PDA

View Full Version : EI therapist WDYT/WWYD



jenfromnj
12-03-2011, 01:06 PM
DS has been receiving therapy through EI for about 3 months now. He receives DI and speech therapy 2x per week each. He's made a lot of progress even in that short time, which we're very happy about. Both therapists are good with him, and he's taken to both of them well. There are a few things about his DI therapist (I'll call her D) that are making me concerned/perplexed/slightly upset, though, and I'm hoping that you can give me some objective feedback as to whether these things are normal/typical, and if not, what I can or should do about them. This is long, so sorry in advance!

1. Lateness/missing sessions. D is consistently 5-10 minutes late, sometimes more. She generally apologizes, gives an excuse (got stuck at RR crossing, got caught up at school dropoff for her DD). We sometimes tack on a few extra minutes at the end, but usually can't because she has to pick her son up from school directly after. It's only a few minutes here and there, but it adds up, KWIM? In addition, she's had to cancel 4 or 5 sessions in the last 1.5-2 months for a variety of reasons (kid with a cold, family obligation, attending a seminar). We're supposed to make up a couple, but she said that she's "not obligated" to make up missed sessions, only to "try to" do so, and that she'll likely not be able to make up all/nearly all of them. Our ST told me something different about the policy--therapist is supposed to make up sessions that they have to cancel, but "try" to make up those the family cancels, so I'm not sure what to think, or what she has noted for the sessions that she canceled. And it seems like a lot of sessions to miss in that time frame, it's not as though she's here 5 days/week.

2. She mentioned yesterday that since DS is so active (has a hard time sitting still for long) and a bit on the immature side, we might want to consider redshirting him from K when the time comes, to give him an advantage. I was seriously taken aback by this. He's 2.5--not starting K for another THREE years, longer than he's been alive! But even worse, she prefaced it by saying "you know, so many people hold their kids back these days. I mean, we didn't consider it with my DD because she's a May birthday, not a summer..."--so basically let me know that she'd never do that/her kid didn't need it, but my 2 y/o would? Ugh.

3. Along the same lines, I feel like she is constantly trying to make everything into "something". For instance, I mentioned the other day that now the colder weather is here, DS loves to snuggle with me under blankets on the couch when he wakes up and before bedtime (I only mentioned it to explain the pile of blankets on the couch when she arrived.) She immediately responded "well, that could very well indicate a sensory issue". No one has mentioned anything about this (including her), and he doesn't have any of the typical issues that a sensory issue would cause (I looked into it a bit and spoke to the ped after this happened.) I even asked if she had any other reason to think that, and she said "well, not really". I just feel like it was an awfully big leap from "likes snuggling under blankets when cold" to sensory issue, KWIM? And that's not the first time something like that has happened.

Sorry this is so long, I'm just not sure if I'm being oversensitive-we've gotten some flak from family members over DS even being in EI to begin with, so I'm bit sensitive about it. We have no friends who have children in EI, so I can't compare notes with anyone IRL, so any thoughts or feedback are greatly appreciated.

sidmand
12-03-2011, 06:58 PM
#3 I would ignore. Our therapist did this too. Oh, DS is having tantrums because he's on the spectrum. He's stimming by flipping the lights on and off (no, he's two, and 2 year olds have tantrums and he just realized he could reach the light switch so he's flipping it on and off!). I think it's a hazard of the job that they forget what a "typical" kid is like and that some of those are just typical kid things!

#1 I think the second person is correct from all that I remember. They don't need to make up anything the family has to cancel but they should definitely have to make up anything they had to cancel. Otherwise they could just cancel them all.

#2 is very odd too. I think maybe this isn't the right person/therapist for your family. A child at five is HUGELY different from a child at 2.5. Why would/should you even be considering anything like that at this time and it is definitely not her place to say anything unless you asked for her advice. That would bring up red flags for me, for sure. DS was a COMPLETELY different child from 2.5 to 5. He didn't even really talk when he was 2.5 and when he was 5 he never stopped talking! EI had a lot to do with that but you definitely need the right fit for everyone in your family.

