Many times as a therapist I recommend to parents that we reduce the amount of time a child spends in therapy. Naturally, they are concerned that less will be; well, less. To the contrary, sometimes less is more in the world of therapy.
Children need time to process information. Typically, they learn something from a teacher or therapist and will “practice” it over several days to several weeks before they master it. Teachers and therapists present the same information over and over again in both the same and in different approaches with the goal of developing a pattern or schema which will become a foundation for learning more information later. Some children need more time to process the information or are able to build onto these foundations on their own. For these children, spreading out therapy sessions can be beneficial because they can gain the information at a more appropriate pace and they will be more attentive and productive within those sessions.
For other children it is simply too much for them to have several hours of therapy a week. Many young children have physical therapy, occupational therapy, and speech therapy at least once a week, and some also have developmental therapy, social work, music therapy, group therapies, and other interventions. Older children can have all of these in addition to a traditional or modified school day. While each therapist symptoms they are the pivotal person for that child, sometimes taking a backseat to another intervention or empowering the parents to take the lead in their child's progress can be more beneficial for the child.
Giving a child the opportunity to focus on those goals which are most important to them and their family at the time can promote increased progress towards that goal. For example, if the primary goal for a child is mobility adding additional therapies to work on other goal areas can distract a child and cause “burnout” for both the child and the family. The constant parade of therapists can cause a child to be complacent, frustrated, or resistant to interventions. Less work can be accomplished when a child does not wish to engage with any of the therapists on their team. This level of burnout can also frustrate the family and decrease their interest in continuing or engaging in therapy services.
Part of being a member of a therapy team is knowing how to work well with other therapists. A good team will communicate with each other and support each other's goals and objectives. All members of the team will encourage speech, reinforce motor skills, and promote cognitive development. Because of this overlap within a good team not everyone needs to have “hands-on” time with the child every week. Strong and dedicated parents can follow through with the work of all of their therapists which can also decrease the need for as many therapists in the home.
Finding the right balance in the amount of therapy can be a difficult task for a therapist. For some children, the less is more approach is perfect, but it is not for every child. Working with the other therapists on the team and the parents, the right amount of intervention can be found and children with special needs can reach their goals with less frustration and more enthusiasm. In the end it certainly comes down to a difference between quality and quantity. Quality therapy time is really what our kids need to not only meet their goals but surpass them!
© R. Wellman2011