How does this all work?
How do I know if my child needs occupational therapy?
Many times, families will receive referrals for occupational therapy from their pediatrician, psychologist, other therapist or may even get told about it from a family member or friend. Below is a list of common issues that children present with that may warrant therapy, in any combination:
- Irritability, frequent or long meltdowns
- Sensitivity to touch, texture, clothing
- Avoids mess on hands or face
- Picky eating, sensitivity to food temperature/texture
- Emotional sensitivity
- Frequent anxiousness, worry
- Can feel what others are feeling, empathic ability
- Seeks out too much touch, can be inappropriate with peers
- Poor interaction with peers—avoidance or aggression
- Difficulty getting to sleep, or staying asleep
- Poor attention and focus, difficulty sitting still
- Difficulty sitting in circle time or at a desk
- Disruptive behavior in school
- Clumsiness, or problems with coordination in large or small motor tasks
- Difficulty learning to ride a scooter or bicycle
- Mixed hand dominance
- Poor ball and/or racquet skills
- Difficulty with bilateral (2 handed) tasks
- Learning differences with reading
- Poor pencil grasp and mechanics
- Poor handwriting
- Difficulty in completing puzzles, mazes, or dot to dots
Should I get an evaluation or start with a consultation?
This depends on your needs. If you wish to have a written report with a set of standardized scores and observations, this may be the choice that is better for you. You will have a written report and base of comparison for your child’s progress. If filing with insurance, some insurance companies require this, as well, so you may want to check first with your insurance company. For other families, they want to jump in and get started with a consultation. We prefer to book initial consultations for 90 minutes, to provide clinical observations, and then to provide you with a Home Education Program (HEP) to get started with things immediately at home. There is no written report for the consultation.
What can I expect during an evaluation?
We tend to hold evaluations in the morning. Please bring your child having had a good meal, and bring some snacks for your child just in case. The entire evaluation process takes one to two 90 minutes session(s). The evaluation will consist of one or more standardized tests, primitive reflex assessment, structured and unstructured clinical observations, and parent interview. You will be expected to wait in the waiting room while your child participates in the evaluation, and can use the time to fill out additional questionnaires for the report.
In some cases, families may drop their child off and be prepared to be back 20 minutes prior to the end of the session for a brief discussion, and to answer any questions that the therapist may have. If your child has separation anxiety, please be prepared to stay the entire time. We have WiFi in the waiting room and water and tea for your convenience. We strive to have a written report for by 3 weeks of the date of your child’s evaluation, barring unusual circumstances. Once you receive the report, we will schedule a 30 minute consultation to review the results on the phone or in person.
How do I prepare my child for the first session?
We generally recommend that you tell your child that they will be coming in to a fun play gym, and that they will be able to learn more about their body and brain, and how they work together to help become stronger, learn better, help with handwriting, help with focus, or just feel better–depending on your child’s presenting issues.
Can you observe my child in school?
Yes! We love to go on school visits. Some families come to us with concerns over school performance, or the school has asked the family for support. We sometimes begin our work with these visits, upon request, with the school’s permission. We like to build time into the observation to have teacher feedback, and even to offer teachers some immediate support. The therapist’s hourly rate applies.
What is the typical length of therapy?
The length of therapy depends on the child’s and families need. We typically recommend that a family start with a higher frequency (weekly or twice weekly) that can be decreased over time as needed. Some children are seen for 6 months, 8 months, 1 year, 18 months, and some are seen for shorter or longer times. This all depends on the child’s needs, how much the parents are carrying over home education plans (HEPs), and financial needs. Some families choose to come in on a consultative basis to provide updated HEPs or for a specialized approach.
Do I need to sign up for a certain amount of visits?
No. We do not have a minimum of sessions required. Each situation is considered case by case.
Do you accept insurance?
We accept payment at the time of service directly from you and then provide you with forms to submit to your insurance companies with coding for insurance reimbursement. There is no guarantee of coverage, so please check with your insurance company to see if they will cover the services or percentage of the services. We accept payment in checks and credit cards, including Flexible Spending Cards and Health Savings Accounts (HSAs).
Are you in network with any insurance companies?
We are out-of-network providers.
Can I schedule my child’s sessions online?
Contact Kate Drummond directly to schedule your child’s initial consultation or evaluation. After Kate puts you in touch with your therapist, you will handle all future scheduling directly with your child’s therapist.
Can I pay for therapy online?