I know what you mean about people giving flak. We heard it all, "he's a boy, boy's are just slower," "kids have a language explosion around 2," "he's your first, you're just worrying," "why would you want to give him a label?"...just go with your gut. We told the people we felt comfortable telling. Not everyone even knew (still doesn't, I think). Hugs to you. You probably know ultimately (in your gut) what is the best way to go. It's gotten you this far!

ETA: Is DI a developmental specialist? I know there can be different terminology for different things.

mousemom
12-03-2011, 11:18 PM
#1, our EI speech therapist was consistently about 5 minutes late and often ended our hour long sessions about 5 minutes early. We joked about it to each other, but we liked her otherwise and figured 40-45 minutes of actual therapy was probably better for him/his attention span at that age. Missing so many sessions in such a short time does seem problematic to me. On average, we probably missed about one session out of 5 or 6, either b/c we or the therapist had to cancel (mostly due to illness or us being out of town). We usually were able to reschedule if the therapist had something like a planned meeting or appointment coming up. On that one though, I might let it go a little longer and see if maybe this was just an atypical period for her with lots of stuff coming up. (We also did not pay anything for our EI therapy, which I know varies from place to place. Had we been paying a substantial amount for the therapy, we might have been more disturbed by things like lateness and missing sessions.)

#2, would definitely strike me as odd, unless you were asking her advice on the topic or had somehow brought it up to begin with. As you said, no real reason to be thinking about it at this point.

#3, Not sure how I would feel about this. Seems strange to me, absent any other reason to think there could be sensory issues, but I suppose maybe those in the field are just always on the watch for possible symptoms.

jenfromnj
12-04-2011, 02:07 AM
#3 I would ignore. Our therapist did this too. Oh, DS is having tantrums because he's on the spectrum. He's stimming by flipping the lights on and off (no, he's two, and 2 year olds have tantrums and he just realized he could reach the light switch so he's flipping it on and off!). I think it's a hazard of the job that they forget what a "typical" kid is like and that some of those are just typical kid things!

#1 I think the second person is correct from all that I remember. They don't need to make up anything the family has to cancel but they should definitely have to make up anything they had to cancel. Otherwise they could just cancel them all.

#2 is very odd too. I think maybe this isn't the right person/therapist for your family. A child at five is HUGELY different from a child at 2.5. Why would/should you even be considering anything like that at this time and it is definitely not her place to say anything unless you asked for her advice. That would bring up red flags for me, for sure. DS was a COMPLETELY different child from 2.5 to 5. He didn't even really talk when he was 2.5 and when he was 5 he never stopped talking! EI had a lot to do with that but you definitely need the right fit for everyone in your family.

I know what you mean about people giving flak. We heard it all, "he's a boy, boy's are just slower," "kids have a language explosion around 2," "he's your first, you're just worrying," "why would you want to give him a label?"...just go with your gut. We told the people we felt comfortable telling. Not everyone even knew (still doesn't, I think). Hugs to you. You probably know ultimately (in your gut) what is the best way to go. It's gotten you this far!

ETA: Is DI a developmental specialist? I know there can be different terminology for different things.

Debbie, thanks so much for your response! Especially the part about people's feedback, and going with your gut. It's really upsetting to me that certain people in our family (well, more DH's family) have said some not very nice things about this, but I know we're doing the right thing. Some very close family members are actually the ones who have the most to say about it, unfortunately. We tried making them understand that getting help doesn't create a problem, but certain people won't listen to reason. So I've made DH promise to stop telling certain people any details about what's going on.

