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Downsides to evals?


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DD is a lovely kid, but very uneven developmentally.  The pediatrician wants her to have evals for speech/PT/OT services based on some gross motor delays, mumbling speech, and sensory concerns.  She suggested going through both the insurance company and the school system.


Are there downsides to getting the evals at the school?  Do I have to accept the services offered if I think they are a bad fit for us?  Does that open us up to potential neglect/CPS issues?


DD is 4 if that matters. 


Thanks so much in advance!


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This is just a total aside, but once you say mumbling and sensory, I would be wondering about apraxia.  You could get an SLP who does PROMPT to evaluate that, and you would find them through the PROMPT Institute website.  It will be an SLP with additional training in apraxia.  But that's just a total aside.  Obviously I don't know your situation.


Going through the ps allows them to create an IEP, qualifying her for services and getting anything the IEP gets you in your state.  Do you plan to homeschool or put her in the school?  If you plan to put her in the school, then having an IEP process started now merely means it will be in place for next school year.  It takes 120 days (when everything goes smoothly!), so if you start now it won't be signed and done till spring or the end of the school year anyway.  But imagine if she were in school, needing those services, and didn't have it.  That would be a wreck.  So that can be a good reason to start now.  


Another reason is to qualify for disability services.  Some states have scholarships or other funds for kids with certain tiers of disabilities.  We paid out of pocket, using our HSA, for my ds' therapy for years and years, at the tune of, well let's just say it was thousands.  Now that he has an IEP the state disability scholarship covers him.  We're going back to get his IEP changed to say autism so that he can move to that tier.  At that point we'll finally have enough funding to cover the amount of speech therapy he needs.  My ds has been getting 2 hours weekly, which for PROMPT is pretty aggressive, and his original tier of funding ($10K) wasn't enough to cover it for a full year plus OT.  The real cost of that is significantly higher.  If your insurance is paying for this, you may find you run into barriers or get less than ideal coverage.  I don't know, we used our HSA.  I'm just saying look at your policy to see what they cover.  Some are really generous, especially once you tip over to an ASD diagnosis, and some are going to have limits.  With what you're describing, you're probably looking at quite a bit of therapy and long-term therapy, which might be why your ped is suggesting you use ALL your resources.


As far as what the ps will put in the IEP, it varies honestly.  At our school, it was laughable.  Very small amounts per week and with someone who is not trained in the technique appropriate for my ds' diagnosis (verbal apraxia).  Same for all of his other IEP services.  It's only by taking the disability scholarship, which in our state means giving up your FAPE, that I'm able to get him the amount of services he needs.  


Your doc is giving you right advice to pursue evals.  You'd rather have that information now than later.  As far as how that goes down refusing services, at *our* ps locally you'd be fine.  The principal was very upfront and said I could end it at ANY point, no strings attached.  Legally you have that right to refuse.  I think I've heard wind of things going other ways.  I don't think you're saying you're going to be in the position of doing NO services.  You're merely saying you might just do it privately and not fiddle with taking the ps services.  That can be FINE!  I know people who do that.  Their dc are enrolled, and they just do their therapies privately.  That's fine and not going to bug the ps AT ALL.  In fact, they'll be relieved, mercy, because it's one less thing they have to pay for!

Edited by OhElizabeth
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In my state it is always fine to decline services. You can also ask for reduced services, if it turns out to seem like too much.


Sometimes people make different choices once they have the information, it is not a big deal.


But this is the kind of thing where you might ask locally or look for information specific to your state.


In my state, there are not concerns like this.


Edit: I have heard concerns wrt weight gain and it has been with the medical establishment (a doctor, a nurse, etc). It is not the same situation with early intervention stuff where I live ----- really not the same situation at all. This is much more optional in every way.

Edited by Lecka
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Thanks all for the encouragement.  Some things are moving very fast already.  The school will send us the assessment plan by Jan 1st, and have the assessments/IEP meeting all done by the end of Feb.  


The private PT eval went well.  DD loved the therapist, and the therapist had some great ideas to work with her.  Interestingly, it seems like almost all of her issues are related to the sensory piece.  She mumbles a bit because she can't feel her tongue move normally.  She struggles with balance and coordination because she doesn't seem to get the same sensory feedback others might feel.  

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