Conference moira::parenting

    As least your HMO will pay for some speech therapy; Fallon won't pay
    for speech therapy or hearing aids or...but I digress.
    
    Your school system HAS to provide speech therapy if he needs it.  If
    the system doesn't have the resources to provide it themselves, then
    they have to pay for other arrangements, such as a private therapist.
    However, the town only has to provide services during the normal school
    year unless you can prove that he will loss ground (i.e., get WORSE)
    during the time off.  Not likely.  The folks at Hahnemann Rehab (who
    did AJ see there?) can help you document AJ's need for the town. 
    Meanwhile, I can recommend an excellent therapist in Worcester whom we
    use during the summers, if you want.
    
    Caileigh has had speech therapy since she was two and will probably
    continue through high school (because of her permanent hearing loss and
    lack of auditory discrimination).  She loves it; it's just playing
    games although she understands there is an ulterior motive.  In my
    amateur opinion, AJ will quickly make up for loss time caused by the
    temporary hearing loss, though I would act on it immediately.  I can't
    comment on any problems caused by the physical deformity (for lack of a
    better word).
    
    
    -Tracy
    

    
    I'm also curious as to who you saw at Hahnemann (just curious, they're
    all excellent).
    
    Since you mentioned school, it must be too late for EI. Now you come
    under Chapter 766. As Tracy mentioned your school system MUST provide
    speech therapy if it can be proven that it will delay his progress in
    school. Because of the school budget crisis in Mass you may have to
    fight for it. This may involve a case worker from the state who may be
    brought in for an evaluation. The folks at Hahnemann are well aware of
    all this and you can trust them to help you get what AJ requires. 
    
    If there's any way I can help you, don't be afraid to ask.
    
    Chris
    

    How old is AJ ? Has he been involved in Early Intervention prior to
    this ?  What town do you live in ?
    
    I have heard of instances where children from one town go to school in
    another under chapter 766. I understand that Marlboro has a speech
    therapy program (don't know anything about it). It may be worth
    exploring.
    
    Two of my brother's children have had speech delays although neither
    had a hearing loss or a structural problem in the mouth. In the case of
    the first child, a few months of early intervention was all it took to
    catch up. In the case of the baby (almost 4), the therapy seems to be 
    dragging out. I belive he has had speech therapy at Children's Hospital 
    and is now in a program at Emerson College (ya, as in Baby Broadcaster..
    unless my brother is kidding me).
    
    Of course you know that you should start fighting now. I know of other
    children who have been placed in programs for the fall.
    
    Good luck.
    

    
    I attended Emerson College back in 1975 before transferring to
    Northeastern. They are a complete communications school, not just Mass
    Communication (Radio and TV) and Journalism, they offer Speech
    Pathology as well. 
    
    Re: AJ
    
    Spencer offers speech therapy through 766 as does Worcester.
    
    Chris
    

    An update....
    
    Thanks to help of the director of his preschool, we have requested in
    writing a fill CORE evaluation by the school department.  We live in
    Oxford since someone asked.  His preschool is in Westboro, and have
    found out several things by talking to the director.  He does NOT have
    to attend kindegarten at all, he can remain at the preschool until he
    enters first grade if we choose.  The director is working in my behalf
    to explore the possibility that if he remains there next year that,
    a) he will receive private speech therapy at the school and b) because
    he will be classed as special needs, the school departmeny may be
    obligated to offset some part of his tuition at the center.  The
    director, owner, his own and several other teachers at the preschool
    are certified for teaching special needs, and the school as a whole is
    licensed for special needs.  (something I didn't ask about when
    interviewing them, prior to placing him there, but am now glad I know.)
    