Yep, DI is developmental intervention. I am still not 100% convinced that it's helping (our main issue is with his speech at this point), but he's doing so well with his speech, and likes both of his therapists so much, that I am a little hesitant to switch at this point (though I go back and forth), especially since he turns 3 (and ages out) in about 4 months and it takes awhile to change therapists (I casually, hypothetically inquired with our coordinator). But it's SO maddening when you're already watching everything your child does for signs that something is "off", and the therapist keeps latching onto every tiny, isolated thing as a possible problem, and when 1 out of every 2 or 3 sessions is canceled on you, usually at the last minute.

I had no idea what a tricky road this all is to navigate, and I give tons of credit to you parents who have been doing it for awhile, into the school-aged years. It's like, of course you want what's best for your child, and you're willing to do whatever it takes to make that happen, but it's sometimes so hard to know what that "best" thing is, and I feel like there's no margin of error when it comes to this stuff!

jenfromnj
12-04-2011, 02:19 AM
#1, our EI speech therapist was consistently about 5 minutes late and often ended our hour long sessions about 5 minutes early. We joked about it to each other, but we liked her otherwise and figured 40-45 minutes of actual therapy was probably better for him/his attention span at that age. Missing so many sessions in such a short time does seem problematic to me. On average, we probably missed about one session out of 5 or 6, either b/c we or the therapist had to cancel (mostly due to illness or us being out of town). We usually were able to reschedule if the therapist had something like a planned meeting or appointment coming up. On that one though, I might let it go a little longer and see if maybe this was just an atypical period for her with lots of stuff coming up. (We also did not pay anything for our EI therapy, which I know varies from place to place. Had we been paying a substantial amount for the therapy, we might have been more disturbed by things like lateness and missing sessions.)

#2, would definitely strike me as odd, unless you were asking her advice on the topic or had somehow brought it up to begin with. As you said, no real reason to be thinking about it at this point.

#3, Not sure how I would feel about this. Seems strange to me, absent any other reason to think there could be sensory issues, but I suppose maybe those in the field are just always on the watch for possible symptoms.

Thank you for your feedback, mousemom! I think your suggestion to wait and see is a good one. DS does really like his therapists, and he has been making good progress, so I hate to rock the boat unnecessarily. Hopefully things will settle down moving forward, and I can always push harder to get some of the missed sessions made up if we miss many more. We do pay for services here in NJ (it's a sliding scale, so it's less costly than private therapy, but still adds up to a decent amount at the end of the month), so it does make it slightly more annoying to have sessions cut short due to lateness. I think I notice it more because our ST is always super punctual and exact about her hour.

I'm thinking (and hoping) that you and sidmand are right and that these therapists are just SO in tune with every tiny thing, that they immediately identify even the most minute potential issue, just in case. As I'm thinking about it, I guess I'd rather know than not know if she suspects anything, it's just a little scary and overwhelming, since we're working to tackle certain issues and figure things out, and every time she says something like that, I feel like I'm mentally throwing something else into the mix.

hillview
12-04-2011, 07:46 AM
those all sound lousy. I am sorry. We had a OT and she had several flaws (she picked at DS1's personality, lacked patience with him at times, suggested lax parenting was a root cause etc). However she was a GREAT OT. DS1 did 12 sessions with her and now we are done. I decided to grin and ignore it. It was 45 mins a week and going to find a different one would have taken months (it took me 4 months to get an appt with her). Had it been a regular teacher or a long term OT plan I would have found someone else.

Good luck!
/hillary

crl
12-04-2011, 09:42 AM
The missed appointments would bother me most. I might check with your coordinator to see if the therapist is required to make up appointments that she cancels.

The kindergarten thing is odd, considering his age, but not very meaningful in that it doesn't effect your ds or his therapy so I'd just try to shrug it off

The sensory thing, maybe she brought it up in case you would then say, oh and he also loves x, y and z, which would be more signs of sensory issues? Sounds like that's not the case so, again, I would try to just shrug it off.

Catherine

karstmama
12-04-2011, 10:25 AM
our st missed/cancelled/showed up late for lots of appts, too. we just made sure she wasn't his st when he started getting speech at nursery school. i just don't have a lot of respect for her - especially when in comparison to his current st, whom we just love & who got us pointed in the direction of the exceptional children's pre-k he's currently in.

