Parents Guide to Pediatric Therapy Options

All kids grow up at their own pace. Some struggle with walking but speak with the finesse any aspiring toddler orator can hope for. Others master the art of fine motor skills long before they can enunciate the difference between dad and cat.

Thereʼs a diverse set of growth patterns and challenges in every childʼs growth. Just as diverse are the therapy options and the experts who provide those solutions. So itʼs no surprise that many parents canʼt help but feel intimidated by the process of getting help for their little ones.

If youʼre in the same boat, youʼre going to love this guide. Weʼve taken all the complexity out of the process so you can find the ideal therapy type and therapy provider for your child.

So if youʼre worried about:

  • Choosing the right expert like an SLP versus OT for feeding problems
  • What each therapy option looks like in practice and how to best prepare
  • Choosing between one-on-one, group, and school therapy options
  • Whether insurance is going to cover the cost of your childʼs treatment
  • How long the results will take to show and what to expect

Youʼll have all those answers and more by the end of this guide. Getting help for your child doesnʼt have to be intimidating anymore.

Don’t have time to read the whole guide right now?

girl playing with colorful blocks at an occupational therapy clinic

No worries! You can download the full guide below.

Chapter 1: Difficulties in Speaking

Do you suspect your child isnʼt speaking as well as they should?

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Do you suspect your child isnʼt speaking as well as they should?

Then use this checklist of speech developmental milestones to confirm whether theyʼre actually lagging behind. If your child is missing multiple milestones on the checklist, thatʼs a cause for concern. Your child probably has a speech disorder that will require therapy to overcome.

Hereʼs a list of the most common speech disorders, one of which may well be affecting your child:

To help you do that, weʼve put together a hand-picked list of development milestones below. Most professionals agree on these targets as reliable indicators of typical speech development.

  • Articulation Disorder: An articulation disorder involves the inability to produce a certain sound. For instance, saying wabbit instead of rabbit or pronouncing /th/ instead of /s/.
  • Phonological Disorder: A phonological disorder involves a pattern of speech sound errors. For instance, always substituting /c/ with /t/ (e.g., saying tup for cup). The difference between a phonological and articulation disorder is that children with the

former can pronounce all kinds of sounds. The problem they have is confusing one sound for another.

  • Childhood Apraxia of Speech (CAS): Like an articulation or phonological disorder, children with CAS make errors with sounds, syllables, and words. But their errors are inconsistent. For instance, while cup may sometimes be tup, other times it may be pud or gud.
  • Fluency Disorder: A fluency disorder involves either long pauses and breaks in speech or unnecessary repetition of sounds, syllables, words, or phrases.
  • Expressive Language Disorder: This involves difficulty using words to communicate needs and ideas. Children with an expressive language disorder often leave words out of sentences, mix up tenses, and repeat phrases or parts of sentences — mistakes that can confuse the listener.

No matter which speech disorder your child might have, the therapy type they will need is the same: speech therapy.

What Is Speech Therapy?

In a nutshell, speech therapy is an intervention that focuses on improving a childʼs speech abilities. It achieves so by re-mediating communication disorders or any other problem that is interfering with the childʼs optimal speech development.

Speech therapy is centered around the idea of creating a tailored care plan for increasing the childʼs speech skills to an age-appropriate functional level.

So professionals who provide speech therapy pick treatment methods best suited for the childʼs age and their specific condition to help them overcome their speech issues.

How Does Speech Therapy Work?

The way speech therapy works varies depending on the specific conditions of the child, including their:

  1. 1
  2. 2
  3. 3
    Specific needs

Those three factors determine what kind of exercises will be used and whether the child should receive therapy in small groups or one-on-one sessions.

All that being said, speech therapy for every child has a lot of similarities as well, including:

  • Talking and playing with the therapist or their peers using books, pictures, and other objects in order to stimulate speech and language development
  • Listening to and then repeating certain sounds and syllables to learn how to pronounce them correctly
  • Paying attention to the therapist and following their instructions. If your child is often uncooperative kids, thereʼs no need to worry. The therapist will know how to catch your little one's attention, no matter how stubborn or inattentive they are.

Who Provides Speech Therapy?

Speech therapy is provided by speech-language pathologists (SLPs) — highly trained professionals who can help your child in two ways primarily.

