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Why Pursue Private Speech Therapy?
There are different options available for early intervention and school-based speech therapy for children and students with speech-language needs.
If your infant is significantly behind on their developmental milestones, they may receive speech therapy as part of Early Childhood Intervention (ECI) services from birth to age three. Once your toddler ages past 3, they may transfer services and attempt to qualify for speech therapy in the public schools.
Receiving ECI services is not a guaranteed admission into public school speech-language therapy. School districts determine eligibility for speech therapy based on:
- The presence of a disability
- The presence of an adverse effect on educational performance due to the disability
- The need for specially designed instruction or services needed to make progress in the academic environment
Often, although a student presents with a disability, there is no evidence of an adverse negative effect on the student’s educational performance, and therefore no need for specially designed instruction to make progress in the academic environment. Meaning no need for speech therapy as determined by the school district. Due to the requirement to show a negative adverse effect on education, one tendency may be for schools to more often provide therapy for severe-level impairments, as compared to mild speech impairments that have no adverse effect on a student’s academics.
There are several important factors to consider when seeking speech-language services in schools. Few realize that therapists in schools are consistently overwhelmed with caseload size, with Texas SLPs reporting some of the highest caseloads across the country. Also, students are pulled out of academic learning in order to receive therapy services during the school day. To some extent, students miss learning opportunities in other areas to participate in speech therapy. Most importantly, school-based speech therapy is delivered via small group instruction. So if you think qualifying for speech therapy gets your student a 1-on-1 opportunity to see a speech-language pathologist at school, think again.
School students share therapy session time, which is typically 30 minutes, in groups. Three to four children are present in most groups, as the therapist tries to address each child’s different goals in one 30-minute session. This delivery method impacts the quality of therapy delivered to students because the therapist’s attention is spread across a range of different needs. Group therapy can have benefits if your child is working on pragmatics and social language; however, if your child needs more direct attention to an articulation, speech-sound, or fluency disorder (e.g., a lisp, apraxia, severe stuttering), then they likely won’t be receiving the direct level of 1-on-1 needed for visible progress. Also, if a student has high levels of anxiety or shyness while addressing their personal goals during a group session, this could hinder their overall participation and progress in therapy.
Many parents who jump through the hoops of getting qualified for therapy in schools are startled to learn their perception of the 1-on-1 school-based speech therapy model is inaccurate. That’s because parents inherently recognize and know the value of focused and productive 1-on-1 therapy environments.
At PACT, we offer tailored, private 1-on-1 speech-language services adapted to your child’s or student’s specific needs, and provide comprehensive and engaging therapy. We offer specialized therapy methods and techniques (Hanen; PROMPT), and can fill in the gaps when school-based speech therapy isn’t yielding expected progress for your student. If you’re interested in personalized speech-language therapy services, please reach out.
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Selecting an Independent Educational Evaluation (IEE) Provider
When you disagree with an evaluation completed by your local school district, you have the right to request an independent educational evaluation (IEE). Parents are entitled to one IEE at the school’s expense each time the district conducts an evaluation if the parent disagrees. When selecting the outside evaluator, it is important to consider whether or not they are the best fit for your child’s needs. First, it is important to determine whether or not the district has specific requirements for IEE providers. For example, they will often require that the outside provider has an equivalent licensure to practice in the schools. Here in Texas, for comprehensive IEEs, the appropriate school-based credential is often a Licensed Specialist in School Psychology (LSSP). This ensures that the provider has demonstrated competencies related to working with school-age children and identifying whether or not they meet specific eligibility criteria for any of the federally recognized (IDEA 2004, Part B) disabilities. When investigating potential providers, seeking out providers who have their LSSP along with relevant school-based experience and training ensures that the evaluator is trained to understand educational need and legal requirements for IEE recommendations. Remember that in most cases, parents have the right to request an IEE that is paid for by the school district. However, when the public schools are paying for the evaluation, then they are able to specify that they evaluation complies with the same criteria that the school district uses when conducting evaluations. If the district has specific requirements for the IEE, then they are required to inform parents of these requirements. One frequently included requirement is requiring that the IEE provider conduct a classroom-based observation. A school district is not able to limit the scope of the IEE because they failed to evaluate a suspected area of disability. Therefore, experienced IEE providers will understand the importance of conducting a comprehensive and thorough evaluation of all areas.
