Guest Author - Bonnie Sayers
The first High school IEP was recently held for my nonverbal son Matthew. School started in September, yet here it was mid April and the first time I had met any of the therapists - Adaptive PE, SLP and OT. There were no phone calls at any time in the year to introduce themselves to me either. I requested through the Special Education department the service logs for all therapies and looked them over prior to the meeting. I brought along a few of them that warranted further clarification.
The General Ed Teacher for the Art elective started with his information followed by the Adaptive PE, OT and Guidance Counselor. At this point it was lunchtime and the Coordinator had to leave for a little while to supervise so this left just the Special Ed Teacher, Regional Center Coordinator and myself since each person left after their portion of the meeting.
The SLP is not an employee of the district, but is contracted out by a third party and has been with this high school for five years. He never read from any papers to go over previous goals or share future goals. He had mentioned to the Occupational Therapist that Matthew had difficulty in fine motor coordination at the start of their sessions.
The SLP stated that Matthew's strengths are sorting, matching and sequencing, which I am aware of since he has been doing these sorts of activities for years. He brought along a game that had boards and cards, showing us how Matthew can pick out items rapidly. He proceeded to show some Go Talk devices that he planned to start using. I purchased the Go Talk 9 several years ago and this goes back and forth to school. Matthew really does not utilize it well and we could benefit from proper instruction.
This SLP plans to retrain Matthew how to use pecs, boards and sign language. I have included in IEPs over the years that I do not want sign language to play a major role in communicating for Matthew, but every time we get a new therapist this comes up. As the parent I believe I have the final say and he was not interested in my opinion.
The SLP asked me about Matthew's health and wanted to know if I had shared with the school if he is on any Medication. I thought this was very odd for an SLP to be asking this type of question. I shared the name of the medication and that I indicated this on the enrollment, emergency and ESY cards. He said he looked through the file and none of the previous therapists ever looked into Matthew's speech.
The service logs from the SLP had the same information for each session. The aide and Matthew go to his room eight times a month for 240 minutes. The session activity has oral motor exercises, conversation interchange with the therapist for focus, verbal and non-verbal cued responses drills, word finding, identifying semantic contexts, building on simple directions within the session with varying semantic context, building on tasks of response to imitation and initiation, 1-3 steps. Simple one step reciprocal tasks, repetition up to ten efforts, multiple reciprocal tasks, 1-3 steps.
Session results included working with verbal and nonverbal behaviors, better verbal and non-verbal reciprocal behaviors, better focus, better response times, good requested responses, responses with fingers and hand movements, improved group work with words and utterances, slight to moderate improvement.
This SLP happens to be a PhD and teaching Professor and proceeded to ask me if he had seen an Otolaryngologist - otherwise known as an Ear, Nose, Throat (ENT) Dr. He drew a picture explaining about vocal folds and how they look if paralyzed. He said he was available for consult and that he recommends I take Matt for an exam at an ENT to check to see if his vocal folds are paralyzed and if there is a threat of aspiration.
The reason he asked about medication is he wanted to know if it made Matthew sleepy as this could be dangerous if his vocal folds are paralyzed and he is eating and sleepy. He said that this could be the reason why Matthew has not been able to toilet train yet at the age of fifteen. I further explained to the Therapist that Matthew was drinking a bottle until a year ago and had feeding therapy for five years. In the past year with ABA his eating habits changed significantly, although he seems to inhale his food, burp often and hardly chew the food. He said it is all connected.
This was all discussed while the Special Education Coordinator was not there. I asked after he left if there was a report from him with this recommendation. I have yet to receive a copy of any reports or working document to this IEP so I can make changes.
I did call the Pediatrician to ask about an appointment with an ENT. They said we have to come in to see her to get the referral. The exam to check the vocal folds would require sedation and a tube of some sort to look down his throat. I find this all very disturbing news to receive at an IEP for a fifteen year old. I wonder why the therapist never called me or sent home a letter to discuss this with me in detail instead of springing this on me at a meeting.
I now feel like I need to call all the previous therapists we have worked with at school and at home to ask their opinion. It is interesting that after fifteen years a professional is suggesting to look further into the reason why my son is nonverbal, instead of just assuming it is because he is autistic. Why have others always focused on the behavior issues and the forms of communication instead of the medical reasons?