2 & 3 i'd let slide though they'd piss me off. just make sure you're not paying for missed sessions, see if you can dock $ for time missed (which i bet would straighten that out!), and wait for time to take care of getting a new therapist.

Pepper
12-04-2011, 01:19 PM
My 2 cents:

#1- consistent lateness and missed appts would bug me too. Agree with the others that you could clarify the missed appts policy with the admin office for your EI. Re; lateness, maybe you could say something to her like, I noticed that the start time for our sessions isn't consistent. It's important to my DS because he grets anxious while he's waiting (or it's hard for us to manage our picture schedule - try to work in some hook that will make it clear that her lateness is affecting your child's needs/services...can we find another time to meet that works better for your schedule?

#2 - yeha, I wouldn't worry about that one either. SOmetimes people just talk too much (myself included!) :-)

#3 - my take on her comment was, since you mentioned the blankets, maybe she thought you were implicitly asking for her opinion about your child's recent desire to snuggle. And FWIW I don't think you need to explain anything with repsect to the state of your house or your housekeeping skills - you have enough to do already! Our couch is in a constant state of deconstruction, it gets put back together once every two weeks when the cleaning people come ;)

Pepper
12-04-2011, 01:32 PM
It's like, of course you want what's best for your child, and you're willing to do whatever it takes to make that happen, but it's sometimes so hard to know what that "best" thing is, and I feel like there's no margin of error when it comes to this stuff!

Oh honey, yes there is PLENTY room for error...even though our kids have tons of challenges, I still believe that they are incredibly resilient. Haven't they managed to survive thus far?

You are getting an early start in helping your child, believe me. My DS1 has been in EI since he was 11 months old. He was born with cleft lip & palate, and got speech and feeding therapy in EI, then later we added social/emotional and behavioral stuff when he went to preschool and started having a lot of trouble. Now he's 5 and attends a special kindy class at our public school, for kids who need a lot of individual attention (he's ADHD and maybe some other things, we're trying to sort that out). Even with all the services he's gotten, and he's had a lot, he still has major challenges with behavior, social interaction, etc. BUT he's also learning to read, loves math, and is finally getting to experience some of the joys of childhood that simply weren't accessible to him before.

Anyway my point is: YOU HAVE LOTS OF TIME. And you don't have to do everything perfectly, or even near perfectly. You don't have to know what the best thing is - who can say what is best? We just have to be good enough. :love5:

arivecchi
12-04-2011, 01:55 PM
Are you paying for EI? Missed appts. and sessions would not go over well with me if i were paying. I ended up paying lots for EI and wished I had spoken up and complained when things started bothering me. Paying tons of money for services I was unhappy with was not fun.

Gena
12-04-2011, 06:38 PM
I'm sorry to hear that you are having such a hard time with EI.

We chose to receive EI services at their center, rather than at home, because that option gave us more frequent and intensive services. As a result, we did not have to deal with late or canceled sessions so I can't speak to that.




2. She mentioned yesterday that since DS is so active (has a hard time sitting still for long) and a bit on the immature side, we might want to consider redshirting him from K when the time comes, to give him an advantage. I was seriously taken aback by this. He's 2.5--not starting K for another THREE years, longer than he's been alive! But even worse, she prefaced it by saying "you know, so many people hold their kids back these days. I mean, we didn't consider it with my DD because she's a May birthday, not a summer..."--so basically let me know that she'd never do that/her kid didn't need it, but my 2 y/o would? Ugh.
.

This is really inappropriate. Kindy is a long way away and there are many factors that come into play when deciding whether or not to hold a child back.

Just to share our experience, we chose to send DS to Kindy on time in part because of his delays/difficulties. By the time DS went to Kindy, he had been in the districts special needs preschool for 2.5 years and had gotten all he could from that program. By putting him in Kindy, he had access to lot more services and specialized teaching methods that were a better fit for his issues.

