Can someone help me make sense of this? Infant Educator 1x/week, no ST

[Anonymous]

We have been going through county (Fairfax County Infant/Toddler) and private evaluations for our nearly 20-month old son. After two assessments, the private ST sees signs of "mild to moderate" apraxia, though it can't formally be diagnosed until much later, including limited consonant sounds, groping for words, etc. DS is scheduled to start speech therapy using PROMPT once per week. The ST noted that she also saw some possible sensory issues, attention issues, turn-taking problems, etc, but that she wasn't ready to refer to an OT at this point. In the county assessment this week, the evaluators decided that DS is not technically delayed in speech (they pegged him at 15-18 months and 15 months is a delay) but they also think he might have some other issues, like immature play, lingering oral exploration rather than using his hands, sensory seeking, turn-taking, attention issues. So instead of providing speech therapy, they are recommending an infant educator once per week. They explained what an infant educator does and I'm open to it (if she will be helpful in the areas they and the ST noted, that will be great). But I'm having trouble understanding how they can not be recommending speech therapy in addition and particularly figuring out how I am supposed to reconcile these two assessments. I assumed that we would be getting additional speech therapy through the county to supplement what he will be getting privately. I realize that it doesn't really sound like I have a question here, but I just find myself confused after thinking I knew the direction in which we were headed and now wondering if the county is providing him with what he needs. Searching here, it also seems that most people get an infant educator 1x/month, and I'm wondering if anyone saw an infant educator 1x/week and what kind of progress was made, particularly when there were some speech issues as well.

[Anonymous]

A couple thoughts:

One.) It really depends on how skilled the infant educator is and their background. The educator we had was an SLPA and honestly much better than the SLPs that we have encountered. I hope you get a great fit from a educator.

2.) If the SLP is using the words apraxia, you can certainly argue for speech therapy to be implemented from the county. Deliver her report to them if you already have not. If you continue to pursue that topic you should receive speech therapy, as apraxia training is quite different from developmental play therapy to promote language and speech development. I also suggest buying the Kaufmann cards for your home practice.

[Anonymous]

Fcps recommended the same plan for my daughter. Her sessions with the educator were worthless. We put her in private St and or right away to supplement. After about two months of the useless education sessions, I called our service coordinator and pressured to have her switched over to St and or and to stop the education sessions, and they said okay. I still kept her in the private services as well, as they seem to be far more effective with my daughter than the infant and toddler people through the county.

I still think it is just ludicrous to tell a parent that their child is a year behind in speech and then only offer the child one hour of services a week. One hour a week was just not enough for us -- I'm very glad we also started the private services.

Good luck to you!

[Anonymous]

I'm in the same boat here in Montgomery Co. My DC is delayed in speech and it was recommended by our dev ped that she get regular ST. Yet the county regularly sends OT and special educator with no ST. When I finally pushed them to provide ST services, what we got was quite lackluster. After seeking private ST, I could really see the difference in the quality of service which was superior with private. The county has admitted to me that they don't have enough STs to fill the needs in the county. Personally, I wouldn't mind getting limited service based on availability, but the lack of quality is unacceptable. I told the county to cancel my DC's ST... we'll stick with private.

[Anonymous]

Bottom line: definitely advocate and get ST, not the infant educator. That's not acceptable.

We're in FFX as well and we started with an infant educator. Having said that, our DS was younger (14 mos.). We had several visits but discontinued them. Our "educator" was a really nice woman but it was a complete waste of time. I can see it being helpful only where the parents really need to be brought up to speed about best practices for any todder. I don't mean to be rude but really for parents who don't know to read to the kids, label things, etc. Also there is the financial side. We had to pay out of pocket for the full cost of the educator because it's not a therapy per se. For actual ST through the county, since it's a therapy, we're only out for the copay we would be paying via insurance (Ffx is in negotiations with our provider to become in network, but Ffx is letting us off the hook for the full amount and just billing the copay until further notice). At 18 months I asked for a full speech eval and they started weekly sessions with an actual ST. We did that for 9 months (in addition to private) and now just do private.

[Anonymous]

Push push push for what your child needs. We had a similar problem in Arlington - my daughter was diagnosed with spastic hemoplegia - neurologist wanted her in PT 2/week to get her walking - county said no way, we have to answer to the state, etc. I called the supervisor, asked her just what the state would want her to have when she had to "answer to it," and offered to send her multiple doctor reports. I immediately was given PT 2/week initially for 6 mos (extended to 8 mos) in addition to OT and ST. It's ridiculous that you have to play the game, but you do. If you push, and you have a medically valid position, you should be able to get what you need. And, if you are unhappy with the quality of your therapists, ask for new ones. We had some great pp through Arlington.