I've made peace with our preschool situation. I'm grateful we have what we do, even if it's not everything I'd like. I'm trying so hard to step up and supplement more at home, which is what I BELIEVE in. It's just easier said than done. We're just a couple weeks from the end of the year and then I'm hoping like crazy that I can use the summer to find a good routine for practicing speech, counting and ABC's at home.
Meanwhile, this weekend we got a letter from our insurance company telling us that they denied our request for more therapy visits. Here's how it works - we get 30 visits per calendar year per individual. These visits include speech therapy, occupational therapy, physical therapy, any kind of behavioral therapy, etc... Just 30 a year - not even once a week. We requested more, which is the first step (and hopefully the only one necessary). They said we couldn't have more visits. Now we face an appeals process that could take 6 months if we have to go through all 3 levels. They continue to pay once you start the appeal process but they will ask for the money back if they never approve.
Carver goes to speech 2x/week and we've elected not to do any other therapy for the sake of time, sanity and money. Really, his speech is his most noticeable delay. Besides not being potty trained or knowing how to ride a bike, etc... but those things don't show quite as often. :)
If insurance doesn't cover therapy, we're looking at around $200 a week in therapy costs. Or we could scale back to $85-100/week if we go down to one day. Obviously, this is a significant cost. And a huge dilemma. How can we NOT get the help we need for Carver? But how can we justify so much money out of pocket? Where will it come from? Is it worth draining our savings account for a few years of speech therapy? These are hard questions.
First step - write to the insurance company. They wrote:
"This benefit restriction is not a determination of medical necessity. This denial is for payment purposes only. if you choose to receive the service, you will need to assume the cost."
Does this mean they don't care that therapy is medically necessary? Is that really irrelevant? How can health insurance deny medically necessary treatment? How are we supposed to get the care we need in a medical system built around the concept of insurance if the insurance won't participate? It's incredibly frustrating.
And so I'm incredibly frustrated. Disappointed. Overwhelmed. Discouraged.
Showing posts with label speech. Show all posts
Showing posts with label speech. Show all posts
Monday, May 24, 2010
Sunday, December 27, 2009
Going Private
Not the blog - just speech therapy. :)
We finished a two part evaluation with a speech language pathologist (SLP) about 35 minutes from home and so far, I really like her. Carver is excited to go, cooperates as well as could be expected. The first visit was really great as far as behavior goes. I was so impressed with how well he sat and said words for her. :) But he's starting to learn where the toys are and is anxious to try them all. She gave us a detailed evaluation that I'll try to include details from later. But the long and short of it is that she recommended talking to the school about upping his therapy time there and probably going to twice weekly therapy with her. It seems on track to me because he certainly needs the time and practice. A couple of the interesting things I learned so far:
Carver has the physical capability to make the sounds for words, just not the muscle control to plan and execute them on demand. All the age appropriate sounds are there. Even L.
He can move his tongue up and make a clicking sound on the roof of his mouth, but if you ask him to touch his tongue to his top teeth, even with a mirror and example - he can't do it. It's a perfect example of his lack of motor planning ability.
He has a hard time with words that switch position in the mouth. "Muddy" ends up sounding like "Muu-ee" or "munny." "Gate" or "Kite" are tricky because it shifts from the throat to the teeth.
Making sounds in a row on purpose is hard. Sequencing is a challenge for sure.
I'm encouraged. I'll be able to listen to books on tape to and from speech... :) Okay, maybe not. It's a great time to practice conversations with Carver. So far, I need to leave Grace at home. Hopefully we'll be able to work up to taking her with me. I don't want to use all my babysitting swaps in one place!
We finished a two part evaluation with a speech language pathologist (SLP) about 35 minutes from home and so far, I really like her. Carver is excited to go, cooperates as well as could be expected. The first visit was really great as far as behavior goes. I was so impressed with how well he sat and said words for her. :) But he's starting to learn where the toys are and is anxious to try them all. She gave us a detailed evaluation that I'll try to include details from later. But the long and short of it is that she recommended talking to the school about upping his therapy time there and probably going to twice weekly therapy with her. It seems on track to me because he certainly needs the time and practice. A couple of the interesting things I learned so far:
Carver has the physical capability to make the sounds for words, just not the muscle control to plan and execute them on demand. All the age appropriate sounds are there. Even L.
