How do I escalate intervention? How do we get more help / investigation?

[Featherybum]

Its probably the million dollar question I know but I don't know where to turn.

My son is 3.5. He has very delayed speech and was diagnosed with severe glue ear and was found to be pretty deaf in Jan. He had surgery in May which appeared to have worked. He's had 2 x 6 week courses of 1 to 1 speech therapy but although we have had some improvement there are still big problems, like he can only say the first syllable of words and although his vocab is increasing his actual speech hasn't improved that much. As its been seen as a reversible issue, there has been no other help offered or escalation suggested. Hospital consider their part done as he passed his most recent hearing test in the summer.

He goes to preschool who are concerned that his speech hasn't improved as expected. He has some other behavioral issues that again no one seems to direct us towards help with, for example he has (IMHO) significant attention and impulse control issues even for a busy 3 year old and can behave very destructively at times, mainly at home although he does seem to be better behaved at preschool (not sure if that means that there isn't an issue?) Toileting is a huge problem too. Its hard to explain, there is just something "different" about his behaviour and communication in comparison with other children of the same age.

SALT has previously suggested an expressive language issue to me and a stammer to preschool but wouldn't give any more info as apparently that isn't her area (but again, no mention of who we contact to investigate that or anything).

He has an IEP in place through preschool to try to catch his speech and language up, but I just don't know where to go or who to approach to get help. Can anyone point me in the right direction? Is there a next stage of assessment? I just don't know what to ask for and I don't know how to get them to escalate the concerns that have been raised, it seems to be just written off by GP and health visitor as a temporary issue resulting from his deafness, which should resolve with time but there are very specific parts of it that really haven't changed.

I know there is something preventing him from communicating properly. Its like communicating is a huge effort that requires all his concentration so he only does it when he is determined to. I just don't know what the barrier is or how to find out.

The absolute icing on the cake is that apparently his SALT is leaving the NHS so that explains why we haven't received a letter offering the further course of speech therapy I was told he'd be offered so no idea whats happening with that now either.

Any advice would be gratefully received

Would the school support an application for an EHC assessment?

Your pre school should have an area SEND advisor! Ask the sencoto contact her/him and to come and observe your son in pre school! Then ask the advisor what the pathway is in your area for a multi disciplinary team assessment. In my area under 5's go to the child development centre but that could be different where you are.

At the same time ask the senco of the pre school to make sure she is keeping evidence of all interventions offered to your son and the impact that they are making! She will need to provide evidence that the setting has made its "Best endeavors" to support him if /when she or you applies for an EHC needs assessment.

Hope that helps and good luck

Brilliant thanks both. I know senco is compiling evidence for a cdc referral but I will ask about an EHC assessment. It's knowing what I need to be asking for that's the problem!

You've been given good advice on how to get things going through the NHS. It may be worth you also looking at the charity called Brainwave. If they are near you they can help train you to do daily SALT/OT/Physio in a home programme so you are not left waiting for NHS treatment blocks or staff. It costs a little bit, but a hell of a lot less than paying someone to do the treatment for you. Glue ear has a massive effect on communication so if that has now improved a huge stumbling block is out of your way! Good luck

PS If the SENCO says that they need to wait to gather evidence, go ahead and apply for the EHC Assessment yourself. IPSEA and SOSSEN have sample letters on their websites for you to flesh out with lots of evidence and examples/reports etc.