Wednesday, February 22, 2012

Better therapy sessions for kids with special needs: therapists share!

I recently asked a bunch of pediatric therapists how kids can get the maximum benefits from therapies: speech therapy, occupational therapy, physical therapy, ABA therapy, whatever therapy! All of these experts are contributing columnists to PediaStaff, and they didn't hold back on advice or honesty. Hope you find their words as helpful as I did!

From Melanie Potock, a pediatric speech language pathologist and feeding specialist in Longmont, Colorado who blogs at My Munch Bug 

• ...Feel free to video our session to share with your partner, nanny or other caregivers.
• ...Call me if you have any sickness in your home that day. I see so many kids who are medically fragile and it’s helpful for me to know if I am about to enter Strep Throat Territory!
• ...Let me know if you feel you need to change to another therapist. Not every therapist’s style is the right fit for every child, or every family. Therapists understand that as a parent, you are just trying to do what you feel is best.
• ...Celebrate each and every step of progress with me! Therapists have the benefit of watching many, many kids make this journey over the years. We know each step on this path. It’s important for everyone to celebrate even the tiniest accomplishments and not become overly focused on the final destination. We will get there, one step at a time!

• ...Hesitate to tell me if you think something that I have suggested just isn’t working for your child or your family. I promise to listen, adjust the therapy and not take it personally.
• ...Clean up the house just because I am coming over to do therapy. I want my visits to the home to make your family’s life easier. Believe me, I’m used to seeing dirty dishes on the counter.
 • ...Lose the therapy tools I loaned to you. I’m happy to loan them, but I can’t afford to replace them. And if your toddler accidently spilled grape juice on the book I loaned you on speech and language development, please let me know before I loan it out to another family.
 • ...Be upset with me when I need to cancel at the last minute due to bad roads. As a therapist who drives from home to home and covers many miles in a day, road conditions vary and I often get caught in bad weather while it is still nice in your neck of the woods.
• ...Ask me to change your child’s diaper or take them to the potty, unless it is a part of your child’s therapy plan.

From Stacy M. Menz, a pediatric physical therapist in the greater San Francisco Bay area who blogs at Starfish Therapies

Do encourage collaboration between your therapists and other team members (including caregivers). Often the other team members will be working on things that are easy for another therapist to carry over, which allows extra skill practice to be 'snuck' in. (An example: if a speech therapist is working on the child producing sounds such as m,b,p then a PT can have the child practice those sounds if they are playing with toys that have things like cows or sheep).
Don't make exercises stuff you have to "fit into" your day—incorporate the exercises and 'homework' into your routine as much as possible so it is part of the day. Often your therapist will have ideas on how to do them; perhaps they can done when you change a child's clothes or diapers. Just be clear on what you can handle as a family so that your therapist can pass on the top priority for you to practice.
Do give your child time to be a kid and have free time, or take a short therapy vacation. Letting them have time to play and interact with the world can often provide their bodies a valuable opportunity to practice, process and integrate all the new skills they are learning.

From Rona Silverstein, an occupational therapist in the northwest suburbs of Chicago 

• ...Communicate with the therapist and participate in the sessions if appropriate.
• ...Ask questions of the therapist—we love to discuss and share our perspectives.
• ...Provide us with your perspective on what is going on. You are an expert as you know your child way more than we do.

• ...Forget the session is about your child. Keep the focus on him, offering encouragement and participating in problem solving.
• ...Ask questions at the end of the session. We may feel rushed and in a time pinch.
• ...Think we know all the answers. We don't! We do have a unique perspective though, so don't hesitate to ask us what we think.