    Yesterday we saw his ear doctor, the news is that his latest hearing
    test is just about normal, and the doctor does recommend speech
    therapy, and will back me with whatever letter need be written to get
    this underway for what ever length of time is necessary, and it WILL
    begin soon as in during the summer months!  The doctor seems confident,
    due to previous experiences, that the HMO will allow him speech therapy
    for as long as is needed.  The other thing is I asked if there were
    other options to the Hanneman rehab, and he recommended two other
    facilities.  Nothing personal, I just don't feel comfortable heading
    into that section of Worcester several times a week.  I made this
    comment to the doctor, who concurred with a comment something like "you
    don't feel like pushing your luck?" (not looking for flames, just
    relating a conversation).  I will likely be contacting Umass Medical
    who actually is in a better proximity to his preschool, and has hours a
    little more accomodating to our work schedule.  If I chose hanneman it
    might have to come down to a decision to either quit work and take him
    to therapy three times a week, or go without therapy.
    
    Please, keep your comments coming.  The speech isn't his only issue, we
    also have some behavioral (hyperactivity and oppostional behavior)
    issues to deal with in addition to everything else.
    
    Lyn 

    When I listened to the director of the Assabet Valley Collaborative,
    he mentioned that 90% of the children in his program (special needs)
    are receiving services related to behavioral problems. He noted that
    kids who can't communicate or control their environment (e.g. motor
    difficulties) are frustrated and act out. Often parents and, more
    often, other caregivers give in to the behavior and reinforce it.
    
    Please do not interpret the above as blame. It is meant to convey only
    the assurance that you are not alone and that the behavior problem is
    probably the consequence of speech delay and not a reflection on your
    child's innate goodness.
    
    Good luck with the core. 

If a CORE is done by the Oxford school system and it is felt by them and/or the 
DOE that the child can best be serviced within the school setting then you are
likely to be 100% on your own if you choose to keep him in the private school. 

Under chapter 766 you cannot simply access the public school setting as you 
wish. You do not have the right to insist on a particular placement IF the 
school dept with jurisdiction over the child can provide the services necessary.

Some schools will give you a very hard time over this and others won't. Be sure
you understand your rights and your responsibilities before you decide how to
proceed. 

    
    It's all not black and white under 766. You have to be a part of, and
    approve of, all the decisions made for your child. You do not have to
    simply accept what they want to give you. Mike is right, though, that
    you cannot expect Oxford to send your child to a private school of your
    choice because that is where you want your child. If you can get the
    therapists, doctors and other professionals to document that this
    school is the best setting for AJ, then they must provide this to you.
    However, the burden of proof is on you. You must be your childs
    advocate.
    
    There may be room to wheel and deal a little. For example, they may
    agree to provide tuition if you provide transportation. Negotiation
    involves compromise on both sides.
    
    Goodf luck,
    
    Chris
    

Anyone have any experience with speech therapy for toddlers?  Jessica, who
will be 2 at the end of the month, refuses to talk, so she's in developmental
therapy every Wednesday, and will be starting regular speech therapy very
shortly.  The developmental specialist thinks she's not making the connection
in her brain to get the words out, but I think she doesn't see any useful
purpose to talking yet, so she just doesn't bother.  She says 'juice', 'more',
and some random other words like ball and bear, but that's about it.  She
understands absolutely everything we say to her, and has no problem doing
tasks.  On the other hand, her twin brother has quite a good vocabulary,
and will spontaneously name things or ask for things. He doesn't do any
sentences yet, but he's visibly  trying to say what we say, and he asks
what things are.  'This is' was one of Brad's first words and he uses it
when he wants to know what something is.

I keep talking to Jessica and repeating words, but she just shows no interest.
Anyone have any experience with speech therapy?  How successful is it?  What
other things should we be doing with her to encourage speech?

Cathy

    I'm sure someone with firsthand knowledge will reply but here is my 
    input.  My nephew's doctor suggested it at about 2.  He used to go 
    to a class in a local hospital.  Now someone comes to his house 
    every Wednesday.  The few times I have been around they have played 
    games...they make a town and she gets him conversing and naming 
    things without realizing he's even doing it...she made playdough 
    a few weeks ago and they talk about things they make...they play 
    outdoors....etc.   At first they seemed to build his vocabulary
    then tried to get two words together..and three and four...now they
    are on five.  We had to jot down during the week for her his longer
    sentences.  He will be three next month and talks quite a bit now
    and seems to like talking alot, sometimes is hard to understand.  
    He had testing done to see if they could continue with him (insurance
    requirement I think) and one of the areas they tested he rated a 
    four year olds skills...cognitive i think.  He has come a long way
    My dad thinks he just didn't feel like talking and time changed that
    he doesn't go in too much for the speech therapy,,,,"every kid is 
    different and that was Sean."  Sean always followed directions and 
    knew what you were talking about too.
    
