SALT - am fuming

[loueytbg]

Just got off the phone to DS1's NHS SALT. Trying to arrange a meeting with her to see if she will increase the provision in her report for his statement. She said there would be no point as "he has been given the maximum package we give"!!! Her manager apparently wouldn't sanction any increase in provision. So much for assessing the child's needs and deciding what provision they actually need....

This is the same SALT that put another child's name in the report, twice - clearly she had just pasted across the provision from his report. She has just amended the report, and guess what, same provision, DS1's name.

She also said "individual therapy does not work for ASD children"

When I pointed out that actually he had learnt an awful lot from his (private) individual therapy she said that the evidence will show that that isn't the way that ASD children learn language therefore the PCT won't fund it.

GAAAHHHHHHH!!!!!

I bet you if you phoned up anonymously and asked what the maximum package was they would tell you that there is no limit as they assess children's needs individually and this is what the provision is based on. You can't seem to win. There probably is an unwritten agreement as to how much provision is the maximum, but if they were to let it be known it would make a mockery of the whole system.

DS3 gets individual support as well, from both his SNU and the visiting SLT Assistant. WOrks a bloody treat

Yes get it confirmed in a letter, most inportant.

star I am very tempted to send her and her boss and the head of CDC a letter saying exactly that. The problem is it won't get me anywhere I suspect. Currently, statement provision is 5 contacts in the first term and then 1 contact per half-term after that. When I queried what 5 contacts would actually mean, it transpires that only 1 contact per half-term would actually be direct speech therapy with a SALT. So my DS1 who picks things up really quickly will work through the programme that the SALT sets in a couple of weeks and then be stuck.

auntevil my portage worker had already told me we had been given the maximum package so it is clearly a very badly kept secret.

(am still fuming btw)

Wtite to IPSEA and tell them about it.

What they are doing is illegal as it's a blanket policy and blanket polices are illegal. IPSEA have asked that people bring them to their attention.

My Salt is same he got half termly indirect salt ie they advised nursery. We were told it was maximum package we even got them to send the info which set out the banding. We went to tribunal for aba and they expressed significant concern no direct salt and gave us some even tho we said with full aba package which we also won we did not need it. My DH tracked down the banding info online and guess what they forgot to send us the last page so what looked like the maximum actually wasn't. Oh and when we asked them to cost their package they said it was nil cost as 'they didn't have to hire anyone just for DS' so they could support LA in pretence there was no cost to anyone if DS kept getting their package and try to make aba seem even more expensive.

Wished we had had star's advice back then and put it in writing!

She misunderstands the legalities here. Deliberately or through ignorance, who knows?
The Lancashire judgement is the thing here: the SALT service has to comment on need not resources and are legally obliged to do so. It is a cut-and-dried thing that they can't tell you that your child has "the maximum package".

We have had cause to direct clients to complain in the past (most particularly related to AAC funding streams/slow diagnostic processes etc). What I have found most effective is to advise individuals to:

• write to their councillor, mentioning the issue and who is involved at a senior level (e.g. head of SLT service, head of LEA). In one case, this literally lit a fire under the whole process.

• write to MP (same as above)

• write to Chief Exec of trust. This should be more transparent than before because the provision of services has nothing to do with those commissioning - so they are freed up to be critical if it doesn't meet standards etc.

I would keep it brief and to the point. You have lost faith that this person is the right person to recommend an intervention level for your son as you have been told that there is no research to indicate SALT is effective on a 1:1 with this client group and yet a cursory glance through the literature tells you this is a load of old tosh.

I am going to go find you some references to that effect now!

I was hoping that a SALT would be on this evening...

working the problem is that if we kick up that level of stink, it is probably going to affect DS1 because the general willingness of the NHS SALTs to help him is going to be damaged. I honestly can't work out what to do - I would really really appreciate any references you have because my instinct is to write in the first instance to the SALT with some evidence and see what she says.

sausagemonster good idea to write to IPSEA at the same time. It probably won't help us but might help someone else I suppose.

agnes I haven't found anything about banding online. Where did your DH find it?

I think I'm more annoyed about her statement that 1-1 SALT doesn't work for ASD children because in my DS's case it clearly does. Therefore they are effectively removing 1-1 from all ASD children without determining whether that is appropriate for the particular child in question. And then of course they put them in all groups becasue they need to learn to share and take turns Great for the waiting lists, knock 6 kids out at once. The irony is that if he hadn't been diagnosed, he would probably be having direct 1-1 SALT.

Sorry, have been distracted from my task by my boy who is poorly and snoozing on my lap now.. but I will return to it over the weekend I hope.

Don't you dare not complain because you are worried it will impact upon your ds1!

In reality, it may make the SALT not like you very much right now but in my experience, it tends to increase the provision for the child and I have never seen it held against a child, even by SALTs I wouldn't particularly rate for their parent partnership skills.

A lot of parents worry about this but I think mostly it's unfounded.

You know what happens when you raise the illegall blanket policy issue? They change track and say, no, we are talking about yoour child's needs and we feel that he doesn't need any more than x,y or z. That is our professional opinion.

Basically, they lie. They tell you 'you're getting the maximum' when they think that will shut you up. When you challenge that, they change it to - it's the maximum for HIM.

Follow Star's advice. Make them prove why he doesn't need more. It's the only way/.

