CHILDRENS HEALTH

Speech Therapy

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Speech therapy (logopedie) is extremely common in the Netherlands . Speech therapists here deal with the whole gamut of speech-related issues: language, speech, breathing, the voice itself, eating, swallowing and hearing. Most speech therapists view their role as preventative - they want to nip speech problems in the bud. With the growth of the multi-cultural society (and the Dutch angst about said multi-cultural society), speech therapy has become even more popular to make sure all those immigrants learn to make Dutch sounds correctly! Though, to be fair, large numbers of Dutch children are sent to speech therapy every year, as well. Chances are, if your child is bi(tri)lingual and goes to a Dutch school, she'll certainly be given some extra attention and may even be referred to speech therapy, even if all seems to be going OK.

In fact, speech therapists start visiting peuterspeelzalen and observing and testing all children at the tender age of two or so. The idea being, of course, that dealing with speech issues earlier is always better. Certainly, by the time your child is in her first years of school, she'll be tested. Roughly around the age of five or so, she'll be observed in a class situation as well as having a brief one-on-one meeting with a visiting speech therapist. If there seem to be any problems, you'll probably get a letter sent home from an organization called " Onderwijs Advies " asking you to call. When you call, you'll be told that there were these or those issues and that they'll work on them in the upcoming year or so. You might get some exercises sent home for your child to practise. If you have a Dutch partner, it's often better that s/he practice with your child! Generally, the school and the visiting speech therapists seem to take a fairly "wait and see" approach and work mostly through speech therapy at school during Groups 1 and 2 (under six). If, by the beginning-to-middle of Group 3, the problems haven't resolved themselves, you'll get another letter home telling you to call a speech therapist and set up appointments.

You shouldn't get too bothered or upset if this happens. It is very normal and, in this one area, the Dutch system tends to err on the side of caution. That probably explains the long waiting lists for a spot at any Leiden area speech therapist. Should your child get referred by the school (via Onderwijs Advies ) for speech therapy, you'll need to follow these steps:

1. Call your huisarts and get a referral for speech therapy. You most likely won't even have to go in and see him. You can explain the situation and, because it's so normal here, the huisarts will probably just allow you to pick up a referral. Speech therapy is always covered by insurance, though you may need to check if your speech therapist works directly with your insurer (meaning he'll charge the insurer directly and you won't ever see a bill) or if you'll need to pay the speech therapist and file a claim for reimbursement with your insurance company.
   
2. Start calling area speech therapists as soon as possible! There are long waiting lists for Leiden-area speech therapists, so you'll need to call as many as possible as soon as possible to get a spot. I called all (literally) speech therapists in Leiden , Oegestgeest, and Leiderdorp and there were waiting lists for every single one of them. Luckily, I got my son a spot within a month or so, coincidentally at the therapist closest to us. I promptly forgot to call all the other therapists with whom I'd put my son on the list and was still getting calls six months later from chipper receptionists announcing happily that my son finally had a spot in their practice! The moral of the story: there is a shortage of therapists so you'll probably have to wait a while before therapy actually begins.
   
3. Bring all paperwork with you to the first appointment. Bring all those sheets you've got from Onderwijs Advies and/or the teachers at school, plus the referral from the huisarts .
   
4. Be patient with the speech therapists. They probably don't mean to sound as condescending and condemning as they come across. I admit that I can get very annoyed with the pervasive culture of "aren't foreigners a bit of a pain" and I tended to bristle at comments about how my son's speech issues (he had trouble making the rolling "r" sound) were my fault because I speak English with him at home. See Alice 's brilliant section on "Dutch Etiquette" as well as the section above about ignorance regarding bilinguality if you need help navigating the smile-and-change-the-subject technique.

Preventative side