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DS won't participate in SALT how can I help him?

(11 Posts)
ladyintheradiator Wed 21-Sep-11 15:08:32

It's pronunciation he is having difficulty with and today the SAL said she would have expected him to catch up rather more than he has (been seeing SALT for two years as initially just wasn't speaking, has come on loads in language but now can't make the sounds) but she said he is not responsive so wants to put therapy aside for now - until Jan and then review.

If you get a phonics card of flash card near him he just ignores it and carries on with what he's doing, he has cottoned on to what it's about now and just doesn't want to join in.

Words/sounds he struggles with are for e.g. another/anubsa flower/wower, cat/dat dog/dod. This is a small example but basically to most people he is unintelligible, along with not being able to make so many sounds the overall pronunciation of words is just very different, I think he stands miles apart from other children, even those who struggle with the sounds listed, it seems somehow more than that. I get most of what he says as you'd expect I suppose but even now, as his sentences get longer and vocab bigger the words get more muddled and the gaps in what I can understand are increasing. The SALT said he just needs to find motivation to be understood. I don't know what to think really, where do I go from here?

There are a few behavioural concerns but nothing major, SALT has suggested a referral nonetheless.

working9while5 Wed 21-Sep-11 15:16:30

Hmmmm... what has the SALT been doing to motivate him? How old is he? What do you do at home when you work with him?

Rewards are your key here.

StarlightMcKenzie Wed 21-Sep-11 15:29:11

Oh FGS. Ask her how the feck she has evaluated her own practice in relation to the 'responses' she is NOT getting from your ds. Ask her why your ds should lose out on therapy just because she is too boring to engage him. Ask for someone better.

I'm sorry working but some of your colleagues are twits!

(or is she just a hardworking, overloaded, untrained SALT doing her best - if so, ask the same questions above but nicely)

ladyintheradiator Wed 21-Sep-11 18:06:06

Sorry, he is 4 next month, I edited my post too many times and left it out.

The SALT today was a new one, well a locum, she had never met DS before. I'll try and be brief but the background is that SALT visits used to be at home, then preschool for a bit, then there was a long gap and when I chased this up I was told that the old SALT had left and I'd hear soon about who would see us. Then out of the blue SALT2 had apparently been in to preschool and left notes for me to the effect of 'DS distractable and would not concentrate' (enraged, he is 3 FGS) - then received a 'report' stating as much and a few lines about his speech (more enraged esp receiving the Friday before bank hol weekend so incidentally 6 weeks after her visit) - 1/3 of a sheet of A4 in total. I telephoned SALT2 to be told she was leaving and I'd hear soon. Then last week a card popped through the door with today's appt on it.

We went into her office, DD (nearly 1) was straight into the box of toys so DS joined in. SALT picked up a few flashcards and asked DS 'what's this?' a few times, DS was either unresponsive or said I don't know, or I am busy. She chatted about what he was doing and he answered a bit. He put a sheep into a trailer and she said 'what's that?' he said 'a sheep' (like seep) she said 'say it again?' and he said (louder) 'a sheep, I said!'

Then she said she doesn't think he will benefit from therapy and she will speak to the preschool staff next week (on the one day of the week that the SENCO doesn't work).

She did ask lots of questions about his progress this far, she was likable which for me means I end up nodding and smiling and it's only later when I reflect that I think hang on! There were 3 SALTs in the area, now just this one so I feel as though there is no choice.

Right, sorry for the waffle. As to what I do at home, tbh it's only the last 6 months that have become more difficult, prior to that he would play a game with phonics cards a bit - we'd take it in turns to choose one and practice the sound - he was interested in the actions and liked the pictures. Prior to that the problem was a lack of speech which I found easier to 'deal' with. I feel a bit lost I suppose.

It's difficult because I have found people - family, friends, preschool - are actually quite quick to brush off concerns and reassure me that 'he'll be fine' - but that's not what I care about - by which I mean meeting his needs - finding out what his needs are - that's what I worry about, helping him as he is now, not just anticipating some vague and distant point in time where he is 'fine'.

oodlesofdoodles Wed 21-Sep-11 19:04:50

That sounds like a mess of a service you're dc is getting. As I understand it your sons pronunciation problems are exactly what salts are trained to help with. We had a salt who was great at setting out what ds was to expect and what his reward would be at the end. In other cases I've often noticed how useless and ill informed allied health professionals can be, but they're so smiley and charming I don't like to complain. In your case I would register an official complaint though and copy your mp in. If the service is being run down on the sly the authorities need to know how unpopular that is.