My DD (ASD) has exactly the same provision written into her statement which I was happy to accept at the time.
I was stunned last week when I spoke to DD's TA and it seems that SALT has not done any individual work with DD just given exercises for TA to do with DD.
I also feel that DD would benefit from 1:1 sessions but it seems that again ASD children are just treated under a blanket policy with no regard to their individual needs. DD's real needs are that she has yet to have a conversation with another child (she does talk to adults).
And yes we also attented social communication groups for ASD kids with lots of turn taking and sharing and working on attention skills which DD already had - again as already mentioned saves LA shed loads of money and makes them seem as though "they are doing something" for our children.

Sorry - just returned to this. Have had horrible migraine all weekend, not helped by the fact that I'm pg and can't take anything and the stress of this probably brought it on in the first place

Anyway....

eveiebaby you're not in Hillingdon by any chance are you???? Sounds very familiar.

working if you get a chance to look out any references I would be grateful (or point me in the right direction...)

I am thinking of doing the following - any comments/suggestions welcome:

Writing a letter to the Head of SALT cc to Chief Exec of Trust, Head of SEN at the LA and to IPSEA

Basically saying I've lost confidence in their service as they have not assessed my childs needs and are in fact acting illegally (citing Lancashire judgment - thank you working). In addition, the theory that ASD children do not benefit from 1:1 SALT is bollocks flawed as ASD is a speectrum and therefore by definition not all ASD children will learn language in the same way. In my DS's case there is abundant evidence that he has benefited from (private) 1-1 SALT. And indeed that he needs this to increase his language but also to improve his pronunciation which is appalling. In fact, when he had some 1-1 sessions last summer to teach him PECS, he picked it up in record speed (the SALT said she wished she had videoed him as he was a model pupil). In addition, I was told by the SALT at the meeting when he was diagnosed with ASD that it was good he was being diagnosed early as it would be mean he would have access to the support he needs. The reality has been somewhat different.

The report that was written for statutory assessment clearly has not recommended an adequate level of SALT for his needs and I would therefore like it to be reassessed. Ask for a response within 14 days.

What do you think?

Loueytbg - funny you should say that!!!!!!!!!!!!!!!!!!!!!!!!!! CDC at Hillingdon hospital don't you just love it - most depressing place on earth! My DD also picked up PEC's in record speed according to SLT - she picked up in one session what it would take most ASD children weeks to pick up although she was verbal anyway but to be fair to SLT she did suggest using PECS as a way to increase DD's sentence length rather than use it in the traditional way and it did seem to actually work. Hope you don't mind me asking how old is your DS and this is probably really cheeky but I am looking to get DD private SLT so would you be able to recommend your private SLT.

Also, I think the content of your letter to Head of Salt etc... sounds great. I'm not sure where you stand with it legally but it sounds good to me. Good luck

How funny. My DS1 is 3.7 - I'm guessing your DD is older?? Will send you the link to the private SALT we use.

Thanks Loueytbg - My DD is 4.6 - I also forgot to mention in my last post that SALT also put another childs name in part of DD's report that supported her statement. I think they must use copy and paste a lot

we got the banding from the SALT dept as they had referred to it in their report - it was only later we saw a reference elsewhere to Band D when they had only given us details for A-C! So they should have their own scale you should be able to see.

Loueytbg, I haven't forgotten the references.. just have had to deal with something urgent at work that also requires references and it was ds's birthday yesterday so haven't had time.

Eviebaby, we do use cut and paste a lot but it's usually just the template. Most departments have a standard statement template.. it doesn't mean that the recommendations remain the same at all although aspects would e.g. there are certain things that need to be included e.g. legal stuff about the resources reflecting need not resources etc.

In reality, there is a lot of overlap in report writing e.g. if you are a specialist in a specific area, there will be assessments that you use frequently e.g. the CELF etc which require a lot of explanation of subtests etc. I very frequently use templates to save time rewriting the details of the assessment process e.g. the assessment details, explanations of standardized and nonstandardised tasks etc. I also use templates to explain commonly used intervention types e.g. colourful semantics, vocabulary teaching techniques, differentiation of synthetic phonics for speech disordered children etc.

I have sometimes made the mistake of not proofreading sufficiently when writing reports meaning that it happens that I have the wrong child's name in a section of a report. It is not uncommon to have 10 - 20 reports to write in a session. It is very embarrassing when it happens. However, I assure you 100% that when writing a report I am thinking about the specific child in question and thinking about them in some detail. Report writing is a funny thing because 20% of it is the actual "putting it together" - 80% is the processing time where you consider the case and the evidence you have acquired and mull it over and try to make that coherent. It's virtually impossible to do without thinking about the child, even if you slightly rubbish at your job. Even if you are very rubbish at your job, I'd say.

Although I have used templates and made errors, I have never "simply" cut and paste a complex report. I will admit I have done it on basic reports e.g. where a child has a very basic speech substitution error e.g. is saying "t" instead of "k" or where a child has mild speech delay as a time saving device.

I wonder if there are many professions where report writing forms a big part of the job where cut and pasting doesn't happen. I think our poor proofreading reflects the rubbish administration support we tend to have - paeds etc usually dictate reports, we do all of ours on the rubbishy NHS computers! I know it's shoddy but it's not evil!

Just so you know

Thank you for explaining working