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Can moondog or anyone help us with this speech therapists report?

24 replies

nikos · 17/01/2009 21:15

We are currently applying for statement for ds (4 with ASD dx). He is in a mainstream preschool with 1 to 1 support and starts reception in Sept. We thought he was doing well, seems quite bright and is very verbal but with some language delay. Most of the time he seems to cope quite well but he can be unpredictable and aggressive at times.
We have received his SLT report and at the end, when she talks about provision to meet his needs, she seems to be asking for things that can quite clearly only be provided by a Special school.
This has taken us by surprise. Should I try and get this in prospective though. Is she just listing all the things in the hope that his ms setting will provide some of them? She has asked for things like a highly structured teaching system such as TEACCH in an adapted classroom environment and it is likely that X will require a higher level support that is usually available in a mainstream school in order to implement the programme.
Feel sick tonight. I need to remember that we know ds best and she has only seen him 3 times. Any words of wisdom appreciated.

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daisy5678 · 17/01/2009 21:29

I think you have to see it as a good thing, though it must be hard to hear. If she has put things like that, a mainstream school might still be appropriate if they adapt the classroom and hire someone with TEACCH experience and pay for the class teacher to have training in it too. This is the sort of thing that can be written in to the Statement.

Saying "X will require a higher level support that is usually available in a mainstream school" is nothing at all to worry about. It is a stock phrase to say that a Statement is necessary as he needs a higher level of resourcing/ funding than the school would be able to provide on its own (and that's the criteria for a Statement, so she's saying he needs one!)

These professionals have to walk a bit of a tightrope. They're discouraged from telling the full truth, but also need to provide a clear picture, so they have to kind of use words to hide it.

J was seen by the EP at age 3 and was totally totally out of control. Everyone who ever met him said he needed full time support at school. The EP had to put something woolly like 'will need a high level of support' and, like you, 'will need more support than would usually be available in mainstream school'. That was good because it got him a Statement.

You could have ended up with something totally woolly like 'will need some additional support' or, even worse, 'would benefit from extra support' - what she's written is really good because the LEA will listen to her and so she's sent a clear message that assistance is needed. They have to spell it out a bit though and sounds like she got as close to that as she would be allowed to!

If all these things go into the Statement, the school HAVE TO do them. So it's good that she put them.

It doesn't mean he's not doing well. It means you got a good SALT who's willing to be as honest as she's allowed to to get the resources for you that DS needs.

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nikos · 17/01/2009 21:37

Thanks so much for your reply. I suppose I'm just scared the school will see it as too much effort and not be on our side. The speech therapist is an expert in autism so I do trust her call. But ultimately the head has no reason to be on our side. The school is a very high achieving one and my other two are there. Just worried that it will be seen as the easy option to stick him in a special school where the TEACCH system is fully working.

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daisy5678 · 17/01/2009 23:45

The head has no reason to be on your side except that that's his/ her job - to educate the children at their school! I know only too well that this is not always the case, and they might make out that it is a lot of effort, but don't let them feel like they're doing you a favour!

The LEA should resource the school to be able to cope with your ds's needs - and you need to make sure the Statement is as close to good as possible for that very reason.

It might be easier to educate him at a special school BUT cheaper to educate him in mainstream (so probably LEA's first choice) and you do have a very strong right to have him in mainstream. From your description of him, I'd be v surprised if they tried to recommend special ed if that's not what you've asked for.

I've found that you can't predict what lengths a school will go to to help your child. J's Infant School went totally above and beyond but the (attached!) Juniors is trying to force him out. IME, children without problem behaviour are accepted much more easily, so you may be pleasantly surprised.

I really hope it goes well for you!

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cyberseraphim · 18/01/2009 07:15

I think you need to seek clarification about what the TEACCH approach can do to help your son. TEACCH (as far as I know, I'm not an expert on it) does have some good points but it's not appropriate for all ASD children so you need to be sure that it's not just one of these blanket 'autistic children need TEACCH' statements. What expectations do you have for him in the next academic year and is it clear to you that TEACCH will help him achieve these goals. Others who know more about TEACCH might be able to help you more but my impression is that there is not enough emphasis on language or academic skills which might suggest it's not ideal for your son.

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nikos · 18/01/2009 09:26

Thank you all for replying.
The SLT has suggested a highly structured teaching system such as TEACCH in an adapted classroom environment. I suppose that leaves the option for some other highly structured teaching system if we want. TBH I don't really know what TEACCH is in practice, despite a search last night. Can anyone give me an idea of what it looks like in practice?
She has also said there should ideally be opportunities to deliver the programme through individual and small group work as well as wider group and class activities.

It would seem to indicate that ds needs more than your basic classroom assistant if he is to stay in ms. His current 1 to 1 is excellent but I think she would say herself that she struggles at times. She is very enthusiastic though and willing to learn. How long would it take her to train in TEACCH?

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bramblebooks · 18/01/2009 09:40

Remember that the SALT evidence will go through to the statement panel. The panel decide the level of support given so the SALT is making it clear to all involved that funding will be needed to deliver a very supportive programme.