If your child does not display other sensory symptoms, I would let the statement about sensory issues go and not worry about it.

jenfromnj
12-04-2011, 09:31 PM
our st missed/cancelled/showed up late for lots of appts, too. we just made sure she wasn't his st when he started getting speech at nursery school. i just don't have a lot of respect for her - especially when in comparison to his current st, whom we just love & who got us pointed in the direction of the exceptional children's pre-k he's currently in.

2 & 3 i'd let slide though they'd piss me off. just make sure you're not paying for missed sessions, see if you can dock $ for time missed (which i bet would straighten that out!), and wait for time to take care of getting a new therapist.


The missed appointments would bother me most. I might check with your coordinator to see if the therapist is required to make up appointments that she cancels.

The kindergarten thing is odd, considering his age, but not very meaningful in that it doesn't effect your ds or his therapy so I'd just try to shrug it off

The sensory thing, maybe she brought it up in case you would then say, oh and he also loves x, y and z, which would be more signs of sensory issues? Sounds like that's not the case so, again, I would try to just shrug it off.

Catherine


those all sound lousy. I am sorry. We had a OT and she had several flaws (she picked at DS1's personality, lacked patience with him at times, suggested lax parenting was a root cause etc). However she was a GREAT OT. DS1 did 12 sessions with her and now we are done. I decided to grin and ignore it. It was 45 mins a week and going to find a different one would have taken months (it took me 4 months to get an appt with her). Had it been a regular teacher or a long term OT plan I would have found someone else.

Good luck!
/hillary

Thanks for all of the replies! I wasn't sure if I'd get many responses, and I'm so pleasantly surprised to have received so much feedback! It seems that the consensus is the lateness/missed sessions are the real thing worth being concerned about. Since we only have 4 more months or so, and it would likely take a good 1.5-2 months to get someone new, we might just try to make it work with current DI therapist, but clarify the policy on late/missed sessions and try to make sure we abide by it.

jenfromnj
12-04-2011, 09:35 PM
Oh honey, yes there is PLENTY room for error...even though our kids have tons of challenges, I still believe that they are incredibly resilient. Haven't they managed to survive thus far?

You are getting an early start in helping your child, believe me. My DS1 has been in EI since he was 11 months old. He was born with cleft lip & palate, and got speech and feeding therapy in EI, then later we added social/emotional and behavioral stuff when he went to preschool and started having a lot of trouble. Now he's 5 and attends a special kindy class at our public school, for kids who need a lot of individual attention (he's ADHD and maybe some other things, we're trying to sort that out). Even with all the services he's gotten, and he's had a lot, he still has major challenges with behavior, social interaction, etc. BUT he's also learning to read, loves math, and is finally getting to experience some of the joys of childhood that simply weren't accessible to him before.

Anyway my point is: YOU HAVE LOTS OF TIME. And you don't have to do everything perfectly, or even near perfectly. You don't have to know what the best thing is - who can say what is best? We just have to be good enough. :love5:

Pepper, thanks for this. I know you're right--I can be a bit emotional/irrational about this stuff. I just don't want to do anything to make things even harder on DS, KWIM? But rationally, I know that things will be fine, we're doing whatever we can to help him, and in the long run, these issues with lateness/random comments aren't going to make or break his success and happiness. Now, I just need to keep all that in mind the next time I am biting my tongue at DI therapist's strange comments!

jenfromnj
12-04-2011, 09:39 PM
Are you paying for EI? Missed appts. and sessions would not go over well with me if i were paying. I ended up paying lots for EI and wished I had spoken up and complained when things started bothering me. Paying tons of money for services I was unhappy with was not fun.

We are. It's a sliding scale, so it works out to be less than if we were paying for private services, but it's still not chump change ;). I'm jealous of those living in states with free EI!

