Verbal dyspraxia - how much SALT?

[abc12345]

My five-year-old May have verbal dyspraxia (awaiting referrals but two SAL therapists agree that his has an expressive language disorder with dyspraxic traits)...

Does anyone have experience of this?

He currently has 3x30mins at school with a LSA, NHS therapist sets targets twice a term and I take him to private therapist 1h a week plus homework. He is still making very slow progress. How much speech therapy do you think I should be doing? Should we do more?

Any advice on what helped? And whether I can get a EHCP now or wait until he is diagnosed (school are crap).
Do you think an intense course with a therapist would help?

I would really appreciate some advice!

[BoogleMcGroogle]

My son is 5 with DVD. I made a parental request to the LA for an EHCP and we had no trouble getting one with SALT evidence. Used the model letter on IPSEA's wbsite In his EHCP he is entitled to 1 hour per week of specialist SALT and 20-40 minutes individual therapy a day in school. Plus TA support for literacy etc. In reality he is an a speech and language unit and gets much more than this. He only really started to make progress once he moved to the unit, his progress with just NHS and private therapy and school sessions was very limited. If there's a speech and language unit in your authority do have a look, although I'm aware that not all parents want this for their child. We held off for a year , thinking he'd improve but regret that now. The Nuffield does some intensive sessions I think, although we've never had a referrAl there, just a local diagnosis. Please PM me if you want any more information. We went through a similar process last year and I'm happy to share what we've learned.

[BoogleMcGroogle]

BTW- speech therapy for a child with DVD is an educational needs so the local authority must find whatever is quantified in the EHCP, which is why he has such a generous allocation. Basically the NhS SaLT wrote that he needs x but we can't fund that. I did have to ask them to specifically quantify the provision , But they were happy to do so when I asked. Once it is quantified in section f of the EHCP the local authority has to fund it.

[abc12345]

Thank you for your advice. I will pm you now

[beautifulgirls]

A lot depends how he works with you and the various people who do therapy with him. It is far better to have a short but useful session than long or repeated sessions that are frustrating for him and achieve little. It took a while to find out what motivated DD for her sessions and suddenly they became fun instead of a chore. (We replaced game counters with M&Ms that she could "win" by having a go...bribery basically!!).
With DD she was still struggling in reception and her school were doing their best for her and we had private therapy every other week. School noted other concerns as time went on and fast forward with a lot of stress and talking to people we now know the extent of her issues. In her case she has a genetic problem often linked with verbal dyspraxia (16p.11.2 deletion) and she has APD and ASD. We eventually got her an EHCP and got the right sort of support for her in a specialist school. At the time she started school the only problem we really recognised for ourselves was her speech issue but it did somewhat overshadow her other issues at the time.

She's 12 now and can reasonably well, make herself understood and the speech therapy and effort was all worth it.

[BoogleMcGroogle]

beautiful that's a really interesting post and resonates with me. And it's so nice to read about the progress your daughter has made in the right setting. Now DS is making progress with speech and getting the support he needs, we've begun to notice other processing and sensory issues become apparent. He really struggles in some situations, especially with anxiety and he holds all of that in at school. There has been so much professional focus on the speech, and I think that school and others really want to think that it's 'just' a speech issue, as that's the easiest for them to address. We are now having private OT, working on vestibular and fine motor skills and are in the same situation we were two years ago with speech therapy- he won't do what he knows is hard! Sadly he doesn't like sweet stuff so the M and M's are not an option, his favourites are smoked salmon and strong cheese (weird!) so we might just have to bribe him with that.

We are seeing the paediatrician soon (who discharged us 2 years ago as DS is 'clearly not autistic (which he's not) so I don't know what you think I can do for you'), we are hoping for some more specialist referrals and a clinical genetics referral as we think that this might be an issue for DS too.

[notgivingin789]

OP, my DS has verbal dyspraxia.

When he was at his mainstream school he was working with the LSA on his speech targets (once a week for 30 mins) though it wasn't specified (so I'm not sure if they even did it) and the NHS salt only came in once termly to set new targets. He also had private SLT once a week but I stopped mid way as I was saving up for his tribunal costs.

DS goes to a specialist school and he gets more than the above. To be honest, the private SLT and the LSA working with him at his mainstream school wasn't enough. He had to be in the school where speech and language therapy was integrated in the school curriculum.

[notgivingin789]

boogie snap... are you me ??

When DS started at his specialist school and his speech really took off I have just noticed DS sensory processing difficulties: pro perceptive difficulties and his lack of fine motor control, DS is having private OT after school though he gets one to one OT at his specialist school.

[notgivingin789]

"It is far better to have short but useful sessions...:". I agree with this too and wonder if DS being in an environment where speech and language therapy was integrated into the schools curriculum that made much more progress with his speech than individual sessions.