Inclusion means that reasonable modifications (to teaching, to learning space) need to be made within the mainstream classroom.

My friend's son is profoundly autistic, deaf and has Downs and has successfully been included in a mainstream school, then in a shared placement between mainstream and special school as he's grown older.

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moondog · 18/01/2009 10:46

Hi Nikos
Some points

Nothing about SALT or communication should be in sections 4 or 5. This is illegal, due to a ruling known as Lancashire Judgement (see IPSEA website for further details.) What it means is that noone can say that communication is a non educational need, (as they have and do).Ultimately it is an educational authority, so even if SALT dept. bleat about no provision, then Education have to get SALT in ,even if they have to pay a private salt.

Everything in the statement must be specified and quantified. nO vague words such as 'needs access to' and 'regular monitoring'. Think of the salt input as like medicine. You need to know exactly how much will be given and when. This prescriptive advice runs counter to philosophy of salt but unfortunatel;y, without it, you will probably be expected to get by with bare minimum like everyone else, due to chronic staff shortages.That is an important issue, but it is not yours to worry about.Your priority is getting salt for your child

It is really difficult to get the across board level of structure and consistency and adherence to a clear communicatino policy in a m/s school. It is even difficult in a special school. Your salt recognises need for this, so that is good.I'm really surprised she mentioned TEAACH without discussing it with you though .It is a way of structuring the classroom very carefully.

Something called ABA is also worth researchin (Applied Behaviour Analysis). I am doing an MSc in it at present as I am partic. interested in children like yours. Join ABA Yahoo UK group for more guidance and info. Some salts are not keen (because they don't understand it) but salt and ABA can work beautifully together.I've just written a very long paper on it.

You need to visit your local ParentPartnership.Special Needs Advisort Project office asap. The Education Authority will tell you where it is.They will go through the legalities of the statement with you.Stay calm ,don't panic and make no decisions until you undersand the implications of everything.

It's a horrid worrying time but hang in there.

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moondog · 18/01/2009 10:48

1:12 isc a minefield. In the field of SN, there are 24 000 assistants employed across UK with no training in the complex needs of the pupils they support.

It is a hugely responsible and very difficult and isolating job which is far too much for one person and very badly paid.

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daisy5678 · 18/01/2009 11:22

Training can be written into Part 3 of the Statement. J's says that any staff working with J must have received at least one full day of training in each of the areas of ADHD, autism and challenging behaviour, as well as being Team Teach (restraint/ positive handling) trained. The LEA have to fund this and have done in J's case. I agree that untrained TAs have a tough job, so this is really important.

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nikos · 18/01/2009 11:40

This is such a minefield and its like we have to be experts to make sure we get the right help for our kids when we don't really know what that right help is .
Just to clarify, the SLT I'm quoting is just her initial report, not her actual input to the statement. We haven't got that far yet, just at the initial stages.
I've looked at ABA (read Hear my Voice over christmas and couldn't put it down). I've emailed the autism partnerhip in Leeds for an assessment of how this could be used with ds. It might be that if the SLT puts his need for a structured system in the assessment then maybe we could get ABA funded. I think there are a few on here have had that.
The SLT really knows her stuff moondog, but I too was a bit surprised when all this came through. She has seen him in his current setting and none of this has been recommended before. If he needs it next year why not recommend it for this year too. God its exhausting keeping tabs on all this. Me and dh just returned from a few days away from the kids (thanks to parents in law) and I'm thrown right back into the maelstrom.

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moondog · 18/01/2009 14:35

A thank you would be appreciated.
I offer this advice for nothing in my spare time.

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nikos · 18/01/2009 14:40

What's wrong moondog? Is that comment for me?

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cyberseraphim · 18/01/2009 14:40

My impression is that TEACCH and ABA , although both structured, are not that similar and in practice, parents and therapists are in different camps about which, if any, is right for the child. ABA tries to use behaviour modification to bring out better social compliance and hopefully to promote verbal language. TEAACH uses visual schedules with symbols to plan a child's work. I think you really have to ask the SLT what she thinks your son is going to learn and how - what would a typical day in school be like?

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mogwai · 18/01/2009 16:58

I'm also an SLT

In my experience of writing reports, we write a report that fits exactly what we feel the child needs clinically. We write this irrespective of the current provision or of what we suspect (or know) the parents would prefer (though sometimes this ties up).

If it's something that can usually be offered only in special school then this means the school will have to try and provide it in mainstream (if this is your choice).

This is the theory. We are not supposed to give (or have) and opinion on what sort of school the child should attend as we are not technically qualified to judge.

However, we usually know our special schools and therefore have a feel for the sort of school we think would suit the child best.

Some children are sent to mainstream because it's the parent's wish. Sometimes this is wholly inappropriate and although the LEA claim to provide what is clinically needed, they fall short.

In your case it sounds as though your child might cope to some extent in mainstream. You need to consider which is more important to you; a mainstream place or the corrcct clinical input.

