Pediatric Therapy – Good or Great

Mel has had some awesome therapists.  She also had a few therapists who seemed to just be going through  the motions.  My therapy drive varied from time to time.  Overall, I wanted therapy to help Mel and to teach me.  I did not want to be her therapist.   I wanted to be MOM. However; I wanted them to teach me how to teach her as we played and lived life. 

In the USA, therapy may be covered under your health insurance.  When Mel was young, the visits were unlimited and covered at 100%.  Usually Mel went one to two times a week.  That is almost unheard of these days.  I remember having to call the Spina Bifida Clinic doctor to get her out of a hospital while we were on vacation one year.  They were running every test under the sun and then some.  Mel was fine.  It seemed like they just wanted to test for no reason.  That’s another post.  Today, we have a set amount of visits and I have to pay a co-pay or deductible.   Therapy also has to be coded correctly.  Mel last received therapy about a year ago for two months, in the summer.  It was to help her meet a few specific skills.  Prior to that, Mel had not received therapy since she was probably in 2nd grade. 

So what makes a great therapist?

  • Compassion – If there is any great secret of success in life, it lies in the ability to put yourself in the other person’s place and to see things from his point of view as well as your own. (Henry Ford)
  • Understanding – The reality of the other person is not in what he reveals to you, but in what he cannot reveal to you. Therefore, if you would understand him, listen not to what he says but rather what he does not say. (Kahlil Gibran)
  • Communication –  To effectively communicate, we must realize that we are all different in the way we perceive the world and use this understanding as a guide to our communication with others (A. Robbins)
  • Skill – Your talent determines what you can do. Your motivation determines how much you are willing to do. Your attitude determines how well you do it.” (Lou Holtz)

The therapist should take the time to listen; to sit, look you in the eyes and explain what they are going to do and why.  You should understand what they are doing, why and how long before you see a change.  The therapist should not bring her personal life into the picture. I do not need to know she has a child the same age as Mel. I do not need to know where she shops.  The therapist should not become my friend on Facebook.  I even think switching therapists from time to time is a good idea.  I became too emotionally attached to some of Mel’s therapist and I think that clouded my decisions and possible theirs. 

Mel saw a great hand occupational therapist around the age of 7.  My goal at that time was to make sure her hands were as good as they could get.  She was probably in kindergarten or first grade.  I did some research and decided to go to a clinic in the town south of us.  I had to wait to get in with the therapist I wanted.  I knew Mary specialized in pediatric therapy and had extra training in hand therapy.  My goal was to go to her for 2-3 months and really focus 100% on Mel’s hands.   It was a great evaluation.  Mary sat and listened to what I was expecting.  The therapist explained what she was doing with each evaluation task and why.  She gave me some great ideas to try at home.  Simple things that I could do during play.  As it turned out, Mel’s hands were pretty close to her age level.  Mary gave me several things to look for at home to promote the next stages of development.  She told me if Mel was not doing these things in the next few months to come back. I can’t recall if we had to go back and get 1:1 therapy or if Mel started doing the few hand skills that Mary wanted me to look for.  Mary listened to my concerns, answered all my questions, gave me her ideas and made sure I was 100% on board with her plan.  Thanks Mary