Additionally, it is important to investigate whether or not the IEE provider has adequate experience conducting IEEs and if they are recommended by other professionals or parents in the area. A provider who has ample experience in conducting IEEs will be a better fit then one who rarely practices in this area. IEEs require extensive knowledge and understanding of the educational system and relevant disability laws in order to write a comprehensive evaluation report with educationally relevant recommendations. Furthermore, choosing a provider who maintains their national certification in school psychology is recommended. By maintaining their credential as a Nationally Certified School Psychologist (NCSP), providers are required to meet rigorous national credentialing standards, and are also required to continue their participation in the community and ongoing professional development requirements.
Oftentimes school districts will provide parents with a list of recommended providers, ones they have likely contracted with the in past. While these lists are a helpful starting place, remember that parents have the right to select an evaluator of their choice. This guidance letter from the Office of Special Education Programs (OSEP) reiterates relevant regulations and clarifies that parents do have the right to choose their independent evaluator. Another frequently encountered problem is when school districts attempt to impose a fee cap and refuse to cover the cost of your selected provider. Once again, the regulations specify that districts cannot impose a fee cap on IEE providers, and they are responsible for covering the cost of the IEE. This special education law and advocacy site offers an example of a letter that the parent may write to request an evaluator of their choice. Are you still unsure of next steps or how to proceed? Sometimes scheduling a consultation with a knowledgeable professional will help you to develop a road map for next steps. Our providers at PACT have extensive experience both working in schools as well as conducting IEEs. Contact us to schedule a free initial consultation to discuss your options.
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Supporting Your Child’s Neurodiversity Awareness
Perhaps your child has recently been evaluated and diagnosed with a neurodevelopmental disability. Many parents struggle when attempting to decide whether or not to share the diagnosis with their child. Encouraging both disability awareness and self-advocacy is important for neurodiverse individuals, especially for children and adolescents. Previously, I wrote a blog about whether or not parents should tell their children about their disability. As a professional who serves many individuals with developmental disabilities, I believe that it is important to educate each individual about their unique needs to empower them. Instead of approaching the discussion by focusing on a label, try focusing on your child’s unique strengths and challenges. Let them know that by better understanding their unique needs, then we are able to find out the best way to support them. Often, when I am beginning an evaluation session with a child or adolescent, I explain to clients that I am a learning and emotions detective, and that it is my job to give information to their parents and teachers on how to help them both at home and at school.
Disability Awareness Print Resources
Be sure before you begin the conversation that you consider developmentally appropriate terms. I often recommend to parents that they read a book with younger children and adolescents about a character that faces similar challenges. There are several lists out there, but this particular list specifies the appropriate audience and the topic of the story. While reading the story, see if your child notices or comments about similarities since these can be opportune moments to make connections and help them to understand that there are others who have experienced similar challenges. This list was compiled by the co-director of the national consortium on developmental disabilities to provide students with an “insider’s view” of an individual’s experience from various perspectives.
Disability Awareness Digital Resources
There are also some great digital resources available such as video testimonials from celebrities who struggled with disabilities as a child to other special shows and series about individuals who are neurodiverse. Also, Understood.org offers unique simulation videos allowing parents to hear testimonials from children with various learning and attention challenges. In honor of autism awareness month, I would like to highlight Sesame Street’s contribution to promoting understanding and acceptance of individuals with autism spectrum disorders. Their Communities resource pages offer resources for individuals, families, and providers.
