Expert's Corner > At Home with Therapists


Jeff Stimpson, 39, lives in New York City with his wife and two sons, Alex and Edwin. He has been a working journalist for 15 years and maintains JeffsLife, a site of essays at jeffslife.tripod.com/alextheboy.

Therapists have been coming into my home for 13 months to work with Alex. After he was born two years ago, he underwent everything from naso-gastric feeding and callous jabbing of needles by nurses to medically induced paralysis, all during what should have been crucial months of his development.

Thirteen months ago, nobody would say what Alex might be able to do, or not do, in the rest of his childhood. So we got therapists for feeding and speech, as well as occupational and physical therapy, as part of federally-funded Early Intervention.

Remembering what we did with doctors for the 13 months that Alex lived in hospitals, we sized up Alex's therapists as they came through the door. We didn't want a therapist who came with simply a laundry list of semi-medical activities for Alex and us. We wanted Alex to have fun.

"You're not looking for someone with a lot of shtick," says one of Alex's therapists, Ron Doomchin, a special instructor in New York City. Ron has worked wonders with Alex, who scampers into the hall bouncing with excitement whenever Ron arrives. "You're looking for someone who comes in and sizes up the situation. First impressions are important."

First on Ron's list was to teach Alex to listen to a flute. Then he taught Alex to sit quietly and flip the pages of a book, then to track bubbles with his eyes.

Our therapists have been pretty good. He likes most of their toys; lately he's happier to see Ron's toy bag than he is to see Ron. Another therapist explained to me a chart of "normal" development and helped me figure out how Alex might be ahead in some areas and behind in others. She also recommended a babysitter. "Sometimes parents aren't informed, and they don't ask enough questions," says Cheryl Rooney, Alex's OT. Ask about experience and education, she advises. "You generally don't want people doing home therapy who have less than one year's experience."

"Ask if they've worked with children who present different types of conditions and challenges," Doomchin adds. "Ask if they know any of the people at the agency that they're working at. Ask if they can recommend different types of therapists and why. In explaining, they'll demonstrate their knowledge. Does the therapist explain the materials and techniques without jargon? Taking the time to explain long-term goals? Establishing communication? That leads to finding out more about the knowledge of the therapist. Are they flexible?"

Inflexible therapists might not talk much and could be quick to dismiss a parent's questions about a new therapy. One of Alex's early therapists, for instance, criticized our collection of toys, insisted on using her own toys instead of Alex's to teach him skills such as stacking, and would sometimes spend a whole session making him reach for a toy without ever letting him touch it -- despite the frustration on his face. She insisted we brush him, though he seemed to get little from it. We got rid of her in a month.

"You kind of get a feeling for people," Rooney says. "And if you have a therapist who's been treating your child for a couple of months and the child screams in pain when the therapist comes through the door, then something's wrong."

Other tips include:

* Keep a notebook. Jill has a three-ring binder with one page devoted to therapists' numbers for beepers, portables, home phones, and e-mail addresses. You can never have too many ways to contact a therapist. Devote another section to therapists' written entries, made once a month.

* Hang around during therapy, especially during the first month. Don't regard it as a break time for you the parent until you feel sure the therapist and your child are a good match. Always watch for how happy your child looks during therapy.

* Bear in mind that some therapists are quick to cross boundaries - especially after they've attended a conference -- with OTs dispensing advice on vision, PTs opining on feeding, and so on. Question a therapist you feel might be stepping beyond his or her area of expertise.

* If your therapist and child seem happy with the arrangement, let the therapist cross a boundary.

Good sites include:

The American Physical Therapy Association
Includes state-by-state listings of specialists and events.

The American Occupational Therapy Association
Includes breakdown of information for consumers, site map, and chat area.

Library of Congress, List of State Government Sites
Shortcut to sites for state governments, including state departments of health that often oversee therapists' licensing.

This information is, with permission, being shared as a courtesy.

 

 
 



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