Weekly Therapy Update

This morning, I have an appointment to discuss Raymond's IEP (Individualized Education Plan) with the Intermediate Unit.  Basically, the reason for this meeting, is that I have disagreed with their plan for Raymond.  Maybe this is becoming a pattern?

Currently Raymond receives these therapies:

 

Speech Therapy - 1 hour session, 1 day per week

Occupational Therapy - 1 hour session, 1 day per week

Physical Therapy - 1 hour session, 1 day per week

Special Instruction Therapy - 1 hour session, 2 days per week

 

For those who might not be familiar with the way the system works, let me give you a very brief, very general explanation.  When you have a child that qualifies for therapy services, they start out in the 0-3 program, Early Intervention.  Early Intervention is a home-based program.  The child can have 6 months of needed therapy, or, for more severe disabilities/delays, they can go the full three years.  If the child hits three years old, and needs to continue services, they are then transitioned to the 3-6 program.  This program is through the local county were the child lives.  The child is then placed in the Intermediate Unit, as opposed to in-home.  Think of the intermediate unit as a small school.  The I.U. then focuses much of it's attention on getting the child ready for kindergarten.

 

Since Raymond has many medical conditions that make him highly susceptible to germs, his doctor's feel, at this time, that being in a classroom setting would be more detrimental then anything.  Because of this, Raymond is still currently receiving his I.U. services at home.  There are not many children that receive in home therapy once they are transitioned to the I.U..  Only a handful.  

 

Let me make one thing very clear before I continue.  My goal for Raymond is to get him to the I.U..  I think that he would enjoy being in a classroom setting with other children.  Can I see him standing in line?  No.  Can I see him sitting still and attending for more then 5 minutes?  No.  Do I think he can learn these things?  Yes.  In my opinion, one thing that will really help Raymond learn will be modeling his peers.  He is always very interested in what other children are doing.

 

The I.U. wants to change Raymond's therapy schedule to the following:

 

Speech Therapy - 1 hour session, 1 day every other week

Occupational Therapy - 1 hour session, 1 day every other week

Physical Therapy - 1 hour session, 1 day every other week

Special Instruction Therapy - 1 hour session, 1 day per week

 

So instead of  5 therapy sessions per week, Raymond would drop down to 3 one week and 2 the next.  The I.U.'s reasoning behind this is related to Raymond transitioning.  Once Raymond is transitioned to a classroom setting, there will be less one-on-one interaction.  Their theory is that this will help Raymond get used to less individualized attention.  I have two problems with this plan.  The first is that we don't know when Raymond will be able to be transitioned.  It's all up to his doctors' discretion.  It could be months before they allow him to actually travel to the I.U..  Why would I want him to loose 10 therapy sessions (10 hours) a month for who knows how long?  Also, Raymond will be going into the feeding clinic in June.  I don't want any type of transition plan to take effect until after that happens.  I think it would be too much change to start the transition, break for 6-12 weeks for the feeding program, go back to the transitioning plan, then transition to the I.U..  I would rather everything start to change after he comes back from Hershey and is out of his normal routine anyway.  It just seems to make more sense to me.     

 

My honest opinion of the situation is that Raymond is being penalized because he receives home based therapy.  I think budget cuts are what is ultimately dictating his IEP.  I also think staffing cuts are limiting the therapists' that can come out to the home.  If he was able to go to the I.U., he would be there for several hours 3-4 days a week.  I'm going to try and go into this meeting without being angry.  Actually, I don't think, at this point, angry is the right word.  Better adjectives would be disappointed or frustrated.  Hopefully the meeting will go smoothly.  Finger's crossed.  I'll update the blog with what was discussed and the outcome. 

 

 

Raymond's Therapy Update for the Week

 

"We have been working on:

Receptive Language

• following directions
• concepts/vocabulary

- Raymond pointed to 3 items when prompted with "show me".  (field of 2)  Hand over hand given for other attempts.  Reward (game) after each trial was successful."

Expressive Language

• N/A today

Using Functional Language

• comment/label
• ask/answer questions
• signs

- Raymond filled in 3 words to songs/books today : ).  He used an approximation for "open", "o-o" on his own.

Articulation

- Raymond signed "sit" and "stop" today which were not previously seen.  He imitated sign for "apple" and "big".

Voice/Establish Fluency

• N/A today

Other

 

- He is doing excellent with choice making with objects.  Need to continue to work on choices with pictures.

 

We worked on these during:

• 1:1 (Home)

Comments:

- Raymond participated very well today.  He verbalized - signed in response to continue routines"

Allison, Speech Therapy
01/31/2013 

 

Lily's Therapy Update for the Week

"Progress since last session - Including Parent Report:

 - Lily's grandmother was baby sitting today.  She reported that Lily said "chips" after model.  Raymond was receiving PT today.

Outcome(s)/Goal(s) from IFSP/IEP to be addressed:

- #1. Lily will increase her language to express her wants/needs especially at mealtime.

Daily Routines Used:

• Play with toys (play foods and puzzles)
• Book Activities
• Songs and Rhymes
• Other: Pictures

Strategies Used

• Offer Choices
• Modify Environment
• Describing or Labeling What You Are Doing
• Adjusting Pace by Wait or Pause for Response
• Model or Demonstrate for Child
• Encourage Child to Imitate

What we did today to address outcome:

- Update word chart - Lily's grandmother was unsure of new words.  She signs "help" with puzzle game.

 

- Lily said "shoe" today during flip book review of consonant and long vowel sounds.

 

- Lily repeated long vowels in boo, bee, bye, bow, pay , while playing with flip book.  She said "muh" for more and spontaneously said "more bow", "more pie" and approximates for "2-3" as we topped and named.

 

- Choices for puzzle pieces - Lily names second item named.  Lily discriminated between 2 named food pictures 90%.  She did not identify begal today. 

Plans for next session:

• A kindle
• Kaufmen vowels skill sound and word imitation
• Receptive language tasks

Suggestions for families to do within their activities/routines:

- Continue vowel song on CD provided. Offer 2 choices, but try singing desired item first once in awhile.

Progress information to be collected between sessions:

- Words Lily says without model on chart provided."

 -Ellen, Speech Therapy

01/31/2013

 

 Until Next Time!

Lots of Love,