[Bellebullerebelle]

No real advice but interested in the replies as my dd is similar. School have been given a few activities to work with her a few times a week at school but this was months ago now so either she's been doing the same few words over and over...or it's not getting done! It's really tricky for us as she has a few words that are clear but often just starts babbling which makes no sense. She's due an assessment soon which I imagine they'll test her vocab but won't engage in any type of conversation so nothing new will happen.
Do you notice any improvement with the SALT work you've already done? I ask as for my dd they basically told us to just turn the TV off and talk a lot . Am also interested in the severity of the speech delay for those whose kids go to specialist schools. My dd can communicate but not well enough to be fully included in her friends games (which then leads to negative behaviour from her!) sorry for the post hijack!

[BoogleMcGroogle]

notgivingin it's good to know that there are others like us out there:) Our sons probably fit into a pretty standard DVD profile- the trouble is there's such a lack of understanding about it that it gets underplayed and misunderstood- including amongst education staff and speech therapists. That's not a criticism, true DVD is rare and there is a lack of training and resources. I'm an SEN professional and had very little understanding of the disorder. I do now- I'm my services' resident expert! So pleased you little boy is getting the extra support now. We are breathing a huge sigh of relief until October when we need to decide about his next move ( he's in an infant school).

While many children have articulatory difficulties, which often can be fixed by odd sessions in school , children with DVD need intensive, frequent and high quality support from someone who understands complex speech and language needs. It simply won't right itself, which has huge implications for a child's later learning and happiness. For us, sessions were never ' good quality' as DS simply wouldn't engage. But the progress he has been able to make with appropriate specialist support ( and group sessions with a very experiences SALT and specialised teacher) has been fantastic. We know that he'll need help to learn to read and write next and to learn to listen well. That's our next 'adventure' I think!

[notgivingin789]

Boogie Your are right, true DVD is rare and it requires intensive input for the person with DVD to make progress. It's weird how DS other issues are becoming apparent, I met someone who had a stroke and this impacted on his communication difficulties but he told me that he now cannot stand the light (he wears sunglasses), he cannot stand noise and he wears ear defenders etc. I immediately thought of Autism and wonder if having communication difficulties impacts on other areas.

Has your DS been assessed my the Nuffield Boogie, they have been really good and have given me sons school some tips how they can help with his speech. Are you thinking of putting your DS back into mainstream school when October commences ?

[notgivingin789]

Belle the majority of children as DS school who have DVD can talk pretty well the trouble is that you cannot understand a word they say which makes it difficult.

[Bellebullerebelle]

Thanks notgivin, thats really interesting. I don't know if my dd does have it, in it's true form, but perhaps some elements. Some single words are intelligible but when she strings them together it goes to complete nonsense. (She's 4). She had a cleft palate so a lot of her speech is nasal anyway. I need to have a chat with her SLT. Thanks for the help :)

[hazeyjane]

I keep meaning to post and then losing the thread!

Ds has a diagnosis of severe expressive speech disorder, and they have used verbal dyspraxia assessments. A speech unit was recommended, but the nearest one was closing, the next nearest had no space, and by the time there was space he had settled in really well to the school at the end of our road. I still worry that we have made the wrong decision. He uses Makaton and an AAC device, and it is a battle to get these things properly used in the classroom.

The SALT has said she thinks he has DLD (Developmental Language Disorder - formerly SLI). We disagree as he has other complex needs - health issues, autistic tendencies (just been referred for ASD assessment) low tone and mobility issues. He is under a geneticist as he has mildly dysmorphic features and some soft markers. He is just about to go into the 100,000 genome study.

Beautifulgirls - I had a quick google of 16p.11.2 deletion, some if it sounds very interesting - do you have any links to information? It may be worth me emailing ds's geneticist.

[notgivingin789]

Hazey your DS uses an AAC device ?! What programme does he use. My DS has started to use one, his using the P2G. He was assessed by an AAC specialist speech and language therapist.

How are you finding using an AAC ??

[hazeyjane]

He uses a Gridpad Go with the Grid 3 - it is from Smartbox. He has had it for 3 years and is great when we can't understand him, and sign isn't working, it is also good for helping build correct sentences - but it is clunky for him, too big and with so many pages and words (as recommended) that he would rather sign and try to write words on post it notes (we have hundreds around the house!) it hasn't helped that training at school has been patchy and they are crap at it being out and accessible all the time. We are talking to his SALT at the moment about a different device, but think the research will be down to me. How is is Proloquo going?

I did start an AAC support thread ages ago here, but think there were only 3 of us, so it didn't last long!

[notgivingin789]

Honestly Hazey I would switch to an IPad or get another IPAD (if you already have one at home) and only use it for communication e.g. Put it on guided access, no other apps, no internet. There was a discussion about how the AAC devices would die out as communications apps are accessible to more mainstream devices (e.g. Tablets, mobile phones).