You can only pay for wellness classes directly on our website. We have a separate and HIPPA compliant Patient Portal through Theranest. As a client of therapy services, you will be set up in our system and have the option of paying by check or keeping a method of payment on file. You will be charged automatically for each session if you keep a card on file.
How involved will I be during the therapy process?
We love and encourage family involvement. It is important to stay engaged with the process, and you will see more results with the more carry over that you can provide for your child. We will need to have you participating throughout the process for training, and updates on training for Home Education Programs (HEPs). We require intermittent consultations without your child periodically, so that we may speak candidly about your child, update goals, and to have time to get a detailed update on how things are going at home and in school. We can use your child’s time to do this, or can try to make another time work, depending on everyone’s schedule.
What is sensory integration therapy?
Ayers Sensory Integration (ASI) based on the work of A. Jean Ayers, and we use this model to improve sensory processing. ASI is child led, and goes under the theory that children seek the information that they need in the environment, such as movement, heavy work, tactile/touch information. If there is a difference in these areas, many things can be affected, resulting in compromised attention, hypersensitivity, seeking behaviors, emotional regulation and academic struggles, to name a few. We provide the scaffolding and challenges for your child based on his or her needs moment to moment to optimize the outcome.
What is reflex integration?
Reflex integration refers to the idea that many children today are experiencing retained primitive reflexes that are interfering with function, and the integration is done through a number of set exercises. Reflexes are movements that develop at various stages of early childhood in order to do things like roll over, crawl, walk, and more. Eventually and ideally, as the movements are repeated, new movements come into the picture so that the reflexive movements are not dominating. People refer to this process as reflex integration.
Some children do not integrate the reflexes and use a variety of compensatory measures. For children who retain reflexes, their movement is dominated by the reflex, and they have no choice but to use the patterned movement. This can be disruptive to not only motor skills, but academic skills such as reading and writing, and also attention, sensory processing, and emotional regulation. Rhythmic Movement Training and the Haller Method are some examples of methods that we use. Using these approaches, we look at building a neural net and then using reflex integration for existing reflexes, and give families home programs to further assist with the process.
What is Reiki?
Reiki is a modality used that involves the passing of energy through the therapist’s hands and into the body, a space or a room to enhance the natural healing abilities of the person it is intended for. This gentle and non-invasive approach is used for relaxation and stress reduction, and can greatly improve mood. Sometimes the therapists will use it in conjunction with other touch based approaches in the therapy sessions.
How does nutrition affect my child’s performance?
We believe that nutrition is a cornerstone to all function and behavior. We have seen children over the years who have consulted with a dietician or nutritionist that have had substantial changes in overall health, wellness, attention, and behavior as a result. This is not a quick fix approach, but it is one well worth the undertaking. The therapists can direct you to a local professional who specializes in this area and can help. Please also see the Resources page for more information.
Can therapy help my child’s behavior?
Yes, absolutely. We find that through our variety of approaches, behavior changes, because nervous system function improves. We also work on giving children tools for self-regulation and self-advocacy, which makes a great impact on behavior as well. Coaching and supporting families is another factor that can positively impact how behavior is addressed. We also work with professionals that can help coach you further in more specific ways. You may check our Resource page for more suggestions.
How long do sessions last?
Our hourly sessions are 50 minutes of direct treatment time including training time and time for discussion, with 10 minutes for therapy notes. Occasionally we will see children for shorter times, but this is our preferred time frame.
What should my child wear to therapy?
Please have your child in comfortable play clothes. If your child prefers dresses, please have them in leggings or shorts underneath, as we do a lot of physical play. Feel free to bring a change of clothes for them if needed.
Can I bring a sibling or my child’s friend into therapy?
We love having sibling and friend interactions! This generally happens at therapist discretion. Sometimes, we may prefer to see children solo, and other times we like to have children share time to observe peer and sibling interactions to give us a bigger picture of what is happening at home and with friends. Please discuss with your therapist.
Isn’t this all just…play?
We love to play! And while it may look like we are simply playing with your child, we are constantly observing and scaffolding the needs of your child based on not only the initial evaluation/consultation, but on how they are presenting on that day, in that moment. We help children to build a strong “neural net” and further support nervous system function through specific types of play.
We address social needs through play with other children in the gym, and work to provide that “just right challenge” for the children at all times. We may be helping your child become less sensitive to some things, and saturating the nervous system needs of another. Children love to come and play with us, often asking to come back in between sessions!
We have tried other practices and therapists, but Maggie is the first occupational therapist to motivate my daughter to make consistent progress. Penny is always asking to see Maggie, and wishes she could go to therapy every day!