how do I deal with a painfully slow talker?

A reader writes:

I have a situation which I think I would know how to handle as a manager but no idea how to handle as a client.

My son has developmental delays that qualify him for certain therapies. After months of searching, we have finally found a therapy provider that fits our needs. This facility’s owner (there’s no one above her) and head therapist, Jane, is clearly competent, knowledgeable, and friendly. She also gets along very well with our son. However, Jane is an EXTREMELY slow talker. By that, I mean she has trouble gathering her thoughts, takes long pauses between words, and constantly uses fillers (um, ah, y’know, etc.). A sentence which might take you or me five seconds to say will take her 30 seconds. This had made meetings with her interminable (for the record, I have no idea if this is a medical issue).

I generally get the gist of what Jane is trying to say after a few seconds but don’t want to interrupt her because (1) I think that’s rude and (2) what if I don’t really know what she’s trying to say? We’ll eventually have another therapist working with our son along with Jane but, for now, we expect to primarily be working with Jane for the foreseeable future.

We are still in the assessment phase for our son, so our recent meetings with Jane involve a lot of questionnaires to make sure our son is getting the right treatment. The last questionnaire Jane pulled out was about two pages long and should’ve taken 30 minutes max to complete thoroughly. It took us a full hour just to get through the first page. We had to schedule another meeting to complete the second page, which also took a full hour. Jane works a typical 9-5 so my husband and I must take time off or use our lunch hours for these meetings. So far, we have had six of these meetings (which should’ve just been two or three) and there are more to come. At this point, I expect we will just barely scrape by the assessment deadline (or else we’ll have to start this whole process over again).

Jane also needs to work closely with our son’s preschool (who are amazing!) since that’s where he’ll receive most of his therapy. Jane has had a couple meetings with our son’s teachers, which they told me took much longer than they expected.

I am prepared to forge ahead with Jane because (1) her facility really is perfectly in line with what we want for our son, (2) she is a good therapist, and (3) the thought of having to spend months finding and completing this process with a new (probably less fitting) facility fills me with dread, mostly because we’d be wasting valuable time my son could really use in therapy.

If I were Jane’s manager, I would probably address this issue with “radical candor,” but as I am her client, I’m not sure how to approach it. Her sessions with my son are fine because they’re play-based, not dialogue-based. But there will also be continuous check-ins with both my husband and me, and our son’s preschool. I don’t want to frustrate his teachers whenever they must interact with Jane (which will be often) or spend my foreseeable lunch breaks waiting for Jane to finish her sentence. What do I say to her, if anything? Is it better to just grit my teeth and bear it?

Can you address the amount of time your meetings with Jane are taking without getting into the reasons why they’re taking so long? By that I mean, when scheduling meetings, could you say to her, “I will have a hard stop at 3:30 that day — can we get it all done in half an hour?”

Or, if you think she’ll just suggest rescheduling for a day when you’ll have more time, you could address it more broadly: “Our meetings are taking a lot more time than I’d anticipated. We of course want to get you what you need, but we’re having to schedule extra, unanticipated meetings because we’re running so long. Is there a way to streamline the meetings to make it more possible for us to juggle them with our jobs and other commitments?” Maybe you could add, “If we’re able to answer some of this over email, that might help a lot.”

Try approaching it as collaborative problem-solving — with a tone of “we want to make sure you have what you need, but we’re already stretched thin and it’s butting up against time claimed by our jobs and caring for other family members / can we find a way for our son to work with you that doesn’t endanger our own jobs?”

The danger, of course, is that no matter how you couch it, Jane could tell you this is just the way it needs to be. But I’d argue that’s ultimately a good thing in that it will provide sharper clarity about exactly what working with Jane will look like (and what flexibility is/isn’t available). If that happens, you’d know for sure that this is part of the package of working with her — and then would need to decide whether you’d rather choose Jane with all the endlessly long meetings over switching to someone else with all that that could entail.

{ 212 comments… read them below }

  1. Festively Dressed Earl*

    Is it possible for someone else at Jane’s facility to handle the meetings and paperwork for both you and the preschool? You can’t be the only one of Jane’s clients experiencing this issue, and someone under Jane may be more efficient in meetings.

    1. Momma Bear*

      This. If she’s a part of a group, then I would talk to her/them about the length of time with meetings and data gathering and see if there’s someone else who can streamline this for you. Jane may be perfectly competent and even a great therapist, but if she’s not a good fit, then she’s not a good fit. The other concern is that the preschool may push back if this persists and they may not be able to give the company all the data. Just like OP is missing work, so too are the preschool teachers/staff missing class time. I’d ask if someone else can step in for this onboarding or you can do any of it via paper instead of interview.

    2. CowWhisperer*

      My concern is the amount of insurance units that this is burning up.

      I get 30 PT/OT/SLP visits per year on a good private insurance plan. The assumption is that I need 1-2 visits for evaluation and the rest is treatment. My son’s Medicaid plan covers around 48 visits per year. Six visits is 20% of my yearly benefits or 12% of my son’s benefits without any treatment being given to the client!
      Similarly, if Jane is working with a public school system, the district is being billed an unreasonable amount of time rather than Jane finding a better set of accommodations.

      I have cerebral palsy, my twin is Deaf and my kid has CP, too. I use accomodations frequently and spend lots of time advocating for creative accomodations in public and private spaces.

      I’m horrified right now because this is a hot mess. I wish Jane can find a way to accomodate her verbal fluency issues that doesn’t cut into client care.

      1. Master of None*

        As a pediatric therapies clinic manager, this struck me too. OP is paying for a service that is billed in timed units. Every 8-24 minutes she is spending with OP and son results in a charge. Time management and efficiency is a major component of a good therapy session. Ask to move to a therapist that can complete the visits in under an hour and communicate with a parent for assessment in under 15 min (max & no more often than every other week) after that first visit.

    3. Princess Sparklepony*

      As I read the letter, Jane is the only therapist and the owner of the business as well. It’s just her. But they may be hiring another therapist later.

      But I’m wondering if the paperwork – this last one was a questionnaire – could be done at home and emailed to Jane and then if Jane needed clarification on any points, they could have a meeting about that.

  2. Properlike*

    If there are other therapists at this facility whom you also have contact with, I suggest greasing the wheels with them by privately commenting on how fortunate they are to work with someone so clearly skilled and insightful as Jane.

    Then next time, or even as part of that same conversation: “we notice she so aka very thoughtfully and really makes an effort to communicate clearly. Any advice for when that might start to change as she gets to know us/our son?” I guarantee they do now about it, and may have some good suggestions or just reinforce It’s An Issue. You can add, “We don’t want to make her feel bad or insulted by bringing it up.”

    In that vein, I think Radical Candor also has a place here, since you clearly think the world of her and it’s simply this one element that’s problematic. Bring it up, say you’re embarrassed and fully realize it’s YOUR issue, but it’s also a work issue. I suspect she’ll try to be more mindful, or may have her own strategies.

    You’re all going to have a very intimate relationship moving forward that should be full of candor. Thank goodness you already like and trust this person! (I was an Early Intervention mom for years.) Good luck!

    1. amanda*

      It’s interesting how your comment advocates “radical candor,” but you also suggest that OP should insulate the issue in layers of compliments, pretend to be embarrassed, and pretend that Jane’s issue is actually OP’s fault. None of that is what I would consider candor!

      Candor would be, “Jane, you speak so slowly it’s making it difficult for us to get through the paperwork in a reasonable time. Can you either speak faster or give us the questionnaire to complete in writing?”

      1. Sloanicota*

        See, I think asking Jane to speak faster is a non-starter; she probably speaks at the speed to speaks. But is there a way to ask for less verbal content? They need to try and shift to another form of communication (probably written) where the verbal is just the parts that are unclear after review, or something.

        1. SoloKid*

          You’d be surprised, there are so many things about speech that can be changed through conscious effort.

          Filler words (“Umms and ahhs”) are one of the most common reasons people go to public speaking coaches, as well as for accent and uptalk reduction.

          All this hinges of course on if Jane wants to put in the effort, and I do think it’s on OP to bring up the “this does take longer than it should” evidence.

          1. Kella*

            The likelihood that Jane has gotten this far in her life speaking so slowly that it dramatically impacts the length of time it takes her to do tasks, and she’s unaware that she’s speaking slowly or completely unaware of potential tools to reduce the impact, is extremely low. It could very well be a medical or cognitive issue in which case, how much effort she’s putting in is absolutely irrelevant.

            If Jane were writing in for advice about her slow speech, speaking coaches could be suggested as an option to explore. But we don’t know that Jane *hasn’t* already been to speaking coaches and exhausted all options to speed up her speech.

          2. Higgs Bison*

            As a slow talker, myself, telling me to speak without umms would probably make me replace them with equally long pauses (or longer due to self-consciousness). Telling me to streamline things may work if you give me prep time, as I can create a script or flowchart (with enough detail and practice to keep me from lever having to search for a word), but as soon as the conversation deviates from my prep I’ll probably be back to slow.

            Some of us are slow talkers and can only speed up situationally.

          3. Spero*

            I want to push back on the idea that all it takes is if she wants to put in effort. Jane has chosen a career working with people who have developmental disabilities – many staff choose this work due to personal experiences, and MANY of those involve delays in speech and cognition. If Jane has a stutter, Broca’s Aphasia, or dozens of other conditions that affect speech then how she is CURRENTLY speaking could be the result of years of effort to overcome her own disability. The assumption that she can easily change this is reliant on the assumption that she started with developmentally normal speech abilities which frankly we have no basis to assume. Using filler speech is common when you are struggling to get words out of your mouth at all, and pauses to collect thoughts and formulate the mouth correctly to reduce stuttering is also a recommended intervention.

          4. MigraineMonth*

            @SoloKid – There are some things public speaking coaches can help with, and some they cannot. Replacing filler words with *silence* is one thing; speeding up the cognition involved with speaking is very different. Based on what the OP has said, (“she has trouble gathering her thoughts, takes long pauses between words, and constantly uses fillers”), I think the latter is the issue.

          1. Shandra*

            OT, on the flip side political satirist Mark Russell mentioned the fact that during WWII, Julia Child worked for the Office of Strategic Services which was the forerunner of the CIA.

            “She probably served only the right wings of the chickens.” :-)

    2. metadata minion*

      If someone commented on how knowledgeably and carefully a colleague spoke and asked if that might change in the future, I would be really confused and want to reassure them that her performance wouldn’t start to get rushed or sloppy at any point.

      1. Armchair Analyst*

        Yeah, if I went this route, I think I would assume it was something that other people had mentioned before. “I’m sure you know that Jane is very smart and very careful and also speaks very slowly – do you know if she continues to speak slowly as the parent-therapist relationship progresses and we have to budget more time for these meetings, or is this something where the more we speak together, the faster we can get through the paperwork?” I don’t know that this is the right way, but I would be willing to stick my foot in my mouth and ask.

