NHS Speech Therapy

[willowthecat]

We had a (failed o:( education tribunal this week - I am in Scotland so the procedures are a bit different. I don't want to bog everyone down in the details but the NHS speech therapist told the tribunal that the NHS has no limitations or restraints whatsoever on its budgets and that all decisions are made on clinical grounds. She only met our son briefly at his school to write a discharge report but said her expertise and work experience enabled her to know that he could not benefit from any from speech therapy (though she did concede his verbal vocabulary could be increased so not sure what she meant by that). She was questioned about this 'limitless budget' by our lawyer but she was adamant it is the case that there are no financial limits whatsoever. She said that his disability/autism would prevent him from benefitting from speech therapy. We are considering an appeal but does anyone have any thoughts on this point ?

I think that they can't be bothered a they don't think our kids are worth teaching as their cognitive impairments mean they will never talk "normally". That may even be true, but my God the difference for my boy of having some speech as opposed to none is immense to his and our quality of life.

He was signed off by SALTs at 3 - "he will never talk, dear".

Here are the things he has asked me for so far this morning, and its only 1030. Yet the NHS and private SALTs would have left him screaming, tantrumming and non-verbal. Right into adulthood.

He may never rival Stephen Fry for eloquence and probably won't converse normally, and perhaps that's why the NHS deemed him not worth the S/lt therapy money. But he can get his needs met and communicate with other human beings using thousands of words: surely that is worth it?

Of course it is ABA which got him talking.

I really feel for you - this is nothing short of a national scandal. Have you thought of threatening the press: " Speech therapists giving up on autistic kids"
The threat alone might focus minds.

Daddy come downstairs

Mummy come downstairs

Watch film

Shrek

Peter Pan

Brown toast

Hot tea

Go toilet

I pad

Go outside

Shut door

Be careful (said to himself, balancing yoga ball on sofa)

Toastie

Watch film - Shrek 2

And I understand that S/lts might consider my boy's list above not much cop. But I think the woman who told me at 3 that he would never talk at all, as he was just too severe, might perhaps have pause for thought.

ds can talk though only at a limited 2-3 word level and has big one word vocab. Even NHS SALT told tribunal that his ' verbal vocabulary could be increased' by speech therapy but went to qualify this with unsubstantiated nonsense about it not being functional language and guess what, not generalising. This is simply not true and how on earth would she know anyway having met him only once ! My feeling is that I want to take some form of action under Disability Discrimination as she was so adamant that there was financial reason for refusing him a service

sorry NO financial reason that should read!

Surely to deny him words when he has a speech/social disorder is an offence under DDA, same as ramps/wheelchairs.

Write an email telling them that's what you're going to do, plus ask them to confirm spelling of names and titles as you are also approaching the Daily Mail. I'm serious!

What is doubly frustrating is that if the SALT profession would just open their minds to a couple of basic ABA techniques, they would find they could achieve so much more! I wrote an article on this once for he SALT magazine, Bulletin, but they refused to publish.

How can single words requesting stuff not be deemed functional? Moondog will know

Willow I am also in Scotland, and DS1 has waited over 2 years for speech therapy. News report last week said that the 18 week maximum wait was being fiddled by NHS trusts, who make treatments "unavailable", therefore cancelling out waiting lists IYSWIM.

It is shit

DS1 is 5.5 btw.

I don't know about Scottish law, but in E&W, the NHS is subject to the rationing principles of the NHS Act which means it is obliged to provide a service based on clinical need.

The problem usually arises when therapists assess clinical need in the light of (a) what they are able to do for the child and not what the NHS as a whole service could do, i.e. they look at the limitations of their skills and don't consider what others, more experienced could provide and (b) they look at a child against the whole of their case load. This means they will always be able to find more 'needy' children.

Point (a) is clearly significant here as what this therapist is basically saying is that she wouldn't know what to do to help your son. You need to show that others do know and it is the limits of her knowledge and experience which lead her to conclude this and not the innate difficulty of teaching a child like your son.

It is important to remember as well that education law is not based on clinical need principle but on evidence of educational need and is not subject to the same rationing principles or any comparative analysis between the child and a peer group or what a service 'usually offers' to a child like this.

I assume the Scottish SEN framework is the same.

Did you have your own S&LT? You will need one to establish exactly what his needs are and how they constitute a SEN and how they can be met by provision. The S&LT then needs to outline what this provision should be.

That is v useful . We need a campaign to say that the S/lt service is no longer 'fit for purpose' as regards autism

Thanks for such a detailed answer. I will investigate the costs of an independent report. It does seem indicative of a fundamental problem not a one off bad decision about ds

what is all this about ASD kids not being able to benefit from SaLT? i'm sorry it makes me really cross. I think it's an outrage. Language issues are often at the heart of ASD and maximising language ability means maximising the ability to generalise, learn, understand the world, and function socially. I just do not get it. I'm afraid what I hear from this SaLT is "I am a bit crap, I can't do anything with this boy". And if she really thinks the NHS is a bottomless pit then she has a very poor awareness of her employer and how it works. I'm sorry, this post is no practical help whatsoever. I am just so angered on so many levels to read this, OP. Honking loudly for you.

Willow can you say roughly where you are in Scotland?

Handywoman - it is because the NHS doesn't know what to do with children with ASD so they say there is nothing that can be done, when they mean there is nothing I can do.

This is particularly complicated with Asperger's as the service never gets any experience supporting them and hasn't clue how to support verbal communication deficits let alone non verbal communication.

But in the case of children with problems speaking, you have to ask what the fooking hell are they doing as a service if they can't treat kids who have trouble talking?

Well that sounds absolutely disgraceful willow and you must wait and see what the written decision.

I don't know if the grounds of appeal are different in Scotland. Did they tell you the verdict verbally?

Yes - on the day - just digesting it all now as was not expected. Even LEA lawyer, who have to admit is very honest and courteous, was bit amazed he got a decision in his client's favour. I think judicial review may be the way to go as there were many other procedural flaws such as convenor(chair) not being aware of how to do a tribunal and our lawyer having to explain it to her - still got to laugh it's only our children at stake...

Thisis - maybe we need to look for some political input in Scotland to help us expose this fiddling and game playing ?

Wilson - I am in Glasgow

Ah, I'm Edinburgh so don't 'know' anyone on that side who could help

If the convener didn't know the process surely that in itself is grounds for appeal? What a horrendous situation.

Willow - our GP said he was appalled by the long wait, and the total lack of anything available to DS1 - he said that perhaps I ought to complain to our local MP. I have lost the will to live at the moment, due to ongoing battle with HT and everyone / everything really.

Yes - thisis feeling similar and need to try to remind myself that it's supposed to be David that wins not Goliath. On the positive side, I am pushing on with my own initiative which is to start an after school SALT club for autistic children. I've had some lucky breaks and so it may happen sooner than I thought !

Willow - you are incredible to be starting an after-school SALT club. I would sigm up in a sht in my area! If you also put something about socialising (mums and kids) in the flyer, I reckon you have a national winner. You could be the new Stagecoach!

Well - if only. The issue at the moment is to limit numbers to what we can manage - i have six local 'mums' on board and don't think we can go beyond that as thinking there will be 2 therapists for a 2 hour session so we will be giving both 1-1 and group based language games (where appropriate) . So all I need is a church hall and a small amount of seed corn money - I wonder if I could go on Dragons' Den ?