    

    I've talked about this in other notes...
    
    My son, Michael was born a month early, he didn't/wouldn't speak
    at all (nothing, nada, zip) until his second birthday. His first
    words, "Hi Dave" was how he greeted our next door neighbor who
    came over to wish Michael a "Happy Birthday". Michael was speaking
    in short sentences and phrases ("Go Big Red" [Dave is from Nebraska]:^)
    a month later. Today he is 5� years old and has a very good vocabulary.
    
    A child's second birthday may be a little premature to worry about 
    speech problems. Your mileage may vary.
    
    Jodi-
    

    Not that I remember, but one story my parents tell about me was that I
    didn't really start talking until I was 4 (!).  I am the youngest of 3
    and they said I would always point at what I wanted or somehow
    indicated.  When I did start talking they said it was in complete
    sentences (and that I haven't stoppped since...) :-)
    
    Dave

    Being a twin myself, I know well how twins take care of each of other
    and compensate for what one may not do/not want to do. Perhaps Brad is
    "helping" his twin by talking.
    
    Just a thought,
    Lynn
    

	You might also put a note in ASABET::LEARNING_DISABILITIES

Two is not too young to be concerned about a lack of speech development, if
it is caused by a hearing loss. Have the child tested, if you haven't already,
by an audiologist that works with children. If you need references I have them.

According to the source (my mom 8^>) I was reciting nursery rhymes at 18
months, but my younger brother didn't say much of anything until he was
three. We found out much later in life that he was dyslexic and suffered
from this in school. He turned out fine...but I always wonder what would
have happened if his learning disability had been caught sooner.

If your child needs speech therapy, the state early intervention program will
cover it until age three, when the school system takes over under Chapter
766. Your health insurance may also cover all or part of it under age three
as well.

Chris

    According to my Pedi at 24 months a child should have a vocabulary
    of between 50 and 100 words.  My son doesn't have this so he asked
    that we have his hearing tested.  That part is done, now they want
    him to be seen at U-Mass for a Developmental Evaluation - scheduled
    for the 20th of this month.  Hearing ranges showed within normal
    limits although he has some "congestion" in his ears.  It could be
    that he just plain isn't ready to really talk yet.  He has some
    words and always manages to get his point across.  Once this
    evaluation is done a decision will be made by the Dr's if he needs
    to have speech therapy or something else to help him along.  I believe
    he's just not ready, but I don't want to take any chances so off
    to testing we go.  The hearing test was fun for him, Hahnemann
    Rehab did the testing and they are very good.  I've heard the 
    developmental tests and speech therapy are also designed so the
    kids enjoy them.     Regards, Sandy
    

Thanks for the suggestions on the hearing test and Early Intervention.  
Those have already been done as it is standard operating procudure to have
ears and eyes tested at 1 year, 2 years, and 3 years for premature babies
(my kids were 12 weeks premature).  And, due to the prematurity, we are
already well acquainted with EIP. In fact, the only day my kids don't
have an EIP appointment of some sort is on Thursday.  

They had their 2-year check-up yesterday, and Jessica's only area of
concern is her speech.  She's been meeting weekly with the developmental
specialist for that, but will be going on to a regular speech therapist
shortly.  I think just the one-on-one attention will be great for her
as she loves attention.

And she has no problems whatsoever with receptive language, just with
the expressive part.  She follows multiple-step instructions quite well,
and understands everything.  It's just the expressive part.

Regards,
Cathy

Cathy,

Thanks for the update, you seem to be doing all the right things. If the 
developmentalist thinks it's time for speech therapy, then I'd give it a
shot. 