Next Steps
Should these suggestions seem daunting, consider reaching out to a local psychologist who has experience in working with neurodiverse individuals. A qualified psychologist with experience working with children and adolescents should be able to consult and help you to develop a plan to best broach the topic. If the provider has recently evaluated your child, then consider requesting that they provide your child with an individualized child feedback session. For professionals, this psychologist has created a helpful list of visuals and videos that may be used to help jumpstart conversations with children and adolescents about their neurodiversity and unique needs.
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Undetected Disabilities in Young Adults
I have often encountered young adult clients with undetected disabilities who somehow managed to complete highschool without receiving any accommodations or support. These individuals may have had supportive parents who acted as their unofficial executive functioning (EF) coaches while they were home or they were somehow able to muster sufficient compensatory strategies to fly under the radar up until they graduated. Sometimes these individuals have exceptional cognitive abilities that masked their underlying neurodevelopmental disabilities and may be twice exceptional. Although they usually are able to identify that they struggled while in school, they typically are able to explain how they compensated for their struggles and managed to squeak by. Unfortunately, once they move away to college without these support systems, they may be unable to hide their weaknesses and may encounter significant difficulties. Once they enter college, they are forced to face a daunting combination of an overwhelming course load alone along with juggling independent living skills. Without their support system readily available, these individuals tend to struggle, and often their performance declines.
Benefits of a Comprehensive Psychological evaluation
A comprehensive psychological evaluation may not only identify this individual’s strengths and assets, but their underlying weaknesses. If the evaluation is comprehensive and thorough, then it should provide a roadmap with research-based recommendations. Appropriate recommendations will identify a plan of action where these individuals may begin to reprogram their weaknesses and utilize their assets. If an emotional or neurodevelopmental disability is identified, then the individual may be eligible for accommodations. The overarching protection of Section 504 of the Rehabilitation Act may qualify them for accommodations either in postsecondary institutions or in the workplace.
Disability Accommodations
A few examples of commonly allowable disability accommodations for adults include additional time granted to submit assignments or projects; access to support services; and receiving copies of presentations in advance. These may help the individual no longer feel overwhelmed. Accommodations may offer the additional support needed so that they can experience success.
Evidence-Based Treatment Recommendations
At times, disability accommodations are only a small piece of the puzzle. There may be treatment options that are important to address underlying concerns. For example, if the individual has a mood disorder, then they may receive a referral for a specific type of evidence-based therapy. Also, if they are struggling to manage meeting multiple deadlines and do not have sufficient planning and organizational skills. In these situations, they may benefit from working with either an ADHD and/or EF coach. Their coach will teach them the skills needed in order to efficiently plan and organize their materials and to utilize better time management skills.
Next Steps
After receiving their interactive feedback and evaluation reports, many young adults comment that they gain a deeper understanding of their needs and capabilities. Some clients may feel validated that their struggles have finally been acknowledged. The psychological evaluation process should both identify weaknesses as well as facilitate the ability to develope a clear plan of action. As part of their next steps the psychologist may help the individual identify where to start and how to access recommended accommodation and/or services. The benefits of having a highly detailed, all-ncompassing evaluation can last a lifetime by equipping individuals with the appropriate tools, skills and a roadmap to follow. When given the appropriate support, individuals may experience an increase in self-confidence and impassioned belief in their abilities and competency to face future challenges. If you are ready to talk to an expert to begin this journey, then please reach out and contact us to schedule a consultation.
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Self-Care for Stress Reduction
Many of us are relieved that 2020 is behind us, yet we are worried about what 2021 has in stock due to massive changes and uncertainties our world has faced since last year. There have been many promises of change and improvements to hasten our return to normalcy, yet our optimism is cautious. Now that our first month of 2021 has passed, how do we reflect and improve our 2021 outlook? I routinely speak with clients regarding the importance of prioritizing self-care. Often, I use the analogy of the preflight safety briefing reminding passengers that they should put on their oxygen masks before attempting to assist others. Without first putting on your mask, you are likely to become incapacitated and unable to effectively help others. Thus, if we do not prioritize self-care, then we are unable to provide adequate care for others.
