Yesterday, we got the "official" letter from our insurance company stating that Sean's speech therapy would not be covered. I kind of expected this, but it was still upsetting. Although we are not out of options yet, it means we have a $747.00 bill to Carle Clinic that is now our sole responsibility. Yippee. But that's the bad news... it could be SO much worse.
The GOOD news is today we met with the State to see if Sean would qualify for services for the Early Intervention Program (birth - age 3). We met with the case worker assigned to us last week, but still had to have Sean evaluated by a Developmental Specialist and a Speech Therapist. In order for him to qualify, he needs to be at least 30% below in one of the areas.
They spent about an hour with Sean doing basically what we had done at Carle, but a little more in depth. They were wonderful! The Speech Therapist did say that based on the ST report at Carle from November, she can tell he's already made improvements. She mentioned that since he's been a little behind in other motor skills (crawling, walking, etc.), it doesn't surprise her to see that he is a little behind in his talking - since it too is a motor skill (fine motor). I had never thought of it that way. She right away asked about his heavy breathing (tonsils - again, another reassuring moment that we are doing the right thing by getting them removed). At the end, she said she is confident that 90% of his speech delay is due to the enlarged tonsils, so once they are out, we should notice a BIG difference. She also said that by age 3, we will probably never know that there was a speech delay.
So, the good news. He does qualify... sort of. He did not qualify from the Developmental Specialist's side (GOOD)! And technically, it's a stretch for him to qualify from the ST side, but they are going to allow it! Like at Carle, the therapist today said from a comprehension side, he's at about 30 months, and from the expressive side, he's at about 18-21 months (an improvement in two months from Carle who had him at 15-18 months). 18 months puts him at the 30% below mark, but technically since it's 18-21, he's over. However, the ST said she can make it work! She actually gave us the option of whether or not we wanted to do it - she thought that he would probably catch up shortly after the surgery. Jamie and I, however, decided we would like to try it for a little bit. So come March (after the surgery and recovery time), we'll try it for six months and then re-evaluate. The nice thing is they will come to his daycare for the sessions! WOO-HOO!!!
The interesting thing that she mentioned is that most of his words that sound a little off (ie, boo/moo is doo or goo) is that most of the words he struggles with are words that require him to close his mouth (m's, b's, etc.). She said most likely this is because with his mouth open just a little even, he's getting air. Since closing his mouth restricts even more oxygen (and remember, he doesn't have much moving through because of his tonsils), he says them in a way he doesn't have to close his mouth. This is why he doesn't say MOMMY!!!!! She also said that we have a very loving, sweet little boy who is right on track, that we should have no worries, and he's further along than we think.
We are grateful and relieved to have this part over with. Now, we look onward to the 13th. We'll take it one day at a time from there.
13 years ago