My two year old son with a severe to profound hearing impairment is just
starting basic speech therapy with his audiologist. She will hold up a flash
card of an object he knows (car, bus, cat etc) and get him to express
himself as best as he can. If he's in the mood for it, he responds very
well. Being a two year old, that mood can change as fast as the speed of
light 8^). It may take a while. We usually stay in the room with him during
therapy but because we're there it's becoming a distraction. We're 
going to start to use the observation room so the audiologist can be more
productive during the sessions. That's something to think about.

Best of luck,

Chris

Chris,

I agree that not being in the room when the kids are having some sort of
therapy seems to help as there is less distraction, and they give their
full attention to the therapy. This is especially true with Jessica who
will stop and wave at anyone everytime they enter a room.  

I'm not usually at my kids' appointments as they are during the day, so my
sitter takes them. We're going to try to coordinate Jessica's speech therapy
with Brad's weekly physical therapy so that my sitter can drop off Jessica
and then bring Brad to his appointment, and then pick her up when they are
both done. It turns out that EIP has a speech therapist about a mile from 
the physical therapist, so it may take some schedule switching, but I think
it can be done.

I'm hoping the extra attention that Jessica gets from someone that doesn't
see Brad will encourage her to talk.  She's an incredible attention-seeker,
so I'm hoping this will work in her favor.  I think she just doesn't see
any purpose to talking yet, so only says what she needs to (i.e. juice and
more) whereas Brad will try to say everything, and will ask what something
is by saying 'this is', and we respond with 'this is <whatever>.'  I think
that once she starts talking, we won't be able to shut her up.

My sitter also has a thought about putting the kids in a playgroup with other
children their age who are talking thinking that Jessica may pick it up from
them.  They are currently in a playgroup twice a week at EIP with other
developmentally delayed children their age, but no one in that group talks
much yet.  I'm considering pulling them from that and finding a regular
playgroup where they will have to interact with other 2-year-olds.  Any
thoughts on this?  The current playgroup has helped Jessica with being
more focused, but I'm starting to think about giving my sitter's idea
a try.

Thanks,
Cathy

   My son also had a speech delay.  He was at home with an aupair from birth
to age 2 and a half.  He has a younger sister but he did not get to interact
with other children that often.  We noticed a tremendous improvement in his
speech once he started going to daycare.  The teachers really encouraged him
to use his words.  And I think having older/talking children around really
helped.  Sending him to pre school was recommended by his speech therapist.

Elizabeth

Patrick attends a once-per-week playgroup with other developmentally delayed
children at the Glavin Center in Shrewsbury. Does Jessica attend this
playgroup, or does she go somewhere else? I haven't had the chance to
observe this playgroup, but from what my wife tells me he is the only 
hearing impaired child in the group and only one of the instructors signs.
Still, his hearing impairment is the only developmental problem we know of
(knock on wood) and thus Patrick is sort of the 'star' of the class if you
know what I mean. Even though Patrick is hearing impaired, he voices while
signing once he becomes comfortable in the setting. From what I've been told
the class is not a 'quiet' one. If you are investigating playgroups, you
might want to call the Glavin Center at 845-9111 if it's within your EI
area. Pat Hackett should be able to help you out.

This summer, Anne Steele from the Worcester EI program will be running a
playgroup for hearing impaired children at the Glavin Center. We are really
looking forward to this as Patrick is ready for it.

Good luck,

Chris

    
    
    
    re: .9
    
    Like reply .14, your note reminded me of my brother and sister (twins). 
    At 3 years old, my brother had speach problems and my sister spoke fine. 
    They (my parents) ended up sending her to pre-school and taking him to a 
    speach therapist. 

    I seem to recall a discussion on repeating vs. stuttering, but can't
    find it here.  Must be in the previous version.  Can anyone help me out
    here?  My son "repeats", i.e. says the entire word several times.  It
    is not what I would call a "stutter", which to me is repeating a
    specific part of the work.  To me it's no big deal, but someone who
    knows a lot about everything (if you catch my drift) says I had better
    get him to a speech therapist before he starts stuttering.  My son is
    3.5, and it is worse when he is tired, excited, or trying to shout over
    several kids to get his story out. When I ask him to "say the word one
    time" he is fine.  However, I wonder if this can become a bad habit
    where he would need some therapy to help him break the habit, or if it's
    normal and he'll outgrow it eventually.
    Sarah 

Attached is an entry I had saved from an OLD parenting notesfile - since I
    couldn't figure out which version it came from, I am re-entering it. I
    found it to be very helpful.
    
