What kind of SALT input is reasonable?

[claw2]

Just had an email from indi school SALT saying she doesn't feel a 'direct' programme of SALT input is needed.

Ds has difficulties with higher language ie language that is complex, sequential or abstract.

Literally and inflexible understanding of language.

Semantic,vocab,pragmatic difficulties etc, these tend to come and go. One minute when assessed he is on 0.04, a few months later 75th centile, then below average. So literally all over the place.

He has severe difficulties with social communication and previous recommendations of structured programmes designed and monitored by SALT.

Severe anxiety, self harming and low self esteem (which appears to be caused partly by his social communication difficulties.

She is not suggesting discharging ds, just that a 'direct' programme of SALT input isn't needed. I also assume she hasn't read any reports about ds.

She has stated she will reconsider if I am not happy about this.

So what can I expect a SALT to do? Are the above difficulties her 'remit'?

Well ask her to give you the details of the SALT programme she IS suggesting then.

'rather than having direct therapy from me, he will be monitored closely through liaison and discussion with his class teacher and LSA’s'

You don't want direct therapy just because. You want meaningful therapy with outcomes. However you would like the details of what this might look like, and how she is sure that it will get the outcomes he requires.

How will it be monitored? Who will do it? How often? etc.

'monitoring' is all very well, but what is she expecting to achieve with 'monitoring'. In what ways will ds' severe language difficulties have improved with say, one month of 'monitoring'.

Just ask her.

She is saying that 'I feel that direct speech and language therapy is not necessary as his language skills are extremely well developed'

I thought we had already established that his language skills, although uneven were not the problem.

It appears she just isn't 'getting it'

Her last sentence 'I hope this sounds ok? If we feel that direct therapy would be beneficial we can certainly review his provision and put something more direct in place if necessary'

I think I need to spell it out for her. However, I want to make sure that I spell it out correctly.

She gave ds some input since Christmas. Some targets which were inappropriate and didn't address his difficulties.

Well targets for things he could already do, like problem solving, he told her of a problem that had arisen in school and was then asked to think of a solution. Ds had no difficulty thinking of a solution (I have been working on this with him for bloody years!) however, he cant put the solution into practise in a real life situation...that's the problem!

You know what? It sounds like a totally reversible fob-off.

Sounds like YOU have to do her job for her and supervise her. Can you ask her to focus on one of ds' difficulties and give you some exercises to work on at home with regards to it, in a 1:1 situation. Ask for intervention to last a for a particular number of minutes/hours depending on what you think your ds could cope with.

(she'll have to figure out what ds' difficulties are first, and get off her arse and plan an intervention to target it)

Then, once your ds has reached a certain basic level of mastery (which you both define together), she can facilitate him practicing the skill in real life with other adults in school, and then with one peer and then with a group of peers. SHE doesn't have to even see him, provided the person delivering it, and you are trained in how to deliver this and record the intervention in a way that enables her to confirm the problem has improved and plan the next intervention.

You don't have to go the whole hog with this, but once she sees you are a)not expecting his language disorder to improve with osmosis, b)willing to put some effort in yourself, c)expecting to see targets and progress, she'll hopefully stop with the nonsense.

Star, my feeling from the start was I am expected to tell her. When she first contacted me after meeting ds for 10 minutes and asking him questions such as what is your hair colour and what do you like etc and he was able to answer. She emailed me saying 'I don't see any difficulties, he has advanced language skills'

I then emailed her a list of his difficulties. Received inappropriate targets, thought I would just let her get on with it, as I was already rewriting ds's statement and his IEP etc. Then just received this email.

Im used to doing everyone's job for them, at least that way it gets done. Years of no one doing their job has left ds in the state he is currently in. Micromanaging is my safeguard.

I will spell out his difficulties again and then ask for what you have said above. I will be polite and to the point, im sick of messing around.

It is fucking awful, years of fighting and for what, this.

My patience is wearing very thin. Im in the process of doing what Star suggested, which is nothing short of DIY.

Star I did as you suggested on 15th Jan, I emailed SALT asking what would be achieved by monitoring etc and suggested we focus on one difficulty etc copied in CT etc....and she hasn't responded.

On Friday I emailed CT basically saying that it seemed to me from what ds had told me that he had a OT assessment in school. SALT has said not input. Counsellor has said she will focus on self harm. However could he tell me who was responsible for providing input for ds's other needs and listed them.

I asked if he didn't know, would it be ok for me to find out from professionals as I didn't want to step on anyones toes. He replied saying, it would be 'more efficient' for me to do so.

So do you think it a good idea to send a list of ds's difficulties to SALT, counsellor and OT and ask who is going to be dealing with what?