Our PROMPT eval

[myboyluvsdinos]

After hearing about some other's great experience with PROMPT therapists, I located one in my area and had my 12-year-old ds evaluated last week. A few of you may remember that he has disjointed speech, with low working memory and processing speed, hypotonia, coordination issues, etc. etc. He was also diagnosed with apraxia at age 2.

 

Anyhow, while I don't have the report, she said that she didn't think any of his past apraxia is at play in his speech difficulties. He seemed to do well on many of the tests she performed, but most of those involved single word utterances. But when she administered tests that involved longer replies, I could start to see the difficulties. Not too bad, but still noticeable by me (not sure what he scored on that test, yet).

 

But then she had him tell her about a TV show that he recently watched. I thought he did a decent job, for him. When he finished, she informed him that he is stuttering! She went on and on, lecturing him about this and telling him that he can't let it hold him back, and that he's got to push himself to join the speech team, yadayadayada. He was totally shocked and was just trying to hold himself together, without crying. I finally told him to go to the waiting room, and she and I talked. No one in our entire extended family has ever heard what we would call a stutter, although if you go by a SLP's definition, I guess his pauses and halting speech qualify. It was a bad situation because he was so upset to get this news, and I knew it would make him totally anxious in social situations and not want to speak, so I tried to convince him he really doesn't stutter, and that the therapist was off-base (I do sort of believe this). I was able to smooth it over (I had to lie and tell him that after he left, I had her listen to my speech, and she said I also stutter, which he knew was ridiculous.)

 

In the end, I still think his word-retrieval issues are the problem, along with his low working memory. The two together cause him to pause and speak slowly with less automaticity. I asked her about just some simple exercises to help with word retrieval, and she said to name items in categories for 5-10 min. a day. So we are doing that, and this summer I plan to get some of the recommended workbooks for improving working memory and go through as much as we can.

 

Just wanted to report back on how it panned out for us.

 

Carolyn

[peacefully]

.

[myboyluvsdinos]

:( Oh Carolyn, I am so sorry. What was that therapist thinking?!?? I'm sitting at my computer feeling quite angry about the whole thing for you and your son.

 

Just so you know (since we were comparing notes about our sons in previous threads), my ds also had a "stutter" that is not at all really a stutter. I don't think anyone who heard him speak would really describe it as a stutter, but the dysfluencies in his speech patterns were noticeable to me and my dh and a few others. Our SLP had specific term for his speech pattern, but darn it, I can't remember the word she used. Anyway, that speech pattern—"stutter," dysfluency, whatever you want to call it—is almost entirely gone now. It only reappears when he is highly stressed or tired, and even then, it's probably discernible only to me because I'm a little hyper about it.

 

Did you see the recent post about word retrieval on this board? I wrote about a few resources there. The naming within a category does help with word retrieval, but the underlying strategy has to do with creating multiple associations with words—visual, symbolic, categorical, even etymological, whatever works with your particular kid. Mine seems to have an affinity for words (as contradictory as that sounds, since he has a language disorder and word retrieval issues :rolleyes:). He likes to talk about words, figure out the syllabication, learn about their origins, play with rhymes and meter, think about antonyms, etc. All of that helps build associations with specific words. For content area vocabulary (geographical names, for example, are particularly tough), we use lots and lots of visuals and play games. These are strategies that work with my particular kid's learning style. I'm sure the specifics will be different with your son, but I just wanted to suggest that there are many, many strategies that help to develop word retrieval.

 

Anyway, I just wanted to post and offer support. :grouphug:

 

Thanks for the support -- it means a lot! I'm going to send you a private email sometime in the next day or so. Hope that's okay. :)

[Tokyomarie]

I'm really sorry to hear you had a bad experience. I'm not really sure why some providers feel a need to break any sort of "bad" news regarding an adolescent or pre-adolescent directly to the child or with the child in the room- especially with that sort of delivery! We had a bad experience with a different kind of provider who started to talk about a particular diagnosis with my then-16yo in the room. It was a conversation that should have been conducted with parents first, who would have a chance to ask questions, clarify anything that might have caused the provider to misinterpret what they were observing, and then find out how the information would be presented to the teen.

[peacefully]

.

