Ava's eligibility evaluation was Thursday morning. The family was up and my husband took care of feeding and dressing the children while I sneaked in a shower. I was about to pull on my usual jeans and a t-shirt when this article popped into my head. Essentially it says that women are judged to be more competent when wearing makeup. I realized that I wanted to be seen as a professional SLP today in addition to simply Ava's mother. So, I dug out my dusty professional clothes from the closet and slapped on a little makeup. I also made sure that Ava was dressed nicely and I fixed her hair. First impressions can be important.
We left early and got there in plenty of time. We were at least 20 minutes early for our appointment. That gave me time to take Ava to the bathroom before we got started. (And yet she asked to be taken back to the bathroom three more times during the evaluation!) They took us back into their examination room which was a room set up almost like a preschool classroom. It had a small child-sized table and chairs and shelves of toys. It had a kitchen play area, block play area, doll play area, etc. It also had an adult-sized table and chairs set up along one wall and a large closet with an open door with another child-sized table in it.
Ava and I were allowed to play by ourselves in the room for at least 10 minutes before the first examiner (case manager) came in. She integrated herself into our play for about 10 minutes before another examiner (the child psychologist) came in. At that point, the case manager and I went over to the adult table to do a case history while the child psychologist played with Ava. The SLP came in shortly after that and joined Ava's play while I did a behavioral evaluation with the child psychologist. During that time, the SLP took Ava into the closet to do a formal speech test. At that point, the evaluation team left the room to score their tests and presumably discuss eligibility while I played with Ava some more.
During that time I spoke briefly with an OT, but most of Ava's sensory issues have responded very well to our First Steps therapy and it is no longer a significant area of concern although we will continue to monitor the situation.
The team was super efficient. All of this had taken only about an hour and a half. The team was good at what they did. They were respectful, and listened carefully to everything I had to say. They asked good questions. They were great with Ava and I felt like they got an accurate idea of her current level of performance. I thought their setup and organization was excellent and a wonderful way of conducting a comprehensive evaluation. Ava and I were never separated so they did not need to deal with anxiety issues, and yet they managed to get what they needed from both of us.
Although I was impressed with the team's competence, interest, concern, and friendliness and felt like they had gotten a comprehensive and accurate assessment of Ava and a comprehensive interview with me, I was not optimistic when they left to score and discuss. I honestly felt like Ava had done too well. The SLP commented in amazement multiple times during the session that Ava's sentences were at least 5-7 words in length. The team members didn't have much trouble understanding her because everything they were discussing with her was in context and the only formal speech test they gave her was at the single-word level.
I wished I had emphasized more that Ava's intelligibility tanks when we don't have context. I wished I had remembered to mention how I struggle to understand her when we're in the car and I can't see her face and have no idea what she's talking about. I wished I had mentioned how much we had worked for all the progress she had made so far. It isn't like she just magically improved over the year since she qualified for early intervention. She worked hard to improve. I worked hard to help her. She worked with a lot of therapists. There is no reason to expect her to continue to make progress if therapy suddenly stops on her third birthday (not that I would let that happen.)
After perhaps a 15 or 20 minute wait, the team came back into the room. They didn't make me wait. They told me right away that they did decide to qualify her. I appreciated that. Not only that she qualified after all, but that they told me right away. Then we discussed the results of the evaluation. She no longer has any other areas of concerns besides speech. It is difficult to qualify a young child on speech alone. They made that determination on "professional judgement". Apparently during the interview I had mentioned that I had concerns about her intelligibility and that she experienced frustration when she was unable to communicate. I think the obvious discrepancy between her high pre-academic and receptive and expressive language skills and her delayed speech was helpful too. So, she qualified for services as a "Young Child with a Developmental Delay."
I don't have the official evaluation report yet, but I did manage to see the results of her articulation assessment. 15th percentile. I suppose that's better than the 7th percentile we got 7 months ago it was still disappointing. Even with all the progress she has made, her speech intelligibility at the single word level is still worse that 85% of children her age. And that's at the single word level. It would be even worse in connected speech.
I spent months, MONTHS worrying about this one day. I was so anxious about this evaluation. I built it up in my mind to be a huge deal. Ultimately it was a couple of hours of something Ava thought was pretty fun. And in the end, the evaluation went well.
And because my daughter comes by her contrary nature honestly, I now have somewhat mixed feelings about her qualifying. Do I really want her to be officially labeled? Would we perhaps have been better off just treating her here at home and avoiding the label? I don't think so. The help is valuable. I can only make the best decisions possible at any given time with the information currently available.
IEP (date to be determined) will be held within 30 days. Guess I need to start thinking about what I want, and how best to advocate for it.