Which Therapy Should My Child Do First?
By popular demand, I’m going to address a topic that parents have been asking me, the front desk staff, and our therapists: “I know we’re going to need multiple therapies. What’s the best order to pursue these therapies?”
It Depends On Your Child
There are no magic answers to this question. There are no recipes. There are trends, and people address these trends in different ways. There’s no right or wrong answer. It really depends on your child, your schedule, your family, your insurance coverage—there are many different things we consider when we look at multiple services.
But I can give you a few pointers on how you can make better choices:
Your Insurance Benefits
It’s important to look at your insurance benefits, because you may have a visit cap or limit, and that cap may include multiple disciplines. Sometimes you have separate caps for separate disciplines, such as 50 OT visits, 50 PT, and 50 speech. But sometimes it will be 40 or 50 combined. With many of our Blue Cross clients, each session could be 4-6 units or an hour to an hour and a half. This is the first thing we have to take into account, and we work within your insurance parameters to maximize your time.
We might find that you have an unlimited amount of speech therapy visits, while your OT and PT visits are limited. We might decide to keep speech therapy going on multiple visits, but let’s maybe start with OT and then go to PT. This way we don’t have gaps in service, and we’re not finishing up services in October because your visits have run out.
Sometimes if we know there’s a visit limit consideration we’ll start one therapy, and then we’ll bleed into another therapy and then another.
When You Start With One Therapy Then Add Another
Some families come here pursuing only one therapy, such as occupational therapy. Sometimes during occupational therapy, your therapist may decide that your child also needs physical therapy, and sometimes that there’s a speech component that should be addressed. We can sometimes add those services in as you go.
We really want to make sure that when a kiddo starts here, that we’re adding in services in a way that they can participate in if there’s any kind of endurance issue. There’s also a co-treatment component, which means that sometimes instead of doing 2 hours and 45 minutes of treatment for three disciplines we’re overlapping so that it’s more like 2 hours.
What If They Are There For a Long Time?
Many of our clients come here for 3-4 hours at a time. They bring a lunch and we take a break, but we make that part of a process so that the child is working on a sedentary activity while they’re taking their lunch break.
Often when a client comes in who knows they’re going to need multiple therapies, they will come in saying that their physician has recommended, let’s say, occupational therapy. We know, though, that the child will also need physical therapy, aquatics, and speech. When we have the parent meeting the occupational therapist will sit down with the parents and say, “We know you need these other disciplines, let’s add them in this order.”
Sometimes there’s not an endurance issue. In those cases, we will evaluate all three disciplines within a week and start treatment for all of them.
Your Child’s Ability
So you can see that there’s no protocol and no general answer. It’s based on your child’s ability. We have some kiddos whose parents want them engaged multiple days, and want to start all three services at one time to make that happen. Others want to move more slowly.
We will assist you in making this decision, and we will work directly with your concerns. But as you can see we approach this from many different avenues, and we take into account all the concerns I’ve talked about before we ever make a recommendation.
Understanding Your Insurance Benefits
It’s important for you as a parent to understand your benefits better than we do. We can make these recommendations but we are managing multiple policies. And sometimes even if you stay with the same policy your coverage may change from year to year. You have to watch to see if they remove or add anything to the policy, or change the visit limits or deductible. I did this regularly as a parent. I can’t tell you the amount of time I spent on the phone to insurance companies! It was pretty much a weekly endeavor for me, almost like a full-time job!
If you are one of our out of network families, ultimately you are going to get information much quicker than we are. We are billing and going through the process, but they are going to contact you first.
We are going to verify your benefits and keep track of that for you, but it’s important that you’re prepared for any changes. These changes can be very upsetting when you’re not prepared for them. We don’t make any of those changes, they’re all changes that your employer has decided to put in place, or that your insurance company has decided to put in place.
If you have more questions feel free to reach out to your clinician, or the front office or the billing folks. They’ll be more than happy to answer these questions for you!