Wednesday, August 7, 2013

Dear Neurodevelopmental Pediatrician: Please Don’t Do That!

I have been supervising and teaching at the university level for over 10 years and I keep in touch with many of my students.  I enjoy hearing about their successes and I welcome their clinical questions.  I couldn't be more proud of Tatyana Elleseff, a former student of mine from the New York University Graduate Program (Speech Language Pathology).  Tatyana was a dedicated, inquisitive and insightful student; her success comes as no surprise to me.  Please see below one of her recent Blog entries about a topic near and dear to my heart.  Thank you, Tatyana!

Recently I got yet another one of the dreaded phone calls which went a little something like this:
Parent: Hi, I am looking for a speech therapist for my son, who uses PROMPT to treat Childhood Apraxia of Speech (CAS). Are you PROMPT certified?
Me: I am PROMPT trained and I do treat motor speech disorders but perhaps you can first tell me a little bit about your child? What is his age? What type of speech difficulties does he have? Who diagnosed him and recommended the treatment.
Parent: He is turning 3. He was diagnosed by a neurodevelopmental pediatrician a few weeks ago. She recommended speech therapy 4 times a week for 30 minutes sessions, using PROMPT.
Me: And what did the speech therapy evaluation reveal?
Parent: We did not do a speech therapy evaluation yet.
Sadly I get these type of phone calls at least once a month. Frantic parents of toddlers aged 18 months to 3+ years of age call to inquire regarding the availability of PROMPT therapy based exclusively on the diagnosis of the neurodevelopmental pediatrician. In all cases I am told that the neurodevelopmental pediatrician specified speech language diagnosis, method of treatment, and therapy frequency, ALBEIT in a complete absence of a comprehensive speech language evaluation and/or past speech language therapy treatments.
The conversation that follows is often an uncomfortable one. I listen to the parental description of the child’s presenting symptoms and explain to the parents that a comprehensive speech language assessment by a certified speech language pathologist is needed prior to initiation of any therapy services. I also explain to the parents that depending on the child’s age and the assessment findings CAS may or may not be substantiated since there are a number of speech sound disorders which may have symptoms similar to CAS

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