Q about OT/Speech therapy resources for private school student

[NCGrandma]

Not even sure what my question is, but here goes: both DGDs attend a good independent K-12 school. DGD2 recently had an extensive work up for a genetic disorder. The neuropsychological part recommended, among other things, that she get OT and speech therapy. Clearly this is not offered by her school.

Is this a situation where they should pursue OT/speech through the children's hospital clinic, and hope that their medical insurance will cover some/all, or is there are role for the public schools even though she is not enrolled?

Also, some specialized tutoring was also recommended. I don't know the details yet but her school does offer a tutoring center for various learning disabilities, so it's possible that will be an option (albeit extra cost). Is this also something where the public schools could offer something?

Any suggestions, or any way I can help them figure out where to start exploring options?


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[candaceb]

I have a child in public schools who needs OT. We have had the same experience in 2 states/districts. The OT in school is good for helping to put accommodations into place (for example, DS needs a specific type of pencil), but school OT services are so limited that they are not close to being enough. So we have been doing weekly outpatient OT - he gets a full hour every week. It is covered by our insurance and our copay is less than $20.

[Charlie]

DS1 used to attend a parochial school and qualified for speech and OT services through the Department of Education. I initially took him to service providers after school and the costs were fully covered by DOE. Eventually, he no longer needed OT and his speech therapist was allowed to come to him during the after school program. So, even though we were not in public school we were able to access services. Have them contact their district to see how they would go about getting services, as I don't know how this varies by state and we went from Early Intervention into DOE services. Again it's probably state dependent but dealing with our DOE was beyond frustrating and aggravating. We have since moved to a different state and DS now gets services in a public school.

[lizzywednesday]

DD is eligible for 2x weekly in-school/pull-out speech/language therapy, but we also have put her in private speech sessions once per week.

Our insurance covers a limited number of sessions for children DD's age (7) but we feel she benefits from the combination of in-school and private therapy.

We pay a copay per visit ($25) plus anything that isn't covered by insurance to meet the deductible. (It appears that we have met the deductible on these kind of services already.)

My bother's sons also do private speech/OT sessions in addition to other accommodations through their schools. Both have IEPs on file; the elder one is on the autism spectrum and the younger one has a severe speech delay. My SIL was able to extend EI for a time for the younger one to fill the gap between speech-therapy preschool and "aging out", but she had to fight!

Once a formal diagnosis is in place, meeting with the school's child study/child development team (if they have one; this may depend on education provisions for children with disability classifications in your DGDs' home state and whether they are applied to nonpublic schools ... in a recent court case in NJ, they were found not to apply to religious schools) to see what resources are available is probably a good first step.

In the meantime, tell your DGDs' parents to check their insurance for the OT and speech-pathology/speech-language therapy coverage and to start calling any in-network specialists NOW to try to get appointments scheduled. (Don't be like me and call a few, get no responses, slack off, and then start up in 3 months.)

[NCGrandma]

Thanks, all. This is very helpful. Fortunately they have very good health insurance. Given what I know about the public schools there, I suspect it would be an exercise in frustration to pursue that. And they most definitely have learned persistence and long waits for appointments. It took over 3 years to get DGD2 worked up for the genetic disorder that they had suspected all along, despite their best efforts.


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[mom2binsd]

Some states offer Speech services to students in the private schools (I know because I did this for a bit), but it depends on the district.

Speech therapy is tricky, often insurance companies are reluctant to pay unless there's a medical component (which it sounds like may be the case). I'd look at the local Children's hospital, a clinic affiliated with a University/College that has a Speech Pathology graduate program, or private clinics.

OT services in schools are mostly consultative, most kids get 15 min a week at most. Again private may be the best way to address this.

[niccig]

The school district has to evaluate the child to see if services are needed under that states Education code. Each state had different eligibility criteria, and the criteria is not the same as medical criteria. I often get a dr's prescription saying to give the child speech therapy , which means nothing as a dr can't prescribe medical speech therapy services like it's medicine, let alone school services. They can refer parents to have child evaluated, but parents must request it and child must be found eligible and to have academic impact in the school setting. Speech therapy in a private clinic has different eligibility criteria, so some students qualify under medical insurance but not under the Education Code. It's totally confusing to parents.

Then it depends on the school district if/how services are given to students that are not enrolled in a public school. I see a child that is home schooled but he is part of a home school program in our local district so he can get speech services. The parent must bring him to my school for the session. If he wasn't part of the program, he wouldn't get any services. He would need to be enrolled in a public school.

They'll have to contact their residential school to request an evaluation and see if/what services are available if the child does qualify.


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[NCGrandma]

Thanks for confirming my impression that services for speech therapy especially are confusing. At this point, my family is pursuing private services (which means getting on waiting lists!) for OT and speech, as well as social skills group therapy and individual therapy. With DGD1 (who had very different challenges and did not need speech therapy), their medical insurance had good coverage for OT and psych. For DGD2, the insurance coverage for the strictly medical aspects of her genetic disorder has been very good so far. However, insurance may question the OT/speech/etc. Apparently, in the past, the neuropsych aspects of this condition were diagnosed as NVLD, but thanks to the DSM revision, there's nothing that quite fits unless she ends up with a ADHD dx when she's a bit older... Ugh...


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