No 1-1 SALT offered in Westminster council? This can't be true, can it?

[eandz]

Hello Lovely Ladies,

So my DS (almost 3) was diagnosed on May 20th (working dx) of ASD.  We were given a letter right away that was not signed and were told to wait 6 weeks, as that is when they would send us a SALT and an OC.  They also said we would get a better more defined letter with the working dx later. 

Eventually, we did get an amended letter. In it they decided against giving our son an ADOS, felt that he was exhibiting echolalia (which isn't accurate).*

All in all we were thrilled with how easy all of this seemed and how we didn't have to fight. We began to look for a plan for our DS and have started PRT with RGO. We were under the impression that since our DS was getting 1-1 SALT weekly through the early intervention team in our council that we would see another SALT 1-1 weekly. The first SALT was who referred us to see the community pediatrician and then stopped seeing us because it was now the councils job to allocate SALT for our DS.

I waited patiently for 7.5 weeks before I called to see what was taking soo long to even hear about what their plan was regarding SALT and OC.  And when I called, I was told that our DS will never be given 1-1 SALT and it is not offered to any child in our borough. 

What we will be offered is an introduction course this Thursday where I will be taught the different things I can do as a parent to help my child and then wait to be told if I am allowed a space into a course that may or may not start in September (that will run 9 weeks) where I again will be taught how to help my child communicate.

No actual SALT for my child will ever be available, because ultimately it's my parenting skills and communication that my DS learns from anyway and the community support team is really there for me as a parent, not for my child. They are also under the impression that SALT's don't really help children anyway, it's the advice they give the parents that make all the difference.

This is bullshit, right?

there have been couple of threads about the SALT provision for ASD children and is not happening in most boroughs to be honest. Having said that my DS did get 1-1 but only 2 sessions with 6 weeks period in between for him to digest what he has learnt.

I have to admit you are lucky to be offered the 9 weeks course, I didnt get anything except invitation to an Early bird course but paed agreed I know more about my DS condition and how to support that they will ever teach on a LA course.

Eandz, is it a Hanen course? If it is, jump at it, they are excellent and TBH more useful than 1:1 SALT sessions that children find hard to transfer what they've learnt to other situations and contexts.

We never got 1:1 SALT even though it was ordered at Tribunal. Our NHS SALTs never do direct SALT, only indirect 'advice and support' to get you or nursery staff to do it. We didn't push it as we have ABA and actually didn't want a SALT who didn't want to work with DS and was in the LA pocket anyway, but just goes to show even when its ordered they don't want to do it. The reality is most SALTS are not trained to teach children with autism, they don't know how to get their attention / how to get them on task, so they prefer to work with children who do follow their instructions who just need help with pure speech issues. It would of course be better if they came out and said we are not trained you need an ABA tutor instead, but they usually just wheel out the line that communication has to be all day every day so its better for parents to do it.

I have no idea if it's the hanen course or not, they don't know themselves.

On Thursday they want me to come in at 10am and they will then present to the group of parents what course they will offer for nine weeks starting in September.

I asked if this was a hanen course and they said 'they didn't know'.

eandz, what is it that your DS requires WRT SALT? Does he have aspects of a 'pure' S&L delay, ie. articulation difficulties, etc, or is the difficulty in actually getting him to communicate?

Lougle

I am ashamed to say I don't even know.

I think he just needs a weekly interaction with someone who is responsible and able to teach him communication skills--skills like responding to questions and using his words instead of gesturing and ignoring.

Because I do lots of other activities with him that do force him to engage, when it comes to pure and basic language skills, he often tunes me out.

For example, In the mornings we have a rough time if we don't wake up a certain way, so we wake up and do our morning routine--getting out of bed, brushing teeth and getting ready then we have to progress to breakfast and figure out what he would like to eat (he only eats certain colors on certain days etc) after breakfast we usually have an activity. After this we get ready and he goes to nursery (1-6pm)

I feel that if someone came in and just worked on language and interaction skills with him, he wouldn't be able to just ignore the experience because someone else would be providing it. (does this even make sense?)

It does. Sounds like you are looking for something like the ABA folks on here have. Focused interactions with the goal of enhancing communication, rather than making speech clearer, etc.

The actual clarity of his words is concerning too.

Could you get a Portage worker to do his SALT with him? Or a keyworker at preschool? It sounds like you're right and he needs frequent regular SLT input fom someone who isn't you, but knows what to do. Maybe if the nursery keyworker could be Hanen and PECs trained, that would be a good start. And of course, you'd need to continue pushing for the SLT input so that person would know how to develop his communication further.

TBH, 20 min daily with a well-trained non-SLT might be even better than weekly one-to-one for half an hour with a SLT. Plus SLT o work with the communication tutor to assess his progress and liase about the next step (and the SLT might well need to observe / work directly with him a times). I guess in a perfect world the SLT wd be moondog or working who often post on here .

Lougle's question is spot on. You shouldn't be ashamed not to know what problems are there exactly. A proper SLT assessment and report, with recommendations for treating the difficulties is the single item which SLT services really can't delegate. Whether or not they provide a direct therapeutic intervention service really isn't relevant to seeing and assessing him.

There is a massive turf war going on between NHS and local councils about who pays for provision at the moment and perhaps you have borne the brunt of it.

Ask to see their pathways for children with:

• ASD
• social communication
• language delay
• language disorder
• speech delay
• speech disorder
• early years children

You can do an FOI on all written information, care pathways and policies relating to the above. I would be interested to know if it is just kids with ASD who are not accessing direct therapy and if so, what other kids are getting and how this is justified.

If the course you are being offered is Hanen, it is a pretty useful course and many people here have found it so. If not.. well.. it kind of depends.

It does seem very early to be saying no more therapy.. but on the other hand, this is happening more and more. It is very distressing and wrong.

i learned yesterday that it is indeed the hanen course. met with another mn-er for lunch and just felt better about everything after that.

i do wish that the appropriate care was just offered right away when a dx was given.

hurray! Hanen is great so please share your knowledge when you finish :)

Hanen really is great... and can you bring his nursery worker along to benefit from it as well?

Hi ladies!

I do feel quite positive about the hanen course. I really hope they let me in the group. I have to wait till Monday to call the SALT head to see where I am on the list.

We don't have a nursery worker. I've only just learned what portage is. I need to figure out how to get it. I may have to take DS out of nursery since he's come home with another allergic reaction. It's soo bad it's affected his eyes and face. My anxiety level regarding him at nursery is ridiculous.