  3. ShroomShroomRagu*

    Offer to provide written it nice recorded answers to questionnaires going forward. And ask if updates can be by email with meetings just for follow up questions. You can use Alison’s except about being pressed for time, and offer these as possible solutions.

    1. Curious*

      Also, if LW can get copies prior to the appointment that would be helpful.

      It may be possible to fill them out or just knowing exactly what’s on the agenda can make things move faster.

      Finally, as a person who’s face speaks even when I’m not, you have my sympathies.

      1. Dust Bunny*

        Oh my goodness–this! See if you can get the paperwork ahead of time and have her help you refine it rather than starting from scratch each time.

        I have a hard time following things auditorily under the best of circumstances (processing, not hearing) and I’m honestly not sure I could follow this well enough to work with her. I’m sure she’s great, but definitely look for compromises in communication method.

    2. Ellis Bell*

      They aren’t just pressed for time, it’s actually a situation were OP says they “expect (to) just barely scrape by the assessment deadline”. I actually think OP is being optimistic there, and need to consider what they will do if they don’t! That’s not okay, and nor is taking up so much of the teachers’ time. I definitely agree that OP should encourage more written communication “to make sure we move quickly in between meetings and to ensure we are prepared for meetings which have to be in person”. I’m giving a lot of side-eye to someone woolgathering their thoughts in this way in a meeting about a special needs child who is facing a deadline. They should be up to date on his file and have their questions and ideas prepared.

      1. I'm Just Here For The Cats!!*

        I think you are being unkind to Jane when you say you are giving side-ey to someone “woolgathering their thoughts.” It does not sound like Jane is absentminded or aimless in her talking. I didn’t take it to mean that Jane was not prepared at all. I think that perhaps Jane herself has a speech impediment. Believe me, when you have a speech or other similar impairment you can be 100% ready but lose words. Then you struggle. To someone else this could possibly seem flighty or aimless. But we are struggling. And you cannot always have everything written down.

        1. wonderl@nd*

          We had a lady where i work who was the same – searching for words, etc. but her issue was that she was recovering from a stroke. I advise patience and perhaps a conversation to see if more of this can be completed in writing.

          1. Lucien Nova*

            One of my favourite members of the church I attend is the same way – she had a horrific stroke some years back and now it’s hard for her to get words out at all, she’s often not able to think of the word she wants, and she speaks very slowly.

            Every conversation with her is worth the effort. She’s lovely. I also advise being patient, because Jane sounds like she is also lovely and worth the effort.

            1. Kara*

              There needs to be some form of compromise in this situation, though. OP and partner are having to take extra time off of work; with all the negatives and risks that entails. They are using extra insurance units by having to schedule additional visits with Jane. And they are in real danger of missing the deadline for their child’s assessment because they are currently on course to just barely scrape by under the wire which leaves no wiggle room if anything at all comes up. Jane may be perfectly lovely, but as of right now she is just barely meeting the OP’s needs. Something needs to change.

            2. sparkle emoji*

              I understand your point and in the future, I’m sure Jane’s verbal input could be really useful to OP but currently, OP has a time crunch regarding getting all the paperwork done to get their child the care they need. Jane needs to be able to work with OP to make sure that gets done by the deadline. After that she is free to slowly work her way through therapy appointments but the deadline needs to be met first. Temporarily moving to an alternative form of communication for that purpose doesn’t mean OP is putting in less effort to communicate with Jane.

        2. Very tired*

          My husband, an extremely articulate college professor, recently suffered seizures. He is now often as slow speaking as jane. It’s enormously frustrating for him. I assure you he is not wool gathering.

          The OP is right to assume good intentions. You should too. Why go for a negative perspective when there are so many others? And really, the why is not important. It’s the what.

          This is why people with disabilities get so freakin tired when trying to just Be in the world.

          1. Rainbow*

            This is so true. I’ve a colleague who’s a slow talker: I don’t think for a medical reason, he just likes to think a lot before he speaks (and he leads a lot of meetings so it matters). I was on the edge of finding it maddening at first as I’m really impatient and like to get things done quickly, but actually he is brilliant and it is worth the time for him to finally finish that sentence. It’s no problem to get any written stuff drafted BEFORE meetings with Paul.

          2. MigraineMonth*

            I have a close friend who experienced a trauma that partially rewired the speech parts of her brain. It took her months to work through the resulting stutter and slow speech, and it recurs whenever she is under a lot of stress.

            OP’s concerns are real and valid, but there’s no reason to assume that Jane isn’t doing her best. I think that changing modality (switching from spoken to written communication, for example) is probably their best bet for resolving this.

      2. Ace in the Hole*

        There are many things that can cause people difficulty speaking quickly. She could have a speech impediment, poor hearing or auditory processing, language barrier, etc. Preparation may help somewhat but doesn’t make the problem go away.

        It’s still an issue if her slow speech is causing them to miss deadlines or getting in the way of effective communication. But it’s not necessarily something she can change.

      3. Kella*

        Since there’s a good chance the speed of her speech is not in her control, that is not something to give her side-eye for. However, it’s likely that Jane is aware that her speech patterns mean more time is needed to go through the process and I do think it was irresponsible for her to not account for that in making sure they could all meet the deadline.

      4. Please check those assumptions*

        Echoing the other replies here. The OP says that Jane is clearly knowledgeable and competent.

        We don’t know for sure based off of the OP’s letter why Jane might be talking like this. But keep in mind that various speech or language impediments can slow down how quickly and fluently someone talks.

        And for those those of us who live with these impediments, it is really, really uncool when people automatically assume like that that we’re “woolgathering our thoughts” or otherwise incompetent just because our words come out of our mouths in a way that’s different than normal.

        1. My Useless 2 Cents*

          Sorry, regardless of what causes Jane to speak so slowly, double the amount of time to do basic pre-screening questioning is bordering on unprofessional on Jane’s part. Jane needs to figure out what she needs to do to ensure things are done in a timely manner, whether that means streamlining the process, emailing questions before hand, having a bulleted list of questions/topics to provide at the beginning of the meeting, or having someone sit in with her on meetings to help facilitate. As good as she may be as a therapist, meetings taking double the amount of time as required will eventually effect her reputation and career. Our society is just too time centric for it to not.

      5. Ellis Bell*

        My apologies in that I should have been clearer in what I actually meant: I’m alive to the possibility that Jane has a condition and needs accommodation (if you treat it as always a possibility, no diagnosing necessary!). Many of us in the SEN field are attracted to it precisely because we have needs and want the world to be more accessible. Jane is an expert in this area. If she needs accommodations, she’s perfectly placed to prepare them to an adequate degree, like scripting out the meeting and referring the OP to pre prepared written statements, or doing some of it via email. You can’t just say I have a condition and that’s why things fall through the cracks. You have to do extra levels of preparation until the way things are done are truly functional. She doesn’t have to talk faster, she just has to prepare the meeting in such a way that it works: for her and for the OP. I do take OP’s words that this is a competent professional; they can do this and they must know the timing dictates it.

    3. Scylla*

      This seems like the best answer by far! Get as much done as possible via email and things filled out ahead of time- and it can be framed as OP needing more time/having a busy schedule instead of turning this back on Jane’s slowness to save face with her.

    4. Artemesia*

      This. The interview could be done on email style or chat style. It is obvious that there is a disability here which may not interfere with her care for the child, but is seriously making communication difficult. Try the indirect — we need to move faster/ how about dealing with this sort of thing in chat or email. But you may need to get more direct. She might welcome being able to communicate in writing — it may be easier for her too.

    5. ferrina*

      Email was definitely my first thought. Anything that can be done in email, should be. Blame your schedule or preferences you want to soften it slightly, but be clear that you can’t keep spending this time in meetings.

    6. Harper the Other One*

      Yes, I have done many MANY a survey for assessments for my kids and I have never done them in the actual office. My husband and I filled them out at home, and then we may have discussed/elaborated on answers in an appointment. This is absolutely something OP can and should ask for.

      1. Ellis Bell*

        Yeah most systems for this kind of thing are extremely pre prepared and structured. I find it kind of amazing that a person who clearly really needs this, isn’t using methods that I would consider standard.

  4. Turanga Leela*

    I would definitely see what you can do over email. Maybe you can fill out these questionnaires in writing? If you must talk through the answers, maybe she could send you the questions ahead of time, so you can think about them in advance? That way, when she goes to question one, you can interrupt as politely as you can and say, “Right, for #1, we’ve noticed that…”

    I wonder how her other clients handle this.

    The slow talking would drive me CRAZY but I also understand that finding a good therapist is hard.

  5. Luci*

    My son has speech therapy and his SLL is also a slow talker
    Honestly she probably has a verbal fluency distort herself and this is one of the methods to help smooth speech.
    Of course that would make it a protected category.
    It’s a tough balance I know

    1. AGD*

      This. We don’t know for sure and can’t diagnose, but I bet she’s ended up doing this for a living because it has helped her.

      1. Butterfly Counter*

        This was definitely my guess. As someone who would be BEYOND frustrated with these conversations, knowing this would also help me find a bit more patience.

        I think Allison and others are correct in stating that OP should try to find ways of written communication and finding ways for both parties to prep for in-person meetings to help things along would be best. OP has a genuine need for these meetings to go faster so framing this as problem-solving from both ends vs. pointing fingers at the therapist for holding things up would probably go the furthest in moving the meetings along.

    2. CheesePlease*

      This was my thinking too. Slow talking is a tool used by many for a variety of reasons in order to communicate clearly.

      But to manage it as a client, sticking with Allison’s suggestions or asking if any paperwork can be completed beforehand (over email etc) may be helpful to allow meetings to run smoother.

    3. Artemesia*

      It may be a ‘protected’ category for her employer but that does not compel the OP to work with her if it is not possible in their time frame. They need to find a work around or a new therapist.

      1. Lizard Breath*

        I think the issue is that OP has an external deadline to get this assessment done (if she’s in the US, Early Intervention services need to be in place by the time the child is 3, for example) and is fairly sure that they would not be able to find another qualified therapist and get the assessment done by the time the child ages out of eligibility. So in this case, it looks like OP has decided that they need to stick with Jane at least for the time being.

        Whether or not it’s a protected medical condition doesn’t matter here, since Jane is the owner of the practice and is certainly allowed to put as many accommodations in place for herself as her clients will tolerate.

        What’s interesting to me here is that Jane presumably does these assessments frequently and should know how long they usually take. If the initial questionnaire session ended up running long even by Jane’s standards, I wonder if Jane is used to people interrupting and moving things along, and OP’s politeness is actually drawing things out?

        1. Boof*

          The other issue is op/fam needs to take double the expected time off work etc to compensate- hopefully there is some other accommodation possible

      2. ferrina*

        This. If it were simply annoying, I’d say OP needs to chalk it up to people all being different. But this is significantly impacting OP’s ability to get their son the care that he needs. That’s a different category.

