DEAR ÁINE

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Not speaking
Q.

My child has recently been diagnosed as having a significant learning disability. I believe her problem is that she does not talk. The service we have been recommended to attend has only one speech therapist for several hundred children. I know my 5-year-old daughter would be okay if only she could speak. Please advise me about what I should do.

A.

Unfortunately there is a severe shortage of speech and language therapists in Ireland and the situation you describe in the service to which your daughter has been referred is reflected in many services throughout the country. So whether your daughter has, as you believe, a specific language disorder, or as the people who assessed your daughter maintain, a more general learning disability, you will have difficulty accessing speech and language therapy. I feel you need to go back to those who assessed her and discuss with them in greater detail the nature of your daughter’s diagnosis and the range of services that might help her. If the diagnosis of general learning disability is correct, then your daughter will need more than speech and language therapy input.

However it might help to put your mind at rest to have your child assessed by a speech and language therapist. Your GP may be able to advise you on whether the health board can organise this. Alternatively you may have the speech and language assessment carried out privately; perhaps the Health Board may be able to arrange a grant to cover costs. If no grant is available, I understand that private speech and language therapy may be tax refundable when therapeutically justifiable.

Separation anxiety
Q.

I am a separated mum with a 3-year-old daughter who is an only child. She has visited her Dad and her paternal Granny every weekend for the past few years and has regularly stayed overnight. Within the past year she has experienced a number of losses of significant people in her life and recently I was hospitalised for two or three weeks, during which time she was looked after by her favourite aunt (my sister) in their house. My daughter and I are now back in our own home and I am well on the road to recovery. Since we came home she is very reluctant to visit her Granny and her Dad in their home. I do not want to force the issue, but I do not want her to lose contact with either her Father or her Granny. What should I do?

A.

From your letter it is clear that you and your daughter have had a lot of uncertainties and losses of loved ones in the recent past. While we adults can often rationalise loss, it must be impossible for a young child to understand why people die and go away. She is possibly feeling very insecure since your hospitalisation in spite of being so well looked after. Even going to familiar places without you could cause worry for the little girl. Remember it is only a fortnight since you both came home together. She may need time with just you to feel secure again. So, for a few weeks forget about visiting and just let you both settle and enjoy each other’s company. To build up contact again with her Granny, perhaps your mother-in-law could be encouraged to phone your little girl once or twice a week. Then after a few weeks perhaps her Granny could visit in your house. There does not appear to be any way to keep her Dad in the picture at the moment, but after a number of weeks, when she appears more settled, you might take her to visit her Granny and leave her with Granny and her Dad while you go to the shops. In other words, have very brief initial partings from you, so that she will get used to you going away and returning.

Bungalow blitz
Q.

I work in a service that provides residential care to people with intellectual disabilities. When I got the job I was told the centre would be closing down shortly and all the clients would be moving to the community. However fairly recently a new manager was appointed and he has told us that he hopes to build a group of twelve bungalows on the same grounds. He says it does not matter where people with disabilities live as long as they are comfortable and that the houses look nice. I disagree. Am I right?

A.

Yes, you are right. There is a substantial body of knowledge showing that people with intellectual disabilities enjoy an enhanced quality of life in community, as distinct from institutional settings. A quick search of the literature will give you detailed information with which to argue the case with your manager. By the way, it appears to me that management misled you when you took up the post-

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