    Lynn
    
    
         <<< HELPME::DISK$HELPME_AUX:[NOTES$LIBRARY]PARENTING.NOTE;1 >>>
                                 -< Parenting >-
================================================================================
Note 464.8                         Stuttering                            8 of 17
BIONIC::ROYER                                        52 lines  23-MAY-1988 10:29
                            -< Ex-speech therapist >-
--------------------------------------------------------------------------------
    I am an ex-speech therapist and have worked with young dysfluent
    children in the past.
    One thing that is important to remember is that EVERY child will
    have periods of "stuttering" from the first utterances in infancy
    to the age of 6 or 7.  This is normal because they are learning
    the power of words and really get excited with this new power to
    the point of trying to get the words out faster than their brains
    and speech mechanism can keep up with.  True stuttering does not
    occur until the child preceive himself/herself as a stutter and
    begins to actually say "I can't talk right."  If you think about
    it, where would a child get the concept that they are a "stutterer"
    unless someone drew a lot of attention to the dysfluencies and gave
    them the label.
    
    There are stages of stuttering.  The first called primary involves
    simply repetitions of word or individual sounds. This should not
    be confused with what happens from the unset of talking till much
    later.  This is also normal for many people and causes no difficulty
    for the person.  Therapy is not necessarily indicated for primary
    stutters. Everyone is a primary stutterer at times. Some children
    will continue the mild dysfluencies of primary stuttering and never
    go to the next stage. This won't cause them any problems as adults.
    It is not abnormal.
    
    The next stage is the stage that usually requires some professional
    help.  It is the secondary characteristic stage.  Here the person
    starts to add other garbage to get their speaking going.  Such things
    as head jerks, snorting, severe blocks, body jerks, blinking, hitting
    something, etc.  This person has identified themselves as a stutterer
    with all the negative feeling that goes with it.
    
    Unless you are seeing any CONSISTANT secondary characteristics or
    the child begins to verbalize that they are concerned about their
    speech don't panic, it is probably perfectly normal speech development.
    
    Somethings you as parents can do to lower your own anxieties about
    your temporarily dysfluent child would be to:
    
    	1. Keep telling yourself to listen patiently to the content
    of what you child is saying.  Don't focus on how they are saying
    it.
    
    	2. When dealing with my own primary stutterer, I would put my
    arm around him or just touch his shoulder to send a message that
    he had my total attention.  He usually showed down and relaxed enough
    to get the message to me.
    
    	3. Relax and trust your instincts.  If you continue to feel
    concerned, seek advise from your doctor or a speech pathologist.
    
    Hope this helps.
    Mary Ann

    My son (now 8�) had severe problems with  "repeating" from the time he
    began talking until, after a year of speech therapy, he was 5�.

    Until he was 4� he didn't notice it and it didn't seem to bother
    anyone.  When he was in "senior" nursery school, he began to notice it,
    at first amused by it, but later increasingly troubled by it.  His
    4-year-old friends were in the pre-brutality phase, thankfully.  With
    public-school kindergarten approaching, we decided to begin therapy.

    The therapy used a "turtle/rabbit" speech paradigm which worked very
    well with him.  He looked forward to the sessions, and still talks
    about it positively from time to time.

    (Being a natural skeptic, I've always wondered, though, if the therapy
    cured him, or if it corrected itself, as we were advised it would.)

    Please feel free to contact me to discuss if you want to learn more
    from my experiences.

    L.

We are about to go through an initial speech evaluation with our 3.5 year old 
daughter.   This is not hearing related, and it is not prematurity related.  
Her preschool believes it is the physical pronunciation of certain consenants 
(sp?), and some switching of them.   

Anyway, if anyone has gone through evaluation, and/or therapy, with a 
toddler, in the Acton school system, I'd appreciate it if you would contact me 
at powdml::dunn, or Karen Dunn on Exchange.  Thank you.