Multiple therapies question

[purpleowl]

Not a schooling-related question, but I'm hoping those of you with experience can help me out here. 🙂 

Short version: If DS needs both speech/language therapy and occupational therapy, does it matter whether they are in the same place or not? Will it be a huge headache to schedule things if they are NOT in the same place?

Long version: DS has been referred for both ST and OT, at the same place. For OT, the place said we should get a call in a week or two, but for ST, they have a freeze right now due to losing two of their speech therapists, and between that and where he is on the waiting list, they said it would be quite a while.

Ped's office (who did the referral) told me that if I find out the wait will be too long, I can call back and they will refer him somewhere else. 

So do I need to go with the OT at the one place but request another referral for ST? Go with the OT and just wait for the ST? Or request another referral for both to somewhere else?

[Lecka]

Well, it will depend on if your child has a greater need for OT or speech — do you need to prioritize one of them.  You might or might not.

I also would not assume you can schedule speech and OT in back-to-back sessions, and then it is a moot point.  It could be either way, and it could be something where sometimes you can schedule that way and sometimes you can’t.

I also would not assume you have the same therapy frequency with both therapies.  They could both be once a week.  Or one could be 2-3 times a week and the other once a week.

Probably most common would be — once a week for each

But depending on your child’s needs — one or the other could be 2-3 times a week. 
 

So — it is hard to predict.  
 

Personally — I think start at current OT and ask for a referral to a new speech option.  Then — down the road you can transfer one or the other service if you see you want to have them at the same location.  

[Lecka]

Ime — it is not a big deal to transfer a service to a new location, but if an assessment has been done they may not be able to repeat it and need to use the previous place’s assessment.  Probably not a big deal.  
 

Sometimes they will want to change your child to a different therapist at the location, and that can be a good time to change locations if you want to.  

[Lecka]

If there is a major convenience factor and you change when you get a spot — I think people understand that, too.  
 

But I don’t think it’s necessarily much more convenient to be at the same place for both, since one could be more often and also back-to-back slots are nice and they may try to do that, but it’s not something to count on.

And if your child is prone to getting tired then you might not even want to do back-to-back if they are tired in the second session.  It’s convenient but still might not be a good choice.  It just depends. 

Edited March 8, 2021 by Lecka

[Lecka]

Depending on your situation — you may be able to get a list of places your pediatrician can refer to, and call them and ask if they have a waiting list for speech therapy, and just ask them if they can usually book back-to-back.  
 

Ime — sometimes all the places have a wait list for one thing but not the other, and then you can get on all the waiting lists and consider how far you would drive.  

[Lecka]

If you can ask around, too, you might be able to request a referral to a place you have heard about from others.  
 

If you do get on a waiting list, you will want to call every week or two weeks (or month or whatever) to check on that.  

[Lecka]

I do not think there will be any difference as far as convenience wrt insurance paperwork. 

I think using the same office or a different office would not matter for that.

As far as I know -- that would not be a consideration at all.  

[Lecka]

Just for example, because I did not think about it this way when therapy was new to me.

But my husband right now sees a chiropractor and a podiatrist.  The issues are related yet separate.  He sees the chiropractor much more frequently than the podiatrist.  

Yes -- it would be more convenient if they shared an office -- but it is not a big deal for them to be seen at different offices, either.  

Can there be some integration of goals or techniques between speech and OT?  Yes -- there can be.  It will depend on your child's needs if this is going to be an issue or not.  

But to a great extent -- if you are the parent and you say "here are my concerns" then both places will respond to that.  If you say "at speech they are doing x technique and it is working well," the OT can also do it.  So -- to a great extent, if there is a need for integration, you can stay on top of it.

There are places that will say -- oh, we can schedule OT, and your child will be calm and regulated from that when it's time to go into speech.  But you can do that on your own, too, and just make sure you are setting up your child for success when it is time to go into speech.  

And then for a lot of things -- that will be a non-issue anyways.  

I have thought the integrated service seemed needed at an autism place I toured, where they could have behavioral advice shared with speech and OT very easily, and they could schedule kids in groups to work on social skills while also doing some OT kind of thing (etc).  Well -- if that is needed I think that is good.  It is often just not needed and a non-issue, though.  

I have had two kids in some amount of therapy, and a 3rd who had school speech therapy.  But two of them had extensive speech and OT.  For one -- we had all these transition issues and participation issues -- and he had autism.  For the other -- he easily got along with new people and easily worked hard and focused and all of those things.  In a 5-minute conversation I could easily communicate with a therapist.  Or in a text, even.  I signed paperwork for therapists to contact each other to coordinate, for him, but it was not needed in any extensive way.  For my son with autism -- this was all needed in an extensive way.  

[purpleowl]

Thank you very much, @Lecka! I seriously think that an autism diagnosis should come with a flowchart of next steps and a detailed manual, lol.

The one therapy place that I've heard people raving about - and which is less than a mile from my house - is out of network for our insurance. Boo. The place he's been referred to is about a 10-minute drive, so not bad. 

I'll call back the ped's office and ask about getting another ST referral.

No one has indicated which one I should prioritize, and I could see going either way if we needed to just work on one at a time. 

He hasn't ever done any sort of therapy, so I don't know whether it will make him tired. He's not a kid who generally gets tired quickly, though. 

[Lecka]

Say he has an autism diagnosis and any other information when you talk to the office on the phone.  It might effect which therapist you see.  

Honestly it could be either one with autism!  My son that has autism -- it is speech therapy, by far. 

But if they said anything to you like "only pragmatics," and he has more OT issues, it could be OT.

I would say -- it is less common to have OT more than once a week.  It is more common to be able to do exercises or activities at home with OT.  

Even at places that people rave about -- there are still kids and therapists who are a better or worse fit, and that can be very individual.  There are also some kids where it is always going to be harder to find a good fit, and kids who will have a much easier time having a good fit with almost anyone.  

You didn't mention a counseling referral.  Ime -- not that everyone needs a referral for counseling, but a lot of times there is either a referral for ABA or for counseling.  If a referral for counseling might be helpful -- you can just ask the pediatrician.  I think this can be for social skills teaching.  It is one of those things -- it can depend on insurance -- but it might be something where you can just ask for it and they will give you the referral.  

If it would work out better for you to focus on one at a time -- you are free to do that 🙂

You definitely can see what meets your needs, and do not need to feel obligated to do things just for the sake of doing them.