He can move his tongue up and make a clicking sound on the roof of his mouth, but if you ask him to touch his tongue to his top teeth, even with a mirror and example - he can't do it. It's a perfect example of his lack of motor planning ability.
He has a hard time with words that switch position in the mouth. "Muddy" ends up sounding like "Muu-ee" or "munny." "Gate" or "Kite" are tricky because it shifts from the throat to the teeth.
Making sounds in a row on purpose is hard. Sequencing is a challenge for sure.
I'm encouraged. I'll be able to listen to books on tape to and from speech... :) Okay, maybe not. It's a great time to practice conversations with Carver. So far, I need to leave Grace at home. Hopefully we'll be able to work up to taking her with me. I don't want to use all my babysitting swaps in one place!
Monday, December 7, 2009
Wake-up call
Lately, I've faced a lot of reality. I exchanged emails with Carver's preschool teacher and SLP -a speech language pathologist, formerly known as a "speech therapist." :) It turns out Carver's not speaking much at school. I had figured that his IEPs and progress reports reflected his ability to perform in structured, formal testing situations and didn't worry too much about the low age equivalencies given. But I wanted to be sure. I was really surprised to find out that he's NOT talking at school. Strings of 3 words at BEST. Mostly single-word utterances. WHAT?! He's talking volumes at home. Granted, articulation is a major hurdle. But he's not letting that stop him. He speaks in paragraphs at home, disjointed sentences strung together with semi-colons or ellipses. So this is a major discrepancy. And it has me concerned for MANY reasons:
1. How can speech therapy be effective at school if he's not talking?
2. Why isn't he comfortable enough at school to talk? He used to talk up a storm at school - last year, different classroom, different teacher and therapist. What's happened?
3. I can't count on the school system. I've been coasting and it's time to get back in the driver's seat.
4. The clock is ticking and we're just under 2 years away from kindergarten. I'm kicking myself for wasting so much time.
SO... I'm diving into the search for a private speech therapist. I'd been on a waiting list and didn't know what else to do. Now we've been accepted to the local therapy center, but I'm not just taking whoever I get. Next Monday we meet with the first recommendation from my pediatrician. (HELLO?! Why didn't I ask him sooner? He's fabulous and knows an awful lot more than I realize.) I'm willing to drive about 30 minutes for therapy, the local place is 15 minutes. I'm hoping we're looking at every week. I've resisted the cost ($25 co-pay each visit), but how can I NOT do it?
But more importantly, it's good for me to have these moments where I get myself back on track at being Carver's #1 advocate. It's exhausting to worry all the time about him, to be constantly teaching and coaching him. I have 3 other kids, laundry, dishes, meals, church responsibilities, a husband and so many more parts to my life. It's a sticky balance between feeling guilty that I'm NOT doing more for Carver and letting myself relax to the point that I'm not doing much at all.
Whew. Add to all that the fact that I keep looking at my sweet 4 year old and wondering when he'll use the toilet and I want to throw in the towel completely!
1. How can speech therapy be effective at school if he's not talking?
2. Why isn't he comfortable enough at school to talk? He used to talk up a storm at school - last year, different classroom, different teacher and therapist. What's happened?
3. I can't count on the school system. I've been coasting and it's time to get back in the driver's seat.
4. The clock is ticking and we're just under 2 years away from kindergarten. I'm kicking myself for wasting so much time.
SO... I'm diving into the search for a private speech therapist. I'd been on a waiting list and didn't know what else to do. Now we've been accepted to the local therapy center, but I'm not just taking whoever I get. Next Monday we meet with the first recommendation from my pediatrician. (HELLO?! Why didn't I ask him sooner? He's fabulous and knows an awful lot more than I realize.) I'm willing to drive about 30 minutes for therapy, the local place is 15 minutes. I'm hoping we're looking at every week. I've resisted the cost ($25 co-pay each visit), but how can I NOT do it?
But more importantly, it's good for me to have these moments where I get myself back on track at being Carver's #1 advocate. It's exhausting to worry all the time about him, to be constantly teaching and coaching him. I have 3 other kids, laundry, dishes, meals, church responsibilities, a husband and so many more parts to my life. It's a sticky balance between feeling guilty that I'm NOT doing more for Carver and letting myself relax to the point that I'm not doing much at all.