1. Diagnosing Disorders

An SLP will start by testing your childʼs speech in order to diagnose a disorder. This typically involves testing for:

  • Patterns of speech sound errors
  • Clarity of the sounds your child produces
  • Any irregularity in movement of lips, jaw or, tongue
  • A delay in your childʼs expressive language skills
  • Common conditions that may be contributing to your childʼs speech issues, such as selective mutism (SM), a lisp, or autism spectrum disorder

Besides that, an SLP will also consider the hearing abilities of your child because hearing loss is often associated with difficulty in learning to talk.

2. Creating and Managing a Treatment Plan

Once an SLP has successfully diagnosed a speech disorder, they create a treatment plan customized for the specific needs of your child. The goal of such treatment plans is to help your child learn to identify and produce correct sounds, and then practice those sounds in different words and sentences.

Another thing all SLPs do is to help parents and other caregivers by providing education, guidance, and support. They also handle additional management aspects, such as documenting the progress from day one and changing the treatment plan as necessary to maximize progress.

How Long Does Speech Therapy Take to Work?

The time it takes for speech therapy to work depends on certain factors, including:

  • The childʼs age
  • Frequency of therapy
  • The type and severity of the speech disorder

Some speech disorders can be fixed permanently within a few months, while others continue into adulthood and require long-term therapy and maintenance.

So it is hard for us to say definitively how long it will take for speech therapy to work for your child. However, according to one popular study published in 2002, it takes approximately 14 hours of therapy, on average, to bring meaningful and notable improvements in a childʼs speech clarity.

Is Speech Therapy Covered By Insurance?

The good news is that speech therapy is a covered benefit for children who have an acute illness or injury that requires speech therapy as part of the rehabilitation process.

So if your child was born with a cleft lip or palate, your insurance will cover the cost of speech therapy. The same goes for TBI, stroke, and all other acute conditions.

But when the speech impairment is not associated with an acute condition, most insurance companies donʼt offer coverage for speech therapy. They either fully exclude or limit the coverage of disorders that are considered “developmental” or “chronic” in nature like a lisp, CAS, or a phonological disorder.

However, that might not be true for your provider. Since every insurance company has its own set of rules, the only way to find out what your insurance covers and what it doesnʼt is by contacting your provider.

Chapter 2: Difficulties in Understanding Others

Does your child often have trouble understanding others?

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Does your child often have trouble understanding others?

Then chances are they may have a receptive language disorder thatʼs messing up their ability to comprehend language.

If left untreated, a receptive language disorder can lead to many difficulties later on in your childʼs life, such as troubles in:

  • Developing reading and writing skills
  • Making friends and engaging in social interactions with peers
  • Completing tests, exams, and academic tasks
  • Answering questions during job interviews
  • Following and giving directions to new places

To prevent such problems, you need to seek therapy right away. The sooner you get your child to a therapist, the better their chances are of fully overcoming their disorder.

One Step You Should Take Before Going to a Therapist

Before you rush off to your local therapist, itʼs best to find out whether your child is actually lagging in their receptive developmental milestones.

You can do that by using this comprehensive checklist of the receptive developmental milestones for children — from birth to five years of age.

  • By 1 Month: Your infant should be aware of the sounds in their environment. So when a loud sound is made near them, if they get startled or start to cry, thatʼs normal. Whatʼs not normal is if they donʼt even react to a loud sound.
  • By 3 Months: By this age, your baby should turn when you speak to them and often even smile when they hear your voice. Thatʼs because they should be familiar with your voice by now.
  • By 6 Months: A half-year-old infant should understand the words, “yes” and “no”. They should also be fascinated by (or at least show some interest in) objects that make sounds like toys with music.
  • By 1 Year: By their first birthday, your child should be able to point to pictures in a book when you name them. They should also be able to point to a few body parts like the head, shoulders, knees, and toes when asked.
  • By 2 Years: By their second birthday, they should understand two-step commands like pick up your socks and put them in the basket.
  • By 4 Years: At the age of four, your child should understand simple questions involving “Who, What, Where, When, and Why?”

They should also respond to instructions and understand almost everything you say to them.

  • By 5 Years: 5-year-old kids should be able to enjoy stories and answer simple questions about them. They should also understand almost everything that is said at home, school, and childcare.

If your child is seriously lagging in their developmental milestones, chances are they have a receptive disorder. The only way to confirm is by getting a diagnosis from an SLP.

Visiting an SLP

As we explained earlier, SLPs both diagnose and treat children. So letʼs discuss each step separately.

