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People today have very busy schedules. It is a very convenient and a time saving service to be seen in your own home or office.

Being seen in your own environment allows you to practice your newly learned skills where you will be using them and in this way helps with carry-over.

In addition, services offered in your own home allow for privacy. I believe the quality of the therapy is better and more personalized.

Contact me to schedule an appointment...

Locations Served | Accent Reduction | Speech Therapy in Schools | Children | Autism | Orofacial Myology

Speech and Language Services for Children

Ela Britchkow shares a similar mission statement to our Pennsylvania schools, "That no child with speech and language needs should be left behind." She devotes her talents and skills towards this obtainable goal. Communications skills are at the heart of lifeís experience-particularly so for children who are developing language critical to cognitive development and learning. Because all communication disorders carry the potential to isolate individuals from their social and educational surroundings, it is essential to find appropriate and timely intervention.

A School Systemís Speech Therapy Resources Are Not Unlimited

The schools have a daunting task of addressing the needs of all the children with speech and language impairments. Research indicates that ten percent of the school aged population has speech communication/phonological disorders (cite sources). More than 1 million children have a stuttering problem. Ten percent of the children have some level of hearing loss and auditory processing difficulties. There is a great imbalance between the large number of children needing speech therapy and the available resources for help in the Pennsylvania public schools. The speech-language pathologist must find time with a large caseload for screening, testing, test interpretation, report writing, team meetings, case management, conferences, collaboration/consultation, and travel between schools and continuing education. As a speech therapist in private practice, I do my best to take whatever progress students have made at school to a higher level.

Pennsylvania speech therapy for children and adults with speech pathologist Ela Britchkow.The maximum caseload allowed for speech and language support for itinerate services is 65 (Commonwealth of Pennsylvania Department of Education, Special Education Services and Programs, State Board of Education Regulations Chapter 14, section 14.142). This is disappointingly larger than any of the other therapies listed (link). In actual practice however the numbers can often be 90 or more! The discrepancy may result from the school district requesting approval for a higher number. Yet the recommended maximum caseload by experts in the field, for appropriate services is 40 students, regardless of the time or number of service delivery models selected. Special populations may dictate fewer students on the caseload, e.g. autism. To keep a balance in my own life and to avoid burn out, I keep my own client caseload at no more than 25.

The actual number of speech therapists hired may not be sufficient to complete all of this work in the manner they would like to. To give an example, based on the percentage of students with speech and language needs, if a school districtís population is 10,000 students, 1,000 would be expected to need some level of speech and language services (link). The number of full time speech therapists required to serve the needs of these students would therefore be expected to be between 11 and 15 (depending on whether 65 or 90 IEPís were assigned per speech therapist). So a parent should consider inquiring about the districtís enrollment size, the number of speech therapists available and the size of their caseloads. This would provide some gauge to measure the actual resources available to evaluate and carry out your childís speech and language IEP or determine if one is needed. Private outside speech and language therapy and assessment can have a very positive impact.

Services can be delivered in a whole classroom, in a group and individually or any combination, which is best for my child?

This question can not be simply answered since there are inclusion models for the delivery of speech therapy, which are really quite good for some students. On the other hand, sometimes the least restricted environment can be the least helpful. The time to express serious doubts is when the progress made by your child falls below what you had hoped for. Talk to the schoolís speech therapist first and see if a resolution is possible. Perhaps you have gone down this path before and would like a second opinion. A well documented in-depth independent evaluation by an outside speech therapist can help parents better determine their childrenís needs and the best way to address them (link). Even if it provides assurance about the current IEP at the childís school, it is still worthwhile to know that everything possible is being done for your child.

How can I know if my child is seen often enough by the speech therapist?

Speech therapists generally do a good job of identifying studentsí needs. It is the intensity of the services which is problematic due to time limitations. What if a student for example, absolutely needs direct therapy four times a week but the therapistís schedule does not allow the time for more than one session? I have personally known speech therapists that missed lunch because they were so busy and concerned about their work. In addition, they were taking an enormous amount of paperwork home with them, so squeezing in that extra time was not always possible. I am fortunate, having a private practice, not to be in that position and have sympathy for speech therapists who struggle with this dilemma. Many have asked the administration for extra help and requested that more speech therapists be hired. Issues like budget pressures and job security are real factors that parents are often not aware of. I would like to propose that speech therapists also share with parents the difficulties they have. Private outside speech services can also be discussed as an option.

A parent might request an independent evaluation and under certain circumstances the cost for this will be paid for by the school district (link). The parents might also consider getting additional outside private speech therapy and discuss with the district or their insurance company the issue of compensation. The parentís other option would be to insist on their legal due process rights. This is not easy to work through. If I can be of help please contact me.

What does compliance with my childís IEP mean?

An IEP is a contract between you and your school district. For instance, if it states that your child will be receiving speech therapy two times per week individually for thirty minutes and you sign the agreement then you have every right to expect this commitment is honored. If this is not the case you have a legal right to address your concerns about compliance with the IEP. However, it is hard to keep track of all the speech sessions that may have been missed and not made up. The speech and language pathologist serves on the Multidisciplinary Team and must complete in-depth evaluations and attend many meetings about children referred. At the beginning of the year this is normally not a serious problem, but as the school term goes on, it is really hard for the speech therapist to keep up with all the demands. So it may be understandable yet unacceptable that some of your childís sessions could be missed. Reasonable parental vigilance is prudent.

Another issue that might arise is the fact that there is normally only one speech therapist available in your childís specific school to deliver the service and keep up with the IEPís. What happens when that person is unavailable due to absence, personal leave, maternity leave or chooses to take another position elsewhere? Interruption of therapy can have detrimental consequences. Unlike teachers, there is no reliable pool of substitutes for speech therapists. There are a limited number of speech therapists available. Does your school notify you when sessions are missed? One example that I can personally attest to was that a speech therapist left her position; another was hired but could not start for at least thirty days. The parents were not notified about the vacancy. Eventually, when some of them found out they complained that their children did not receive speech therapy. The response was no school certified speech therapist was available that they could locate. One parent found me. That parent was given compensatory individual sessions at home by the school district and I took over responsibility for the speech and language IEPís for the children in that special class until the replacement therapist arrived. This story had a happy ending for the children attending that particular special education program in that school. I do not know how, outside of the watchful eyes of those parents, what help was offered to the rest of her caseload? This is only one example, there are thousands of speech IEPís in the geographical area (link). I provide services in families homes. Your childís speech and language IEP is a contract that must be respected and you need to be watchful.

Special Education laws and full disclosure of limited resources

Your legal rights are so strong that school personnel are sometimes understandably reluctant to admit at times that the level of service (frequency or duration of speech/language therapy offered) is less than optimal. The critical word often used as a defense is "appropriate." Be prepared to discuss this point, it will usually come up in discussion about your childís IEP. They can not say to you that there is a waiting list.

• Ela can both advocate and mediate.
• Ela can act as a safety net for those conditions that may not be covered. With so many medical conditions related to speech problems (link), outside health insurance can be a relief to all parties. Someone who is licensed and school certified and in independent practice can be very helpful in dealing with insurance issues.
• Ela often has a new approach to share. She is creative and markets innovative language games. Someone who knows how to fire up kids and motivate them is an asset to everyone.

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Pennsylvania Speech Language Pathologist Ela Britchkow

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