Speech Therapy Help for 3-Year Old

Updated on July 11, 2010
K.B. asks from Oswego, IL
9 answers

Hi moms, I need your help! My 3 year-old son (turned 3 at the end of April) needs speech theraphy for his expressive language.

I had him tested by our school district for preschool intervention (because I was worried that this was an issue.) It was determined that he is behind his peers in expressive language. So, they had an IEP meeting (Individualized Education Plan) wrote up his goals, and determined that he would need an hour of speech therapy per week. The problem is that either my husband or I need to bring him to speech - both of us are teachers in the school district, and it is impossible for us to bring him to speech during their hours which are the exact same as our work hours. I do not have family in the area that can bring him to the hour session each day nor can my day-care bring him. They do have transportation, however that is reserved for students that are at-risk.

Feeling very frustrated with my school district (because they were suggesting that perphaps I can take a longer lunch hour to bring him? Working in a school they should know that is totally absurd to suggest) I took him to a private place and had him evaluated where I could bring him after school/weekend. They agreed with the school district, that he is behind in expressive language and needs an hour of speech. The problem now is the insurance company. Blue Cross/Blue Shield is looking at it as a developmental delay (although it was not coded this way) and refuses to cover any therapy needed.*Please note - that yes, the private speech clinic sent this over to BC/BS and the claim was still denied - despite coding that they though would be covered.

So...Help! What do I do? Have any of you been in the same situation? What have you done?

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M.R.

answers from Columbus on

You are caught in the bubble that many are. It is a shame, but there is a stark reality here. He needs the therapy, and you must get it for him. If you have to pay for it, then pay for it, if you have to pay for transportation so that he gets to the school, then that is what you have to do. He needs the therapy, and I would suggest that you do both private and public because while it may cost you now, he will pay so much more dearly later if you don't find a way. If you suspsect more than a langauge delay as he ages, make sure that you always hold the evaluation that contains his diagnosis, and that you not depend on the district to give you a plan for you child. You should never know less than any school district about what your child needs.

Your school district is misguided on the transportaion issue, the only reasons that they would be required to provide transportation is if they provided transportation for this service to nondisabled children too (not possible) or if they determined in an IEP meeting that the service was necessary for the child to recieve FAPE-something an IEP team can always do, but they cannot reserve any service for a specific category (at risk) and must determine each child's elegibility for any one service individually. Chances are slim that an IEP team would offer it though, even if you can prove that they are full of it, because the district has set a moratorium (they so much as told you so) so they have probably calcualted this being one violation that they can get away with or they would not be doing it quite so openly.

You can join with the rest of us who lobby for insurance to cover these things, but that will not help your son, though it might help someone eles' son. Insurance will only cover what they have to, and if this is what your school bartered for, I would be aking your HR person why a school district has opted for insurance covereage that denys speech therapy. that seems kind of like a pharmacitical company selecting a plan without drug benefits. You can also appeal an insurance denial, but don't delay the therapy while you do.

It is terribly unfair, but time is wasting, and you son has none to waste. I wish I had better news to share with you. Find a way. Move daycare closer, one of you take them, one of you pick him up. Pay someone to drive him, but get the therapy.

Start learning about advocacy at www.wrightlsaw.com. You are in a sticky situation by being employed by the school district, so tread lightly and be sure to follow the suggestions for staying on good terms with them.

Above all (it stinks) but get him the therapy even though you assumed that it would be free or covered by insurance, that is an unfortunate reality for many parents. Take it from those of us who wasted time stomping our feet when we realize that developmental issues are difficult finacially, you have to get past it and realize that the moeny is well spent today.

M.

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B.J.

answers from Kansas City on

We also got denied through BCBS for our 3 year old sons speech therapy, and we went through our local children's hospital. Through the hospital they have a grant program for those who qualify, and I believe it was if you make under $95,000. And if you don't qualify for that they still have some assistance for you. I'm not sure if you have a children's hospital nearby, or if they would be able to see you any different hours or not, but maybe something to look into? Good luck!

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C.G.

answers from Davenport on

If he is 3, does he qualify for the head-start or the early education program though the school. We also live in IL and we were told that he could not receive speech from the therapy center once he turned 3, because then the school district took over. Once he turned 3, he went to the preschool program through the public school and was provided transportation to and from daycare. I assumed all public schools in IL offered this?

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M.F.

answers from Sioux Falls on

Call your local Masonic Lodge. Speech Therapy is their philanthropy. You will get top quality speech pathologists for your son, and they will do everything in their power to help you get him to his sessions. They will be thrilled to help you!

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B.A.

answers from Chicago on

See if a family member, friend, driving Grandma from church could help drive. This way he is in the districts program. If he should need other help, he is already there and getting familiar with the people. Or cut home expenses and do a job share so that your son can get the help he needs. I have never had success with my child to get my health insurance to pay for most of her therapies.

,

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B.F.

answers from Atlanta on

Yes, same in the sense my hours of work same as the school etc. I also didn't have family were I live so I asked at the school i worked out of babysitter info referrals...I got them had a very nice young college girl drive my son to his speech therapy wait and drive him back. Her and I came up with a fair figure it was twice a week and it worked for us that year. The next year we came up with another idea you can only work with what you have then be creative.
I think they also have folks in your area and I know Doctors and nurses that use this service you want to check out sittercity.com it might be helpful in your situation finding someone to drive the little guy and wait on him etc.
Best wishes

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D.B.

answers from Charlotte on

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M.T.

answers from Cincinnati on

My son was in speech therapy for 2 years. He is 5 now, and speaks perfectly. With that being said, our insurance, blue cross as well would not cover any of it either bec of diagnosis. We sent him, still to private speech therapy. It was $160 an hour 2 hours a week for the first year, then went down to 1 hour a week. We are just normal, every day people, my husband is an engineer, and I'm a SAHM, but we came up with the money. I sold things like furniture on Craigs list, and maxed out my credit card, which we are now, almost payed off, Thank God. Do not let the money stop you. It was a lot, and got us into debt, but yopu can always pay it off in the future, but early intervention is key for them with theses issues. You will not getr this time back.

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J.F.

answers from Philadelphia on

Did you get a evaluation through a private speech therapist? If not try that they will write the correct coding. Your insurance company should have speech therapist they cover so that shouldn't be a problem.

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