        1. Pennyworth*

          It could also be doubling the cost to OP if they have to pay for twice as many sessions with Jane.

          1. Dog momma*

            And you only have so many sessions available per calendar year by contract with the insurance company. also, what if the parents are putting their own jobs in jeopardy by taking so much time off…writeup, possibly being let go, someone may have to cover for them and then can’t get their own work done..its all a possibility

      3. sparkle emoji*

        Coming from personal experience, the availability of pediatric care in certain specialties can be grim. I grew up going to a child psychiatrist that made me uncomfortable and made really weird sexist comments because he was literally the only option. He had clients that drove cross country for appointments because his work was so specialized there weren’t many other options.

    4. Ra*

      Yes, please try to have empathy. My son has a stutter and he deals with it partly through speaking slowly and using lots of fillers. I agree with Alison’s suggestions to find other ways to make more efficient, but she may not be able to help how she speaks.

    5. Mad Mac*

      Person who stutters here. My first thought was that Jane’s way of speaking is exactly this, that it’s how she manages her disfluency.

      I used to get speech therapy from a practice that attracted a lot of SLPs with speech impediments themselves, which offered the compassion, empathy, bonding, lack of judgment and safe space that a patient needs to succeed—and, for the younger patients, proof that they are not their impediments and that the way they talk is not a life sentence.

      However, if it’s impacting things like assessment deadlines, that’s an essential part of the job that she needs to know about.

  6. Kai*

    Interesting that, while her child has need of therapy & has delays, it hasn’t occurred to her that perhaps Jane also does?
    That not everyone communicates the same way/level, & that children who need therapy become adults who has therapy & work.
    Because to me, I am autistic, & I don’t communicate the same way as NT, & often it is needing time to find the worlds because the words can escape me fast. Slower is better.
    Also, autists are constantly misunderstood so we take more time/clarity to ensure we aren’t (see this message, for example).
    My point is, Jane knows she takes time to speak her thoughts. She also knows you, OP, grit your teeth and bear it.
    Email might work, but be prepared for lengthy replies to read through.
    The same accommodations you might need for your child, the same considerations, Jane might need to. Just think of how you will want your child to be treated, when they are adults. Disabled people need to work too, after all, & Jane sounds excellent at her job.

    1. Arts Akimbo*

      “Just think of how you will want your child to be treated, when they are adults. Disabled people need to work too, after all, & Jane sounds excellent at her job.”

      This x1000000. Some of these comments are making me so sad. I hope the OP can be compassionate. I’ve seen people be impatient with my kid once he passed the age of looking like a child, and it is dismal how folks with invisible disabilities get treated when they can’t “pass.”

      1. Artemesia*

        The situation is causing real hardship for the OP having to take extra time from work so Jane needs to have a workaround to make this more efficient. They obviously don’t want to drop her — but they need some methods to make this work.

      2. CowWhisperer*

        I’m far more worried about all the adults who are treating Jane like a fragile glass vase because she has a visible disability.

        Jane’s earned a college degree, a professional degree and passed qualifying boards. She’s a highly competent adult – and competent adults can handle the reality that they are not equally efficient in all areas of her career. Having Jane focus on patient therapy instead of intake isn’t a sign of intolerance; it’s a good accomodation.

        As an adult with cerebral palsy, I can’t afford to use multiple units of my PT/OT/SLP insurance benefits for testing because the therapist can’t complete the testing in the normal one hour slot. I would have an even harder time justifying using my son’s insurance units for testing that is taking multiple hours due to a therapist’s needs.

    2. Lydia*

      OP needs to prioritize her child and her family’s needs, and she can’t do that by not addressing the issue with Jane. Especially since the OP has a legitimate fear they will miss the deadlines for getting therapy for her child because of having to schedule more meetings. None of the comments here are making fun of Jane or anything unkind, people are addressing the practicality of the situation and the need to figure out a process with Jane.

    3. Really?!*

      “Just think of how you will want your child to be treated, when they are adults” is something I’m certain LW thinks about every day, even without your input.

    4. LadyVet*

      The LW says “(for the record, I have no idea if this is a medical condition).”

      So they have thought about it. That doesn’t help speed things up, though.

      1. Sloanicota*

        Yeah, the issue to me is that *the system* is not being accommodating enough, what with limited time to fill out forms and a deadline looming; I don’t think it’s completely fair to blame OP for noticing that they’re not meeting the deadline and that meetings are taking longer than scheduled. OP needs to work with the facility and Jane to find a way to meet people’s needs; I agree she should be patient and kind with Jane but it sounds like she is doing that.

        1. Jennifer in FL*

          Exactly! Getting these kinds of services requires everyone (parents/teachers/therapists) to work together as efficiently as possible because everyone has a crucial role. There is so little wiggle room for errors or mistakes. If one area doesn’t get their part done, then nothing happens and the child suffers.

    5. Princess Trachea-Aurelia Belaroth*

      The thing is, though, that accommodations need to be reasonable. Every sympathy to Jane if she does need to speak slowly, but OP is concerned about very inflexible real world deadlines which could affect her child receiving treatment in a timely manner. If Jane is a professional in this field, she should be mindful of these deadlines, and of her clients’ time limiting access to treatment. A reasonable accommodation is not “everyone has to be inconvenienced by me as I do things in the way I find most comfortable, using the first avenue that comes to mind.” It involves taking everyone’s needs into account. If Jane knows that she needs twice as long for an in-person meeting, or twice as many meetings, she should be looking at which meetings are necessary to be in person and/or verbal, and which ones are not, in order to accommodate herself and her clients reasonably.

      OP has not said anything about thinking Jane shouldn’t have her job, or that the issue at hand is a personal annoyance with Jane’s speaking mannerisms, but that Jane’s way of doing things could possibly have serious ramifications for OP and their child, and a request for guidance on how to address this.

      Reading through lengthy emails would be a very reasonable compromise, because people can read through emails on their own time and not miss work. Phone calls instead of in-person meetings when you absolutely must speak verbally are also more flexible. Or even just a reassurance that Jane is aware of the deadlines and is prioritizing OP’s case and not just continuously scheduling more and more meetings would probably help, but some compromise would probably still be needed so OP doesn’t have to miss too much work and endanger their livelihood.

      1. Jennifer in FL*

        Yes to all of this.

        It’s also worth saying that Jane is most likely getting paid for her services by session (however long that session is supposed to last). It unreasonable to expect anyone to pay for extra sessions because it takes Jane longer to get through things.

        1. Victoria Everglot*

          If the sessions are covered by insurance, that may also affect things because insurance often will only cover a certain number of sessions. Sometimes they’ll allow for more if necessary but that would mean even more paperwork and meetings.

    6. NeedRain47*

      Alll of this… jane can just email the forms ahead of time, they start what they can w/o her help, and do the rest in person. and it wouldn’t even involve lengthy emails.

    7. Kella*

      It didn’t sound to me like OP is being dismissive of Jane’s way of communicating or think that Jane is bad for being a slow speaker (though some of the comments here have been.) The reality is, the speed of Jane’s speech means that the process is taking longer than they expected it to. I don’t know where those expectations came from, if they were wrong to think them or if someone *told* them it would take X long but didn’t account for Jane’s speech patterns.

      It is perfectly okay for OP to identify that the amount of time needed to complete this process with Jane’s assistance is more than she, her spouse, and/or her children’s teachers have available. And it’s perfectly okay for OP to identify that the current rate of progress is putting them at risk for not meeting the deadline and wanting to seek a solution for that.

      Accommodating someone’s disabilities entails not assigning a value judgment on them for needing something different. There are plenty of situations where it is appropriate for a non-employer to say, I’m sorry that accommodation isn’t compatible with my situation.

      1. Princess Trachea-Aurelia Belaroth*

        Employers can also say that. That’s why deciding on accommodations is a collaborative process to find something that is tenable for all parties.

    8. Lizard Breath*

      OP specifically addressed that this might be a medical issue for Jane, and correctly assessed that it’s really none of OP’s business–that the primary issue is how to make the assessment process work so that Jane gets all the information she needs and OP and their spouse don’t spend hours that they can’t afford to take off work filling out questionnaires that they could have done in 1/4 the time.

      Honestly, this really seems like the ideal situation for “this meeting could have been an email” and saving the time out of work for actual therapy.

    9. ferrina*

      Jane sounds excellent at her job.

      Except that….she’s not? At least, not all of her job.
      She’s excellent at parts of her job. OP says Jane is knowledgeable, friendly, and has rapport with the son. That’s fantastic!

      But Jane is also working at a speed that is untenable. OP is taking up to 4x the amount of time in meetings with Jane as she should be. That’s significant (especially if that meeting time is being billed). It’s very reasonable that OP is looking for alternatives that would work for both of them. Of course, OP shouldn’t expect Jane to communicate exactly as OP does, and it also doesn’t sound like OP is expecting that. OP is looking for something that is workable for all parties.

      1. sparkle emoji*

        Yes, part of the job is being able to get through certain tasks in the time allotted for them. It seems like the typical interview-style intake is really ill-suited to Jane’s verbal communication speed. There are a number of ways to accommodate that(have another professional handle intakes and handoff to Jane for therapy, conduct part of the intake process using written communication, etc) but the current status quo where Jane takes substantially longer than OP has time for is not workable.

    10. CowWhisperer*

      Jane sounds excellent at doing speech therapy with young clients while being unable to complete parental assessments and professional consultations in a reasonable time frame. Having to split each assessment across multiple meetings is likely a deviation from the testing procedures set when the tests were validated – and is putting excessive demands on the clients in terms of time.

      Thankfully, those two action areas can be split without endangering Jane’s career. The hospital system my son got his initial speech support through had one highly experienced SLP who did intake assessment and a bunch of therapists who did the nuts-and-bolts therapy appointments.

      Lengthy email are a very different (and usually minor) issue compared to being asked to fit multiple hour-long- plus- travel-time meetings in for an initial assessment around work schedules.

      I’d send Jane a polite email stating that I was available for one more one hour meeting to complete the assessment – and what can I do to make that happen? If we need more than that, I would loop in a director.

      Accomodations are a great thing – and there’s gotta be a way to use Jane where she’s great while working out a more effective system for intake.


      Special needs person with a special needs kid.

    11. Rob S*

      I was thinking the same thing. You know this mom hopes/wants/expects people to give her son grace for his development issues and yet she is struggling to give someone else any grace.

