how much is too much therapy?

[mommyandmore]

My son is 5 years old and has developmental delays and hemiplegic cerebral palsy. I would consider him fairly high functioning in that he walks and talks- just at a 3 year old level, not a 5 year old level. Right now he goes to a regular preschool and gets therapies through the school district- 2.5 hour OT, 1 hour PT, 1 hour speech, 1 hour orientation and mobility, and 2 hours vision instruction per week. Plus after school he has horseback therapy for 1 hour a week, gymnastics 1 hour per week, private adaptive swim lessons 40 min per week plus soccer and baseball in season. Next year he will be in kinder and our district has kinder from 8:20-11:30 daily. So he has to get all those school- based therapies during basically 3 hours of school a day- including transportation to and from the OT (2x/week) and PT (1x/week). So it seems like if we keep up with all his therapies, he won't have any time in actual school learning to read and count and all that stuff. But I don't want him to lose skills in speech, OT, etc. What to do? Should we just take all the therapy we can get as long as the school will offer it? Sometimes I feel like he makes just as much progress "hanging out" with his peers- but I do know that when he didn't have PT for 6 months because they couldn't find a therapist, he lost a lot of skills- all of a sudden he was toe-walking again and he couldn't go up and down stairs by himself, etc. So, for parents with older kids- what did you do? What would you reccomend?

 

[Goofyluver]

My son, who is also DD, attended an early intervention program from birth to 3, and then a DD preschool from 3-5 before beginning regular elementary, where his therapies continued. He was in speech, OT, and PT. He is now in speech, OT, and sped. His DD preschool hours were similar to the Kindergarten hours you mentioned. His teachers still complain that he is never in his regular classroom. This is the way I look at it...get them all they can get now! Because we have also had to pay for private therapy...don't even get me started on that. Don't be so concerned now with them missing out on some classroom time. Kindergarten is very repetitive and and he will get the material again. But, I would limit many outside therapies and activities to just a select few. I spoke to an adult who has the same condition that my DS has been diagnosed with. I asked him what one thing he could tell me about my son's condition. He said the biggest thing is the amount of fatigue and tiredness that come along with all of the physical challenges. Can you imagine how tired their little bodies must get with all of this work? How tired would you get? Now think of how tired these babies get with all of the physical stuff going on. Limiting other activities would be my only advice. These kids need more rest, sleep, and recooperation time that other children do.

 

[Luv Bunnies]

I have a different opinion than the previous poster. I work with special needs preschoolers and "therapy fatigue" can be a huge problem for some kids. Our kids are in class for 3 hours a day and some are taken out for speech or OT. However, our teacher tries to keep the pull-out time to a minimum. The academic material we cover and social skills the kids practice in the classroom are just important to their overall program as the individual therapies. For preschoolers, learning to line up, take turns and share toys are all vital to their future success in school. We do a lot of intensive language work since all of our kids are language delayed. We encourage them to talk to each other and not just to the techers so they learn to communicate with their peers. If the kid are constantly being pulled out for therapies, they will miss a lot.

There are a couple of solutions so they can still get their therapy and not miss classtime. Several of the therapies are schedule for right after class. Our first group of kids is dismissed at 11:30 and some get their behavioral or speech therapy at that time. Some of our kids get therapy at home so the therapist visit them in the afternoons. Some therapy can be done during classtime. Our speech therapist spends one day a week in our classroom. She works with kids individually within our group lessons. She also sits with the kids during lunch and encourages conversation, has them ask for what they want, etc. Most of the kids still get individual speech sessions if it's on their IEPs, but the group approach helps the kids get some speech instruction without leaving the classroom.

We've also had cases where kids get one-on-one behavioral therapy in the classroom. An aide comes in for 2 hours a day and shadows them through the classroom activities. They use behavioral techniques to keep them on track and learn to function in a group environment.

I think it's good to keep kids in the classroom as much as possible during the early years. Kindergarten sets the tone for their school careers and I think it's an important time. You also don't want your son to feel like he's missing out on anything fun. We've had kids start to resent their extra therapy time. They act up during their sessions because they'd rather be somewhere else. This is what I mean by "therapy fatigue." All the sessions start having the opposite effect if the kids feels "therapied out."

I would recommend talking to someone at the school district. Map out his schedule and see if any of his therapies can be done right after school, at home or during classtime. Hope everything works out!