[Adhopsg]

I am sorry you had such a horrible experience with the PROMPT therapist. Unfortunately, you are not alone. My first encounter with a PROMPT therapist didn’t go well either. However, with encouragement from OhElizabeth and 4evercanucks, I decided to give it another short. This time, I searched the PROMPT website for a certified PROMPT therapist. I found a PROMPT instructor who evaluated my two sons. She diagnosed my 7yr old with word-recall issues . He has difficulty retelling past incidents, be it books he has read, shows he has seen on TV or incidents at his school. She also had me record him at home for her to watch him in his normal setting before giving me a final diagnosis. She didn’t diagnose him with stuttering even though my son sounds disjointed at times. She only had an opening for one patient so we decided to have her see the youngest one, who will be 4 in two months.

 

We started seeing this lady at the end of February and in six weeks of weekly one-hour sessions, my son has started showing significant improvement in his speech. She diagnosed him with a loose jaw and some poor motor control. This makes it difficult to understand him. I haven’t cancelled his regular speech therapy at the local elementary school and didn’t inform them that we have started PROMPT. At our recent IEP, the school SLP remarked that my son has shown sudden significant improvement in the last month.

 

My humble suggestion is to visit the PROMPT institute website and search for a PROMPT instructor or a Certified PROMPT therapist for a second eval. I will stay away from anyone who is not certified or is not an instructor. You may have to drive quite a distance for such a therapist. Mine is about 1.5hrs drive each way. OhElizabeth had to drive even further than I am. When you find the right PROMPT therapist, the distance won’t be an issue. The good ones are also very willing to help you find a program to work at home even if they will not be able to see your child. This is what the lady did for my 7year old.

 

Best of luck to you and your son!

[PeterPan]

My lands that's horrible. What level of training did this SLP have in PROMPT? Just asking, because seriously I think a lot of people take the level 1 training for continuing education credits, not because they have any plans of implementing it or learning the full method or being effective practitioners of it. If they WERE planning to be effective practitioners of it, they would HAVE to take the level 2, transition, and certification courses and work, because they DON'T know the full method after just the level 1 course.

 

What happened to you was appalling and rude, and I feel horrible about it. It had nothing to do with *PROMPT* though. This lady is just missing a few social cue clues. I mean mercy, you don't talk to a 12 yo that way.

 

It may be that you would be like Adhopsg and keep calling and find a real gem a bit farther. It's still a good lead. You're still in the vein of people who are specializing in apraxia and the things that go with it. If this was a level 1 person and you move up to someone who is certified or an instructor, you're going to have a totally different experience. I know ours would NEVER have treated a dc like that.

 

Keep looking. There's going to be some help. But I'll say this again. Our therapist talked with me for an hour on the phone, on her dime, before we ever went in. I would find the closest certified or better level and just call and talk with them. Tell them you got burnt once, what you think is going on, and ask if they're the right person or whether they have someone else who would be better. Our therapist is SO busy, she doesn't take anybody who doesn't need help. Seriously. Like I went back in with my ds and she said she can't see him again till May, that he's doing ok with the work we're doing at home and she's just booked. You don't want somebody you can get into fast. ;)

 

I hope you find the right path. The bummer is you really don't *know* exactly at this point whether it's remnants of his apraxia or what. It could be, and with what you're describing it would be a question I ask. But go up the chain to somebody better. And frankly, I'd write the people at PROMPT and tell them what a horrible experience you had. They need to know so they can remove the lady or follow up on it. That's APPALLING.

Edited April 4, 2012 by OhElizabeth

[Guest]

I am sorry you had such a horrible experience with the PROMPT therapist. Unfortunately, you are not alone. My first encounter with a PROMPT therapist didn’t go well either. However, with encouragement from OhElizabeth and 4evercanucks, I decided to give it another short. This time, I searched the PROMPT website for a certified PROMPT therapist. I found a PROMPT instructor who evaluated my two sons. She diagnosed my 7yr old with word-recall issues . He has difficulty retelling past incidents, be it books he has read, shows he has seen on TV or incidents at his school. She also had me record him at home for her to watch him in his normal setting before giving me a final diagnosis. She didn’t diagnose him with stuttering even though my son sounds disjointed at times. She only had an opening for one patient so we decided to have her see the youngest one, who will be 4 in two months.

