Q about therapies

-T- · October 2013

DS gets PT and OT 2 times a month each through EI. For the last year I have been taking him to private PT 2 times a month. I was just curious if having private and EI therapies was normal? The EI here is not as good as private in my opinion. I want to start private weekly sessions of PT and feeding therapy since he is too young for school and easier to do it now with our schedules since I'm not working. I've tried increasing EI visits, but they don't seem very willing. Since all kids are different I'm sure there is no normal here, I guess I'm wondering if people do this?

ToastieSimons · October 2013

Yep, here we have great EI but it's all in home so we do private PT at a center.

-T- · October 2013

ToastieSimons said:

Yep, here we have great EI but it's all in home so we do private PT at a center.

Would you mind sharing how many times per month/week you have each service?

ToastieSimons · October 2013

-T- said:

ToastieSimons said:

Yep, here we have great EI but it's all in home so we do private PT at a center.

Would you mind sharing how many times per month/week you have each service?

In our old state we had horrible amounts. DS1 is 3, nonverbal, nonwalking. He was born extremely hypertonic so he started services at 3 days old in the NICU. He received one combined session of PT/OT per MONTH until about 9 months old. At that point he received PT 1x/week and OT 1x/month. At 18 months when he still had zero speech they added in ST 1x/month. This was ALL the services we received even when we moved when he was 24 months.

Here he received PT, OT, ST and DI all 2x/week. And we do private PT 1x/week.

DS2 has the same genetic issue and he receives PT 2x/week, OT & DI 1x/week and we do private PT 1x/week.

light52 · October 2013

My kids are too old for EI but they still receive services through the school system. We do both school and private. We saw very little improvement through the schools and our pedi said that medical based therapy takes a completely different approach than EI/school so it is best to keep the free therapy but also branch out into private. We've seen a ton of improvement with this approach.

-T- · October 2013

Thank you for your replies! I know very few moms of SN kids. I don't see great strides in EI like I do with private. Hoping he'll slowly catch up if we hit therapy hard now while he's young.

MaxandRuby · October 2013

When DS2 was in EI, he had private speech, feeding, PT, and OT in addition to the same EI therapies. He is in school now (just turned 4) and he gets private PT, OT, and speech at this time.

MaxandRuby · October 2013

Just saw our other post on frequency.

When in EI (depending on the state since we are a military family and I moved home during a deployment) DS2 had:
Kansas EI: PT-weekly, OT, feeding and speech - every other week; Kansas private: PT, OT, speech-40min each week for all EI and private therapies
Iowa EI: PT-weekly, OT-every other week, speech-once per month (didn't feel it was worth it personally); private PT and OT weekly and speech and feeding were every other week (speech one week and feeding the opposite week). EI therapies were 30min each and private therapies were for about 45min each.

Tennessee EI: PT, OT, speech once per week but by 1 developmental therapist (I don't like how they do EI here). Sessions were 1hr; private PT, OT, and speech twice weekly for 30min and feeding once per week for 30min. We are still here in TN currently. At school he gets two 30 min therapy sessions each for PT and OT per month. Private we currently do a total of 1hr PT weekly, and 1hr of OT weekly (this is split into two 30min sessions), and one 30min speech session.

lite-bright · October 2013

We got DD1's dx too late to do EI (she turned three as we went through various evals), but we've always done a mix of private therapies plus services through her preschool/school. I think that's pretty typical if your insurance offers any coverage or if you can afford to pay OOP.

As she's gotten older, things have slowed down on the formal therapy front, at least for the time being. We started out with a year of RDI and weekly and/or bi-weekly meetings, plus Floortime/speech therapy as we could do it on top of 2.5 hours of preschool a day. Now she's in full-day kindergarten and we just don't have as much time for therapy; at the same time, we chose full-day because we felt there were big therapeutic benefits there to more time in the classroom for her.

Plus there are a wider range of activities she can do now that have some therapeutic or social value but aren't "therapy" as such. So she does a social skills class once a week, soccer practice and a game on Saturdays, and also does a small-group music class. I stepped up therapies last summer while she was out of school, and I expect we'll keep taking that approach to work on things/keep her engaged & progressing and prepare for the next school year.

d.f · October 2013

DS was also older so we entered in the preschool setting instead of EI. At one point he had all of his therapies at school (speech, OT, and Special Ed) and 1hr of individual private OT and 1 hr 45 min of group speech a week with other therapies thrown in at different times (music therapy, social skills group, other classes that weren't officially therapy). Right now he's in Full day K where he receives pull out services and privately we're doing a social skills group facilitated by an OT and SLP. I expect there will always be somewhat of a private component.

mommy0411 · October 2013

Interesting, Texas nust be unique. We are not allowed to double dip as they call it. DS1 only gets EI if he is not in private therapy. We put him in an intensive everyday speech therapy program at a university and lost EI speech as a result. It was definitely the best decision because DS was made huge progress having every day therapy but it would be nice to be able to do both.

abs05 · October 2013

mommy0411 said:

Interesting, Texas nust be unique. We are not allowed to double dip as they call it. DS1 only gets EI if he is not in private therapy. We put him in an intensive everyday speech therapy program at a university and lost EI speech as a result. It was definitely the best decision because DS was made huge progress having every day therapy but it would be nice to be able to do both.

