I am the only speech therapist at the center I work at 3 days/week.  The other 2 days, I am in the field, itinerant, going into head starts, daycare, and church basements.  My center, unfortunately, has a caseload more suited for a full-time person, or at least, 5 days’ worth of a therapist.  We had that back in September, actually, but the other gal left november 4th for a new job, leaving almost half the kids at the center without speech therapy.  I picked up as many as I could while still managing the new kids coming into the classrooms I was already committed to.   At present time, I am seeing 38 kids in 3 days.  Logistics are a bitch, as I overlap with the kids only on certain days.  Many only come in 3 half-days, so I end up having to see Johnny on Monday morning, and Quadir on Thursday afternoon.  And of course, for every child who’s highly capable and only needs service 30 minutes a month, there are 2 kids who need extensive support 60 minutes a week.  So the number 38 does not tell the whole story.

What about the other 27 kids not receiving any speech therapy?  Well, we say that they’re “unmet needs” kids.  We acknowledge — to those who ask — that we have no therapist for them.  They’re still in a special ed or regular ed classroom environment, a language-rich environment with highly trained teachers, etc.  But we’re not able to fully meet their needs as per the IEP.  So they go on a wait list, waiting since November for speech to pick back up, or (for new kids) to begin at all.  All of which feels pretty yucky. 

How do parents feel about this?  Well, for the ones who don’t ask, they don’t know.  We offer full disclosure, but it’s kind of a don’t ask- don’t tell policy.  Who gets service?  Who doesn’t?  Is it based on need?  Which classroom the child is in?  Which teacher has a louder voice or asks nicely?  Nope.  It’s based on which parents know their rights.  They’re the ones who demand service, my friends.  And they’re the ones who get it.  I now have 2 extra children on my caseload who came in after November 4th, in a classroom where I do not support any other children officially.  One child’s parent seemed so anxious, so eager to have speech therapy, that I was asked by our director to support that child.  He has a new diagnosis of autism, after looking like a typically developing kid for the first two year of his life.  He has a young mother who does not speak English.  She is desparate for support, for help, for herself and her child.  So I took it.  Kind of as a favor.  The other child is the most beautiful child at the center.  He’s a tiny round-headed boy with straw-blond hair and elfin eyes.  All he’s missing are pointy ears and you might believe he had been born out of a flower with dew on his freckles.  His mother knew her rights.  Demanded service.  And probably compensatory time as well.  His level of service: 60 minutes a week.  Guess who stepped up to avoid getting taken to due process?

It’s not that we’re doing anything illegal.  Really.  Our parent agency tells us to take in children even though we cannot fully meet their needs.  We report them.  We have them on a list.  But the parents, many of whom do not speak English, do not know their rights, or are too new to the world or early intervention, just do not know. 

The second child’s evaluation report read like a parent’s worst nightmare.  Autism spectrum diagnosis, global delays, poor social connection, avoiding eye contact, tantrum behaviors, and resistant to talking.  The child I encountered when I first began seeing him in March was a different child altogether.  He’s highly social, and has a best buddy in the classroom with whom he plays cooperatively.  He makes eye contact, shows adults his work with pride, and is now imitating 3-word phrases with me.  When I gently frustrate him to elicit language (e.g., block his path so he has to tell me to move), he readily responds verbally, sometimes by signing and saying “move” or “beep beep”.  Either he has made untold gains in 3 months of just being at the center in a preschool setting (could be; what do I know?); or the evaluation was criminally wrong.  Why does this matter?  Couldn’t it just be an assessment taken on a bad day?  Couldn’t his natural development have spontaneously accouted for these leaps and gains?  Yes, and yes.  But it does matter. 

That evalation report read so ominously for this poor child’s future, that the parents flipped out.  That report, written when he was scarcely 3, freaked them out so severely that they needed to seek out every single option for intervention.  And when they found out it was not being provided, they saw their child’s future jeopardized.  If it were my child, and I read that report, I would have done the same thing.  I have to hope my children will all be healthy and have typical (nay, exceptional) development, but if I were in their place, I would have fought tooth and nail to get my child what he was allegedly provided under the law. 

Give me involved, interested parents vested in their child’s education.  Give me parents who show up for conferences and read the mail I send home.  Give me parents who show you they care, and I’ll show you better therapy, faster progress, and a happier speech therapist.

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