oodlesofdoodles Wed 21-Sep-11 19:06:20

Aargh misplaced apostrophe

DeWe Wed 21-Sep-11 19:31:24

His speech sound very like ds's, who was 4 in June. He's only just started speech therepy, and he spent the first one growling everything like a dog. confused
He doesn't really want to play with the flashcards, but he does it as she lets play a game. "When you have your turn now I have mine, now you say "cat" before your turn." Or she bribes him with blowing bubbles.
One the time I went and he wasn't concentrating she cut the session short as she didn't want a stand off with him. He was fine the next time.
Ds has glue ear, although has grommets now, but I suspect he has (probably permanent) hearing loss now due to lots of burst ear drums.

ladyintheradiator Wed 21-Sep-11 20:50:31

Thanks oodles, am left feeling totally bewildered by her almost writing him off in that case, I wonder what the deal is? They have all gone on about how busy there are, as of the old team of 3, 2 went on mat. leave never to return and somehow weren't replaced. And preschool do it too, oh the SALT is so busy they say. Well I'm very sorry for them but what am I supposed to do? Is it just a get-out, one less child to squeeze into the week? A complaint sounds extreme even now, I am not good at standing up and saying I'm not happy. I could phone her and say I'd like another appt?? But how do I explain myself? I feel I must sound pathetic, this is my son after all.

DeWe are you happy with the SALT, I'm guessing so? Bubbles, what a simple and effective idea. We have had DS's hearing checked - several times - do you think it's worth asking for this again? HE was tested at 2.4 2.6 and 2.8 - the first test he got fed up, so they said we should go back - the second time he was getting over a cold so missed a couple of things - they said they probably had enough to say he is fine but a third test would give certainty, so a third test it was! But obviously the last was over a year ago now.

Thank you all for talking to me.

beautifulgirls Wed 21-Sep-11 21:30:28

I resorted to bribery with DD#1 when she went on strike about doing any of her SALT work. I used M&Ms as counters and we could use however many to mark acheivements and then would allow a certain amount to be eaten as a reward when the task was complete. It turned her around from no interest to asking to do it!! I'm sure sweets are not everyone's idea of a good idea but something somehow will motivate him and it is just a matter of finding out what now. A start chart type of thing with a special toy at the end for example.

working9while5 Wed 21-Sep-11 21:31:40

Star, I know you have had bad experiences with SALT but it's hard to tell here what's going on based on the details given. "Watchful waiting" for speech delay for the under 5's does have research backing, so not total twittishness smile. This is essentially what has been suggested here, although I feel it has been poorly explained!

Have you a working diagnosis, ladyintheradiator? The errors you describe are not particularly "serious" in and of themselves (e.g. they sound on the basis of this incredibly small sample like normal developmental errors/delay and encouragingly he is using a range of sounds and syllable shapes, with final consonants marked (tat for cat etc), all of which suggest it is less likely to be disordered). Of course that may not be the case at all and only thorough individual assessment can really tell. Have you been told whether they think it is disordered etc? When you say he is unintelligible, how unintelligible (e.g. 90% understandable only by you, 90% understandable by you and close family, 90% understandable by some familiar adults, 90% understandable by all familiar adults, 90% understandable by strangers etc). If preschool really are saying they feel he'll be fine, I would take some reassurance from that when it comes to speech as they tend to have a "good ear" for speech production in the early years (watching all kids go through the normal developmental errors etc).

Do have his ears checked again, hearing loss can fluctuate at this age and play havoc with speech perception, impacting on how speech sounds are made.

I wouldn't worry too much about flashcards and I wouldn't really enforce them without good reason if he is resisting them. It sounds like things are settling after a period of initial disruption and perhaps this is what the SALT is thinking?

StarlightMcKenzie Wed 21-Sep-11 21:44:50

I just spoke to ds' new SALT on the phone. I've never met her but she was all a fluster because ds attendance at the school she is the link SALT for has been deferred until after Christmas.

She was whinging about how much more time it will take to see ds in a clinic setting than if it was at school with the others.

I told her that I thought it best that we take a wait and see approach until after Christmas grin and that I have no desire to take a child with social communication difficulties to clinic sessions out of the context of his problems. She's now my best friend! smile

FWIW Working I haven't had that much of an issue with SALTs after I raised a complaint that got me 19 appologies. The last one was fab. Didn't really know how to engage ds or how to motivate him but wasn't adverse to my suggestions on that account and wrote an absolute killer report in which I recognised my ds completely. I think we could have worked better together if I wasn't preoccupied with my dads last few months. She didn't know much about ASD either btw, but stood up for me a couple of times at multi-disciplinary meetings and I suspect a couple of times outside of them.

She won the unique position of not making an awful lot of difference to ds, but at the same time my respect and inability to complain about her.

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