How much therapy does my child need?
A big question therapists are often asked is, “How long will my child need to be in therapy?” Unfortunately, there is no set answer, and all professional organizations limit therapists from stating a specific answer to that question, and with good reason.
It may be frustrating or seem unfair, but many factors determine how long a child will be in therapy, including:
- Frequency of attendance
- Child’s attentiveness and/or participation during a session
- Carryover of a home program with parents and/or caregivers
- The child’s specific diagnosis
Even when a case seems somewhat straightforward, an unexpected illness of the child or his/her caregivers during treatment, insurance limitations, and other outside factors can have an impact.
If you’re new to speech, occupational, or physical therapy…
If you’re new to speech, occupational, or physical therapy, let’s start at the evaluation. Once your child sees a therapist for an evaluation, a recommendation will be made for the number of days a week they need to be seen for therapy. The recommended number of days and length of sessions are based on the therapist’s assessment of how long it will take to make progress toward goals and objectives.
Newly diagnosed and lots to accomplish? Then typically to begin, more therapy is better. The brain is absolutely amazing and brain plasticity gives us a beautiful canvas for shaping and molding to a child’s specific needs. The earlier intervention starts, the more likely success for change is a potential.
If you’re a “therapy pro”…
Let’s say you’re a “therapy pro,” experienced with therapy waiting rooms, case history forms, insurance headaches, and IEPs. Whew! First off, I admire you. You love your child deeply and want so much for him/her and want him/her to make great gains. You know that therapy is not a short term thing and will be part of your lives for some time. When do you say “We need a break!”? Here are my thoughts:
- It’s important no matter what stage your child is in to find balance physically, emotionally, and mentally. Intensive therapy multiple days a week has its place, but children also need “down” time. They need time to play and have breathing room for their brain to soak in all the wonderful things they are absorbing. It’s just as important for children to connect with their families, too, whether through reading your child a book, family game night, or sibling play time. In the case of children who are non-verbal or have limited communication skills, don’t assume that they don’t know what is going on. These children are experiencing and aware of everything around them…they just aren’t able to tell you about it. They need down time, too.
- Some parents worry about taking a break, even for a short vacation, but we have often noticed that if a child is gone for a week or two from therapy for vacation, that they return refreshed and ready to work again, and have often achieved or made progress on a skill that was being addressed in therapy.
- Some of our friends will be “lifers” (needing long term intervention to address much needed skill development). Therapy will and should look different for these children through their years. Early years are devoted to developing critical developmental skill sets. Middle years are about transitioning toward skills of independence. Pre-teen/teen years should focus on functional life skills and implementation in the community.
- Sometimes mom or dad just need the break. It is perfectly fine to take a “sanity” break once in a while, just because. When you need support or a break from the therapy routine, don’t apologize for taking care of yourself!
Always seek out a therapist who believes in your child and what they can achieve. If you are constantly met with a description of your child’s weaknesses and what they couldn’t do in a session, it may be time to re-assess or change your therapist. You need a professional who will be both honest with you about where your child is functioning and can set realistic functional goals that will move your child forward in development toward needed skill sets.
Navigating the world of therapy is a tough adventure path. There will be seasons you go through with your child of significant progress and other seasons where it seems like they have plateaued. Through the ups and downs, keep an open conversation going with your child’s therapists about where your child and family are at the time. Discuss together the need for more intensity or for a break.
Melanie McGriff, M.Ed., clinic owner and speech therapist