior?
Are we to assume that the disabled child who has a condition (autism) that results in the very behaviors which interfere with her ability to gain from her education environment was allowed to continue to have increased negative behaviors?
What was the district doing that you know of to manage those behaviors at school?
Who was ultimately responsible for changing the behavioral situation at school?
Why weren't those behaviors being addressed adequately so that Megan could learn in the educational environment?
I have in my possession two different reports for this particular speech and language evaluation. One that I recieved two days before the other. The first report dated 3/3/2010 recommends continuing her then current speech and language therapy at five hours per week of individual therapy and no group therapy. The second report, dated 3/5/2010 is the one that was discussed at the IEP meetings on 3/7/10 and 3/15/10. It recommended no specific amount of speech therapy but it did recommend small group speech. In the IEP meetings the offer for speech therapy was one hour of individual therapy and one half hour of group speech therapy.What changed between 3/3/10 and 3/5/10? I was told that there was a "pre-IEP meeting on 3/4/10, is that what changed your recommendation?
IDEA states "The parents of a child with a disability are expected to be equal participants along with school personnel, in developing, reviewing, and revising the child's IEP. This is an active role in which the parents (1) participate in the discussion about the child's need for special education and related services, and (2) join with the other participants in deciding what services the agency will provide to the child."
In order for parents to take an active role in the IEP they must first be invited to the meeting. We were not invited to a meeting on 3/4/2010. In order to convene a meeting without the parents in attendance the district must, by law, have made every attempt to include the parents and the district must be able to prove that they were unable to convince the parents that they should attend.
In a due process case in Ohio, the hearing officer explained the importance of the IEP meetings, "The IEP meeting is supposed to serve as a communication vehicle between parents and school personnel, and is supposed to enable both sides, as equal participants, to jointly decide upon what the child's needs are, what will be provided, and what the anticipated outcomes may be." When meetings are held secretly that is in direct contrast to the law as set in IDEA. We were not allowed to communicate, be an equal participant, decide with the district what our child's needs were, and what the anticipated outcome would be of one set of therapies versus the other.
In fact, this "pre-IEP" meeting and it's work product denied our daughter FAPE just by the fact that it took place according to IDEA. Was there a "pre-IEP" meeting before today's meeting? What was decided at that meeting? If there was, would you admit it? Would you feel comfortable testifying to that under oath in court? Because it could come down to that, and I do have the proof I have told you about, and in fact my attorney is holding that proof at his office.
For feeding/swallowing (which I was told for years is NOT a school issue) -
Does ASHA offer guidelines as to whether swallowing (feeding) fits into an educational setting?
Can you show me that in writing?
I believe that part of why Megan has such difficulty with muscle tone in her mouth is because she cannot eat.
So, since the school should have been helping her with eating issues, this would have laid some groundwork for learning to speak. But since the district straight out lied to us about the school's role in feeding/swallowing therapy the district in fact made it more difficult for my daughter to learn to speak when she was younger and more open to learning both feeding and speaking.
This district seems to think that she should be able to overcome her apraxia in the same time-line of any other child with apraxia but in reality she is receiving the therapy so much later than she should have that it will take significantly longer for her to gain the skills necessary to speak. Who but the agency responsible for her only receiving those services so late should take the responsibility for that and commit to the long term fix that is now needed? I was aware of her needs, advocated for those needs, and was told "no" over and over. I did what I knew then to do in order to force the issue, but was faced with lies and deception from the district. I thought the district personnel were being honest with me about their plan, when in fact the plan was to avoid giving my daughter necessary speech and language services. Now that I know what was going on I expect the district to do the right thing and make up for their egregious failings with my child. The district caused this problem to become this big and the district needs to live with how big it now is and make it right. Expecting her parents to fix the problems created by the district is basically an attempt to steal from the children (and their parents) that you, the district are charged to educate.
I am not necessarily comfortable with being as direct as these questions are, that is why I wrote them down. It is much easier for me to be direct when I have a script in front of me. Also, I may or may not ask all of the questions I have prepared. It really depends on the answers. In this particular case the SLP who had done the evaluation the year before was no longer there so I used very few of my prepared questions. However, I was so much more prepared than I would have been otherwise that I was still able to ask difficult questions and I could focus on their answers.
I also prepared questions for the general classroom. I asked these questions of the Neuro-psychologist who observed her in the classroom setting.
How much of the time that you were in the classroom did Megan spend working with the
teacher and or the aide?
Did they say anything that made you believe that the day you visited was significantly
different from other days at school?
Was there anything that made you believe that there was anything unusual about the
day you observed?
So, if this is the usual school day for Megan it would be safe to assume that she might
get about 1/2 hour of actual instruction per six hour day of school?
This would then add up to about 16 days of instruction per year. Would this in your
professional opinion, be FAPE?
What is going on in the classroom that is keeping Megan from learning?
Why is it, in your professional opinion, that she is having these behaviors at school,
when these behaviors have been severely reduced in other locations?
Such as dance class, ot, home, physical therapy.
How can we increase the amount of learning time for Megan to benefit from her education?
What specifically does she need that she is not getting in the classroom?
Last year the district promised to send her one to one aid for training with the ABA
company, is there a reason that hasn't been done? Why wasn't this done?
Wouldn't it have made sense to do this while she was out and in HHI?
Again, I did not ask all of these questions, but having them ready prepared me for a very difficult
meeting. I recommend having this sort of thing ready, even if you don't use any of it, it will
prepare you to keep the meeting focused where you want the focus to be.