This is what we were told as well in regards to double dipping. Now that we are entering the school district I am being told that is false. If you qualified for EI then services should be provided to you whether you receive private therapy or not. The school district was furious when I showed them the evaluation that said "qualifies, but already receiving private ST which would be a duplication of services." EI changed their policies over the summer and as a result we got lost in the shuffle. It is much, much, much easier to enter the school district when you receive ECI services. We really had to jump through a lot of hoops to get the ball rolling before my daughter's third birthday (evaluations, etc.). Since your DS is still a few months away from his third birthday I would call ECI again and see what they say.

Assembly_Reqd · October 2013

mommy0411 said:

Interesting, Texas nust be unique. We are not allowed to double dip as they call it. DS1 only gets EI if he is not in private therapy. We put him in an intensive everyday speech therapy program at a university and lost EI speech as a result. It was definitely the best decision because DS was made huge progress having every day therapy but it would be nice to be able to do both.

Does TX have Private Therapy Police? How would they know?

Assembly_Reqd · October 2013

Here's Nate's List (maryland) as i can remember off the top of my head:

DX: genetic deletions causing: hypoplasia of the corpus callosum(brain), hard-of-hearing, mild nystagmus, maybe low vision, adducted thumbs, dysarthria

EI PT 1x/wk/30min since 8 weeks old until current

Private PT program which was daily 1hour for four weeks at 28 months (20 sessions)

EI OT 1x/mo/30min from 3 months to around 14 months (feeding only) she was a PITA

Private OT 2x/mo/60min from 8 weeks until 30 mo (adducted thumbs-splints-fine motor)

Private OT 1x/mo/60min from 30 mo until current

Private OT program which was daily 1hour for four weeks at 28 months (20 sessions)

EI OT 1x/mo/30min from 37 months until just recently 'graduated' (fine motor)

EI VT 1x/mo/30min from 4 months to 12 months then 1x/quarter 12 months-1 yr

EI TOD 1x/mo/30min from 8 months until 3.5 yrs ( i discontinued for sanity purposes )

EI ST 1x/wk/30min from 20 months until 34 months

Private ST hippotherapy 1x/wk/60min for 8 weeks (30 months old) sooo CUTE

EI ST 2x/wk/30min from 34 months until current

Private ST 1x/wk/30 min from 40 months until current

Our local school for the deaf provides some group speech, a parent support group and parent ASL classes weekly, that i think they get reimbursed for from the city/counties

DAMN! I never listed it all in one place before. No wonder why I am exhausted.

maryland has been more than generous in their EI offerings, but we also supplemented in almost every category with our private insurance which is awesome. The only OOP has been the speech therapy(prompt) and the horse. At this time we are staying on the extended IFSP program until next summer. Once he turns 4 and a new school year begins, he will move to an IEP. He is still pretty delayed even with double dipping.

mommy0411 · October 2013

Assembly_Reqd said:

mommy0411 said:

Interesting, Texas nust be unique. We are not allowed to double dip as they call it. DS1 only gets EI if he is not in private therapy. We put him in an intensive everyday speech therapy program at a university and lost EI speech as a result. It was definitely the best decision because DS was made huge progress having every day therapy but it would be nice to be able to do both.

Does TX have Private Therapy Police? How would they know?

I don't know if people lie about it. I actually never thought of that. I don't know many people who have children in EI as well as private! but they all lost the EI therapy when they did private therapy. They encouraged the program DS1 is in because it's the best in the DFW area.

Assembly_Reqd · October 2013

ahh. i guess it is only a matter of time before MD starts charging for services or doesn't allow double dipping....we'd be willing to contribute to the cost, but no one is asking us to pay. I will say our city taxes alone should cover it. They are super high here.

Assembly_Reqd · October 2013

they do ask here if you have medicaid and will charge medicaid for therapy services, but they do not run it through anyone else's insurance....

1+tripsmom · October 2013

When we were in SC our EI was 100 times better. She got EI once a week, OT, PT, feeding 2 times a week each in home. In CA we get EI in home everyone would rather us go through insurance including the state. She gets EI in home once a week to every other week. We go to a class at the school once a week. Then do PT and OT an hour each in clinic and need to change our feeding/ speech since she only does 30mins once a week to cover both. My DD1 has CP and is very delayed.

Justinlove · October 2013

We did both private end EI, and insurance paid for it all since EI either bills insurance or has a sliding scale for payment in my state. Insurance doesn't care how many therapists we have, just how many sessions are allotted.

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