From Becca Jarzynski, a pediatric speech-language pathologist in Eau Claire, Wisconsin who blogs at Child Talk 

Do ask questions! Sometimes we therapists get in our own heads and forget to explain things well. That’s our fault, not yours! Never feel like a question is to simple or to silly. It’s your right as a parent to understand what we are talking about. Make us slow down. Ask as many questions as you want and don’t stop asking until you have gotten the answers you deserve.
Don't hold back on sharing with us. A good therapist will not only get to know your child, but you and your family as well. Tell us what you love to do each day. Tell us the struggles you face. Tell us the successes you’ve had. The more we know, the more we can help you integrate what is best for child development into what is best for your family.
Do take our suggestions with a grain of salt. We are probably going to give you too much to do—we're therapists, it’s what we do. Although we have the best of intentions, sometimes we worry too much about the child and too little about the family. Give yourself permission to ignore us sometimes. Tell us if what we are asking you to do isn’t reasonable. Remember that no matter how important therapy is (and it is important), it must be balanced with maintaining a healthy family, full of love. Trust yourself to find that balance.

From Joleen R. Fernald, a pediatric speech-language pathologist in Dover, New Hampshire 

• ...Be punctual to your appointments. I know you have so much going on in your life, but we have lots to get done in a short period of time!
• ...Tell me when homework is too much. I recall early in my career when I would remind families to read at least 30 minutes per day with their child. Then I had children of my own. I suggest 5 to 10 minutes now!
• ...Try out any exercises with me present so we can make sure you feel comfortable doing them.
• ...Understand that you, the parent, are far more knowledgeable about your child than I do; however, also understand that I am the expert in speech and language and together we make a wicked awesome team!

• ...Act as if you understand what I am explaining when you really do not. I don't mind explaining; please ask.
• ...Respond for your child. Let him work it out for himself so he can learn.
• ...Tell me you practiced your homework every day when in reality, you practiced on the way up the stairs to see me.
• ...Forget to update insurance information or paperwork. This can be very expensive for you and a pain in the neck for me. I'd rather spend my time working with you and your child than chasing down insurance reimbursement.

From Karen Head and Meghan Graham, speech-language pathologists, and Jill Perry, a pediatric occupational therapist; based in Boston, they're the founders of All 4 My Child, a site about collaborative tools and technologies 

Do explain your family culture and routines to your therapist.
Don't feel that you need to be a therapist—"mom" is the most important role you play.
Do share those special little moments of progress (or just adorableness) with your therapist. We treasure them.


  1. This is a great list! Just two more from a therapist who has a special needs child...things I learned recently as a mom.

    Your child may cooperate with the therapist more easily and not tantrum as much, as when they are with you. Take this as a compliment. It just means your child is more attached to you and in this comfort may act out in frustration more with you than with them. It's a good thing, though hard! My son is my hardest client ever! Just don't give up, they will come around and you may need to problem with the therapist on how to really incorporate their suggestions into your life!

    It's okay to feel overwhelmed and take short breaks. Problem solve with your therapist on how to make things easier and which suggestions are the priority. Bring your family schedule and ask the therapist how to incorporate therapy into regular life.'s okay to change therapists if their style doesn't match your child or your family. Or if their level of expertise doesn't include the pediatrics or specific techniques that that you would like to sensory integration.

    Now I have to check out their blogs! Thanks, Ellen!

  2. As the mom of an almost 12 year old with multiple disabilities, with about 1500 hours of assorted therapies under out belts at this point -- thanks for a good collection of tips.

    Our therapists have been a lifeline-- encouraging, supporting, celebrating, and struggling with us. They've helped my son overcome some barriers, and minimize others.

  3. what a great list of tips. thanks for being a great resource!

  4. wonderful! I couldn't agree more with Bea. Parents can become really overwhelmed with fitting therapy goals into their daily routine which may include tube feelings, other therapies and doctors appointments. Brain storming and collaboration with parents and other therapists can help tremendously in incorporating therapy activities or "homework" into every day activities....even diaper changing! Kristina

  5. This post was flat out awesome - I am going to reference it myself!

  6. Wonderful posts! I second all of the comments on ask questions and provide as much information about daily routine as possible. Parents know their child best!

  7. I loved the blog posts. What a useful list! Thanks.

  8. Love this post and the additions in the post! Especially Bea's! Thanks!!!!

  9. Thank you for putting this list together! It had some reminders that I know I needed to read (especially the one about not getting upset when there are cancellations due to bad roads), so thanks for that!


Thanks for sharing!

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