    12. sparkle emoji*

      To me, it seemed like OP was thinking that Jane along these lines. She writes in the first paragraph “for the record, I have no idea if this is a medical issue”, which acknowledges the possibility but seems like OP doesn’t want to speculate. Whatever the cause, OP has a hard deadline to get the assessment process done and needs Jane to work with them on a solution to meet the deadline. After that OP might be able to work with Jane’s verbal pace in therapy sessions, but again, this part of the process cannot move at the current pace.
      I’m also autistic, and if my needs are interfering with my ability to do a necessary task, then I need to find a solution, I can’t neglect it. It sounds like there are a number of possible accommodations Jane could make for herself. I hope OP and Jane can find an accommodation that serves all parties. But missing the deadline because Jane’s verbal communication is slow is not a suitable accommodation here.

  7. GreenDoor*

    This reminds me of when I needed new windows and called one place for an estimate. The first window guy came and I (stupidly) sat through an hour and a half sales presentation before I finally got an estimate! I vowed that would the be the last time that ever happened. Window guy #2 came and I said, “I do not want a sales pitch. I know I want window type A and frame type B and hardware C. Can you get me an estimate in less than a half hour? And he did. It was liberating to realize that it’s OK to steer the conversation with a service provider.

    It feels super weird to be so clipped and blunt – especially with someone you’ll likely have a long term relationship with and who will be working with your child. But you might need to do that here. “We cannot afford to keep taking two afternoons off work for each consult. What can we do to get these meetings done with in X amount of time?” Said in an upbeat and collaborative tone, it’s not rude. It’s business.

    1. Filthy Vulgar Mercenary*

      I would say there’s a fundamental difference in your situation and the letter writer’s.

      Jane is “clearly competent, knowledgeable, and friendly” but has “trouble gathering her thoughts, takes long pauses between words, and constantly uses fillers (um, ah, y’know, etc.).”

      That makes me think it’s not a sales pitch that she can just stop doing. I agree that LW should still ask if there are ways to speed up the meetings due to excessive time off work, but I would go into it with the idea that this may indeed be medical.

      1. Lydia*

        Yep. It’s not the same and I’m sure Jane will be understanding of the need for doing a lot of the information gathering via email rather than in person for all the practical reasons the OP gave.

    2. Sola Lingua Bona Lingua Mortua Est*

      If I’d done this with our HVAC vendor, he’d have quoted me the system I wanted instead of teaching me the fundamentals and designing the system we needed instead. Ended up saving us a lot of money in the long run.

      So… caveat emptor sin tempus.

      LW… take a deep breath and allocate the time that Jane needs to perform her services for you right.

      1. fed up with anecdote cited as data*

        …and if LW misses deadlines for services for her son by sitting back and allocating time?

        You miss the point entirely. This is not an HVAC situation.

        1. Sola Lingua Bona Lingua Mortua Est*

          “If all you care about is time, that’s all that will be considered, even at the expense of quality” was my point.

          We’ll have to agree to disagree on whether or not that’s relevant.

          1. Environmental Compliance*

            This is not a situation though that is simply a “this is taking longer than I *want it to*”, this is a situation where there is so much time being taken that OP/OP’s son may lose out on benefits because of the length of time of service as compared to what the system/insurance will cover. There is a real deadline for the assessment to be completed for the child to get what they need. If Jane cannot get the assessment done by that timeline, that is a problem. If Jane needs so many appointments that the insurance is questioning the amount of coverage, and/or if OP cannot feasibly take off that much work to dedicate to Jane taking twice as long as necessary, that is a problem.

            We see letters here all the time of employees not performing up to standard and taking twice as long as the work should take. The general answer to that is still not “allow them to take as long as they want” – work still has deadlines. I cannot tell the EPA that I need an additional 6 months to complete a semiannual report because I work slowly. This situation really is no different.

  8. Warrior Princess Xena*

    Not a therapist, but as someone who uses a lot of templates for client information for consistency I would recommend asking to fill out the templates before meetings anyways. Then instead of spending the meetings filling out the questionnaires (which I’m guessing inevitably includes a whole bunch of questions you don’t need help with) you can focus in on the questions that were confusing or that you had trouble nuancing on the document.

    1. NeedRain47*

      I’m wondering if these are the kinds of forms where if you don’t word them exactly a certain way, you will get turned down for needed services…. but still, OP can make a start and itd be faster to edit in person.

      1. Sloanicota*

        or they could edit asynchronously, which may also give Jane a chance to access other accommodations if necessary too (having a colleague help or using text-to-speech or any other method easier to make progress in)

        1. ferrina*

          This. I do this on a ton of my work- I get initial answers, then I go back and reword them to fit certain standards. I then cycle that new draft back for a thumbs up/thumbs down (not editing).
          It can save a lot of time, even without the issue of the speech pattern.

  9. Delta Delta*

    I’d see what you can get done by email/in writing ahead of time so there’s plenty of time for the actual therapy. It may be that Jane a) has a verbal or auditory processing issue (a friend of mine has this and is brilliant and a wonderful writer but responds and talks kind of slowly) or b) has trained herself to talk slowly so she doesn’t talk too fast. Or she does it to slow down the other person. I’m an attorney and I have a few clients who talk really fast – I talk very deliberately to them (and slower than I normally do) in an effort to slow them down.

    I’m a little more up front about things, and I might just say to Jane that we need to get through some stuff, and she talks more slowly than I do, so is there a way to do some of the paperwork (or whatever) ahead of time so that we’re not spending all our time on that piece. It’s not a criticism, it’s a request to be efficient with time and to keep things moving in order to get to the important part, which is the therapy.

  10. anony*

    Assume it’s medical and seek creative accommodations (like heavier use of written communications) that might meet everyone’s needs better. Even if you’re wrong, it’ll help you stay in a place of empathy rather than annoyance while finding a solution to the actual issues.

    1. Jojo*

      This. Assume its not really something she can change and look for the other things that can change. If the problem is conversations, see if you can push as much of it out the conversation arena as possible, like the suggestions to use email or getting questionnaires ahead of time.

      I really do feel for you though. Finding good care for you child is a long, hard process, and this must be so frustrating. Also, if it helps, keep in mind that this won’t be forever. You won’t be having these meetings when your son is 25. This is not a forever situation, hopefully, just a few years of the grind of advocating for your child.

    2. MigraineMonth*

      I don’t know if you need to assume that it’s medical to approach the situation as collaborative problem-solving. “This is what I [or the insurance company] need, can we work together to get there” works whether or not the speed of her speech is something she can control.

  11. Unkempt Flatware*

    I have a long, slow talker in my professional circle. It’s unbearable. I screen all her phone calls and try to refuse her communications for as long as possible. It creates so many problems. My irritation and feelings of being disrespected have taken over any courtesy I had toward her.

    Honestly, the only thing that has produced real results is getting pretty strict with her. When my Jane would start in on a pattern I knew would end poorly, I would interrupt. “Please don’t tell me the leading story before you ask me whatever you need to ask me. If I need the background I’ll ask for it. What is the end question you are needing an answer to?” This got a 10 minute mind numbing story to change to a 30 second question like, “Can there be co-applicants for this grant?” Then I sometimes name the issue. “I notice you ask several lead-up questions or indirect questions before you get to what you’re really asking. I need to you to ask what you need the first time without the lead up/indirect.”

    Here, I would stop her at the start and ask, “how many of these do we need to get through today?” and then keep her on track. “Okay let’s get through all of these and any editorial can be emailed”. “Oh let’s table that for now–we don’t have time for that”. “No let’s not go there. Let’s stay on target”. “Let’s move on”. “The button you’re looking for is right here. Click here.” “Let’s just dive right in. No need for openers or introductions.”

    1. The Unspeakable Queen Lisa*

      I think you’re misreading the problem because you’re thinking about your person.

      The LW did not say the therapist rambles and talks too much, but that she is slow to articulate her thoughts with lots of pauses. That will not be made better by interrupting and chivvying her, that will likely lead her to have to start over again.

      1. MigraineMonth*

        Yeah, I have a former manager who is a rambler and a friend who stutters. My approach to the former (“Sorry to interrupt, but looks like we only have a few minutes left and I want to make sure we cover X, Y, and Z”) and my approach to the latter (“Take as much time as you need, I’m listening”) are diametrically opposed.

    2. NeedRain47*

      The OP is going through a process of getting services for her son- you can’t “table that for now” any more than you can table the things they ask for when you get a passport or drivers license.

    3. WastedTooManyMinutesThinkingOfAScreenName*

      Wow, people are being really negative about other people’s comments. The OP can read the various stories and advice and decide which ones apply, depending on what the therapist is actually doing.

    4. Kella*

      That sounds like the primary issue is that they are an *unfocused* talker, rather than being slow or having a lot of pauses (though that may also be happening). The fix, as you say, is redirecting to the point and re-emphasizing the need for a direct answer. The direct answer could be given slowly, which is different from the direct answer that follows a 10 minute story not necessary for the conversation. Slow to get to the point vs. slow to get out the words are two separate issues that could overlap but it sounds like they don’t for OP.

    5. CommanderBanana*

      I have a relative like this. She is a lovely person but I am not exaggerating when I say that interacting with her makes me want to chew off my own arm to get away.

    6. Armchair Analyst*

      this is different from the OP but I can relate in that at b-school I learned about business communications and how it differs from other communications

      for example, key takeaways up front. an executed doesn’t have time to sit and listen to the hypothetical methods experiment findings in detail. imagine that a person in a 30 minute meeting has to leave after the first 10 minutes. will they have the information they need? if there are details, put it in the back.

      and same with questions. ask the question, provide background if needed. Imagine the people you’re talking to don’t have time.

      perhaps your Jane could benefit from a formal business communications class

  12. A Frayed Knot*

    As you schedule meetings, ask how long the meeting should last. Are you assuming that meetings last one hour (or however long) or is she scheduling them that way? Can you set aside an entire day to complete Everything That Needs To Be Done to meet the deadline? It would be an awfully long day, but may be worth it.

  13. WastedTooManyMinutesThinkingOfAScreenName*

    I don’t think this will get better no matter what you say to her. What you’re describing is really far outside the range of normal, and if she could fix it she would have.

    It may feel rude, but I would start breaking in when you figure out what she’s trying to say. This is actually a normal conversational maneuver. If said with the right tone of voice, it conveys “oh, I get what you’re saying, it’s [this], right?”

    She probably is used to this, and may even be relieved.

    1. Owler*

      I disagree. This is not a situation where she is floundering and wants a rescue. If she wanted to be cut off, she would set that expectation.

      1. Heather*

        I’m with Owler on this. It can be so difficult to pause and listen when someone who has, for example, a serious stutter take a long time to get a sentence out. But most of us understand that as a matter of respect, we should allow them to complete their thoughts. I put Jane in the same category. For whatever reason, her speech is way outside the range of normal. You’ll have to adjust and work with it.

        1. WastedTooManyMinutesThinkingOfAScreenName*

          I think you and I got really different pictures of what’s going on from the OP’s description. Which is fair. OP can decide what applies.

