As a parent of a child with special needs, there is nearly always a lot going on. There are appointments to attend, phone calls to make and many conversations with professionals, businesses and government agencies. Parents tell me that it often feels as if everybody else is speaking a difference language, pulling you in a different direction and ‘selling’ something. In my latest book, “Becoming Chief, How to lead your child’s special needs tribe”, I discuss the advantages and disadvantages of having therapy at home, school, at a special clinic or even virtually using Skype. Sometimes it is hard to know which will be the best option. Your Family Service Coach is a good person to chat this through with, so that you are clear about who you are working with and where the therapy will take place. After all, the magic happens when you have the right people working in the right way on the right goals.
As with most service delivery options, you can certainly try different models and locations on for size, measure the value of each, then mix and match as you feel your child needs. Let’s review each of the following service delivery models:
- The location of intervention
- Home visits
- Clinic-based intervention
- School-based intervention
- Using technology
The Location of Intervention
The location of the intervention doesn’t always have to be clinic based. Depending on how your family program is running you may want to find out about preschool or school visits as well as, or instead of home visits. It can be great to have a mix of both.
Pro: Different locations mean you can tailor your child’s schedule around you and your family’s different needs.
Home visits let you see exactly what is happening in therapy sessions, including core learning concepts and experiences, the language being used, the pace, the activities used and the task transitions. It is good to try to normalise the therapy sessions when possible, but remember to keep it real and playful. Children experience a whole new level of learning when they are happy, relaxed and having fun.
Pro: Home visits mean you don’t have to leave the house, it’s a familiar environment and there’s no travel and waiting time.
For some children and families, the home environment is too familiar and potentially too distracting. They are used to being able to do as they please and have a range of home behaviours that don’t support good therapy and learning. Clinic-based appointments may be cheaper as many service providers charge an additional cost to travel to your home.
By contrast, going into the service provider’s room offers a friendly formality that supports some children to work beautifully. There are also lots of lovely toys, equipment and even assessment tools that can be used at a moments notice and you may develop friendships with other parents and the administration staff.
However, there are several considerations when it comes to clinic-based intervention. I have seen parents struggle to get their kids in the door juggling strollers, bags and little people who need their hands held, mouths wiped and noses blown. It can also be a challenge to take the skills that your child is learning out of the clinic room and into real life. Yes, skills need to be developed, but they also need to be smartly applied into their real lives.
Pro: The opportunity to develop routines and skills for children helps them learn how to get ready, be flexible with car travel, wait quietly, work with new people and manage their belongings and travel toys.
Many service providers provide services in your child’s school or preschool setting. This is often a positive option and one well worth discussing with your child’s team. School and preschool are where so much of your child’s learning will take place, so it makes sense that specialist therapy and psychological input are invested in this location and educational staff.
Most therapists will be more than happy for you to join the session at school and to meet with you, but it takes a little planning. Work with the therapists on ways to apply the concepts, content and strategies to life at home. It is essential to stay closely connected to your child’s preschool and school-based service providers.
Pro: School-based services increase (but don’t guarantee) the likelihood that information will be shared, performance expectations will be consistent and inter-agency communication will take place.
Technology can help save more time and further streamline your child’s program. Skype is one key example – beyond using Skype to host meetings with your child’s team members, evening catch-ups with parents, it can also be used for your child’s appointments. Speech pathologists in particular work very well with this fantastic service delivery tool.
It is perfect for parents and team members to quickly connect and should be used way more than it currently is.
Pro: For older kids it works a treat – no schlepping, waiting or appointments in ‘uncool’ kiddie rooms.
Many families work through a range of therapies in different locations. They may visit the Speech Pathologist in her rooms and have the OT visit school. It is great to work with practitioners who offer flexible home, school and clinic based services so that you can alter your child’s program as required. An example would be home visits during pre-school with occasional kinder consults, then shifting to school visits for teacher collaboration and occasional home consults. This flexible model meets you and your child’s needs at different times. As a Family Service Coach, I frequently facilitate team wide conversations where we collectively plan the best possible therapy program. You are encouraged to explore all the options, review the program you put in place and tweaking it as required.