Start with a Self-Care Self-Assessment
To determine your self-care needs, first, you should complete a quick self-assessment. Once you have completed your self-assessment and identified your areas needing improvement, then you should create a self-care plan. A self-care plan will be a useful tool to help you identify what resources that you need in order to reduce your stress. Having a personal care strategy will help you establish new routines, and recruit support from others.
Set Reasonable Goals and Boundaries
Another common casualty of poor self-care is the increased risk of suffering compassion fatigue and burnout. Compassion fatigue may negatively impact and impair our personal, social, and occupational functioning along with increasing our risk for future psychological and health problems. Many of us are finding that the pandemic has blurred the boundaries between our personal and professional lives. For many, the proverbial lunch hour no longer exists. So how do we reclaim time for ourselves when we are constantly inundated with to-do lists? First, start slow and set a reasonable and attainable goal. Are you able to set aside 5 minutes or at least 10 minutes a day? If so, research has shown that integrating meditation or mindfulness practice into your daily routine can improve your overall well being along with enhancing your focus and mental stamina. What if you have a bit more time to spare? Perhaps you can carve out an actual lunch break where you leave devices in another room and just sit and eat mindfully. Setting a goal for longer outings is also important, like going for a mindful walk or a hike.
Practice Self-Compassion
In addition to setting aside time for breaks and outings, another important skill is learning the ability to self-soothe. An individual’s ability to self-soothe may be improved by adopting a kind and gentle approach to oneself. One critical skill that drastically improves our ability to self-soothe is practicing the art of self-compassion. By learning how to comfort ourselves and forgive ourselves for our inadequacies, we increase our capacity to cope during difficult times. Our ability to recover when faced with adversity is often referred to as resilience. By practicing self-kindness, recognizing that suffering is part of the human experience, and observing our feelings in a nonjudgmental manner, we feel more compassionate towards both ourselves and others. Taking time to care for yourself regularly will make you a better caretaker not only for yourself but for others as well. If you feel that you may benefit from additional support after reading this post, please reach out to schedule an appointment with one of our providers.
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Should Parents Tell Their Kids About Their Disability?
Often, I have parents ask whether or not they should tell their child about their recently diagnosed disability. Whether or not to share with your child their identified challenges is an important question. Personally, I feel that it is important to inform your child about both their strengths and their identified challenges. Given this information, your child is able to learn how to advocate for their own needs. Therefore, I recommend that it is important to share. However, it is important to first decide how to share this information.
How to Share
Recently, a colleague of mine explained how she coaches parents to share with their children. She explains that everyone has individual strengths and weaknesses, and they all differ. For example, the fastest runner in class is most likely not the fastest reader. Also, instead of calling a disability a “label,” consider it a pattern that just happens to have a name. By giving their pattern of strengths and weaknesses a name, then we are better able to identify how to help them reach their potential. Recently, I discovered an informative podcast with a parent discussing diagnoses, labels, and stigmas with her 12-year-old son on Tiltparenting. The child shares why he feels it is important for kids to understand their disabilities and challenges.
Resources
There are many age-appropriate resources available either online or through books. Children will likely relate to hearing others’ personal experiences or by reading about a character with a similar experience. This site has a list of children’s books about disabilities that are sorted by readability and their description: https://www.teachervision.com/childrens-books-about-disabilities. Additionally, here is a reading list of books that will provide the reader with an insider’s view of disability: http://www.nlcdd.org/resources-books-movies-disability.html. Currently, The Child Mind Institute is sharing stories from public figures about their experiences growing up with challenges with learning or mental health called #MyYoungerSelf. Lastly, Understood.org offers simulations that help you to see why learning and attention issues can be so challenging. Also, they have videos with kids talking about what it feels like to have learning and attention issues. Remember, your child uses you as their first-hand model for appropriate emotional expression. Prior to having this discussion with your child, you may want to prepare by first processing your concerns with a professional so that you are able to openly discuss your feelings with your child. Contact us to schedule a consultation.
