Monday, January 14, 2013

Thoughts on therapy

This is Carver with a favorite physical therapist at preschool.  She really loved Carver and he really enjoyed working with her at school.  I have been so grateful for exceptional therapists over the past 5 years - and almost all of them have been truly outstanding.  I gotta say that up front and then hash out the problems we've faced.

Carver started out in a government sponsored program that covers birth to age 3.  It's free, in house therapy.   He got 30 minutes of speech once a week.  Then he graduated to the school district's program, which is also free and government sponsored.  Children with severe enough delays qualify for therapy services in their school district.  Carver qualified for all services offfered.  I was grateful and devastated at the same time, so I had my first total meltdown...  I came home and sobbed off and on all day.  This happens from time to time and I really belief it's healthy.  It's like a grieving process and an accumulation of stress and anxiety that sometimes reaches a breaking point.  It happens from time to time and then we just dig in and get back to work.  At this point, it was a huge wake-up call to see how truly behind he was.  Our district has a developmental preschool and that's where Carver got all his therapy.  I wasn't impressed with the speech services and realized that he wasn't getting one on one help, so I pursued private speech therapy when Carver was 3.  We found a fantastic therapist who helped him once a week, then twice a week for maybe a year?  I drove 45 minutes each way and brought his little sister along... twice a week.  Insurance paid for the first 30 visits, I think.  We ran out of visits and started shorter sessions to save money.  Then we ultimately had to quit once we were paying out of pocket.  At around $100 a session, you can imagine how therapy adds up.   For awhile, we also did occupational therapy at a different location, 30 minutes from speech and 30 minutes from home (they make a triangle).  The summer before Carver started kindergarten I was determined to help prepare him for school, so I would load up all 4 kids and lunches and start the trek.  We'd do speech, run errands, do OT, stop at a park and head home.  Every single week!  We also started paying out of pocket during this time as our insurance changed again.  The routine was busy, expensive and sometimes exhausting for all of us.  When Carver started kindergarten, I decided we were done.  I felt strongly that I needed to enjoy the half days with him while I had him at home and not run us ragged and broke chasing more therapy.  I was also expecting our 5th child and didn't think I wanted to keep up the routine.

BUT.... during those years of private speech therapy, the ONLY developmental category that Carver made "catching up progress" was in speech and language.  He generally makes progress, but not even at typical speeds.  He is ALWAYS falling more behind.  Don't think about that too long, it's a horrible feeling... like sinking into quicksand.  In speech and language, he was actually catching up.  Is that coincidence?  Maybe.  It's impossible to know.  Speech can explode when a child is ready.  Or it could've been the years of therapy.  I tend to think it was in large part due to his therapists and our efforts to practice at home.

I read articles like this one from time to time and know that it's all true.  Therapy works.  We've seen it happen in Carver's life.  But that family must have spectacular health insurance or a boatload of money in the bank for such things.  Therapy is EXPENSIVE.  At 40 hours a week, our benefits would've been used up in a single week.  When did that mom do her grocery shopping or her laundry?  She had other kids - did she volunteer in their classrooms?  Did she do birthday parties for them?  Extra-curricular activities?  How did she do it all?  I read those articles and feel highly inadequate.  It's impossible to put a price tag on helping your child succeed, but at the same time, the resources have to come from somewhere.  We just can't do what that mom did.

In the end, I have I prayed a LOT.  Over and over again, struggling to decide when to do therapy and when to stop.  I felt so peaceful about our decision to end therapy as Carver started kindergarten.  He has WONDERFUL therapists at school that meet with me, provide homework and advice and support.  They love him and think about how to help him succeed.  It has to be enough.  I do the best I can at home and never feel so good about myself as a mom as when I'm helping my kids learn.

It has been good for Carver not to be loaded up and taken too many places.  He is a little boy and needs to be able to play.  He's learning to play by himself and with his sisters, help out at home and have playdates with friends.  We've done swimming lessons in the past, which are cheaper than therapy per hour and provide incredible sensory input and physical therapy for him.... not to mention giving him real life skills!  Now that he's in 1st grade, he needs time to do homework, learn to read and we need to eat dinner as a family.  Where's the time for therapy?

Sometimes I think that if money were no object, I'd put him back in private therapy in a heartbeat.  But it's more complicated than that.  Everything with him always is.  :)

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