If you suspect that your child may have a speech or language concern, a gross or fine motor problem, or difficulty processing sensory information, a speech/language evaluation or occupational therapy evaluation may be warranted. If you have any questions, an experienced therapist can discuss your concerns and assist with deciding whether an assessment would be appropriate. We also welcome you to visit The Therapy Place. We offer tours of the clinic, as well as the opportunity to observe treatment sessions and meet with clinic staff to discuss any questions you have about the services that are offered here.
The first step is to complete an intake packet providing basic information on your child and health insurance information. A therapist will return your call to schedule an appointment for an initial evaluation. The evaluation takes approximately two hours. Once completed, an assessment report will be compiled with recommendations and sent to you and your child's physician. In some cases, prior authorization from the insurance company is also required, so the appropriate information will be provided to them as well. Once authorization is received, any necessary therapy is scheduled. The children receive a regular appointment time, generally two to three times per week.
A general rule is that an order from your child's pediatrician is required for both assessment and treatment. We can assist with orders. With some insurance plans, a referral from the primary physician is required. This is the parents' responsibility.
Many insurance plans cover speech, occupational, and physical therapy services. It is very dependent on the individual insurance plan, which needs to be checked carefully. Some plans require prior authorization before services can be rendered. Others have restrictions on the number if visits per year that are allowed. Still others require referrals from the primary clinic your child attends. It is necessary for parents to be aware of these benefits.
Currently we have openings in all areas of therapy.
The length of time that a child spends in occupational therapy is very dependent on his or her individual needs. The average length of time is six to nine months, but it can be less or more. Length of time is also very dependent on follow-through at home. A strong home component is necessary to the success of the therapy.
Children who have sensory integration deficits or sensory defensiveness tend to be uncomfortable and have difficulty coping, particularly in unpredictable environments. This can result in withdrawal, avoidance, or aggressiveness. They oftentimes have difficulty modulating their arousal levels, which interferes with their motor skill. As they are better able to modulate and interpret the sensory input that they are experiencing, they should be better able to cope and learn, with decreased negative behavior. Also as their neurological system becomes more organized and they become more aware of where their bodies are in space, their motor development will also improve.
Parents and caregivers are very critical for therapeutic progress. As part of your child's treatment, you will receive a home program. Since your child is only in therapy two to three hours per week, carrying over suggestions at home is necessary for progress. The course of treatment is also decreased by consistent follow-through at home and across other environments that your child may be involved in.
An assessment generally takes two to two and a half hours to complete. It generally consists of a developmental motor test such as Peabody Developmental Motor Scales, or a motor proficiency test such as Bruininks-Oseretsky Test of Motor Proficiency. These tests provide standardized scores and information regarding you child's motor skills. Sensory development is assessed through clinical observation, which consists of observations regarding motor function, postural and ocular responses, muscle tone and reflex integration, as well as their responses to movement and tactile stimulation. The third part of the assessment consists of a parent or caregiver interview, as well as completion of several forms. These include a Developmental History form that details pre-, peri- and post-natal information; infant behaviors; developmental milestones; present behaviors to varying stimuli (auditory, gustatory, visual, tactile, proprioceptive, and vestibular); school and home performance, and other testing that has been done. Parents also complete a Sensory Profile and a Functional Daily Living Skills Screen. Therapists also review previous testing.
Once testing is completed, the therapist will compile a report with recommendations, which is sent to parents to review. If therapy is recommended, therapy sessions can be scheduled at this time.
The length of the speech language assessment varies, depending on what the need /referral concerns of the child are. If a child is coming in for only a speech assessment, assessing sound production, the assessment is typically completed in 45 minutes to an hour. During this time a standardized assessment such as the Goldman Fristoe Test of Articulation will be administered. Based on the child's age and level of cooperation, an oral motor exam might also be completed.
If a parent has concerns regarding their child's language (ability to understand others and/or ability to effectively express wants/needs) the assessment tends to be longer, lasting approximately one and a half hours. For younger children, assessments such as the Preschool Language Scale-4 may be used. For older children, tests such as the Clinical Evaluation of Language Fundamentals or the Test of Problem Solving are typically used.
In addition to completion of standardized assessments, the child's speech/language skills are assessed through clinical observation. A child's eye contact, means of expressing wants/needs, and ability to follow simple directions are among the items the clinician will watch for.
Finally, the child's parents are asked to fill out a developmental history, which includes information on pregnancy and birth as well as information about when the child reached certain developmental milestones. Depending on the child's age, the parents may be asked to fill out a pragmatic language (social language) checklist as well.
After the assessment is completed the clinician will discuss results with the parents and make recommendations. Within a couple of weeks after the assessment is completed a report containing test results and recommendations will be sent to the parents as well as the child's physician. If therapy is recommended the treatment times can be scheduled at this time.
School therapy needs to be based on your child's educational needs. It is also necessary to qualify for those services. Occupational therapy is considered a related service, meaning that it must be related to a primary service such as an academic service (i.e. learning disability or a speech/language service or physical disabilities, etc.). It cannot be the only service that your child is receiving. Occupational therapy services also vary greatly from district to district and they often are most focused on fine motor issues. Due to time constraints in the schools, sessions tend to be much shorter in your child's school-based programs. Therapists may not be able to provide the intensity and the frequency that is needed. Often schools do not have the space for the equipment or the necessary equipment available to address sensory-based problems. The Therapy Place has large gyms with a variety of suspended equipment. Therapists have participated in extensive training focusing on sensory integration. We emphasize contact with your child's school therapist for consistency in treatment and sharing of information from setting to setting.
A co-treatment consists of two therapists from different disciplines who treat your child simultaneously. Sensory input provided by the occupational therapist stimulates language learning. Within the therapy session the needed sensory component can be provided during or directly before a speech/language task. The collaboration of both professionals provides children with the best possible intervention.