Tuesday, August 12, 2008

EI to Public School, private therapy

Early Intervention ends when children reach 3 years of age. This doesn’t mean that once your child is three all therapy options cease-but they do change abruptly. I was prepared months in advance for this change. Our case coordinator said that when Early Intervention stops, the Public School System takes over—but that’s not exactly true. Elena was assessed by several therapists that work for the PSS in order to see if she qualified for services. Having a disability is not enough to qualify—since the PSS works on an educational model, the deficit has to be causing an impediment to education.
Elena’s first assessment was with the Speech Therapist in December 2007. At this time, she was using words, but she could only use one word per breath. She knew her colors, and could answer yes or no questions, and could point to the answer to a very involved scenerio, like this: There are three pictures involving groups of different colored kittens. One group is playing with string, one group is playing with a ball, and one group is playing in and around a box. There are kittens playing, sleeping, eating, jumping in the different pictures. The therapist would ask “Where is the black kitten in the box?” and Elena would find it, even though there were black kittens in each picture. “Where is the grey kitten sleeping with a ball?”—she’d get those questions correct every time. So even though she couldn’t say “black cat”, she could convey she understood the situation. A speech delay, if it is major, is considered an impediment to learning as it is difficult to communicate in an educational group setting—so that was an automatic qualifier.
Occupational therapy was next. In essence, this is assessment was of Elena’s fine motor skills and “skills for living”. Most of this is normally done sitting down in a play area—but Elena does not sit down well on the floor, so she was allowed to sit or stand at a table. This wasn’t optimal, either, as the chair was too larger for her, and had no side support, and the table was too tall for her to be able to lean on while standing up. Still, she showed no massive problems related to fine motor skills—she could put beans into a pill bottle (and screw and unscrew it), string beads, draw lines (straight and circular), stack blocks, and fold paper, to name a few of the tasks. She did not qualify for OT services.
PT was next—the assessment of her gross motor skills. This is her obvious deficit—but just b/c a 2 year old couldn’t walk didn’t mean she couldn’t be a smart student. This was my biggest fear—her largest need not being met b/c of the educational model. I argued that children learn social skills and education at this age through things like pretend play or group play, and Elena’s gross motor issues prevented her from engaging in those activities. The therapists and teachers agreed with me, but wasn’t sure if that explanation would be good enough for the State.
Since we had the speech delay as a qualifier, she was accepted. I’m not sure if she’ll qualify for therapy services in the future, as her speech progresses. I have been told that once you’re in, it’s easier to stay in the program, so I’m hoping that is true. I also think that she’ll end up qualifying for OT services in the future, as being potty trained in the classroom would be important—we are close to being potty trained, but she can’t get her clothes on and off by herself, and won’t be able to for a long time, as her balance is terrible. OT and PT to improve balance could be available to us, depending on the spin factor. I’ve also heard of parents toting the ‘safety line’, using various therapies as a way to keep their child safe while they are at school (improved balance while being jostled in the hallways, being able to carry something while walking, etc). Apparently the word ‘safety’ tends to evoke a strong response when nothing else works, as schools care about liability.
Elena’s EI program was to end May 1, and school ended June 6th. I didn’t like the idea of having her therapists switch up for a month and then have a large summertime gap. I opted out of EI earlier than her 3rd birthday, mainly b/c I got to “double up” on her therapies—she got Speech T and PT at school, and she still saw her EI therapist, only not in the home (I drove her to the therapy center).

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