Re-evaluations for Speech

Yesterday was the 6 month re-evaluation for the boys’ Speech Therapy. It’s a chance to re-visit their goals, see their progress, and possibly make new goals. Sometimes, though, it can mean ending their services. That isn’t always a good thing, either. So here is what is going on with our boys and their speech.
Little man went first, as usual. It really throws him off his routine if he doesn’t, so it’s just a given now that if it’s a therapy day where they won’t be switching (one day a week one is in OT while the other is in Speech and they switch), Chaz goes first. He was having a good day today, which means he wasn’t being grouchy and disagreeable. Luckily, that continued into the evaluation. They said he did really well and cooperated without any fuss! As far as the testing goes he’s about the same as he has been – no delay in receptive communication but a moderate delay in expressive communication. It doesn’t mean he hasn’t made any progress – he has. He’s made A LOT of progress! He’s actually communicating with words now, which is a big difference! Some of his words are still getting “stuck,” though. What I mean by that is instead of making a clear sound they come out nasally. He has so much going on with the nasal speaking, the choking on drinks, the stopping breathing when he sleeps that we’ve been taking it one step at a time – seeing one specialist at a time. We discussed, though, that instead of doing it that way (which is taking a long time and getting us nowhere), she is going to give us referrals to both ENT and for the swallow study so we can knock them both out. It might be easier to see then as well if they’re related or separate issues – and if both (or neither) could be affecting his speech. So, we are keeping the same goals for Chaz and we’ll just keep going! I am so proud of the progress he’s made, and we’re so blessed he has such an amazing Speech Therapist that works with him on his good AND bad days and truly is concerned for him!
B then had his evaluation. I have to admit I was most nervous about his because he was already “borderline” of not being able to qualify the first time. When the testing came back he did score at age appropriate level for receptive communication and just under age appropriate for expressive. Not enough to qualify him by our insurance’s standards. Overall, though, they’re really cracking down on therapies, but that is a post for another day! Well, then we talked about articulation, which was (and still is) a BIG concern. He tested below his age more significantly for articulation, but it still wouldn’t be enough. The next biggest concern is pragmatic speech. This is a common concern with children on the Autism Spectrum. Pragmatic speech is basically how you communicate socially. Things like having him interact with others on a regular basis seems like the easy answer, but when they’re on the Autism spectrum that is definitely not always the case. Some concerns with Brayden’s pragmatic speech are:

• Not being able to look in your eyes when communicating.
• Interrupting.
• Not being able to stay on topic, changing the subject, etc.

And well, those are just the tip of the ice burg. He really has many of the key issues with pragmatic speech that are listed in this article, but those are the main concerns. Because he has a diagnosis of PDD-NOS (Autism Spectrum) there is still a chance he will get approved to continue speech therapy based on the pragmatic speech concerns. The wonderful team of therapists will be doing all they can to try to keep him in therapy, so now we just have to pray for the best. Don’t take this the wrong way, we are VERY happy he is at age appropriate levels for receptive and expressive communication and getting better with articulation, but a child on the Autism Spectrum needs that extra help particularly with the pragmatic speech. He is also so very close to meeting the goals we had set with his speech! Of course, I’ll always continue to work with him, but I can’t quite describe how it’s not the same. So, we’ll find out in a couple of weeks whether he will be able to stay in speech or not.
As a random closing: I’m really disappointed with the way things that are important in regards to special needs children get disregarded by insurance. They’re also cracking down on all types of therapy. Some are saying once they hit a specified age (I believe it’s around age 7) they will no longer qualify for things like Occupational Therapy because it’s a “chronic illness that can’t improve.” That DISGUSTS me. Yes, Autism and Sensory Processing Disorder don’t just go away, but they CAN and DO improve with help! I think it’s so wrong that they basically just tell you to “live with it” rather than giving each person a chance to be the best they can be. Actually, they don’t even acknowledge Sensory Processing Disorder as a disorder needing therapy if you remember what I wrote about our daughter’s evaluation. Again, there are MAJOR concerns that need to be addressed, but everything is calculated by test scores and other things that don’t reveal the whole picture. I hope we can spread enough awareness that it trickles to those that make these important decisions for insurance coverage! I know I, for one, won’t stop pushing to be an advocate for my children!