Therapy Time

by Tammy Mihalow

I am a speech therapist at our local intermediate unit. I have students ranging from 6 years to 21 years.

I was wondering how other therapists determine and justify the amount of time they see each student. I "feel" that some need five times per week and some only one, but how do I justify this.

I need a way to put it on paper to show a parent who may be questioning the times.

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Feb 28, 2013
More info needed
by: Audrey

Sorry, I don't know what an intermediate unit is.

Is that a school?

I take into account a lot of factors when considering time.

Generally, I believe children with artic. issues need more frequent, but shorter sessions.

Children with language issues, I consider if they are placed full-time in my school (where they get lots of language input outside of therapy), or if they're an only child at home all day with mom.

I do think children on the Austism Spectrum seem to do better with more frequent, but often shorter, sessions.

For length of session, I also have to consider the attention span of the child. I think it's insane to work with a 2 year old for an hour, but that's what our early intervention CDSA therapists do.

It's crazy.

I also consider the needs of the parent, if the child is a drive in student. I may think ideally I would see the 3 year old for 15 minutes, 4 times a week. But mom doesn't really want to drive the child to school 4 times a week, for such a short session.

Basically you just have to look at each child individually and make a case-by-case decision based on as much information as possible.

You will ALWAYS have parents who think you need to see their child 5 times a week, for an hour a day.

I try to take these requests as a compliment, but I have to say, as a school-based SLP, it does bother me sometimes how parents place speech as such a high priority, over other needs I see as so much more pressing.

If a student is sitting with me in speech, what instruction are they missing in the classroom?

What opportunities are they missing with their peers? More therapy does not always mean more progress.

I have had more than a handful of students who got 'too much' therapy (from school, from private tx, from parents who drilled them at home) and ended up shutting down and refusing all speech-related tasks, period. Basically stopped talking!

Balance really is the key. Go with your gut, have good reasons for your decisions, and then change things if it turns out you were wrong.

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