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The Seriousness of Suicide
Sadly, media coverage of suicide may weaken suicide prevention efforts. Recently, it seems that we are losing an increasing number of key public figures and celebrities to suicide. According to the CDC, suicide rates are on the rise, possibly due to the internet and social media. Each year, we lose 45,000 individuals to death by suicide. Presently, suicide is the 10th leading cause of death in America, confirming that suicide is a serious public health problem.
It is important to carefully consider our own mental state. Individuals who have a personal history of depression or other mood disorders may find suicide news triggering. Thankfully, there are many resources for support if you or someone you love is feeling overwhelmed or feeling triggered by news of suicides.
Suicide Prevention Resources
One reliable support is the National Suicide Prevention Lifeline. Trained professionals are available to answer your call, at any hour, providing confidential support. Additionally, they have a useful list of do’s and don’ts for helping someone else who is contemplating suicide. Lastly, if someone you know is posting about suicidal thoughts the National Suicide Prevention Lifeline has social media safety teams who will reach out to the individual directly.
The National Association of Mental Health (NAMI) also offers resources for suicide prevention. Including these useful 5 steps for helping someone in emotional pain:
1) Ask directly whether or not they are thinking about killing themselves and get specifics on whether or not they have a plan.
2) Keep them safe by monitoring them and removing access from any lethal means.
3) Be there to listen. Talking about suicide actually lessens, rather than increases suicide risk.
4) Help them connect to support whether or not it is giving them the National Suicide Prevention Lifeline number, taking them to speak with a mental health professional, or calling 911 for more serious cases.
5) Stay connected. Follow-up with them and check-in after they have received support.
Lastly, if you are concerned about a child or adolescent, the National Association of School Psychologists (NASP) offers useful guidelines for preventing youth suicide. Also, the Child Mind Institute has a good article that discusses what parents can do if they are worried about suicide.
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Intervention Recommendation Overload?
Our present interconnected world offers so many sources that individuals often feel as if they are suffering from intervention recommendation overload. When feeling overwhelmed by intervention recommendation overload, how can you sift through the sources? How exactly do we weed out recommendations or interventions lacking evidence or support?
The unfortunate truth is that most of us don’t have unlimited access to current scientific journals. Even individuals lucky enough to have such access often feel overwhelmed when faced with an overabundance of choices. Thankfully, there are many reliable sites designed to assist individuals in their quest to becoming an informed intervention consumer. These sites simplify the process, giving clients the ability to verify whether or not treatments are evidence-based or if they lacking support. Listed below are a few key sites useful for investigating evidence-based mental health and educational programming interventions.
Mental Health Reference Sites
The Substance Abuse and Mental Health Services Administration (SAMHSA) website gives guidance when choosing effective treatment services for emotional/behavioral health or substance abuse. The site also has a useful link for clients to find help and treatment nearby.
Autism Speaks has an abundance of information for families and caregivers linking them to information, tools, and resources.
The National Eating Disorders Association (NEDA) offers resources for individuals or caregivers, including screening tools, information, links to resources, and support.
Locally, the Central Texas Eating Disorder Specialists site offers professional development opportunities and listings for local specialists that is searchable by specialty and/or distance.
Educational Programming and Intervention
This national clearinghouse gives access to research on current educational programs, products, and practices. Studies and evidence are referenced on the following website Institute of Education Sciences What Works Clearinghouse.
The National Association of School Psychologists has made handouts publicly available to both parents and teachers to explore current, solution-focused strategies for home and school. Additionally, there are many informational handouts available.
Intervention Central is a clearinghouse of information regarding evidence-based strategies for supporting struggling learners or individuals needing behavioral interventions. The site offers free resources for teachers, schools, and parents.
Disability Rights Advocacy
The Council of Parent Attorneys and Advocates offers resources to empower caregivers or professionals who are working to protect educational rights for their children.
Wright’s law offers information about special education, education law, and advocacy for individuals with disabilities.
Texas Parent to Parent provides support, information, and education to families of children of all ages with disabilities or chronic illnesses.