Rita is a different story; she owned the clinic closest to our home.  Mel was maybe 3 or 4 years of age.  I do not recall having any set goals and was probably getting therapy to just get therapy.   At that time, I felt we were supposed to be in therapy.  I was allowed to sit in therapy and watch.  I remember working on shoulder strength.  One day, Rita put Mel in a swing on her tummy and wanted Mel to move around in the swing.  Mel screamed.  It was a terrified scream. A scream any mom knows means HELP.  Rita asked me to leave.  I guess she felt Mel was screaming so I would save her and Rite thought Mel needed to work through the terror.  I walked around the clinic for a few minutes and could still hear Mel crying.  As I walked, I thought:  What is the purpose? Why does Mel need to be in that swing?  I then turned around, walked into the treatment room; Rita was taking Mel out of the swing.  No explanation about why Mel needed to be in the swing or what the purpose of her working through the terror.  No mention as to if she was going to put Mel in the swing again.  I called and requested discharge the next day.  I later found out Mel’s eyes do not work together at all.  Due to each eye working independently of each other and not communicating with each other, Mel has poor depth perception.  Mom was right, Rita was wrong.  Mel was screaming because as she was swing back toward the ground, Mel probably could not tell how close the floor was to her head.  I’ll post later on Mel’s eyes.  I should give Rita credit. I hear she is a great therapist.  On this one day, however, she lacked communication and I think, was not open to Mel’s and Mom’s needs.  Yes, maybe I should have spoken to Rita about my concerns.  Yes, I have been known to be a little impulsive.  Sorry Rita

I remember Jane.  Jane was a private therapist who also worked in the school system.  She worked with Mel on her walking.  She was quite, soft and Mel loved her.  Jane gave me a few things to do at home and usually I tried them in the clinic before doing them at home.  She told me how often I needed to do them and why.  I remember she had a soft voice.  The tasks were things I could easily do at home.  I had confidence in Jane as I felt she was looking out for Mel’s best interest.  Jane took the time to listen to me and respected my ideas; even if they were crazy.  Jane knew my goal was not 24/7 therapy but therapy only if it was going to lead to a difference for Mel. 

When Mel was 3 years old, she went to a public school program for half a day and a private daycare for the other half.  The school program was something I felt Mel was supposed to do.  After about 2 months, Jane walked me to the car as I got Mel from school. She asked if Mel really needed to be in the school program.  She asked about my thoughts and the overall purpose of having Mel in both the school program and the daycare.  I thought she was going to recommended Mel do more school.  She then, indicated she felt Mel might not be 100% happy in the school program.  I was kind of shocked and worried.  She quickly reassured me Mel was being taken real good care of. She mentioned that there were several kids in the class who loved mechanical things and tended to follow Mel around all day. She told me Mel did not appreciate them constantly touching and playing with her chair. She told me the teacher were working hard to keep the two mechanically minded kids at bay. She indicated that Mel had the skills she need at age 3 and really did not need the program from an educational/therapy standpoint.  She felt Mel would benefit more by being around kids from her neighborhood; the kids who were going to know Mel in elementary school and then in high school.  If l liked her day care, and I could afford it she recommended I take Mel out of the school system and have her attend the private daycare center all day.  She told me to think about it and let her know.  She indicated Mel was welcome to stay in the school program.  She would support my choice either way.  Now, at first I probably was heartbroken, I probably thought Jane did not like Mel and thus did not want to be bothered by having to help make the other kids stop messing with Mel. But then as some point, I realized Jane was very courageous and was just telling me her opinion about what was best for Mel.  I’ll post later on Daycare.  Oh, yes, Mel then started to attend day care full-time.  I worked 4 to 5 days a week. 

I think the best gift a therapist can give any child is to be 100% present during each therapy session.  M. Scott Peck said “You cannot truly listen to anyone and do anything else at the same time.”

I recall going to one local clinic.  Therapy was held in a big gym with lots of therapies going on at one time.  I was a noise parent and I loved to listen to all the chatter between therapists.  At some point, I started thinking about this group interaction.  Was Mel’s therapist really present and giving Mel 100% if she was speaking about this and that or giving a different therapist advice?  No, Mel’s therapy was her time and I felt the therapist should be 100% focused on Mel and Mel’s need. This was not a social event in which all exchanged information.  This was supposed to be Mel’s time to help Mel.   I was supposed to be learning about Mel’s needs not expanding my knowledge about all the other kids/therapists in the room. 

All in all, therapy did a lot to help Mel and to help me.  I am glad we went to therapy and I have many fond memories of Mel’s different therapists.  Carl W. Buechner saidThey may forget what you said, but they will never forget how you made them feel.”

Thanks to all who helped Mel achieve. 



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