      2. WastedTooManyMinutesThinkingOfAScreenName*

        “she has trouble gathering her thoughts, takes long pauses between words, and constantly uses fillers”

        Sounds to me like floundering. And “cutting off” is the wrong term for the conversational phenomenon I’m talking about.

        I could be wrong, but the OP may be being more reticent than neccessary about chiming in.

        1. Lydia*

          It’s also methods used to help people who have stutters or other language processing disabilities. Jumping in to cut them off is not something you can do all the time because it is rude. It might be a once in awhile thing, but it’s not something the OP should rely on.

    2. I'm Just Here For The Cats!!*

      Please DO NOT DO THIS!! As someone who has a speech problem and flounders for the words when when someone interrupts me it does not help. Not only is it agrevating, but I lose my train of thought and flounder more, especially if the other person’s guess is incorrect.

      1. Sloanicota*

        I agree that this might help someone who just perambulates in their conversation (“talks out loud”) but not someone with a speech problem. Do you agree with the commenters suggesting that written communication may be faster/easier? Or any other suggestions OP might be able to suggest that would help everybody get their needs met?

        1. I'm Just Here For The Cats!!*

          Oh yes, I would recommend if at all possible that the OP try and do as much of the paperwork and such before the appointment. I think it really depends because I could see if it is an assessment that much of that would have to be done in person by Jane.

      2. Very tired*

        Yes. My husband can express very complex thoughts if you wait. But he has trouble with word-finding.

  14. llama*

    My greatest concern is making sure your child doesn’t pick up this habit. Regardless of the reason, it needs to be addressed for the sake of getting anything done. Email, setting time limits, reducing frequency of meetings.

    1. I'm Just Here For The Cats!!*

      As others above have mentioned, this slow speech is often used by people with speech problems.

    2. xylocopa*

      “Picking up this habit” is an unnecessary concern. OP says that the therapist is competent and offers the service they need–it’s hardly going to make issues for their child to have a slow talker as one of the many adults in their life.

      1. Armchair Analyst*

        right. it’s not like it’s the coworker who just picks up a British accent. for that coworker I’d be worried it’s contagious

        /joke targeting the coworker with the fake accent, not the OP’s son

  15. Jennifer in FL*

    From a preschool teacher POV, I’d bring up the hard deadline with Jane. As someone who often does the initial, time-based assessments I’d be livid if I had to do them over again because the therapist didn’t get the paperwork done on time. I’d have a conversation with your child’s teachers (who are undoubtedly just as frustrated as you are) to all get on the same page, and both you and the teachers have separate conversations with Jane. Frame the conversation with the deadline in mind (you’re all working together against the bureaucracy, etc) saying something like, “We all know this deadline is approaching, and we know A, B, and C need to be done before then. How do we make that happen, because starting over is not an option for anyone?”

    Honestly, Jane should be working to accommodate YOUR schedules (yours as as well as those of your son and teachers, who presumably are only in school during certain times), and I really think both you and the teachers have the ability to say “We need this meeting to be end by 11:30 so the teachers can have their lunch break” and gently move Jane along whenever needed.

    1. And I'm the alchemist of the hinterlands*

      I am also a preschool teacher, and would be very frustrated on my own and the parents’ behalf! I know parents need to really advocate for their children during this process. I think the OP can kindly but firmly say that they are running out of time and that the process needs to be speeded up. They can say this, I think, without mentioning the slow speech.

      And like you say Jennifer, it’s totally fine to say that a meeting or assessment or whatever needs to be over by a certain time.

      Also as others are saying, having as much as possible be in writing would probably help.

      1. Jennifer in FL*

        Yeah, mentioning the slow speech isn’t really needed when the real issue is that they are up against a deadline. Everything going forward needs to hinge on that.

    2. Your Computer Guy*

      I’m surprised that everyone is meeting to fill out paperwork together. Both my kids have had a lot of services, transitions between services, transitions to school, and IEP. So much paperwork, so many evals. But we’ve always gotten forms ahead of time, filled them out, and then meetings are just to review. Could be different in different states, but I’d see if doing the forms ahead of time could happen for everyone. That would hopefully cut down on meeting times.

  16. Prefer my pets*

    I feel you so much! I went through this with a coworker and I had to do everything by email with him…he spoke so slowly that my brain simply could not stick around for him to get to the end of a thought. (Wasn’t just me…there were perpetual communication errors in that office because anything he said verbally people couldn’t absorb) He made the DMV sloths in that kids movie look like speed talkers. He communicated just fine in email and didn’t seem to take any longer to review documents but dear god his speech patterns! It seemed to be something with the very small community he was from…when we ended up with a couple seasonals from there they were the same way.
    No suggestions except trying to do as much as possible in writing but all the sympathy in the world!

    1. Fierce Jindo*

      Interestingly, research has found that languages convey information at the same rate—just with a faster rate of speaking but lower rate of information per word, or the reverse.

      1. Katydid*

        That is interesting! We’re not talking about different languages, though, but about difficulties experienced when people who are working together speak (and process information) at radically different speeds.

      2. linger*

        Very roughly true, on average, for first-language communication on everyday topics. Generally there are real-world pragmatic constraints on overall speed of communication possible using a language, but there are many linguistic solutions depending on whether efficiencies are maximised for perceptual or articulatory distinctions in the sound space vs. word length (affecting vocabulary retrieval by producer and recognition by recipient), vs. level of information required by grammar, vs. explicitness needed to convey the message unambiguously vs. time needed to clarify remaining ambiguities.
        By contrast, using a second language, for a topic not originally learnt about in that language, almost always yields a much slower communication rate.

  17. Salsa Verde*

    This is a tough problem, and hopefully she will be responsive to using written communication more in the future. I do feel like as a therapist, she is better positioned to expect radical candor.

    You do have all my sympathies though – especially the part where you mention that she seems to have trouble gathering her thoughts – that frustrates me to no end, even though I know I should have more patience with it.

  18. OyHiOh*

    I didn’t need to do therapeutic surveys for preschoolers, but have done a a lot of those for school age kids (I have two on IEPS). If these are the same sort I’m thinking of, you the parents, and you the preschool teachers, should be able to get an electronic link to the survey, complete it online, and email or call with any questions.

  19. Macchupeach*

    If she’s been a therapist for any length of time, and is a decent one, she should be prepared for people to ask about her speech issue. Do it by email if you like, but you can say politely: “We’ve been so glad to have you working with our son, and you seem very skilled. I notice that it takes a long time for you to speak with us, esp. when we’re filling out paperwork. Is there a way we could make this easier? Should we use email, or is there something else that would help?” She will almost certainly acknowledge the problem (see: good therapist) and may have a way to get around it that isn’t occurring to any of us.

    1. Sloanicota*

      Yes I think this seems to be the most respectful way to address it. “We have X days to meet the deadline and so far it’s taking us Y hours to answer Z number of questions. I can’t add any more meetings to my calendar, so do you have any suggestions to help us be more productive in the meeting we have scheduled? Perhaps we can email in advance?”

      1. DrSalty*

        This. Just be matter of fact and polite about it. The sessions are taking too long – what can we do to speed it up?

  20. Bruce*

    Nothing more to offer for advice, but I appreciate that people recognize that people with slow speech patterns can be highly competent in other ways, and that there are constructive approaches to try! I have some family members who needed speech therapy and still have some issues, while others chatter away at hyper speed :-)

  21. Pucci*

    Do you need to pay for the extra sessions her slow talking causes? Paying for two sessions when one should be sufficient would be a deal breaker for me

    1. DisabilityTax*

      Me too. I’m legally blind and doctor’s offices have stopped having people available to do paperwork before an appointment so I often have to have/schedule/pay for/delay the care I need for 3, 4, 5 appointments for the dr to collect my info verbally. Super frustrating.

      1. Properlike*

        That’s not okay to charge you for that. In the US, I imagine that would be some form of illegal.

      2. Gyne*

        This is standard because EVERYONE has paperwork they need and it’s all unpaid work that either the doctor needs to do after seeing a full day of patients, or pay a staff member to do. We contract with a company that fills out FMLA forms for us and the patients pay them directly. Or have the patient come in for an appointment to fill out the paperwork. No one should be expected to work for free!

  22. Snoozing not schmoozing*

    While reading the OP’s letter, all I could think was, “How would you feel if someone wrote a letter about how difficult it is to communicate with your son, with no empathy, just how inconvenient it is for that letter writer.” My assumption was that Jane had some developmental or speech problems that she had overcome, and got into therapy work to help others.

    1. The Unspeakable Queen Lisa*

      Where do you read no empathy? The LW sounds compassionate to me. Knowing that someone has a problem and having empathy for that problem still doesn’t change the effects of the problem. My husband has ADD – if he forgets his wallet somewhere, having compassion for him doesn’t change the fact that we have to replace everything in the wallet, which is yes, inconvenient, and I’m allowed to also have feelings about that.

      The LW and spouse have spent 6 hours trying to get these assessments done – that’s 6 sessions they had to pay for and take time out of their work days to attend. She is literally worried they will run out of time/miss a deadline because of Jane! That’s not “inconvenient”. That is understandably concerning for the LW because that would slow down her son’s ability to get what he needs – which is the whole point.

      Frankly, if Jane is aware that she has this problem (and I assume she is), *she* ought to be more empathetic to its effect on her clients.

    2. OK*

      A parent reading a letter about their adult professional child? LW could feel bad or not.

      That doesn’t change the fact that LW needs faster service than they are receiving. LW is advocating for their son. LW needs information provided by a deadline. LW is asking for an actionable plan to get this done in time for their son. I see no insults to the therapists.

      This doesn’t make LW “unkind.”


    3. Sloanicota*

      I have sympathy for this position, but I don’t think the solution is that OP just has to accept they’re not going to meet the deadline to get her son help. Surely that is also not what the therapist is going for. So they do need to shift into a solutions-finding mode, with empathy and respect for all.

    4. OK*

      I am sure that Jane’s support system had to meet deadlines as well, as proof, I would note she was able to become a therapist.

      LW is allowed to do what they can to advocate for their son, including requesting an actionable plan to get faster service.

    5. Betty*

      This seems unkind to the OP, who repeatedly emphasized Jane’s positive qualities and doesn’t make any value judgments about the behavior in question. (Also, I don’t think it’s remotely equivalent to compare being frustrated with a small child to being frustrated with an adult professional whose behavior is impeding something very time sensitive.)

    6. constant_craving*

      This doesn’t seem fair to the OP. They said nothing unkind. They want to continue working with her and just need to make it work for them without their child missing supports he needs.

      It’s also a therapeutic relationship, which means it should be a one-sided arrangement, not a social relationship where both people’s needs are equally important. That’s an extremely important context.

    7. Myrin*

      There is nothing in the letter to indicate that OP lacks empathy for Jane – she praises Jane’s work, acknowledges that there might be a medical component to it, but indeed prioritises her own child’s needs over that of an independent adult professional in the very field.

