Your Child’s Therapy: Weighing the Options

By Jennifer Meyers Bekins, MS, CCC-SLP, Cincinnati, OH

Parents of children with Down syndrome are often familiar with the three therapies most frequently recommended for their child: physical, occupational, and speech therapy. Therapy frequently begins when the child is just months or even weeks old. Once in an established therapy routine, parents may find themselves asking, “Will my child ever be done with therapy?”

Parents and caregivers often work. Children have school and extracurricular activities. Adding weekly therapies on top of it all can be a lot to balance and may lead to burnout. A healthy, supportive family also is important for a child’s development, so it is helpful to understand there are many different ways to meet a child’s developmental needs without always packing a schedule full of therapy visits.

If you are considering private therapy for your child, here are some ideas to help you make your decision.

How long should my child be in therapy?

Therapy does not need to be life-long. However, there may be seasons in your child’s life when physical, occupational or speech therapy is especially helpful to your child’s development. It’s important to ask up front how long the child should be in therapy and to establish goals that both the therapist and parent agree to work to achieve. This is central for learning new skills and accurately reassessing the child’s abilities.

After a few months of therapy, it’s necessary to revisit the goals and identify the child’s progress. Following reevaluation, therapy may continue with updated goals, decrease in intensity or discontinue altogether. Working up front with your therapy team to create child-specific goals will ease the transition to less frequent treatment or discharge from therapy. These objectives also will help guide the team in selecting the most appropriate treatment.

Are there different models of treatment other than weekly sessions with a therapist?

Yes! Depending on the resources available in your area, there are a variety of treatment options available. These may include individual private treatment, group therapy, consultative treatment, co-treatment or short-term topic-focused classes lead by therapists. When selecting a therapy option, it’s important to consider the child’s attention or energy level, medical status, educational commitments and the family’s time restrictions.

Here are some examples to illustrate different therapy options.

  • For a child receiving chemotherapy treatments who has reduced endurance, co-treatment with occupational and speech therapy gives the benefit of both specialties in half the time.
  • For teens having difficulty understanding boundaries, participating in a small structured group with peers is a great opportunity for modeling and practicing new skills.
  • A short term exercise group is a fun and practical way for a child to learn about healthy living.
  • A child with apraxia often does well with short, frequent sessions with lots of opportunities for repetition.
  • In a summer session, a preteen can work on balance while learning to ride a bike to be able to hang out with his neighborhood pals.

What is co-treatment and what benefits does it provide?

Co-treatment is a therapy session where the child sees more than one provider. This is typically speech and occupational therapy; however, it may include physical therapy or psychology.

Co-treatment is appropriate for children with sensory, motor planning, and/or behavioral disorders along with communication needs. The child often has decreased progress in one domain as a result of difficulties in another area. For example, a child with Down syndrome may have sensorimotor needs, which hinder progress during speech therapy sessions. Co-treatment allows the speech pathologist to address speech and language skills while the OT focuses on the sensorimotor needs. This approach can lead to greater gains in both areas.

How do I know I am picking the right model for my child?

Choosing a therapy team and model of treatment is just like selecting a day care or school. Explore the options available, ask other families for recommendations and consider your specific family needs. Then, make the decision you feel is the best fit for this time of your child’s life.

Editor’s note: Bekins is a speech pathologist at Cincinnati Children’s Hospital and, along with Katherine Frank (OT) and Stacey Maignan (PT) will present a workshop at the NDSC Convention in Sacramento.