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Drawing the Line

August 30, 2012

While perusing the news stories that appeared in my Facebook news feed the other day, I came across this interesting story that really made me think about some of the issues SLP’s face in their daily practice.

The news article featured the success story of 3 year old Flannery, a child who developed a speech and language delay that placed her in the severe range. After attending programming at Elmwood School in Edmonton, Alberta, her diagnosis was adjusted to mild-moderate, because of how much progress she made. If the story ended here, we would probably consider it to be a happy ending, and an example of how children’s speech and language can be drastically improved with early intervention.

However, the policy of the system comes into play as well. The Edmonton Public School board has a program in place to provide transportation for children in the program, but only for those with a diagnosis of a severe speech/language delay. For Flannery, a child whose parents both work full time and who lives too far from the school to walk, the transportation to and from the program was one of the key elements of her success, one that she is no longer eligible for given her improvement and new diagnosis.

The two sides of this issue are obvious. On the one hand, there are families that need all the help they can get in managing and treating their children’s speech and language delays regardless of diagnosis. On the other, there is the government or school board that is trying to spread out a limited resource, (money and professionals) to a large population that needs it. As the representative from the EPSB points out in the linked video, there are many mild/moderate children who are in the same boat and who must find their own transportation to and from the program. Where is the line drawn? Who should get funding and who can go without? How can we objectively determine who is best served by getting money and support for service and who can manage without? Is a blanket diagnosis the best way of deciding, when we know how varied individuals can be in the types of issues they have, or is it a standardized, fair practice?

Funding is one aspect of this field that I did not even consider as I began to pursue a career as a Speech Language Pathologist. Qualifying clients for funding, whether it be by diagnosis for Program Unit Funding (PUF) or for transportation or some other financial alleviation, will be an important part of my future advocacy for my clients, one that I’m sure will come with its own controversy and red tape.

So what do you think? What do you think is the best way to deal with situations such as Flannery’s, where improvement in speech and language results in a reduction of support and funding, even when it is still required? How should governing bodies such as the Edmonton Public School Board decide who gets funding and who doesn’t? What is the fairest way to spread the limited resources of our field? Leave a comment below!

-Adele Courchesne

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