And if it's a mainstream school you really want, how integrated will your child be? Children with 1:1 support are not truly integrated and always stand out from the crowd. However, of course, there are other benefits which might outweigh this.

FWIW I don't like ABA. Moondog has other ideas and knows more about it than I do. I just don't like what I've seen of it, my opinion entirely.

Good luck!

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mogwai · 18/01/2009 17:00

sorry, meant to add that the reason SLTs don't like ABA is not always "because they don't understand it".

This implies that if we understood it we would all agree with it.

I know several SLTs who understand it well but don't agree it's effective for the child.

Depends on your attitude to "normalisation" I guess.

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moondog · 18/01/2009 17:33

How well is 'well'?
The drive now is to a minimum of an MSc in the field. Ideally a Phd. Definitely Board Certified Behaviour Analyst accreditation.
Finishing My MSc I am only scratching the surface.I'll be working on my PhD and BCBA next

FWIW, I think there is a place for the 'gentle therapies'. I work a lot with music therapists and have a successful private baby signing business that is run by myself, an MT and a professional musician.There are also gentler forms of ABA.It is not always the Discrete Trial Training stuff that people see initially and get freaked by.There is RDI and Floortime which other posters use.

I will readily admit that ABA freaked me out when I first saw it but now I understand the scientific (ie verified by countless academic studies, most of which can be found in the journal JABA 1968-present day)principles of behaviour which underpin it,I see how it is an application rather than a one size fits all programme as some see it (erroneously).

I came into it via PECS which was created by a (married) Behaviour Analyst and a SALT. It is fantastic.

What do you mean by 'normalisation'Mogwai Are you talking about it as O'Brien did? I also work with adults so spend a fair bit of time mullling over policy issues.

At the moment it is a largely unregulated field. Anyone can call themselves an ABA therapist (unlike people like SALTs who are registered with RCSLT and HPC-a good thing). That is not good. However things are changing. In the last 6 years ,16 MSc courses have developed over Eurpoe.The uni at which I am studying was one of the first 3 to do so.SALTs and Education Authorities ignore ABA at their peril.Research shows without doubt that it is the most effective treatment for children with ASD type disorders, much more so thaN salt, sensory integration therapy and so on.

ABA has a lot to laern from SALT and vice versa.They both fill the gaps left by the other.

Nikos, yes it was aimed at you.If a thread goes out with my name on it and I take considerable time to answer it I do appreciate a thank you.

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nikos · 18/01/2009 17:36

Thanks Mogwai. One of the issues I am considering is why I have an aversion to special school and that me and dh should go and view a few to, maybe, take the fear away.

I suppose I don't want ds to go down the special school route because I think he can access the curriculum and would need the academic input of a mainstream school. All I've read of special schools is that the academics are secondary. So its not about wanting a mainstream place or the correct clinical input, but getting the education for ds to fulfill his potential. I also make the assumption that ds will develop into a different kind of adult with a different kind of life if he goes to special school.

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nikos · 18/01/2009 17:37

Thank you

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nikos · 18/01/2009 17:44

And you are right it is a horrid worrying time. I regularly said thank you during my posts but got caught up in the conversation shortly after yours.

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moondog · 18/01/2009 17:56

You are welcome.
So much depends on the schools.I have worked in scores and there are useless ones (and terrific ones) in each category.

It's so hard ot know unless you are in there.Anyone can (and will) give you the blurb about what they do and don't do so only you cam kae up your minds.

One thing that ABA has taught me is that we don't push kids with SN hard enough. What ABA tells us about learning can be used to get them to rocket ahead (for more able kids there are sub branches of ABA called Direct Instruction and Precision Teaching. Look at results from 'Project Followthrough inte states-biggest educational experiment in the world for what DI can deliver.All ignored of course because heaven forbid that anyone should question the 'art' that is teaching.)

I used to embrace the touchy feely accept people as they are watered down 'normalisation' dogma bandies about (often an excuse to not develop perfectly able people. I don;t anymore.

ABA has changed my life seismically both professionally and personally, not least becasue I use it with my own dd who is language disordered.She has SALT (not me) and ABA input and has made astounding progress in the last year.

I began to study ABA for proffesional not personal reasons but it soon became apparent that we could use it and it has changed our lives, so i speak as a mother as well.

Hope this helps you in your quest.

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moondog · 18/01/2009 17:57

Excuse awful typos and bad syntax.

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nikos · 19/01/2009 13:07

Thanks moondog. Had an email back from autismpartnership to say we are too far away (we're in north east, they are in Leeds) but sent us a price list for their consultants. It is a huge expense.
I was very impressed with it reading Hear My Voice. Does anyone know if there is any way to try it yourself to see if it would be suitable for your child?

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nikos · 19/01/2009 13:08

'It' is of courses ABA therapy.

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moondog · 19/01/2009 16:38

You need the support of a behaviour analyst to supervise. You must have one who is BCBA (the best qualification)

Nikos, get onto the ABA UK Yahoo group and start chatting.You will get the detyaield advice you need there.

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