How to Ensure that Children Receive the Therapeutic Services They Need

by Mary Ann Evans McGuirk

It is a beautiful, sunny spring afternoon and Angela is excited as she waits for her mom to help her out of the car. She is dressed in a pink jogging suit and tennis shoes and has a backpack to match. As she gets close to the building, she lets go of her mom’s hand, enters the doorway and runs towards the door on the right. The room’s walls, shelves, and corners are filled with boxes of toys, books, games and other items. For Angela, this setting is intriguing because she has access to many more toys than she has at home. Angela, who is 4 years old, turns and insists on the doll house on the top shelf. Nearby, an adult encourages Angela to stand on her tiptoes and grab the doll house herself.

Fast forward 7 years --- Angela is now 11 years of age, dressed in a jogging suit and tennis shoes and is carrying her backpack, but this time turns to her mom and voices her displeasure as they are parking in front of the same building.

Angela is not going to a toy store or a classroom. This is the facility where she has gone twice a week for the past 8 years to receive therapies which help with her physical and cognitive disabilities. .

What is different? Why does Angela not want to go to therapy like she has done in the past? Therapy is no longer play; it is work. Angela has made progress, however, the hurdles to overcome her challenges, now are more complex. In the waking world, Angela – an 11-year-old middle school student – spends many of her school days hunched over a computer desk, being pulled out and pushed in for speech, physical and occupational therapies. She, then, goes to more therapy after school, but yearns to go to soccer practice and gymnastics with her siblings. For many kids like Angela, these facilities are like a second-home because of the amount of time they are there.

Adding physical, occupational and/or speech therapies, as well as social skills classes to your child’s hectic daily routine, both inside and outside of school, can be very overwhelming. It can feel like a full-time job to work on acquiring or restoring difficult skills. Therapies take on many forms and all children can benefit greatly from it. Therapists should constantly be looking for ways to reinforce the skills they are teaching so that kids do not feel like therapy is a job or a dreaded activity. When kids are engaged, they focus better and their opportunity for learning and mastering a goal is greatly increased.

Let’s look at your child’s IEP. Therapy is often a significant component of an IEP – what kind your child will receive, how long, how often, and how it will help your child. Therapists are often not employed by the school district but by private agencies which means they might not always be available for IEP or planning meetings. If you, as a parent, feel that they should be there, take the necessary steps to contact them directly and ask about their availability. Their input is valuable as they have to submit specific and measurable goals to account for the time they spend with your child. Collaboration is a key component of a successful IEP team which is why all team members should be at the meeting.

After reading over your child’s IEP, talking to the therapist, and hopefully, observing the therapist in action, and you disagree with the therapist or feel the program is inadequate -- use your voice and advocate for your child!

"I believe that when my child can turn an activity into their functional day-to-day environment, that's when their life changes." (Quote from a mom)

Whether you are paying for the therapies privately or they are being provided by the school district, you need to voice your concerns and ask questions. Do you know the therapist’s background, training, experience and approach? Why is your child showing signs of frustration and behavior problems when receiving therapy services? Document all phone calls, emails and letters and keep a copy for your files. It helps with organization as well as collecting data. Talk to the school administration and/or IEP team, also. Maybe the setting where the therapy is being held needs to be changed or perhaps, the therapist needs to be replaced.

Ways to advocate for your child and stay connected:

• Keep in touch with the therapist on a regular basis via phone or email. Keep the therapist updated on things that are happening at home, both good and bad. Let them know how thrilled you are that John can button his coat with no help and also, how it has helped with John's self-esteem.
• Are any academic and behavioral goals impacted because of your child’s gross or fine motor challenges? If so, make the therapist aware of that. Emily‘s OT was solely working on writing skills with her and the parents expressed their interest in the use of a laptop. Emily and her therapist are now working on keyboarding as well.
• Goals should be relevant and meaningful to your child’s life and interests. Are the therapies your child currently receives, sufficient for him to reach his goals? If a student needs help with running or jumping, the physical therapist (PT) could talk to the gym teacher about what the class will be working on in the future and the PT could work on those goals with your child.
• Technically, therapists can only be concerned with working on goals that affect schoolwork. That being said, goals that are functional at home and in the community can also relate to school The Occupational Therapist (OT) can work on tying shoes as well as navigating an ITouch for communication purposes. Encourage the teacher to work on these goals also.
• Offer suggestions on what your child likes to do for fun and incorporate that into therapy. If your child loves basketball but needs help with mastering some skills, ask the therapist to take your child outside or in the school gym and work on these skills as part of the therapy time.
• All therapies need to be age-appropriate. The goals of the IEP might stay the same (working on math problems, increasing independence, etc.), but the way to accomplish that goal must change as the child matures. Sesame Street characters should not be used with 6-year olds to work on colors, but socks and fruits can be a good choice.

Professional speech, physical and occupational therapies, at school or in a private office, are invaluable to a child with specific challenges. However, the “traditional” way of doing therapy is not the only way. Just because your child is receiving therapies, does not mean you should stop advocating and offering suggestions.

1. Advocate for your child in the school district if you feel he needs more.
2. Provide scenarios and examples on how continued therapy or the discontinuation of therapy will have an impact on your child’s life.
3. Check with your insurance company on supplementing with private insurance.
4. If private therapy is being utilized, make sure that there is communication between the school therapist and private therapist.
5. Know what is happening in school and private therapy sessions. Keep the lines of communication open.

Therapies are powerful tools which can help children thrive. As parents, you have the power and knowledge to ensure your child has adequate resources and therapies, because you know and understand the needs of your child like no one else.

So, for the little girl walking down the hall to the room on the right, the choosing of a specific toy or activity connects her to something larger and more complex. The right therapist can be the “gatekeeper” to a whole new world of opportunities.

We invite you to attend our May 17th workshop “The Bridge Between Therapy and Community” to hear directly from therapists themselves and have them address some of the questions you may have.