Brain Matters

Does your child have an IEP, but is still failing?

Many parents attend IEP meetings every year only to see their child not reach their full potential, often the perspective of the parent is different than that of the personnel of the district issuing the IEP.   Despite best efforts often underlying issues haven't therapeutically been treated appropriately.  The key difference between a special educator and a pathologist is habilitation/rehabilitation.  Pathologists treat language areas that are "disordered" based on diagnostics and it requires a doctor's script for treatment.  

A Speech Language Pathologists...

Fundamental training lies in treating the underlying disorder; however it is also our training that sets us apart.  As a seasoned pathologist, treatment often varies, is highly individualized, and typically evidence based.  For treatment plans,  generally we look at the receptive, expressive, and pragmatic language scores, but many stop here.  Having had clinical experience steeped in brain trauma and neurological disorders my training exposed me to different treatment considerations.   So, before I prioritize disordered language I look at other cognitive aspects. 

Cognitive Functions 

I need to know basic cognitive functions, working memory (visual, spatial, auditory), processing speed, and executive function for starters.  Are there co-morbid conditions that need consideration like CAPD, or ADHD inattentive, or difficulty reading? All the therapy in the world will do no good if the deficits here remain untreated. So we look at all aspects of function and implement a plan.  I have had colleagues in the school setting tell me "executive function" isn't really our domain, or since we don't directly test working memory we do not need to consider it in our treatment, in which case I refer back to ASHA and our scope of practice.  Where does speech and language stand on your IEP? https://www.asha.org/policy/SP2016-00343/      

Umbrella Approach

Each individual we treat begins with a plan.  Information and reports are reviewed and other disciplines are considered for diagnostics on a case by case basis.  We look at the individual as a whole and look to see where the breakdown of information is occurring?  Is it in recall and storing of information,  or an auditory processing signal breakdown, is there a visual or phonological processing breakdown?   Review the IEP.  Does the IEP contain a goal similar to this one "student will recall 4-6 words/numbers" This is a typical IEP goal,  but it does not treat the underlying disorder.  Many years will be wasted  in special ed or speech with a goal like this. However; if we change the goal and base it on the underlying deficit "student will categorize/associate vocabulary words" (teach encoding skills, categorization skills, chaining, linking, association skills) then we will be building memory skills through the application of a  more organized filing system called "the brain", allowing for faster more efficient recall preventing "information overload" and freeing up working memory for higher order critical thinking tasks instead of retrieval tasks.  But what if  working memory hasn't been a consideration? How will these cognitive functions be addressed? They wont unless the underlying deficits are addressed in combination with the speech and language deficits.  Show me a student who can't recall things and Ill show you a struggling student who, 1)uses flash cards at an attempt to store information and 2) a student with weak categorization/association skills with poor recall.  Student's need strategies and skills and more importantly they need to learn how their brain learns.     

Treatment Plans

Start with a 12 week plan with individualized stair stepping goals to build to academic confidence  and success.  Time frames may vary, but growth, skill set, and confidence gained in using strategies geared to one's specific learning needs are more productive and lead to a greater successful academic outcome overall. Ready to make a change, consults are free, call now to get started.