Dear D.K.,

You are correct to be concerned about your son’s self-esteem, and it is reasonable to expect that his clinician will set goals that you can both agree upon. Your first option might be to meet with one or both speech/language pathologists, share your concerns very clearly, listen to their rationales, and try to reach an accord about his treatment.

Four-year-old children who are not enrolled in school are still entitled to speech and language services through the local public school. Typically they have to meet certain severity criteria to get help. This might be another option for you.

If all else fails, you will need to check out the services available elsewhere. Seek out a clinician who can work with you to minimize the number of trips you will need to make. For example, it might be appropriate to stay in the city for a few days initially to get an intensive start. Perhaps the clinician can teach you how to follow through with treatment activities at home, a preferred practice of many clinicians. You might get telephone support and encouragement between visits.

Best Wishes,
Ruth Alice Jurey, M.S.
Speech/Language Pathologist