Shall I let him be discharged from SALT?

[daisy5678]

J has 'had' SALT for a year. It was recommended on his ADOS report to be 'ongoing' because his social communication was so poor.

So the SALT met him, wrote a report and recommended daily SALT delivered through TA. She set up a programme for TA to deliver. Came back a couple of times to check up. Doesn't help that J isn't keen on her and will often only 'talk' to her through his TA.

Then she wrote a follow up report saying she'd discharge him soon because there are so many other services involved which there are - OT, behaviour service, inclusion team, SS, autism outreach etc. but nobody except autism outreach actually sees him and that's not often and is usually re: anger management.

She's coming out to see him at school soon and I'm guessing it's a final visit. I never responded to the initial idea of him being discharged as there were bigger battles at the time, but I sort of feel that the other services are not going to offer the overview of his speech and language issues that SALT will. I'm also mindful of the need for 'ongoing' SALT as recommended by CAMHS.

I'm getting more than a little pissed off that a lot of the services are now scaling down any involvement on the basis that 'so many services are involved'. Well yes, but none of you actually see him or do much now, and the point is that he needs those services because of his complex difficulties, or he wouldn't have been referred to you and you wouldn't have taken him on! Grrr.

WWYD?

[sickofsocalledexperts]

They sound to me like they are taking the piss a bit, and surely unless his speech is now entirely normal, she would need to keep updating the program on which the TA works with him?? It's amazing how annoying these people are - what matters is that "loads of other agencies" are involved, if the most relevant need is speech development? I would be unfailingly polite, but also very difficult and stubborn.

[daisy5678]

This is the problem - his vocabulary and expressive language is great; it's the to-and-fro of social communication that he finds very very difficult - things like waiting his turn, responding to questions, asking 'polite' questions like 'how are you', keeping on topic. It's all very one way - he will talk for hours about his obsessions and ask incessant questions about things relating to his obsessions, but gives nothing back. It's slowing his social progress with other kids who are, of course, increasingly sophisticated in language use.

Because his speech development in terms of vocab etc. is usual (or better than), the SALT seems to be saying he's not a priority. Is this about waiting lists? Do they get a nice tick if they discharge?

[sickofsocalledexperts]

Yes I'm sure she will take credit. I'm not sure she will be able to do much though from what you describe, but then I have a longstanding low opinion of SALTs! It could be that you, or the TA, or even some other tutor/adult after school could work with him on conversational stuff. One autistic 9 year old I know still sees his old ABA tutor once a week, just to practise social stuff like that. The SALT though I think would be out of her depth on this. I am always trying to get rid of mine, but they hang on in there even though they do sod-all for my very speech-delayed son!

[daisy5678]

The problem is, he is so resistant to direction in every area that the practise needs to be unobtrusive but purposeful, iykwim. So I could try to practise it at home (and obviously I do) but, if I say 'let's play a turn-taking game' or something, he is quick to pick up that I am trying to teach him something so will kick off. But if I did it TOO subtly, he wouldn't 'get' what he was supposed to be learning and certainly wouldn't/ hasn't/ isn't changing his very fixed rules of 'conversation' i.e. he talks and talks and nobody else is allowed.

The good thing at school was that the SALT sessions were very similar to PSHE things they were doing at the time, and also to general classroom routines, so the TA could work on his turn-taking/ ability to stay on topic and it just fitted nicely in to the day - he coped with it as it didn't seem out of place. He sees school very much as the place you learn so he will accept things there that he won't at home.

Does that make sense?

So I suppose I want the TA to keep getting the benefit of the SALT's advice on his programme.

[TotalChaos]

I ended up in a similar position - and tbh I now regret letting DS be discharged from SALT, as I think having SALT involved at least flags up issues to the less erm SN aware teaching staff (SALT were only professionals involved as my DS's only DX is/was language delay). I wonder if it might be worth suggesting that SALT has some continued but minimal input - eg. that she discusses a plan of work with your DS's TA termly, but only sees your DS once a year say?

[daisy5678]

That makes sense and I guess she might go for it. I need to bring it up at Annual Review time, I reckon, cos I suppose it's not her decision in a way, is it? Not if it's specified in the Statement (part 2 and 3) that he has ongoing S&L issues and needs regular input (can't remember how specific the Statement is, think it's termly visits). If CAMHS recommended ongoing, they can't just remove SALT after a year, surely?

I kind of took my eye off the ball with specification of SALT and OT in the Statement cos my main goal 2 years ago when trying to get them to amend it was to get full time TA support. Need to look at the Statement again carefully, I think. I do remember I got them to put weekly social skills groups with SALT-trained staff in...but they haven't started yet this year. They have one more week to allow for settling in (always like to give benefit of the doubt) and then I will have to start conversations.

Thanks guys for advice. Hate having to decide which battles to pick.

[vjg13]

I would resist him being discharged and try to get the social skills group increased to twice weekly!

Whilst the staff may be SALT trained it is still very important IMHO that the SALT gives input and direction by observing the group and giving stategies.

[TotalChaos]

good point re:statement, if you continue to have CAHMS backing re:SALT then you hopefully won't need to offer any compromise/reduction.

[daisy5678]

Well that was easier than most battles to win!

Spoke to her this week and just asked that she continues working with him as no other agency is working on those skills and she just said OK then!

[daisy5678]

Social group isn't happening but will bring that up again at Annual Review in December; I've already mentioned it to HT this week so would like to see if it happens or not...