I am aware that I haven’t talked about much of a professional nature here lately (unless you count the fact that I wear those cashmere sweaters to work), and I’ve wondered to myself why that is. I came to realize that my attention cycles through the major things in my life over time. When we moved here I was immediately aware of the need to get our family and home settled, but then once I started to set up my practice in Chicago I had to really throw myself into it with a lot of energy to get it up and running; I started with a full caseload the day I opened my doors, and that was very challenging. And so I think this past fall, when I took even more clients and there were far too many days that felt like the wheels might be falling off the bus – and then in the winter, when the kids were on sensory overload and Lyle was in dysregulation hell – I realized that it was time to shift the balance of my attention back to my family.
It’s not as if I’m ever not present in one place or another, it has more to do with how I choose to tip the scale. Right now it’s tipped in favor of home. And so, although I’m loving my work, working hard, seeing great progress in the kids, and continuing to do those fabulous Date Nights at the clinic, my thoughts (and, therefore, blog posts) are more firmly planted at home. I have no doubt that on some level my clients and colleagues feel the difference. I don’t return calls or emails as fast. My notes don’t always get sent around exactly on time. I forget things once in a while. Everything is getting done and done well enough, just not with the same level of precision.
However, exciting things are happening at work that I would like to share with you, and I’ll start with one of them today. You may remember that I’ve participated in two SCERTS Model trainings this year and that I am a huge fan of the program for kids on the autism spectrum. It fills an enormous void in that it’s designed to train school districts to use the SCERTS curriculum, which a) is developmentally appropriate, b) emphasizes social communication and emotional regulation as well as laying out specific strategies that parents, teachers, and therapists need to work on to support the child, c) is very family-centered, and d) encompasses the current best practices for children with ASD as described by the National Research Council. SCERTS is taking off around the U.S. as well as abroad; Great Britain in particular has been extremely open to adopting the curriculum. It is an interesting side note that ABA therapy, so popular here in the States, is far less common in England; this has probably led to a greater openness across the board for a solid developmental program since this tends to be their philosophical bent to begin with.
Given our strong belief in the SCERTS Model, my wonderful, talented colleague (who is also a certified RDI consultant and in the process of DIR certification) and I have created our own SCERTS-based therapeutic group program for the coming school year. We are going to work with 6 children, preschool aged, who are non-verbal or have emerging verbal language skills. We hand-picked the children from our current caseloads and all of those families have accepted. (In fact, we have turned away quite a few other families who have already heard about our program from parents and other therapists. While this is a hard thing for us to do, the quality of the program will drop significantly if we take more children than our staff and space allows.)
The program, called L.E.E.P. Into Communication, will run five mornings a week for 3 hours per day. My colleague will be there all five days and I will work three days as I do now. We will also have two paid assistants (who already work at the clinic) and 2-3 interns (mine will be an SLP grad student from Northwestern). This will give us as close to a 1:1 ratio every day as we can get. The kids will have SCERTS assessments completed by the time we start their group in the fall and each will have very detailed, highly individualized therapeutic goals that will be chosen in conjunction with their parents and based on the assessments (which will be naturalistic observations, not formal testing). We are asking parents to commit to spending a morning with us at least once every 6 weeks and we will hold meetings with parents as often. We will contract with a DIR faculty member (clinical psychologist) and an excellent OT to come in and consult with us about our program on an on-going basis throughout the year, and we will offer movement classes with a children’s theater specialist each week. Whew!
It is really exciting to give this group of children an opportunity to have such a fun, appropriate, individualized program that also allows them the chance to begin to form bonds and socialize with peers. This particular group does not generally have the chance to do so in other settings and it’s such an important part of their development.
Because I know that many of you are going to ask, I will explain how this will be set up financially. We are independent practitioners, creating our dream program. We have cut back on our typical rates in order to bring the tuition down, but it is still very costly due to all of our expenses, including the additional paid staff members and consultants. Our clients pay out of pocket and some of that is reimbursed by insurance; the hours when I will be there next year can be submitted to insurance by the families under speech therapy. By no means are all of our families extremely wealthy; many of them, like many of you out there, are simply doing what they know their children need no matter the cost and are under great financial strain. We have been very open with the families about wanting to brainstorm ways to cut the costs further, and there may be a fund-raiser to defray some of it, but the families have committed to attending either way.
With our local school district services in bad shape due to poor funding and inadequate training, and the deplorable state of insurance coverage for families in our country, there are no easy answers. Our best bet as therapists is to create the best program we can imagine and make it work for the kids who need it. We are thrilled that everyone has signed on so quickly and are looking forward to the adventures that await us next year. I’ll keep you posted.