Virtual Quilting Bees: Bee Still My Heart

Speech and Other Services: Schools or Medical?

A blog friend was curious to know why we decided to get Wonderboy’s speech therapy and audiology
services from the public school district instead of through a private
(i.e. medical) source. It was a tough decision, and I still have
moments where I second-guess it. Navigating the system, dealing with an
IEP—not to mention the IEP team—hasn’t always been easy. But most of the time I think it was the best choice, bearing in mind that no alternative is perfect.

The advantages, for us, of accessing these services are:

• close to home

• free (including ear molds and hearing aid batteries)

• no waiting time before a scheduled session

• our ST and audi are easy to reach via email or phone, are
excellent at keeping lines of communication open with us, and are eager
to work with us on a friendly, personal level.

These are very important factors, all of them. For therapy
situations in a medical environment, such as the local children’s
hospital where Wonderboy currently receives physical therapy—his PT
needs are medical and involve consultation with orthopedics doctors—we
must accept long travel times, difficulty finding parking, parking
fees, insurance co-payments, a bit of time in the waiting room even before a scheduled
session, and a more detached relationship with the therapist. Our
current PT at Children’s is certainly warm and friendly and has an
excellent rapport with my son, but she works in a Big Hospital System
with all sorts of bureaucratic red tape crisscrossing between us. I
can’t call her directly on the phone; we certainly aren’t going to be
emailing back and forth. It’s a different kind of relationship.

The speech therapist (our "new" speech therapist—not really new
anymore, as Wonderboy has been seeing her for over a year now—this is not
the therapist who sandbagged me in the "not always easy" post I linked
above) and audiologist we work with in the school district are
wonderful: excellent at their jobs, very respectful of our choices as
parents, and eager communicators. We are in regular contact via phone
and email, not to mention our weekly sessions. Wonderboy adores them
both and looks forward to " ’peech days."

The down side, of course, is having to deal with the whole maddening
IEP process and School District Policy. I have to be constantly on
guard against encroachments upon our rights—not by the individual
therapists, but by the school district. The district representatives
are completely frank and somewhat apologetic about their need to "cover
themselves" from any possible legal action disgruntled parents might
take against them. This particular district has been burned before, it
seems, by parents who filed lawsuits because they felt, after the fact,
that the district had not "done enough" for their children.

District reps have told me quite frankly that they "just don’t know
what to do with a parent like" me, i.e. a parent who believes meeting
my son’s needs is my responsibility and not the public school district’s.

One tangle we ran into this summer was over the matter of
evaluations for PT and OT. Wonderboy has muscle tone issues and motor
delay, all part of his neurological, shall we say, unusualness. 😉
Because he has congenitally short, tight muscles, we have had to do a
daily stretching regimen with him since he was four months old. About
once a year, we check in with PT to make sure we are still doing
everything correctly, and to see whether there are any new areas we
ought to concentrate on. Every time he has a growth spurt, his muscles
get even tighter (because bone grows faster than muscle), and when that
happens, sometimes we’ll do a kind of booster session with a
professional PT for a few months. That’s what we’re doing right now:
three months of every-other-week PT at the children’s hospital to work
on some specific issues.

I scheduled an OT evaluation at Children’s as well. (Which is a
whole other story in itself, one I’ll have to save for another post.)
His fine motor skills seem to be developing very nicely, but his
doctors thought an eval would be a good idea to look at some global
sensory issues and stuff (to be technical about it).

The school district had a very, very, very hard time accepting my
assertion that we would be declining their offer of OT and APE
(adaptive physical education, the closest they can come to PT) evals
this fall. Since I already had PT and OT evals scheduled at Children’s,
and since we intended to get PT and, if necessary, OT at the
hospital rather than through the school district, I saw no reason to
squeeze yet more appointments into our already busier-than-ideal
schedule. I declined the district’s eval offer and gave them the dates
of our scheduled evals at Children’s just so they’d no we were on top
of this.

As I understood the regulations, the district is obligated to offer the evaluations and I as parent have the right to decline them.

The district begged to differ. That applies, they said, to the first
time evaluations are offered. But once a child is in their system, once
a need has been documented, they must (so they told me) provide these evaluations.

This conversation went back and forth between us all summer—amiably,
mind you. I (amiably) dug in my heels, because I guard our family’s
time very carefully. Every new appointment is a drain on our time.
These medical and therapy-related appointments add up. They could
easily dominate our schedule if I let them. There was no reason for us
to make two extra trips to the school to duplicate evaluations he has
already had, especially since I had no intention of receiving those
services through the school district.

Oh, this was hard for the district to accept. Finally, in one rather
surprising phone call, an extremely friendly and earnest district rep
told me—with immense apology in her tone—that "we were at the point
where the district would normally be forced to seek mediation." Hello!
This despite my having provided the district with documentation of the
PT and OT evals scheduled at Children’s. But the district really,
really didn’t want things to get ugly (i.e. go the mediation and
arbitration route). They decided to "compromise" (I put it in quotes
because I still believe they are talking about district policy, not
state law) by accepting a written statement from me in which I
acknowledged that they offered the evals, we declined them, and we are
aware we can ask for them at any time.

I was happy to provide such a statement and put the matter to rest.
I know that many parents in other school districts are in the position
of having to fight to get their children necessary services, and I’m
not inclined to get too cranky about having a district all too eager
to provide services to my child. But I do think it is vitally important
for me, as for all parents, to stay alert and informed about what the
law says and what our rights are, and to make sure not to passively
cede any of those rights.

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