Assistive ware core word classroom (it's free to use as of now) have great videos/ tutorials on how to implement AAC/ games and so forth. It is a company that uses Proloquo2go but it does not matter as implementing AAC is the same thing. The angelman communication series (if you google is also good and goes into depth about supporting reading and literacy by using an AAC) but all their videos are an hour long and I just don't have the time ! Assistive ware have quick 5-6 min videos.

I wonder if it's worth getting an AAC specialist to come into the your DS school. DS specialist school have come up with ways to include his AAC into the school curriculum and where I was working at a particular specialist school, the school implemented AAC perfectly.

DS has only been using it for three months but it's astonishing. His still getting adjusted to it as the assessment team put up his grid size higher so DS is having to relearn the positions . I wish I discovered high tec AAC earlier.

Please do start another discussion (or maybe I should ?) about using high tec AAC, I think they are great and not a lot of people know about them ! I currently work at another special school and I know there are some students that using a high tec or a low tec would bring out so much to them ! But they don't believe in it and would rather let the children use their own voice to speak.

[hazeyjane]

I think the ideal for ds would be getting something like am iPhone that had a text to speech function. The Gridpad Go does come in an 8" tablet too (the one he has at the moment is 10", but he is small for his age and struggle to walk safely around school without the added weight of a massive tablet swinging around!)

He sees an AAC specialist, who sorted funding for the system he has now and training for the staff, (unfortunately they are no longer the staff working with him, and further training had taken an age to sort out). We are due to see her again soon, and I am going to suggest the smaller device.

[cheekymonk]

Hi all, just wanted to share my experiences. DD was diagnosed with severe speech delay at 2.5. She also had glue ear and grommets pit in at 4. She started mainstream school despite my apprehensions and it seemed as though this had to fail before anywhere else could be considered. DD had weekly private speech therapy after seeing private paediatrician who also diagnosed PDA. NHS speech therapy was sporadic and slow but school did put extra intervention in place, 2 x 30 min sessions. The head of speech and language in the area then saw DD, diagnosed probable verbal dyspraxia and then things took off. After several TAF meetings DD was assessed as being eligible for the specialist additional resource centre for speech and language so transferred there for the start of year 1. It was a difficult decision to make, she had made some friends at original school but was being seriously left behind academically and her self esteem was very low. She has really blossomed since being at ARC, she is in a class of 2 all morning then joins mainstream in afternoon. It's been fantastic for her and her confidence and progress has really improved. Bad points are we still don't have an EHCP as LA have said need to prioritise transitioning old statements but I think this is rubbish and am considering doing it myself, just don't want to mess it up. DDs PDA is also downplayed and the emphasis is all on speech. School seem annoyed when I remind them or question possible ADHD...x

[Bellebullerebelle]

Can I ask a possibly really stupid question? How do you know if your child needs specialist provision? My dd is only nursery at the minute but already a good 2 years behind her peers. School say she's sociable and happy but her peers are frightened of her as her behaviour is unpredictable. I requested an EHCP but the school said she won't get one so don't waste your time. Is it the norm to wait until she falls farther behind?

[BoogleMcGroogle]

bluebelle I wasn't sure if DS needed an EHCP, and I work in the SEN system. It's hard with a specific speech disorder as its not always clear how that will develop. But it went through with speech and language as the primary area of need very easily. The report from the head of speech and language therapy stated that he has the highest level of need (in our area called SAL 1a), which was all they needed to know really. I was quite decided about wanting DS to stay in mainstream, but he really struggled in reception and they really did not understand his needs at all. It was such a relief when I raised the s and l unit and his speech therapist said that she'd felt that's what he needed all along. I suggest you visit your local unit and take it from there. They will be able to give you an idea about whether it's right for your child.

We found it very easy to apply for an EHCP as parents. We used a fleshed out version of IPSEA's model letter. It's also worth knowing that, even if the LA turns down your request, the majority of parent.s win an appeal against this and the EHCP happens. It's just that sadly most parents don't appeal.

[BoogleMcGroogle]

cheekymonk the thing about prioritising transfers is a separate issue, that shouldn't affect issuing new plans. They are having you on, ignore and make a parental application. It's really not that arduous. I'm happy to share our experience if you send me a message.

[cheekymonk]

Belle, DD had a baseline assessment when she started reception that assessed her as age 3 in most areas and the progress was there but just not at a speed that a teacher with a class of 30 could support. It was only when DD was aged 4 and SALT said she had a severe delay I realised that she wouldn't 'grow out of it' as NHS paediatrician had said.

[cheekymonk]

Thanks google mcgroogle

[cheekymonk]

Autocorrect sorry!