In-Home vs. Clinic-Based Therapy

5 Pros of different therapy settings...

Deciding on speech or other therapy options for your child? Here are some things to keep in mind:

5 Pros of In-Home Therapy:

1. Natural Environment...therapy done in a child's natural environment has so many benefits! Not only does the therapist get to see where and how the child lives, but we get to see how the child plays and interacts when most comfortable. Working in both clinic and home settings, I've seen how, for some kiddos, it can take weeks and weeks of sessions at a clinic before finally feeling comfortable with the therapist's office, toys, expectations, rules, and transitioning to and from clinic/home.

2. Parent involvement... at a child's home, a parent can't help but get involved in sessions. Even if they try and stay in another room, the child often pulls his mom or dad into the session naturally. It's also easier for parents to listen in on sessions at home compared to in clinic. Therapists are also able to catch up with, inform parents of progress, and train parents using the child's every day routines and space. How empowering for the parents!

3. Convenience...having one less place to tote your child to, is a huge benefit of in-home therapy. Let the professional come to you, and you can relax! No need to pack up and coordinate another 15-30 minutes before and after the session of travel time. Some parents are even able to get some things done around the house during their child's session. Although I'd recommend getting involved in the therapy as much as possible.

4. Sibling Involvement...if there are siblings present, they can be great therapy tools! Let the siblings get involved minimally or for however much the therapist is comfortable. I've involved siblings to target social interactions like turn-taking, conversational back and forth, flexibility, and enlisting siblings as coaches and mini-therapists to help carry over goals. It's amazing how quickly siblings can pick up techniques to help their brother/sister at home (sometimes more naturally and faster than their parents!). If you have examples of times when your child struggles to interact or play well with his siblings, let your therapist know, so she can help you work on these skills in the moment.

5. Options Options Options!...Weather permitting, you can decide to take the session outside to a park or in your backyard. Why not?! Keep things fun and natural. Sessions can occur in the child's playroom or in the kitchen during snack time. There are always ways to incorporate speech and other therapies into the child's routine. Don't be afraid to ask your therapist to be a bit more playful, creative or flexible if you feel your child would be more motivated outside on his trampoline, or while eating a snack.

5 Pros of In-Clinic Therapy

1. Insurance's often more difficult to get in-home therapy reimbursed by your insurance company. Clinics sometimes have contracts with a multitude of insurance companies, making it more affordable. But keep in mind, this also might mean a quicker turn-over of staff and your child may not get one dedicated therapist for the long term (insurance based clinics cannot usually afford to pay their therapists as much). But for families who cannot afford the cash rates of in-home therapy, it's understandable that they may have to seek out services in clinic.

2. Scheduling Options...this one is tricky, but if the clinic has multiple therapists, they may have more availability for your child. In addition if a therapist is out sick or on some kind of leave, oftentimes there is another therapist who can fill in. This can be great or difficult for your child to keep sessions going, depending on how flexible your child is with other people.

3. Equipment and Supplies...there's a benefit of new toys or equipment that your child does not have at home. It can be extremely motivating for children to go to a clinic where there are games, toys, slides, climbing equipment that are different than their items at home. They often look forward to "playing" and may be able to focus better. This varies from kid to kid, but might be worth trying out if home-based therapy seems less productive.

4. Team a clinic, you often get a team of supporters. You may have an office administrator helping you with insurance inquiries, your therapist(s), and other team members who get to know you and your child. In some cases, the more the better. Therapists are able to collaborate with each other and pick each other's brains in team meetings or between sessions. You may feel better supported in this type of environment, but again this varies from clinic to clinic.

5. One stop shops...some clinics are able to offer multiple types of therapies (OT, PT, ST, and more). If your child is in need of more than one type of therapy, it's really convenient and beneficial to receive all the services, or as many as possible, under one roof. The therapists are able to collaborate with each other and support your family as a team, all on the same page. You're not having to drive from office to office or coordinate different schedules at home. There may even be opportunities for co-treatment sessions, which can really be beneficial as well. Not all clinics run the same though, and I wouldn't assume that they all run well as a team. Make sure to ask how their team collaborates and ask to observe sessions often.

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