    8. popko*

      The LW acknowledged that the therapist’s speech could be as a result of a medical issue, complimented her multiple times, drew no negative conclusions about her character, and focused solely on the practical consequences of her slow speech– which go beyond “inconvenience” into “potential for significantly delaying their son’s care.” There was nothing unempathetic about it.

      I myself am a speech therapist that has worked in outpatient pediatric care alongside physical therapy and occupational therapy, and I absolutely have sympathy for Jane, but it’s also not at all out-of-line for the LW to ask if there’s a way to speed up their visits. If the LW is in the US, taking this many visits just to get through the initial assessments could mean:

      – the LW’s family is going to be responsible for additional copays (for the “additional” visits)
      – even if there’s no out-of-pocket cost from really good insurance, the assessment visits are eating into the allotted number of total visits that could be going towards the child’s therapy instead
      – not to mention what the LW already brought up in terms of eating up their PTO and/or lunch hours, which is already a pretty significant consideration when you have a child with special needs who likely requires more office visits/services than the average child
      – and not to mention the deadlines involved.

      Jane is a good therapist, so she is almost certainly aware of all of these things, and should be open to problem-solving around them if the LW brings up the subject. If the assessments are parent-report forms, they can be sent home with the LW to fill out in advance, and they can go over only the items that need further clarification in meetings.

      If they’re not parent-report forms, Jane can still give the assessment protocol to the LW for the LW to read through, answer aloud, and Jane can score her own copy of the protocol; she can cover the scoring keys on the LW’s version with sticky notes etc. if she’s afraid it’ll introduce bias. There are lots of workarounds that don’t involve impacting the patient’s care.

    9. Seacalliope*

      I’m sorry, but this is a really unpleasant response to the OP. She is seeking advice on how to get required services for her child when the therapist responsible for meeting deadlines is continually taking more than the expected amount of time — an expectation set by the therapist, BTW, not the OP. She is also seeking this advice in a very respectful and measured way and speaking to the competence of the therapist she is working with.

      Trying to shame the OP for prioritizing her child over the theoretical mental/emotional well-being of someone impeding her child’s care — whether or not willfully — is appalling.

    10. Cherries Jubilee*

      This seems like an unreasonable read on the letter. OP is entirely respectful of Jane. The slow speech is a problem that needs a workaround in order for Jane to meet her client’s needs.

    11. Ginger Cat Lady*

      You do realize that BOTH can be true, right? OP can have all the empathy in the world for Jane and her (potential! possibly! but we don’t know if they really exist!) problems.
      AND she still has deadlines looming AND she has limited time away from work AND this is taking much longer than it should AND she’s paying for more therapy visits than usual.
      In fact, the letter pretty clearly sounds to me like she’s trying to figure out how to navigate these conflicting feelings. She *likes* Jane and wants to work with her AND there are problems to resolve.
      Empathy does not – and should not – mean pretending there are no problems and ignoring issues that should be resolved. Empathy is not codependence.
      If only you gave OP the tiniest bit of the empathy you pretend to be advocating for.

    12. Starbuck*

      You haven’t given anything actionable here to help OP though, none of this advice is going to help her work on figuring out how to get the therapist to meet the deadline for services she needs to meet.

      1. Roland*

        Yeah, that’s the crux of the issue. Snoozing’s comment is all about how they feel and would feel and how OP should feel, framing feelings as the most important. But that not the conversation OP is having. They are looking for actions. Feeling a different way doesn’t actually change the situation they’re in. Thoughtcrimes aren’t real.

    13. sparkle emoji*

      If Jane isn’t able to move things along in time to meet the deadline, it’s entirely possible OP’s child won’t be able to receive Jane’s services regardless of how much empathy OP has for Jane’s potential condition. OP’s letter has no indication of ill will towards Jane or poor treatment of Jane. They’re just seeking a solution that allows them to continue working with Jane while meeting deadlines for their child’s care. Jane is likely experienced with the type of deadlines and bureaucracy OP is dealing with so unless the slow speech is new, I’d expect she must have some experience adapting how she communicates when her work is time-sensitive and spoken communication is moving too slowly.

  23. Aquamarine*

    I would try to stop thinking about how much shorter the meetings would be with a different therapist and try to just accept that working with Jane means that face-to-face meetings will be long.

    If things can be done over email, that would be great (and it might even be helpful to have a record of updates and check-ins?).

    You could ask to minimize the face-to-face meetings by stating the truth – it’s difficult for you and your husband to take that much time off work.

  24. Pizza Rat*

    I am from south Georgia and pursued my science PhD in New York City. My natural speech pattern is slower and my voice is accented, as it was influenced by my upbringing. Many New Yorkers would try to hurry me along when I spoke, to which I would always say, “I may talk slow, but I don’t think slow.” OP, there are undoubtedly some problems with how long some of these processes are taking, especially when you are using your lunch hours and administrative elements at the preschool are delayed. Name those objections/concerns, but don’t attribute it to her speech, or how long it takes her to get a sentence out. This situation should not be addressed as though you’re her manager or even a peer – you won’t be successful in dictating your terms of communication to her. Ultimately, she is providing a service that you need, and by all measures she’s good at it. It may be that, for now, you’ll have to take the good with the bad. You can name concerns and make suggestions, but be prepared that nothing may change on her side – but a sense of empathy and patience on your side is far more accessible.

    1. Dust Bunny*

      The LW wasn’t un-empathetic or unsympathetic. It’s entirely reasonable to have concerns when this is taking fully twice as long as expected and the LW’s child is in danger of missing deadlines (and, possibly, the LW is paying for twice as many sessions as it should take).

      I’m from Texas, for the record, and I very much doubt you or I talks so much more slowly than any New Yorker that we need twice as long to get the message across.

      1. Raida*

        And in some parts it’s four times as long!

        Personally if I have a specialist set up a half hour meeting with me, that they are running, and they are familiar with, that they are the subject matter expert in, that we’re on a deadline for and it takes two hours total? For a questionnaire??? Before the next damn appointment they can provide me with any further questionnaires and I will email them the responses.

        I certainly am not gonna dance around the issue, a therapist needs to know about concerns so they can at the very least acknowledge them but hopefully modify their approach to suit the client’s needs.

  25. Betty*

    I wonder if it would be helpful to frame this to Jane with an “I” statement– “I’m personally much more efficient with written information than verbal. Do you think that it would be possible to send me the forms ahead of time so that I could send you my notes, and then we could use the meeting time just to cover any clarification or additional information that we didn’t cover” [And possibly also “I feel like our current approach is going much slower than I’d anticipated, and I’m concerned that at this pace we will miss the deadline to complete the assessment process.” ]

    OP, you have my sympathies as someone who haaaaates being read to, even at a standard pace. (Like, I turn off sound and turn on captions for all instructional videos because I cannot retain anything otherwise.) Ironically, my spouse and I had to fill out information for a medical clinic where they asked “how would you prefer to receive information from us?” with several options written (including “verbal”) and I answered “written” and he answered “video or visual” and then they proceeded to verbally read the information out loud to us. :-/

    1. Armchair Analyst*

      Yes – I read so much faster and retain more than hearing it (and even more if I’m writing or taking notes from what I read or see or see, but that’s not faster)

    2. allathian*

      Yup, I’m the same way.

      That said, I can deal with forms being filled in during an appointment if the other person speaks at a normal speed and listens to my responses and fills in the form. Maybe that’s because I absolutely detest filling in forms.

      Ugh, I’m sorry about the medical clinic, I’m not sure I would’ve been very confident in the quality of their care if they asked the question and ignored my response like that.

  26. Not A Manager*

    I wouldn’t mention anything about her actual speech/language characteristics. Either they are neurological or they’re not, and in neither case are they going to change now because you bring them up. I think you need to assume that this is how Jane communicates verbally.

    I can’t tell if these questionnaires and feedback require verbal communication, or if that’s just how she does it/apparent best practices. Tell her (as gently as you like and with whatever softening you need) that no one has time for long meetings, and ask how you and the school can have regular check-ins with her via email or online chat.

    I’m really sympathetic to your not wanting to re-start this process, but it’s even more important to protect the teachers from her than it is to protect yourself. They will absolutely begin to resent you and this process if they have to interact verbally with Jane with any frequency. I know this from having had a very similar experience with my child’s team.

  27. constant_craving*

    As someone in the mental health field, I’m going to suggest you bring this up very directly with Jane. Therapists should and typically are open to adjusting what isn’t working for their client. Every therapist I know would rather you bring up a problem than that you avoid doing so. It’s important to remember that therapist-client relationships are supposed to be different than general social/business relationships, so a lot of the norms and social niceties don’t apply. Of course you shouldn’t be aggressive or rude about it, but a polite, straightforward discussion is something any good therapist would welcome.

  28. MsMaryMary*

    I had a client who was a slow talker AND someone who had to talk through his thought process to make a decision. I’d be in meetings with two attorneys, an actuary, and me as the consultant where he had to have cost the company thousands of extra dollars since we all charged by the hour. I did not personally receive additional comp for four hour calls that should have been a hour and it drove me nuts.

    That doesn’t help OP. Other than Allison’s suggestions, maybe a talking to Jane’s manager would help? You could stress that your family really appreciates Jane’s work otherwise. Jane’s process might be causing issues with other clients or internally for her coworkers and it would be helpful for her manager to know.

    1. Katydid*

      FYI, there is no one above Jane: “ This facility’s owner (there’s no one above her) and head therapist, Jane…”

  29. CorpGirl*

    I don’t really have advice, just here to empathize. I used to work closely with someone who spoke like this, but I didn’t manage them – it was more of a team lead situation. They were really eager to work directly with a client of mine, so I let them run a few meetings, after which point the client came to me directly and was like “is it possible for you or someone else to run our meetings going forward? This new person we’re working with seems smart but they talk way too slowly, and I don’t have that kind of time.”

    I didn’t want to offend my coworker, so I told them the client would prefer if someone at a higher level ran the meetings going forward, but it was nothing personal. That coworker then went to my boss and boss’s boss to complain about how I don’t think they’re “good enough” to talk to my clients. Luckily, they came to me and were understanding when I explained the situation, but that co-worker ended up quitting shortly afterwards and was very cold with me right up to the point they left. I do wonder if radical candor would have worked better in that situation…

    1. learnedthehardway*

      I would have told the colleague that it was the client’s request. It’s not your fault that they client didn’t want to make accommodations for your colleague’s communications issues.

      1. Expelliarmus*

        It sounds like CorpGirl did say that; she specifically says “I told them the client would prefer…”

        1. Raida*

          No, CorpGirl said the client wanted a higher person.
          not the client has stated the meetings are too slow and they want a faster person.