Takeaway
There too many reliable sources to list, many that are disability or specialty-specific. If you are struggling to evaluate your child’s unique needs, perhaps a consultation with a specialist may be in order.
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Reassuring Children about School Safety
It is difficult to shield our children from incessant media coverage increasing their risk of experiencing secondary trauma. Our data-streaming world assures that our kids are well-aware of the most recent school shooting incident. So, how can parents help their kids feel safe at school?
Discussion Tips
Choose a setting to have a discussion where your child will feel comfortable. Perhaps this will be in the family room or at the kitchen table. While talking, allow the child to guide the discussion. Be honest and don’t make promises that you can’t keep, such as promising you will never allow this to happen to them. Instead, reassure them that you are taking steps to keep them safe. Be sure to stick to the facts. It is important to give them enough age-appropriate details to understand the situation. Discuss with them how low the actual probability is that these incidents occur. Explain that it is normal to feel scared or worried and even share your feelings with them. Help them devise a plan that will help them feel safe. Whether that is sharing your understanding of their school’s safety procedures or preparing them for safety drills at school. Last, it is important to limit their exposure to graphic media coverage as much as possible.
School Safety Resources
There are many resources available to plan your discussion in addition to advocating for changes in policy. The National Association of School Psychologists (NASP) has a list of tips for parents and teachers to help discuss violence with children. Also, NPR recently posted a discussion with one of NASP’s former presidents about tips for discussing terrible things with children. Lastly, Safe and Sound Schools offers many resources to empower parents, including toolkits that explain how they can impact policies to increase school safety. Monitor their mental health status and if their fears do not subside after a few weeks, consider seeking therapy to address their underlying anxiety.
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Sticking to Your New Year’s Goals
The New Year is upon us and along with it linger our New Year’s resolutions. Have you already considered discarding your goals this year due to lack of progress? Maybe you haven’t even set any yet because they haven’t worked in the past. It is not too late to set a few solid New Year’s resolutions for this year. Sticking to your goals simply requires some fine-tuning.
Most people set goals for the New Year that are health-related, either seeking to improve their physical well-being by improving their eating habits or increasing their exercise habits. Others may be in search of improving their emotional health. By addressing unresolved emotional concerns or improving their preventative mental health practices. If you want to be firm in your resolve, then have a look at your goals and determine whether or not they are possible.
Refining New Year’s resolutions is not a new topic. Many individuals have written about how by using self-compassion, you can motivate yourself to reach your goals. There are other related blogs that discuss how you can overcome inertia using the 5-minute rule.
Setting S.M.A.R.T. Goals
One acronym that helps you decide whether or not your goals are actionable goals is S.M.A.R.T. It stands for the following:
- Specific – The more detailed you describe your goal, the better. Consider exactly what you want to achieve and then work out the details (e.g., what, when, how, and why).
- Measurable – Identify exactly how you know when you have reached your goal. What you will see, hear, and feel.
- Achievable – Is your goal reasonably calculated given your current obligations and life circumstances? Consider what you need in order to reach the goal. If the goal is impossible to attain, then you need to reevaluate and choose something else.
- Relevant – How motivated are you to achieve the goal? Ask yourself if the goal is worthwhile and whether or not it is the right goal for you.
- Time-Bound – it Is important to set a realistic time frame for accomplishing your goal. Setting up smaller goals will help you determine if you are on-track for meeting your ultimate goal.
Accountability
Once you have devised your SMART goal, the last step is holding yourself accountable. Share your goal with someone else. If others know about your goal, then you will have someone else checking in to see whether or not you have made progress. Your accountability partners will be able to offer you encouragement and you will be more motivated to not disappoint them.
The Takeaway
Now you know how to develop goals that are Specific, Measurable, Attainable, Relevant and Time-Bound. Take some time to write down your new goals and develop your plan for checking on your progress. If you follow these steps, then you will have more success this year sticking to your goals and will experience a sense of accomplishment.