Long evaluations, constant scheduling, endless driving back and forth, re-scheduling, and re-evaluations -- therapy is not only a lot of hard work for our children but for us too. So how do we maximize each session to get the very best from all of that combined effort?
Let’s start with the basics:
Diaper check (if applicable) and snacks. This seems obvious, but I can’t tell you how many times we started a session with a fussy toddler and realized she had a wet diaper or was hungry. Offer some snacks, and fluids before the session, and do a quick diaper check to start off each session on the right foot. And plenty of fluids and snacks after too — therapy is mentally and physically draining.
Therapy should be fun! If your child is crying at every appointment, it’s time to find a new therapist. No one learns when they’re crying. Protect your child’s enjoyment of therapy at all costs. If your child is crying for longer than five minutes, ask the therapist to end the session and try again next time.
One session of a therapy per week is usually not enough. Fight for that extra session.
Find a developmental pediatrician to help you navigate your child’s development. They are THE KEY to your child’s success. They will help you navigate everything — how many sessions are appropriate, who are the best therapists; and they will help you find the providers and services your child needs, like specialized dentists, hippotherapy, and myofunctional therapy.
Now that we’ve got the basics covered, and your child is having fun, getting the appropriate services and frequency of services, and you’ve got your team set up, here’s how to maximize each session:
Take notes. Our nanny takes a note pad and summarizes each session, so we can all keep track of focus areas and progress.
Ask your therapist for three exercises to focus on each week. Write them down on a white board so everyone knows what they should be focused on. A team approach is crucial here. For example, in PT, we’re working on (1) “Hands down, stand up” (standing up unassisted staring from a low block); (2) ankle flexibility (stretches morning, afternoon, and evening), and (3) stepping over obstacles (broom stick).
Consider your child’s routine. Our daughter is a big time napper. She was napping from 2-5:30pm (now 1-3:30pm). And she is pretty grouchy when she wakes up. We tried afternoon therapy sessions, and they were always such a struggle. One day, I’d had enough, and I changed all of her sessions to morning sessions. What a difference it made! She was having fun and learning, and it was easier on all of us. It was also more beneficial for her.
Practice each therapy for 20 minutes per day. EVERY SINGLE DAY. Your child must practice the three exercises for each therapy for 20 minutes each day. If you skip a day or two, it's fine. Home practice is the most important part of therapy. We spend 20 mins on OT, 20 mins on PT, and 20 mins on ST each day working on the three focus exercises for the week. Our therapists see our daughter developing rapidly each week, and they know it’s because we’re working hard at home. Again, these practice sessions should be fun. Make therapy a game, with plenty of encouragement.
Re-evaluate therapists. Your child should be progressing. If they aren’t, talk with your therapist, let them know your concerns and ask them for a plan to address them. Give it a few more weeks, and then, if things still aren’t progressing or your therapist isn't being creative and given you new things to try, find a new therapist. It’s all about finding the right fit. (If you notice long plateaus or regressions, contact your neurologist immediately. If you don't have a neurologist, contact you developmental/general pediatrician instead, let them know your concerns, and ask for a referral to a neurologist. Regressions can be super serious and may require medical attention.)
Remain calm. Your child isn’t going to start walking or talking overnight. Our daughter has been in speech therapy for over two years and hasn't said a word yet. She was in physical therapy from 12 months old to 32 months old before she took her first independent steps. It took 20 months of therapy, nearly 160 PT sessions, three different AFOs and DAFOs, and countless hours of home practice for her to learn how to walk. It takes patience, love, and encouragement. And it takes time.
These tips have made such a huge improvement on our child’s development, and we hope they help yours too. Remember to stay focused on the present and celebrate each milestones as it comes.