    2. Boof*

      I’m really not sure what “Radical candor” means, but I do think something like giving the employee a heads up that there were concerns about how the meeting was run, maybe arranging a mock meeting for direct feedback (or if that’s too much, sitting in on a meeting +/- filming it and going over it if that’s allowed – again, giving the employee a heads up on that this will happen), and then coaching on the problem, and then following up on whether it’s correctable etc. Yes direct feedback on how to effectively run a meeting and training if that’s helpful would be important steps to try over just cutting someone out without telling them why.

    3. Tau*

      Honestly, as someone with a speech disorder myself… yeah, in your coworker’s shoes I’d be frustrated too. Not by the client request (well, OK, that would also be frustrating) but by the fact that you didn’t tell me the truth about it. Like, how am I supposed to realistically assess how much of an impact my stutter is having on my career and employment and what paths are feasible if people try to hide it from me when there’s a negative reaction? Why set your coworker up for thinking “aha, I need to work my way up the career ladder and then I will get the client meetings I want” instead of flagging that they either need to figure out something with their speech or adjust their expectations for what job duties they’re capable of?

      Which is to say that yes: from my perspective, radical candor would have been the way to go, although I can see that it would’ve been an awkward conversation, especially if the coworker had acted unreasonably in the past.

      All that said, I don’t think any of this is super relevant to OP because they’re in the position of a client and not well-positioned to give feedback. The advice people are giving to try to take things to email and flag the upcoming deadline seems most likely to be productive.

  30. learnedthehardway*

    OP – treat the therapist the way you hope people will treat your son, if / when he gets to a point in his life that he is able to hold a job. You say he has developmental delays. Consider that the therapist may also have some kind of invisible disability. Be patient and kind.

    Of course, if there are more efficient ways to communicate, it certainly makes sense to explore those – most forms can be filled in and emailed, many updates can be emailed. That may be more convenient for the therapist, as well.

    1. Looper*

      I came here to say exactly this. I find it ironic that the context for this is finding therapy for developmental delays.

      1. nnn*

        Why is that ironic? You seem to be implying the OP is doing something wrong by raising the question but she can be empathetic to the therapist’s disability (if that’s what it is) while still needing to find a way to speed things up because there is a deadline for her child to receive treatment (and because sometimes people genuinely can’t afford to pour this much time in).

    2. allathian*

      This is a very good point. My son had speech development delays and he had speech therapy about once a month between the ages of 4 and 9. He still has a minor speech impediment that doesn’t affect comprehensibility, but so does my sister and she’s nearly 50. I had the same speech impediment, an inability to pronounce the Finnish trilling R correctly, until I was 12, and I still revert when I’m tired. His therapist also happened to be the sibling of one of my sister’s classmates, and I learned that they had a severe speech impediment as a kid (they had a very unusual name). I would never have guessed if I hadn’t known.

      That said, I don’t think taking twice as long as the client expected to do an assessment because of a disability is a reasonable accommodation, especially if there’s a risk that the kid will age out of eligibility for the therapy.

      That said, I do agree that commenting on or complaining about the length of time the assessment’s taking is unlikely to yield a good result, but asking to fill in the forms before the appointment sounds entirely reasonable. Especially if the LW can raise any unclear points with the therapist by reading out the form. A workaround to ensure that the therapist talks as little as possible.

  31. Raida*

    For things that are like a questionnaire – as the Client I’d have my hand held out to be given it.

    Anything that’s not specifically a conversation, anything that’s an answer to a question – should be in writing and I will answer as soon as I can, in writing.

    I would certainly approach this as “We had xx scheduled, but it took yy. That’s a pattern that we can’t sustain, so we need to work together to find some efficiencies.” I’d definitely first thing use a questionnaire as an example – that could have been given to me, and I’d ask for clarification if need be as I go through and answer it. The answers surely need to be recorded anyway, so speaking is not an efficiency there.

    If she says she has difficulty with written communications – well then there’s just a real big issue here that she sucks at comms overall :\

  32. Hope*

    This would drive me absolutely insane after probably the first 30 minutes. My approach would be to speak very candidly with someone else in the practice. Something like: “We think Jane is going to be a great therapist and we like her a lot (etc.), but there is a pretty serious concern we need to resolve.”

    I actually had to do something almost identical recently. I’m responsible for scheduling an annual audit my company is required to undergo. Last year’s auditor was exactly like Jane: he spoke slowly, he took a lot of pauses, he took long, silent stretches to process information while people stared at him, waiting for him to speak. As a result, pre-scheduled meetings with our employees (including top management) dragged on for more than double the time they were scheduled. It was seriously stressing people out and annoying them. When the audit was over, I contacted the account rep and listed some of the auditor’s strengths, but said that ultimately I don’t think he’s going to be a good fit for our organization, because there was a drastic mismatch in energy levels between the auditor and the team. Then I gave specific details describing the things I listed above. It feels like a personal thing, but it’s not personal. Jane is providing you a service, and the way she’s doing it is wasting a ton of time and resources. There are probably people who can really connect with her speaking style, but the majority won’t.

  33. Lizard Breath*

    As a medical provider, I absolutely love it when patients want to do questionnaires or paperwork ahead of time so that we can use our limited time together to actually formulate a plan to move ahead and not have me asking questions off a checklist.

    I think Alison’s suggestion of emphasizing that your schedules are tight and that you are worried about missing the deadline for assessment, and trying to get as much done ahead of time as possible. I would also frame this as wanting to make sure you’re using HER time efficiently as well.

  34. Abogado Avocado*

    OP, I second the folks who have suggested you ask for questionnaires in advance and submit them filled out or that you ask to fill things out via email. However — and this is a big however — it is quite possible that the forms that Jane is filling out are not merely questionnaires but evaluative instruments. You may wish to determine if that’s the case.

    An evaluative instrument often requires a trained professional to ask the questions of the person being evaluated or of a “trusted informant” (you’re in this category) and then the trained professional fills out the answers. Evaluators in this position tend to speak slowly and carefully because: (1) they must ensure the informant understands what they’re being asked; and (2) just rattling off questions can invalidate the assessment. An evaluative instrument also can be invalidated where the informant fills out the instrument him- or herself.

    If this is what’s happening here, I understand that it is frustrating. At the same time, you want a well-done evaluation so that those in charge of paying for your child’s assistance don’t brush off the evaluator’s conclusions by saying the evaluation is invalid or your child’s problems are mere developmental delays that will go away with time and without intervention.

    1. Dust Bunny*

      I would have to question if an evaluation is accurate if it might be tainted by frustration on the part of the patient/clients.

    2. Ampersand*

      Exactly. My daughter’s behavioral/developmental eval required many questionnaires that we filled out at home, both on paper and electronically. Then the appointment with the specialist was several hours of in-person questions for us (her parents) and with her. If OP is doing something similar, I can see how this could span multiple sessions and be really frustrating. It’s not anyone’s fault; it just is—and it sounds like Jane is doing what she needs to to communicate the best she can. That said, just reading this letter put me on edge because that degree of slowness would drive me up the wall. I have sympathy for everyone in this situation.

    3. sparkle emoji*

      I was wondering if some tasks need a trained evaluator, but even if that’s the case I think it’d be worth it for OP to raise their concerns about missing the deadline moving at the current pace. If the slow speech is deliberate to ensure understanding, maybe Jane can speed it up or check for understanding in other ways. If it’s something out of her control she might be able to rope in other evaluators or open up other times in her schedule to meet the deadline. OP emphasized her skill at this job so I’d think she may have experience working around this in the past.

  35. Jiminy cricket*

    I love the way Alison’s advice focuses on the length of the meetings (which Jane can more or less control) and not on the speed of her talking (which she can’t).

  36. Kella*

    As a disabled person, I tend to assume that if someone is behaving in a way that significantly impacts their ability to do a task, that they are already aware of that and have exhausted their options in how to mitigate that. So I am going to assume that Jane’s speech patterns are based in a medical or cognitive issue and not something that is going to change.

    That said, I have one big question for OP: You say this process has taken much longer than expected, which is definitely frustrating. Where did that expectation of length of time come from? Did Jane tell you “This will only take half an hour” and six hour-long sessions later you’re still not done? Did someone else in the process estimate the time, not knowing that Jane would be the one working with you? It seems like a lot of the stress here is caused by expecting it to take a certain amount of time and consistently those expectations not being met.

    I’m also curious to know if Jane is aware that you are close to not meeting the deadline and if there is anything she is doing to ensure that doesn’t happen. She may not be able to control her speech speed but she can definitely account for that in making a plan with you for your child.

    I agree with Alison about focusing on the impact, not the cause, and approaching things from a problem-solving perspective. But also, if some of these mismatched expectations are being caused by Jane herself, that might be worth bringing up too. “You said this process would only take half an hour at we’re now at 6 hours working on it. In order to sustainably plan my life around this process, I really need more accurate estimates of how long it’s going to take.”

    1. LMHC.BLT.QVC*

      love all of this. Please don’t comment on the speech pattern of the therapist, it’s doubtful she can change it. Please do comment on the mismatched expectations (so well phrased) and make it clear when the deadline is.


    Current therapist here and former stutterer. Please don’t actually comment on how long she is taking to speak, as a few people are suggesting. I had a decade of speech therapy and I’m PROUD of the fact that most days I don’t stutter at all because I take my time with my words. If one of my clients mentioned that I speak too slowly it would not only be embarrassing but would beg the question: what would you like me to do about it? This is my coping skill, MY therapuetic intervention. Speaking faster isn’t an option. All the other suggestions: focusing on the length of time and the need for email communication is great and will hopefully speed along the process.

    1. Jade*

      I’m glad you are doing well. But accommodating Jane is not the parent’s role or responsibility. Getting their child services is. If this is too much of a roadblock parents need to look elsewhere.

  38. BellyButton*

    I would ask Jane to provide a written summary of her analysis, thoughts, whatever prior to the meeting. I would phrase it as “Jane, I want to make sure we can get through everything during the allotted time. Can you please provide a written summary prior to the meeting? This will allow both of us to highlight the most important things to discuss from each section.”

  39. Cherries Jubilee*

    I’d say filling in questionnaires ahead of time should be standard anyway! Many schools now are moving to a model of kids watching the lecture at home, and then doing “homework” in the classroom where the teacher can answer questions and work with them. In both cases, the passive part shouldn’t be the part that takes up the valuable meeting time, it should be done beforehand.

  40. WellRed*

    Condolences. Theres us a physician assistant at my specialists office. I can’t recall her speech patterns but ever movement (walking me to the room), taking BP etc was so slow I don’t know how she stayed upright. I want to scream.

  41. Llama Llama*

    No real advice except watch out for your billings that you were charged 2 hrs for a ln evaluation that should take 30.

    Signed a momma of two developmentally delayed kids who has to fight medical billing a lot.

