In-home therapies and sibs

macchiatto · August 2014

For those of you who have in-home therapies and any other child(ren) at home, what does the other child do while the one child is getting therapy? How much do you watch/participate in the therapy versus spending time with your other kid(s)?

Now that my boys are a little older (and having just re-added PT and ST, all in-home), I'm re-thinking the best way to handle this. PT especially is giving me pause because the new PT has been including both boys, but gross motor is where the difference in ability between X and his typically-developing twin is most obvious, and I'm wondering if that's the best approach.

kcisthebombdotcom · August 2014

I would let ds play on the iPad or watch tv in another part of the house.

Hiccup15 · August 2014

We've had many problems with it. DS2 gets 4 hours a week in home and these are just miserable to DS1. He won't go to another part of the house because of his anxiety, and if he is watching t.v. or playing a game it distracts DS2. So I watch/interact with DS2 and his therapist while trying to interact and keep DS1 calm.

The last few months have gone better though because two of the therapists DS2 sees, DS1 now sees in the clinic. So now they know him and have him work on something to help with balance, fine motor, speech, whatever he was working on that week in the clinic.

Unknown · August 2014

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macchiatto · August 2014

-auntie- said:

Time for a gut check.

If you're questioning this, there's something about it that clearly isn't sitting right with you. Trust your gut. In the interest of full disclosure, I am OAD, but this comes up a lot on forums and I did grow up with a challenged sibling.

I remember hearing about your sibling; that's a helpful perspective to have. What does OAD stand for?

Every situation is different, the kind of work being done matters as well as the age of the kids in question.

Some random thoughts, specific to your unique twin (to this board) situation-

1. Sometimes including a sib can be useful. It can make the therapy seem more like play. It can be especialy appropriate for social skills training, although if your kid doesn't globalize you end up with one who can only interact with his sib.

That makes sense. Including the twin has been working well in EI and OT and I think it works in the social skills training, too (which just started), though I plan to bring in a couple of other friends at times (carefully selected since only a handful of closer friends know about the social/possible spectrum concerns).

2. When a therapist is working on a skill and needs to consider the other child's feelings, offering turns, etc it eats into the actual amount of threatment the child who needs it gets.

Good point.

3. Feelings have to be considered, if the client is aware of his delays, and feels badly, having his typical peer as a therapy partner sucks to the point of cruelty.

Yeah. They've both known for a long time that the twin is faster, stronger and more coordinated. X has a few areas where he excels as well. It's hard to tell if he feels badly about it; he's really always expressed disinterest in most physical activities. This kid doesn't like to move much; never has. I think if he doesn't feel discouraged or self-conscious about it yet though, that it's probably coming soon. I think that's what my gut is telling me and that I probably do need to find a way to get my other son out of the sessions.

4. But the typically developing child has feelings, so you'll need a frank discussion about all of the whys in the situation that touch on sharing a dx with both parties, issues of fairness, etc. This should be on your agenda if it isn't already done, but it's a hard talk to have as a parent.

Absolutely. It's on our agenda. I recently talked through with X's EI how to approach this and now need to work out a time when DH and I can talk to each kid separately.

5. For some families, services at a clinic exacerbate the inconvenience to the NT sibs who spend a considerable amount of time sitting in the car and various boring waiting rooms.

True. During X's year of clinic OT and PT when he first got into therapies, we were actually able to work it out so DH took care of him during X's clinic therapies (after using him as a peer model the first month ... which worked well 3 years ago, but of course a lot has changed since then). It worked out well since I was present for all X's sessions without being distracted trying to keep his brother occupied. DH has a less flexible schedule now though.

6. Getting services in school, especially when the kids are in different classes, is the best solution.

I totally agree, which is one reason why we were so disappointed when he ended up "not qualifying" for an IEP this year. We will revisit the issue once we see how he does in full-day K. He breezed through the PT screening the school district did (super basic skills) and they had no concerns about his gross motor skills. His new private PT is a school-based PT also in a different district and feels she could make a case for him to get school-based PT. I plan to invite her to the next IEP meeting.

Thanks to you and to everyone else for the input, as well!

macchiatto · August 2014

Ohh, of course. Thanks.

macchiatto · August 2014

We did the screen time for brother in another room during PT today and I think it's a definite improvement. PT and X could cover more ground and he seemed more focused and more confident. Thanks again for the input!

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