I remember months ago, when one of Kamdyn's therapists mentioned that the kids who receive therapy services, do not usually start Speech Therapy until 18 months. I had no idea at the time what Kamdyn would or would not be doing after her first birthday, but I knew that 18 months seemed late to start focusing on speech. The rule I usually go by when introducing new skills to Kamdyn is : When did my other kids start doing _____________? Even if I don't think she will pick it up, I start introducing it. With Kamdyn, I have found that she needs a lot of repetition to learn something. We repeat and repeat, and one day, it clicks, and she's got it. I feel the same way about speech. I know that we will have to work with it and repeat, repeat, and I don't think we should wait another 6 months to start. At Kamdyn's 9 month review, I mentioned to her Service Coordinator that I wanted to add speech. I also had conversations with her therapists about my thoughts and concerns with the speech, and her therapists were also on board. Then, at Kamdyn's one year check up with the pediatrician, I spoke to her doctor about therapy. Her doctor also agreed that Kamdyn should start speech and keep up with her other therapies. Finally, today at her one year evaluation, we were able to bring all of these pieces together. Rather than signing Kamdyn up for weekly Speech Therapy, however, we are signing her up for monthly services. If you sign up for weekly and no one has a spot open for weekly, you have to wait until a weekly spot opens up. If you sign up for a monthly service than you are more likely to have a therapist assigned sooner. Then, when a weekly spot opens up, you are immediately changed to weekly.
My other agenda for today's meeting was to not only add Speech Therapy, but also to keep her other therapies, Physical, Occupational, and Special Instruction. Typically, a child only receives three services, so they are reluctant to allow a fourth. They pretty much make it sound like you are not allowed to have more than three. I was actually told that I could not at one point, but a couple of weeks ago, one of Kamdyn's therapists informed me that you can get past that stipulation if you push for it and have a valid reason why. So when the Service Coordinator asked me what my concerns were, I was ready with my well rehearsed response and my doctor's note that stated he wanted Kamdyn to continue her other therapies after adding speech. I explained that I do not want Kamdyn's delays in Physical and Occupational Therapy to cause her cognitive progress to slow. If she cannot move around to explore her environment, her curiosity may be stifled, or at least that is what I said ; ) They wanted a reason. There ya go.
We also had to rewrite Kamdyn's goals, because there needs to be specific reasons and goals established to justify each service, especially with my dreaded fourth therapy. We kept her Occupational and Physical Therapy goals the same, but we added a goal for demonstrating cognitive thinking with more purposeful play. Lastly, we added a goal for increasing vocalizations and sounds, interacting with family members, and using sign language. And there you have it. A justification for Physical, Occupational, Special Instruction, and Speech Therapy.
Today, I was the squeaky wheel that gets the oil.
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