  42. Cookies*

    The best option for you and your child is probably to talk to the clinic to see if you can switch to a different provider. It’s unreasonable to waste so much time listening to someone dawdle verbally, no matter what the cause is. Presumably there’s someone who directs the clinic who can point you to someone else. It’s not personal, it’s just a matter of fact that you need this assessment done swiftly and she seems unable to do that. I know it’s difficult to work with these processes but you have to advocate for your child and yourself here.

  43. SnappinTerrapin*

    We don’t know whether Jane has a disability.

    We do know that her verbal communication is creating an obstacle for her clients.

    LW can properly request some changes in the way Jane delivers her services. The client’s time and fees are just as important to this relationship as the therapist’s needs, if not morehouse.

    Jane hasn’t asked for advice, but she should be forthcoming with her clients about her communication style, and should address its impact on her service delivery. In particular, she needs to address how she adjusts her billing so that she avoids overcharging her clients and their insurance. That’s a legitimate worry for the clients.

    If it takes twice as long to deliver the service, the rate should reflect that. If the client needs to budget twice the time, Jane needs to disclose that up front. Some clients might seek another provider up front. But if she doesn’t get in front of it, it will be a bigger problem.

    1. SnappinTerrapin*

      “moreso” not “morehouse”

      The drunken elf in the phone edits to amuse itself rather than to enhance communication.

  44. Therapy Blues*

    While lacking advice I can certainly empathize with LW. Our son has multiple developmental delays and the speech delay was the first and most obvious but we’ve added occupational therapy now too. The average age in our area is about 60 and pediatric specialties are hard to come by at all and quality one’s harder still.

    We worked through and let go our first therapist (who was often absent, provided short sessions, and wasn’t effective for our son) and in the process we fell behind for state assistance on early intervention and can’t complete an enrollment before he ages out. Insurance ran out and we’re on pace to spend more on his therapies this year than our mortgage. We’ll apply for the program for his age group after his birthday (we can’t apply early) but the funds for our income bracket (more than twice the federal poverty line) are first come first serve in this state and we’re applying about 3 months into the program year so we aren’t optimistic about any state assistance before next August.

    It’s hard and it’s frustrating and impossibly unfair to have to decide between effective medical care or the stability of your personal finances. You’re not alone struggling with therapists and the state (whatever one you’re in) and I wish you all the best.

  45. Me too*

    So many comments here are mind-blowingly awful. As a stutterer, it inspires words ill-suited to a respectable public forum. So grateful for the people on this thread who get it.

  46. Linzer Retorte*

    I don’t do school therapy so maybe it’s different in your context. But in out-patient and in-patient medical facilities, insurance only lets Occupational or Speech therapists bill for time spent with the patient. Emailing a parent without the child present is not billable time. Otherwise email could be a good solution.

    1. Gyne*

      This- the reality of medical billing is that you get paid per visit and can upcharge for extra time. It’s to Jane’s financial advantage to stretch these sessions out as long as possible and spread them across as many visits as possible. It’s easy to sit on the internet and tell other people they need to be more compassionate when it’s not your PTO that’s getting used up, not your money being spent on extra therapy sessions, and not your insurance that only covers five visits and the rest are out of pocket. It’s completely reasonable for Jane to either charge a fee or schedule an appointment for paperwork that needs to be filled out (because otherwise she is working for free) but it should be a flat rate or ONE standard-length appointment to do the forms. The fact that Jane can’t get through a single questionairre in one appointment is a big red flag to me.

  47. ItsTheFinalCountdown*

    Sending OP warm wishes because I know how hard it is to find a good therapist fit. I’ve had probably 20 OT/PT/SLP therapists for my kid in nearly 6 years, and had short tenures with several. Some were not technical experts (despite certifications), some lacked patience with young kids, some were great therapists but flaky about scheduling, etc. At this point, you are still evaluating if this person is a good therapist fit for your child. However, you know for sure that their communication takes time away from all caregivers and affects your child indirectly. Knowing the struggle to communicate with adults, they may also struggle to communicate with your child, as play-based therapy still requires communication. I don’t know your personal situation, and you seem determined to make it work, but want to give support that it’s also ok to cut your losses. I personally wish I had cut ties sooner with therapists that demonstrated a poor fit early on.

  48. Nicky*

    I’m thinking two things:
    1. If part of your son’s difficulties include any speech pathology (and I don’t know), is a therapist who herself has speech pathology which significantly functionally impairs her, a good model for your son? And

    2. To all the people suggesting emails and written communication outside appointment times: whilst this is a reasonable idea from the patient’s point of view, and one of the things I too considered in solving this problem, if a therapist has 40 hours a week of face-to-face appointment work (Mon-Fri 9am-5pm), and is fully booked up (i.e. most clinicians), and every patient or family wants extra work done (e.g. emails read/written/actioned, questionnaires found and sent/read and scored/re-worded into a report/submitted, forms filled in, calls to preschools, etc.) outside those hours, the therapist can easily and quickly find themselves doing 80+ h/w work, 40+ h/w of which can be unpaid, depending on the payment rules (e.g. in my work I get paid for nothing unless the patient is with me).

    I’m a clinician and my colleagues complain a lot about this extra non face-to-face work as a modern expectation, and thus many insist on filling these forms in, scoring surveys, etc. with the patient in front of them (otherwise they don’t get paid for the time spent doing that work). Over the years there has been a massive creep in this extra paperwork workload for clinicians.
    To be fair, most non-clinicians see it mainly from their own point of view, i.e. “it’s only 3 forms/2 questionnaires/4 emails/5 phone calls I’m asking her to do,” understandably not appreciating that if even just a dozen patients ask for the same every few days, it’s a lot of extra unpaid (and not allocated in the working day schedule by many clinics) work for the clinician.

    OP, someone this slow would frustrate me, and I couldn’t have her as my personal clinician, but she will primarily be your son’s therapist, not yours. Is it possible she communicates at a speed that exactly suits your son? If so, she is a wonderful find, and keeping that in mind may help you remain patient, and persist.

  49. Lily*

    Bookmarking this comment section to re-read whenever I’m wondering whether 100% work-from-home might be problematic for my mental health, as a reminder to never take for granted the joyous wonder of using my own bathroom, unsullied by workmate’s skidmarks, free from pass-ag notes, as clean or as dirty as I have chosen to leave it, always well-stocked with ample cleaning supplies and my favourite handsoap.

  50. ELL*

    I hope you’re able to switch a lot of this stuff to written format — especially if there are any questionnaires that can be done in advance. I have ADHD and my comprehension falls off a cliff with slow speakers, so I feel your pain. I would not be able to work constructively with Jane. It sounds like this is at risk of becoming an insurance issue for you (too many sessions taken up without actual care), so maybe work from that angle? Best of luck.

  51. RatInAMaze*

    There is a good chance that Jane struggles with a speech disorder. Some of the best therapists are ones that have received care for similar conditions.

    I second asking if there are other methods of communication. Otherwise, you’ll have to decide if the care given is worth the communication issues.

  52. EngineerMom*

    My dad speaks more slowly than is considered “normal” – no cognitive issues, no speech delay, nothing medical or mental, it’s just his particular speech pattern.

    That said, he’s also figured out how to effectively communicate in fewer words when necessary, especially for professional situations (he retired from a very successful engineering career a few years ago). He excels at writing up his thoughts, and uses that as a supplement in meetings and presentations, to make sure what he needs to get across is communicated effectively.

    He does expect folks to slow down and listen to him when necessary , and gets pretty annoyed when people try to finish sentences for him or rush him.

    But during his career, he was also known for running tight meetings that started & finished on time, and were effective (getting through what they were supposed to get through, not getting side-tracked, adequate time scheduled to the task, etc.) – early in my career, I worked with some folks who had worked with him, same huge company different department.

    Speaking slowly is fine – allowing it to highjack other people’s schedules is not. This is something that needs to be addressed directly with Jane’s manager, especially in a business where Jane is charging based on how much time she spends with clients.

  53. Young Ten*

    Does anyone remember Flash Slothmore from Zootopia? That’s what I kept imagining when reading this. All kidding aside, I would really push for email correspondence. I mean what would happen if your family came down with the flu or something and couldn’t come in person to talk?

  54. Musikalchairs*

    You said Jane is the business owner. As the owner, she needs to know that the amount of times she is wasting in these meetings is impacting her clients . You may be willing to stay with her, but how many clients is she losing because of the number of meetings required? I think it is kinder to her to tell her the truth so she can make adjustments. I would be straightforward. You can send it in an email if that is easier. “Jane, we really enjoy how you work with our son and how knowledgeable you are with his condition. We appreciate your expertise and experience. We have some concerns however, about the length of time that the meetings are taking. You speak very slowly and because of this, meetings are taking much longer than expected, sometimes 2 or three times longer than expected. We are having to schedule 2 or 3 meetings for matters that could be completed in one session. It feels like there is a lot of wasted time. We would prefer to utilize our insurance benefits in actual therapy. We also have to take off work for every meeting, and spending this much time in meetings is not sustainable going forward. Is there a way that meetings can be streamlined? Can you provide the questionnaires in advance so we can fill them out and turn into you? What other options do we have for eliminating some of these administrative meetings? Can we communicate via email? I look forward to hearing your ideas for resolving this issue. “

  55. Introvert Teacher*

    So the thing for everyone to understand is that the assessment process is determined by the therapist. The assessment helps diagnose the issue and then therapy sessions from there would take 30 minutes or an hour and run on a regular schedule. No one else can run the “meetings” and do the paperwork because she is a skilled provider and must be the one performing the evaluations and making clinical diagnoses/ providing assessment results. It’s my understanding that typically, a therapist wouldn’t take more than 90 minutes total to evaluate a client, and therapy would begin shortly after. Most therapists are looking to choose the most salient assessments and do what they can within a specific time limit. Once therapy begins, it’s always possible to reassess via progress monitoring and adjust goals as needed. The issue here is that the therapist is taking endless amounts of time to complete numerous assessments, including parent questionnaires which could just as easily be done at home and brought back, and billing for that time on the parents’ insurance. And they’re missing many days of work to do all of this. Even if she weren’t a slow talker this would be incredibly frustrating, and unethical, in my opinion. I say the parents should feel confident to advocate for themselves here and could have started a conversation about diagnosis and treatment plan as soon as it was clear that things were taking more than a reasonable amount of time. A good clinician would listen to clients and adjust accordingly. Ask to stop the questionnaire and complete it at home. Say you would rather focus your child’s time on completing the evaluation. Ask why there is a need for more evaluation if she wants more appointments. Say you’re concerned about the amount of time taken to evaluate, press her to explain what the length of a typical evaluation is, and say you’re not available, you work, etc, if she tries to schedule more follow-ups. You are the client and you shouldn’t feel like it’s rude to be up front with her. She needs to hear that she isn’t managing her time well or respecting her clients’ time in order to recalibrate and do her job well. She might well hear you out and simply discontinue evaluation and work with the data she already has. And honestly, there are other good therapists out there if she just doesn’t work out.

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