Whew. Add to all that the fact that I keep looking at my sweet 4 year old and wondering when he'll use the toilet and I want to throw in the towel completely!
Thursday, April 16, 2009
Things I don't want to forget
Carver gave me a dandelion yesterday on the way home from the bus stop. I can't be sure it's the first time, but I think so. Very sweet.
He played outside yesterday while I weeded and got all friendly with worms and caterpillars. He wriggled a worm back and forth between his thumb and forefinger until it became 2 worms. :) He kept saying, "friend - worm!"
On the way to the bus stop today, a wasp landed on his arm. I looked down in the stroller and he was saying, "awww" to his new friend like he does for hugging babies and stuffed animals. I flicked it off and smashed it. No more wasps for friends, please.
We had jello at lunch yesterday in little plastic cups because he watched me make it the day before and saw Lydia take one in her lunch to school. He was SO excited. Sat right up there, asked for a straw and tried to drink it! :)
I keep forgetting to blog about the lack of SPIO. After months of hoping and trying, I decided it wasn't helping and it wasn't worth the hassle of keeping it clean. I still completely support SPIO and encourage it for others. I've heard enough amazing success stories first hand to believe it works for a lot of kids. It just didn't help Carver.
He's telling me lots about school lately. "Dance. Circle Time. Freeze. Stop." Or "Brown table. Snack. Cereal." I love it. I'm hearing more and more verbs, too. "eat snack" or "play sand" or "watch Kipper." Hurray!
He played outside yesterday while I weeded and got all friendly with worms and caterpillars. He wriggled a worm back and forth between his thumb and forefinger until it became 2 worms. :) He kept saying, "friend - worm!"
On the way to the bus stop today, a wasp landed on his arm. I looked down in the stroller and he was saying, "awww" to his new friend like he does for hugging babies and stuffed animals. I flicked it off and smashed it. No more wasps for friends, please.
We had jello at lunch yesterday in little plastic cups because he watched me make it the day before and saw Lydia take one in her lunch to school. He was SO excited. Sat right up there, asked for a straw and tried to drink it! :)
I keep forgetting to blog about the lack of SPIO. After months of hoping and trying, I decided it wasn't helping and it wasn't worth the hassle of keeping it clean. I still completely support SPIO and encourage it for others. I've heard enough amazing success stories first hand to believe it works for a lot of kids. It just didn't help Carver.
He's telling me lots about school lately. "Dance. Circle Time. Freeze. Stop." Or "Brown table. Snack. Cereal." I love it. I'm hearing more and more verbs, too. "eat snack" or "play sand" or "watch Kipper." Hurray!
Monday, December 29, 2008
a SENTENCE!!
The other night Carver and I were cleaning up his big beads and strings that G&G made him. He reached and stretched to get one under his bed, came up and declared: "I did it!" His first sentence and it couldn't have been more appropriate.
A few days later, I was telling him he couldn't have more water (the kid had probably 12 ounces at dinnertime) because he'd wet the bed. (We've had that problem recently and he's still in diapers!) He copied right back, "wet the bed" clear as day. 3 whole words together! YIPPEE!
I have wondered lately how often he cognitively speaks in sentences that we just don't understand. Often there are strings of sounds that might be words, but we would never know it. Speech delays are interesting in that way because it's SO difficult to interpret what represents a lack of communication and what is a cognitive delay, as well. I guess we'll never really have answers for that one, but I'm sure excited to see this progress.
A few days later, I was telling him he couldn't have more water (the kid had probably 12 ounces at dinnertime) because he'd wet the bed. (We've had that problem recently and he's still in diapers!) He copied right back, "wet the bed" clear as day. 3 whole words together! YIPPEE!
I have wondered lately how often he cognitively speaks in sentences that we just don't understand. Often there are strings of sounds that might be words, but we would never know it. Speech delays are interesting in that way because it's SO difficult to interpret what represents a lack of communication and what is a cognitive delay, as well. I guess we'll never really have answers for that one, but I'm sure excited to see this progress.
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