Spinoff: Speech Therapy... What About Oral Health?

Scrabble123

Thu, Dec 18 2014, 12:17 pm

This topic has two parts.

1. How many of your took your children for an orthodontic evaluation around ages 6-8 with an orthodontist?

2. On another thread where early intervention therapy was discussed, a posted mentioned that some areas such as NY are "trigger-happy." I brought up that people may be trigger happy because they want free services, and others because many issues must be handled immediately. It got me thinking about the ages that many people take their children for orthodontic evaluations.

I understand that for some people braces and functional appliances before braces may be a major financial burden, and I understand why these people push it off, but what about those with Medicaid? Do they take their children to functional orthodontists at the recommended ages? I'm not discussing actual braces for 6 year olds (although some children do need two sets of braces: my brother had two sets of braces). I'm talking about measuring your child's jaw and having it adjusted naturally into the healthiest shape possible at an early age. If someone has free dental care why would they push off that appointment for a later age? Is it that your dentists do not advise it? Is it that it's difficult to get an apt.? Or is it that you do go for the consultations? I really have no idea if people take their children to orthodontists or not because I don't ask such person questions. I'm just curious if what amother called trigger happy applies to areas besides for therapy. Orthodontic health is important for overall health: for sleeping, for oral health, for chewing, for tmj, etc., and it is recommended that children see an Orthodontist at least once by age 8.

amother

Thu, Dec 18 2014, 12:34 pm

I'm the one who used the phrase "trigger happy". I started to explain over there, but will explain more fully here. First of all, it's not about free therapy because it's not just the parents, it's the evaluators- you know, the ones who are going to be the ones who tell the state they have to pay for yet another case. So it's not about getting stuff for free, because even the people who have more of an incentive to NOT say "therapy" will often err on the side of giving it. They are trigger happy in the sense that they tend to approve iffy cases that may well resolve with time. I don't blame them because when presented with a borderline case, we can't really predict ahead of time if someone is just a late-bloomer or has an issue requiring intervention to correct it.
The parents are not looking for a free ride either. They are anxious about their child's development. Again, talking specifically about borderline cases (as opposed to when it's obvious), it's very hard to figure out what to do when it seems like everyone else's kid is doing X, and yours isn't, but they're kind of close to it and maybe it's just personality or maybe they're just a late bloomer, because everyone is different and not everyone adheres to the textbook rules. So sometimes, it turns out the parents are getting worked up over a late-bloomer, but sometimes it's justified. So yes, trigger happy with jumping into therapy. But again, when it's a close call, it's hard to know ahead of time what seems so clear in retrospect.

Scrabble123

Thu, Dec 18 2014, 12:38 pm

amother wrote:

I guess that part of my premise involved a lot of people looking for a free ride, but I have to realize that there are always individuals who will "use and abuse" a system and that they are not representative of a whole. I saw your explanation on the other thread. It was very clear, and I appreciate it. Thanks. Also, are children constantly evaluated to see if they have met and/or exceeded their goals?

21young

Thu, Dec 18 2014, 1:00 pm

Scrabble123 wrote:

I agree and disagree with amother. For children who need therapy from a young age, EI is a lifesaver. My own child had therapy starting at just a few months due to a physical disability, and it made all the difference. While there are many borderline cases where the patents just aren't sure, there are also many parents who are happy to receive free babysitting. I know this because my mother is a therapist in NY and she often has to turn down cases after a few sessions, when she sees that this is going on. The evaluators are not paying for the services, they are told to stay within a limit, but at then end of the day it's not skin off their backs if the mother really pushes for therapy.
Children are usually evaluated every 3 months by the therapists and every 6 months-year by evaluators to see if they are reaching goals. However, for therapists who want to keep the caseload of 'easy' cases it's easy to know what to write that will ensure that the child stays in therapy. Sorry, I'm just stating my experience, if anyone has a more positive spin I'd love to hear.

amother

Thu, Dec 18 2014, 1:25 pm

21young- I don't think we really disagree, let me clarify Smile

I was specifically referring to borderline cases, because if it's not borderline, then of course the child needs therapy! But where it is borderline, you end up with a lot of unnecessary therapy. The downside is the cost to the state, as well as the way it fuels anxiety and causes more people to worry- if the Schwartz kid needed therapy for that minor issue, maybe my kid does too, kind of thinking. But ultimately, better to err on the side of caution because it's hard to know ahead of time which it's going to be and the outcomes are better if you start early.

Scrabble: do you mean screening children who are already getting services, or do you mean all children? if the former, yes, the therapist have to do alot of paperwork and clinical assessments and they regularly review whether services should continue as is, be changed (either more or less), or stop. If you mean the latter, there is no formal screening. I mean, pediatricians ask at well visits if your kid is meeting certain milestones, but unless one is glaringly behind, they'll usually take the "late-bloomer" view. More often, either parents notice something is off, or daycare workers and preschool teachers notice it, like what prompted the other thread.

amother

Thu, Dec 18 2014, 1:26 pm

I took my DC that has speech therapy since 16 months, to an orthodontist recently as per my dentists request. DC could use braces now at 9 and then again when the adult teeth come in. Actually now it would mostly be an expander for the pallet (which may improve the speech), and braces for the front teeth.

I dont have medicaid and the orthodontist told me to wait. Not just because of the money, but braces can be traumatic to a young child, and some kids refuse to get braces the second time around. I didnt push it since we are already paying for different dc's braces.

by the way, no one ever mentioned to me to get DC checked out by an ENT. My friends kids that have speech needed to go to an ENT. Anyway we realized that DC wasnt hearing well, we had tubes placed more than once. I had to be ontop of the hearing tests, I used the results to continue speech when they wanted to stop.