I posted below about finding qualified therapists for my son. Auntie (as usual) made some really great points. One of them was that EI is often a training ground for therapists, and not all of them are really experienced. I realize that of course there are amazing therapists within EI too - I'm not here to offend any EI therapists. That being said, is their an advantage to using private therapy if we can afford it? Would my insurance possibly pay for private therapy?
Has anyone here gone through EI and then supplemented with private therapy?
Thanks!
Re: Early Intervention vs Private Therapy
We didn't really have a dx until ds graduated from EI (the preschool eval is really what prompted us to have ds first tested for asd). He was in PT from 9 months-17 months and ST from 2 1/2 to 3 through EI.
It really depends on your policy and state laws on what they will cover. With an ASD dx here in Indiana, or Kentucky (where I work and will get insurance coverage next year), laws mandate coverage for the most common treatments related to ASD. Indiana has unlimited cap in dollars, but companies can cap on number of visits. KY has a cap, starting next year, of 50K per year and unlimited visits. But, both are these for insurance policies that are not self-funded programs (meaning that it is an employer based policy with a company large enough to fund it's own insurance program). My ds has a "private policy" in Indiana that we pay for on our own, he was originally on a UPS employer policy that was self-funded and they refused to pay. In KY next year, I will purchase my employers policy (state university), and even though they are self-funded, they are still abiding by the state laws (they are funded by the state, have the states autism training center here along with the states primary evaluation center for autism), so they kinda have to.
We went private because the services in my local town were pretty pathetic. But if you have a good EI or school system, you may be better off going with them. It just depends. That is why it is good to talk to others in your area.
We use EI speech therapy which is free to us once we showed our local EI agency that our medical insurance denied our son services.
We've been referred to two therapists. The first we didn't click with (or rather, DS didn't). He was a school based therapist who fit in his EI clients at night. The second is awesome. She has a mix of private and EI clients. EI doesn't have any staff therapists that I'm aware of in my little area. I live in a large metro area.
Our EI services have been provided by the following people experience-wise
PT-15 years
VIT(vision teacher)-15-20 years
OT(feeding)-2 years
Speech-at least 15-20 years
ASL Home visits (2) - probably about 4-5 years each
You will get some people who are inexperienced, however those people with less experience are also the folks right out of possibly learning the most up to date therapies. They can be enthusiastic about their jobs and are willing to admit when they don't know something. So there could be some positives to younger therapists.
We also go once a week privately for OT at Kennedy-Kreiger. Our insurance is pretty good so we just pay the co-pay for 1 hour which is 30 bucks. I would guess that our OT there has about 8-10 years of experience. We love her. We go there because EI could not provide thumb splints for Nate's cortical thumbs. We are concentrating on more fine motor stuff with her.
You aren't "stuck" with who you get from EI. If someone doesn't fit you can request trying another.
We do both. It's overwhelming to have so many cooks in the kitchen, but I really get a better sense of where DS is at and what to work on. I also love having the different perspectives.
My little guy is a mystery in terms of DX, so I like getting as many people looking at him and making suggestions as possible.
Also, talk to the social worker at your hospital. Our state has a great supplemental insurance program for handicapped children that has provided us with lots more private PT/OT therapy sessions. The private sessions are over 200 per hour, so getting approved for this program was like winning the lottery for us.
I'm new to this board and we just started the EI process (for hearing loss). Our evaluation was on Monday. We're planning to do EI plus private sessions at our childrens hospital where DS gets his hearing tests done (CHOP). I think speech/language appointments are covered under our insurance.
The audiologist explained to us that it's like a "checks and balances" system...we'll have two different people evaluating him and well be able to compare their recommendations.
All three of Lillian's EI therapists have at least 15 years experience in pediatric therapy. However, the clinic around here has all the new grads and under trained staff.
Can you go on the EI matrix and read the descriptions of the therapists? That's how we decided which ones to go with for Lillian.
In my clinic, we did both EI and private therapy. So you could pay to see us in the clinic, or get us on the state's dime via EI. We weren't hiding the good therapists for clinic use or anything.
I trained in clinic therapy and EI therapy, and I don't think my clients suffered for it, particularly in EI. In IL, they require a pretty heavy level of supervision. I had all the newest information and enthusiasm for my clients. I wasn't on autopilot, overworked, or burned out. Many people started off in clinics and moved to independent EI when they felt experienced and confident. I did.
There are two kinds of therapists I didn't like working with in EI. Those were the older therapists and the people moonlighting in EI for extra cash. Frighteningly often, older "more experienced" therapists were great at getting the parents on board because of their self-assured nature and often outright bossiness, and were doing bizarre things with kids that had been taken out of practice many years ago. You can go to continuing ed, but if it's taught by people just like you, you can really stray from best practice. For example, thousands of people are out there devoting themselves to oral motor programs for speech (not feeding) issues, when ASHA and all the research strongly contradicts its use. Older therapists also tended to be (in my experience) Super Therapists, who wanted to dictate what all the other therapists did. Sorry, OT, you don't know how to do my job no matter how long you've been doing this.
I had friends working in adult rehab positions (think hospital swallow studies on stroke patients) who would pick up a few EI kids. I wouldn't want them seeing my kid because they don't have the guidance from peers. You don't walk into your hospital the next day and say "I have this client doing X, do you have any ideas?" if you work in a totally different environment.
Getting a second therapist can be awesome. It can also be incredibly frustrating if they don't see things the same way. One is working on one thing, the other is pushing another direction, you're taking orders from both, and sometimes the conflicting therapy hurts rather than helps. If I knew a child had another SLP, I would typically talk to them and divide up our jobs - you work on phonology, I'll work on grammar, etc.