About this series: We recently asked Theresa M. Snelling, MA CCC-SLP, to help us learn more about speech development and support for the school-aged child. We are so pleased to share her response with you in this special eight-part, One From the Team series, Speech Therapy and the School-Aged Child.
Teresa is clinical coordinator for the Cleft Palate and Craniofacial Center at Rose Medical Center, Denver, CO and has been working with patients and families affected by clefts for more than 30 years.
Speech With the Team, Speech at School
Part 1 of 2
Look for part 2 tomorrow:
Building the Relationship Between Parents, Team and School
What’s the best way for parents to engage with speech services through schools?
Request an evaluation with the speech therapist directly or ask for a Child Find evaluation. It is typically very effective to bring to the school your child’s team records and any assessments done by other speech therapists involved in your child’s care.
My child works with a speech therapist through his treatment team. Why does he need another speech therapist at his school?
Speech therapy services provided in a clinical/hospital setting differ than those provided in a school setting in many ways. School-based services can offer additional speech therapy that supports the goals and objectives determined by the speech therapist on the team. With limits on resources and insurance coverage, the additional therapy, when coordinated between the two settings, can truly result in more consistent progress. Most children with articulation (sounds) and resonance (simply put, sounds in the mouth=oral vs. sounds in the nose=nasal) issues will at some point require treatment from a Speech Pathologist associated with their team or in the local community and who is specialized in speech issues related to cleft.
School-based speech therapy allows for direct assessment and treatment for your child’s success in being understood by their peers and teachers/other adults, at school! In a hospital/clinical setting, children may make consistent speech progress, yet there are no ongoing changes or noted progress at school. In a perfect situation, a child would receive services in both school and clinical settings to optimize carryover and generalization of speech skills to all environments!
The key to benefitting from school-based services is a Speech Pathologist who is willing to investigate the differences in techniques, surgical management and cleft related speech patterns if their experience is limited. In a local survey I did in our metropolitan community, the Speech Pathologists surveyed reported only 1 or 2 children with cleft palate or related speech needs on their caseloads over an average of 15 years working in the schools. That small number makes it difficult for the speech pathologist in the schools to be specialized in the speech needs specific to children with cleft palate. That does not mean you should avoid speech therapy through the schools; for many children it is their only option. In this case, your role as parent advocate and facilitator connecting both speech therapists involved in your child’s care ensures more and varied intervention for your child (keep in mind that signed releases are an important first step for both the school and team speech therapists).
Can our team speech therapist help the school speech therapist?
In our community, we often find that children are being seen for speech therapy at school but not by a speech pathologist specialized in cleft palate speech and resonance issues. The primary reason for this, typically, is lack of funding for the private speech therapy, and as previously noted, limited experience on the part of the school-based Speech Pathologist. It’s important to discuss with your team speech pathologist, at your child’s regular team visits, the need for collaboration between the speech pathologist specialized in cleft palate speech needs and the school-based speech pathologist who may be providing your child’s only therapy. The school-based speech pathologist has a Master’s Degree in Speech Pathology; however, many university programs may offer no instruction on cleft palate speech issues, or possibly only a lecture as part of other classes. In fewer university programs, an entire class might be devoted to speech and cleft palate.
Your school-based speech pathologist has the background to address most of the needs your child may have related to cleft palate, but will likely need input from the team speech pathologist or a community-based speech pathologist specialized in cleft palate speech and language needs.
In the 30 years that I have worked in a moderately large metropolitan area, I have found “MOST” school-based speech pathologist appreciate the guidance and recommendations from the team. In spite of large student caseloads, most want what is best for the children they serve and welcome the support.
Does speech therapy at school cost money?
No. Speech therapy in the schools is funded as part of special education. Please don’t let that worry you! I have met many parents who didn’t want their child labeled or pulled out of class. Children do need to go through development of a formal EIP (Individualized Educational Plan) which includes assessment, data collection and parent meetings. This process is to protect your child. No school I have ever worked with wanted to deliver special education services that were no longer needed! It is a fear verbalized by many parents I have worked with over the years. However, in a typical school day in a typical classroom, children are coming and going for extra help for many reasons, and your child moving in and out of the classroom will be another typical event. I add this information to this question because even though it is a free intervention provided by the schools, many parents have resisted because of the concern for the process.*
*CPF staff note: Regarding the concern for labeling and social stigma associated with cleft and speech services, parents, teachers and school counselors often emphasize that a child who struggles with speech issues may already suffer some social challenges because of them. Helping a child access resources that improve speech to some degree empowers the child to improve his or her social experience and with support of school staff, may be an opportunity to destigmatize the cleft and its effects on speech by helping peers learn more about it.
If you need assistance locating a team or a cleft-specializing speech therapist, please, drop us a line or give us a call! 1.800.242.5338 or firstname.lastname@example.org.