Too Much Therapy?

Q: My 7-year-old daughter has been mandated for a variety of services by the Department of Education, and my husband and I have different opinions about whether she should use all the services she’s been given. I’m not even sure if there will really be enough people available at her school to give her all these services.

My husband feels that she will miss out on too much of her classwork, and that other children will eventually start teasing her because she always leaves the classroom.

I thought that it might be better if she would have some of these “helpers” (such as the special education tutor) work with her in class. The teacher, however, is against this, as she feels that my daughter will use it as a crutch and not put all her effort into her schoolwork.

My husband himself doesn’t understand how she is so behind in her understanding of material that she learns in school; when we work with her one on one she seems to get it quite easily.

Physical therapy is hard to come by, and my daughter does have problems riding a bike, etc. I feel that she would benefit greatly from this. They said good occupational therapy would help with her general functioning and self-esteem, as she has definite sensory issues that affect her daily life.

I think counseling would be very helpful to improve her self-esteem. And, truthfully, speech therapy might help her respond in class more confidently when her teacher calls on her.

My husband thinks that I’m looking for a magic wand that will make all my daughter’s limitations disappear.

What’s a good way to know what we should do?

A: As each child has individual needs, so it is difficult to ascertain which services are best for your daughter without seeing the actual evaluations. In general, the quality of the service provider and his level of skill (both professional and personal) makes the difference in whether your child has a good learning experience — or the opposite. (Even this concept has limitations, as an excellent therapist might have his own personal issues that affect his work in a given year.)

Research shows that the consistency in approach and the scheduling, plus the quality of the therapist/student relationship, create the optimal therapeutic setting. That being said, perhaps the caliber of performance of the therapist is more important than the service being offered.

There is no definitive answer to your question about number of therapies, as this needs to be monitored and re-evaluated throughout a child’s life.

An example of this can be seen in the work of a devoted speech therapist who continuously works on auditory processing skills, allowing the student to greatly improve his academic performance. This same therapist can work on teaching social skills, which is of lifetime value.

Occupational therapists have limited ability to work on sensory issues in a school environment, due to the nature of the work that is needed. Yet the goal of an occupational therapist is not only working on fine motor skills and sensory issues, but to help a person better acclimate to their present “occupation” in life — be it student, homemaker, etc.

Thus, it is not actually a question of “How many services are too many?” but rather “Which services would my child most benefit from, and which therapist would best suit these needs?”

Though it is fortunate that you and your husband are able to do school work with your daughter with success, the reality is that this is not occurring in the classroom setting.

Though students can be teased by their classmates for leaving the classroom, peers can easily come up with any issue to poke fun at. A child who doesn’t feel comfortable with himself can easily become a target for bullies. The positive benefits of therapy generally outweigh any temporary social discomfort that a child may encounter. The improved general development gained through superior therapeutic interventions is of inestimable value.

B’hatzlachah!