While you’ve prepared for the cost of nappies, childcare and school fees, you might not have considered the costs involved in the diagnosis and treatment of remedial or learning difficulties.
We spoke with a number of experts who share not only the cost of treatment but the importance of getting the right kind of help.
What was it like discovering your child had a learning difficulty? What are the additional costs to your budget? Share your story with us, and we could publish your letter. If you'd like to remain anonymous, let us know.
ADHD assessment and medication
ADHD is a label given to many children, but often without the proper diagnosis – which incidentally requires parents to invest a fair amount of time and money.
"ADHD is a neurological disorder that affects executive functioning such as attention and working memory," says Cape Town-based educational psychologist Abigail Simpson.
"There are different forms of ADHD and therefore the presentation is not always the same in all children. You have those that are more inattentive (often described as 'daydreamers'); the hyperactive type, which is often easier to pick up on; and then there is the impulsive type – these children are not able to manage their reactions both verbally and physically."
If your child displays behaviour associated with ADHD, Simpson recommends having them assessed by an educational psychologist – and the earlier the intervention, the better.
"When children are unable to function and learn in the classroom environment due to their lack of attention, they can begin to feel inadequate. Sometimes their behaviour, if undiagnosed, leads to them being labelled the 'naughty child' or the 'rule breaker', which can be damaging," she says.
Aside from the emotional impact of not getting the right diagnosis and treatment, ADHD often goes hand in hand with one or more learning difficulties. While an OT or a speech therapist may be called in to manage certain behaviours and areas of learning that the child finds difficult, they can’t make the overall diagnosis.
"An occupational therapist or speech therapist often works on management of behaviours that are a result of ADHD, but there are many disorders that share symptoms of ADHD – such as auditory processing disorder, sensory processing disorder, autism and oppositional defiance disorder – and an educational psychologist is best placed to make the diagnosis," says Simpson.
But expert help can come with a hefty price tag. In fact, you can expect to pay between R4 500 and R6 500 for an assessment. Fortunately, some medical aids do cover a portion of the costs so always check before booking the appointment.
"It may seem like a lot of money but an assessment is a very detailed process – in my private practice, for instance, I dedicate up to five hours to one client for an assessment and the post-assessment report can take anything between 3 to 5 hours to compile," says Simpson.
If your child is diagnosed with ADHD, medication may be prescribed, which will add to your monthly expenses.
According to Health-e News, Ritalin can cost anywhere between R367 for 10mg, and R942 for 40mg of long-acting Ritalin, which is the dose generally prescribed for teens and adults. Concerta is an alternative medication but more expensive, ranging from R858 for 18mg to R1 066 for 54mg.
Dealing with dyslexia
Another learning difficulty that can cause children to fall behind in school and result in low self-confidence is dyslexia.
"The important thing to note is that you cannot diagnose dyslexia unless your child has been in formal schooling (Grade 1 and 2) and their reading level is significantly weaker than expected for their IQ score," says Simpson.
Dyslexia screening assessments look at language delays, word recall, naming speed, letter and sound identification, and phonetic skills. These are scored and a child is rated as 'at risk' or 'low risk'. "It’s not a straightforward process and that’s why seeing the correct practitioner who knows their stuff is advised," says Simpson.
A remedial therapist can do an initial screening but an educational psychologist is best equipped to make a formal diagnosis.
If your child does, in fact, have dyslexia, there are different ways of helping them and your course of action will depend on the severity of their dyslexia.
Sessions with a remedial teacher can be very helpful and will cost between R200 to R400 a session depending on the area you live in. Alternatively, you can download helpful reading apps and do extra phonetics homework with your child.
Also see: Does your child need therapy?
When it comes to speech, it’s not always easy to detect a delay, particularly in very small children.
"When your child is between 1 and 3 years old, it is difficult to judge whether they have difficulties or are simply developing differently to the children around them," says speech therapist Rachel Singleton from Small Talks Speech Therapy Centre in Joburg.
"A good rule of thumb is that by the age of 3, most people should understand what they are saying and they, in turn, should be able to understand what the people around them are saying."
She adds that there are a number of red flags parents can look out for.
"Toddlers who are delayed in speaking and who seem frustrated when they are trying to talk, or who have poor eye-contact or struggle to follow simple directions, may need speech therapy.
Children who struggle to interact and play appropriately with friends and siblings or take a long time to begin and complete tasks may also need some assistance," says Singleton.
If you decide to take your child for an assessment, the speech therapist will first gather information from the parents and teacher before conducting a series of tests to evaluate all areas of speech and language development.
"Both formal (standardised) tests and informal tests may be used during an assessment," says Singleton. "When the practitioner is using an informal test, they may seem to be chatting or playing with the child, but they are gathering speech and language samples and seeing how the child processes information, follows directions and attends to tasks. The formal tests usually involve the child pointing to pictures or explaining what is happening in pictures presented to them."
Sessions can vary in length, depending on the child’s ability to concentrate. They usually range between 30 to 45 minutes and most children attend one or two sessions a week, but in severe cases or when participating in particular programs, sessions may occur more frequently.
"You can never be certain how many sessions a child is going to need before they can be discharged from therapy. Each child is different and they all develop at different rates, some children get plenty of support at home and others do not. These are all factors to consider when developing a treatment plan," says Singleton.
The cost of sessions depends on the practitioner but many charge medical aid rates and you can expect to pay anywhere between R275 for 20 minutes and R325 for 45-minute sessions.
What was it like discovering your child had a learning difficulty? Share your story with us, and we could publish your letter. If you'd like to remain anonymous, let us know.