 

We started seeing this lady at the end of February and in six weeks of weekly one-hour sessions, my son has started showing significant improvement in his speech. She diagnosed him with a loose jaw and some poor motor control. This makes it difficult to understand him. I haven’t cancelled his regular speech therapy at the local elementary school and didn’t inform them that we have started PROMPT. At our recent IEP, the school SLP remarked that my son has shown sudden significant improvement in the last month.

 

My humble suggestion is to visit the PROMPT institute website and search for a PROMPT instructor or a Certified PROMPT therapist for a second eval. I will stay away from anyone who is not certified or is not an instructor. You may have to drive quite a distance for such a therapist. Mine is about 1.5hrs drive each way. OhElizabeth had to drive even further than I am. When you find the right PROMPT therapist, the distance won’t be an issue. The good ones are also very willing to help you find a program to work at home even if they will not be able to see your child. This is what the lady did for my 7year old.

 

Best of luck to you and your son!

 

I have no experience to share. I just wanted to say hi to my buddy :seeya:. My only contribution to all this, was to have her get in touch with OhElizabeth, since she does not usually post on here. It's good to see her here, however brief her presence may be :)!

[Guest]

After hearing about some other's great experience with PROMPT therapists, I located one in my area and had my 12-year-old ds evaluated last week. A few of you may remember that he has disjointed speech, with low working memory and processing speed, hypotonia, coordination issues, etc. etc. He was also diagnosed with apraxia at age 2.

 

Anyhow, while I don't have the report, she said that she didn't think any of his past apraxia is at play in his speech difficulties. He seemed to do well on many of the tests she performed, but most of those involved single word utterances. But when she administered tests that involved longer replies, I could start to see the difficulties. Not too bad, but still noticeable by me (not sure what he scored on that test, yet).

 

But then she had him tell her about a TV show that he recently watched. I thought he did a decent job, for him. When he finished, she informed him that he is stuttering! She went on and on, lecturing him about this and telling him that he can't let it hold him back, and that he's got to push himself to join the speech team, yadayadayada. He was totally shocked and was just trying to hold himself together, without crying. I finally told him to go to the waiting room, and she and I talked. No one in our entire extended family has ever heard what we would call a stutter, although if you go by a SLP's definition, I guess his pauses and halting speech qualify. It was a bad situation because he was so upset to get this news, and I knew it would make him totally anxious in social situations and not want to speak, so I tried to convince him he really doesn't stutter, and that the therapist was off-base (I do sort of believe this). I was able to smooth it over (I had to lie and tell him that after he left, I had her listen to my speech, and she said I also stutter, which he knew was ridiculous.)

 

In the end, I still think his word-retrieval issues are the problem, along with his low working memory. The two together cause him to pause and speak slowly with less automaticity. I asked her about just some simple exercises to help with word retrieval, and she said to name items in categories for 5-10 min. a day. So we are doing that, and this summer I plan to get some of the recommended workbooks for improving working memory and go through as much as we can.

 

Just wanted to report back on how it panned out for us.

 

Carolyn

 

I have no experience but gosh, this sounds so unprofessional to me :glare:! I am so sorry for what you went through. Especially for your son. That must have definitely hurt his self-confidence :(! I hope you find the best solution for your boy, regardless of where it comes from!

[myboyluvsdinos]

Thanks for all the support, ladies.

 

I SWEAR the first time I looked at the PROMPT website, it said she was certified. But today, when I checked again, the maps are slightly different, and it says she has only completed the bridging.

 

She does work for a respectable children's rehab hospital, so I took that as a good sign -- guess I was wrong.

 

The certified therapists are too far away from us -- like 12 hours, and two states away. So that's not an option.

 

I did ask her via email to consider not including the stuttering diagnosis in his report, as I'm afraid it will come up again in the future. He's having testing for CAPD beginning on Friday, and I don't want the audiologist to comment on it (same hospital). She said she would note that the family does not see signs of stuttering and she will talk to the audiologist before hand, so they don't comment.

 

He seems to be over it, and it hasn't come up, so I'm hoping it's behind us.

 

Thanks again!

Carolyn

[PeterPan]

Well that's certainly interesting. It's just bizarre that her take would be so radically different from anything else you've had and not jive with what you see. Hope you get it sorted out. Maybe the audiologist will be helpful.