I am going to call our coordinator tomorrow and just casually ask about the relevant policies along with some other questions I have for her. It's taking forever to even get a bill/statement from them, I am going to be really, really unhappy if we end up getting charged for sessions that she canceled!

jenfromnj
12-04-2011, 10:02 PM
I'm sorry to hear that you are having such a hard time with EI.

We chose to receive EI services at their center, rather than at home, because that option gave us more frequent and intensive services. As a result, we did not have to deal with late or canceled sessions so I can't speak to that.

Thank you, Gena. I wish it were an option to receive on-site services, but they don't offer that as an option here unless a child is approved for a certain number of hours per week or requires certain specialized services.


This is really inappropriate. Kindy is a long way away and there are many factors that come into play when deciding whether or not to hold a child back.

Just to share our experience, we chose to send DS to Kindy on time in part because of his delays/difficulties. By the time DS went to Kindy, he had been in the districts special needs preschool for 2.5 years and had gotten all he could from that program. By putting him in Kindy, he had access to lot more services and specialized teaching methods that were a better fit for his issues.

If your child does not display other sensory symptoms, I would let the statement about sensory issues go and not worry about it.

Thanks for this also! There's just so long until he'd be eligible for K, and she's only been working with him for 3 months, so I was really taken aback. I have no idea where we'll be then as far as DS's issues, progress and readiness for K. And our town offers EI preschool, including a transitional K option if we need it, so there are plenty of options to get him whatever he needs whether we go ahead with K or not when the time comes.

I really do give so much credit to those of you who have been successfully navigating this all, it seems so straightforward on paper, but the reality of it is SO not!

JTsMom
12-05-2011, 08:50 AM
It can be so frustrating trying to figure everything out. You'd think it would be a lot more straightforward than it really is. Having not-so-supportive family in the mix adds a whole other layer to it too.

If it helps at all, just know that none of us have all of the answers either. When we think we do, something shifts, and we're back to trying to figure it all out again.


As for the therapist- I pretty much agree with everyone else- I'd have a problem with missed sessions and lateness, and ignore the rest of it. On the other hand, you aren't paying for the missed sessions, are you? If not, and you're not sure it's even helping your DS, I might not worry to much about that either- instead, save the money up for private speech in a few months. The lateness is still a issue though, imo, b/c that you ARE paying for.

Gena
12-05-2011, 09:44 AM
If it helps at all, just know that none of us have all of the answers either. When we think we do, something shifts, and we're back to trying to figure it all out again.

:yeahthat: Just when you think things are smooth sailing, the boat tips over.

jenfromnj
12-06-2011, 07:43 PM
It can be so frustrating trying to figure everything out. You'd think it would be a lot more straightforward than it really is. Having not-so-supportive family in the mix adds a whole other layer to it too.

If it helps at all, just know that none of us have all of the answers either. When we think we do, something shifts, and we're back to trying to figure it all out again.


As for the therapist- I pretty much agree with everyone else- I'd have a problem with missed sessions and lateness, and ignore the rest of it. On the other hand, you aren't paying for the missed sessions, are you? If not, and you're not sure it's even helping your DS, I might not worry to much about that either- instead, save the money up for private speech in a few months. The lateness is still a issue though, imo, b/c that you ARE paying for.

Thanks so much, Lori! I really did think it would be a lot more straightforward! It's especially frustrating b/c DS has a speech delay and a couple of other "quirks" that may or may not mean anything in terms of bigger picture. So we don't even really know the extent of what we'll be doing or what we might need, since we're still very early in the process.

I don't think we're paying for missed sessions, but I am still waiting to be billed for the past 2 months or so, so I don't know for sure. But yes, we are paying for the full session each time, so the few minutes here and there add up. I am not trying to nitpick, since the therapist really is good with DS and he likes her, but I also don't want to give the impression that it's OK to consistently be 10 minutes late (especially since she leaves 10 minutes at the end for paperwork, so we lose 20% of our "working time" when that happens) and cancel 1 of every 3 sessions.