1. Diagnosis of a Receptive Language Disorder

The diagnosis will be performed with the help of multiple tests aimed at determining whether your child really has a comprehension problem. If they do, the tests will also pinpoint the culprit.

SLPs use a wide variety of tests to diagnose a receptive disorder, including:

  • Hearing Test: Your therapist will work with an audiologist to check if a hearing impairment might be causing all the language problems. They will perform a thorough auditory processing assessment comprising a series of tests that determine if your child can fill in missing parts of words, hear speech in the presence of background noise, and detect subtle differences in sounds.
  • Language Comprehension Test: The SLP will test your childʼs comprehension and compare it with the results of the expected skill level for the childʼs age.
  • Psychological Test: A psychologist will be brought in to help identify any associated cognitive problems that may be contributing to your childʼs comprehension issues.
  • Observation Test: The SLP will put your child in a variety of settings with people they havenʼt met before to closely observe how they interact with new people.
  • Vision Test: The therapist will also perform a thorough vision test to determine if vision impairment is the culprit of your childʼs comprehension issues.

That list does not contain all the tests that SLPs use for diagnosis. So your SLP may perform additional tests if necessary to figure out the cause of your childʼs struggles.

2. Treatment for a Receptive Language Disorder

Once the SLP is done with diagnosis, they will then move to creating a custom treatment plan tailored to the specific needs of your child.

The treatment plan will outline all the important aspects of how your child will be treated, including:

  • Daily home assignments and activities
  • An outline of expected goals and milestones
  • The recommended frequency and duration of therapy sessions

As we mentioned earlier, the time it will take for the therapy to work will depend on your child's age, disorder, and specific needs. That being said, you can expect to see significant improvements within 14 hours of total therapy sessions.

Chapter 3: Difficulties in Eating

Does your child often seem to have trouble eating food?

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Does your child often seem to have trouble eating food?

Then chances are they may have a feeding disorder. Like every other disorder, the only way to confirm whether your child has a feeding disorder is through a professional diagnosis.

So if your child shows any of the following signs frequently, you should seek professional help right away:

  • Cries or fusses when feeding
  • Falls asleep when feeding
  • Faces problems with breastfeeding
  • Refuses to eat or drink
  • Faces breathing issues when eating or drinking
  • Eats only foods with certain textures, such as soft or crunchy
  • Takes too long to eat
  • Coughs or gags during meals
  • Drools a lot or has liquid come out of their mouth or nose

No matter which of those signs your child shows, the therapy they will need is the same: pediatric feeding therapy.

What Is Pediatric Feeding Therapy?

In a nutshell, pediatric feeding therapy is an intervention service that focuses on improving oral motor skills, swallowing skills, and feeding skills. Basically, all the skills required for chewing and swallowing food properly.

The therapy is centered on training the child to eat age-appropriate size portions and accept a variety of foods from different food groups.

Another thing you should know about feeding therapy is that it provides training for all four stages of feeding:

  1. 1
    Oral Preparation Stage: Chewing the food inside their mouth to form a bolus
  2. 2
    Oral Transit Phase: Moving or propelling the bolus posteriorly through the oral cavity
  3. 3
    Pharyngeal Phase: Initiating the swallow and moving the bolus through the pharynx
  4. 4
    Esophageal Phase: Moving the bolus through the cervical and thoracic esophagus before it finally goes into the stomach via esophageal peristalsis

How Does Pediatric Feeding Therapy Work?

The way pediatric therapy works differs for each patient based on their specific needs.

Some children only require help with oral motor skills, while others need training for all sorts of things, such as learning how to enjoy their meals or eat different types of foods.

So what pediatric feeding therapy will look like for your child depends completely on their needs.

All that being said, feeding therapy for every child has a lot of similarities as well including the following:

  • Following instructions of their therapist and learning the proper mouth movements required to chew and swallow food in a safe manner
  • Getting a reward for cooperating with the therapist — the reward may be anything your child wants enough to follow the therapistʼs instructions
  • Experimenting with food and learning to enjoy their meals with other people

Furthermore, no matter what your childʼs condition is, the main focus of the feeding therapy is three-fold:

  1. 1
    To help your child learn how to eat properly
  2. 2
    To help your child overcome any disorder that is preventing them from enjoying their meals
  3. 3
    To teach caregivers how to create a positive mealtime experience for the child

Although the road to achieving those three goals may differ from child to child, the destination is the same for everyone. So once your child is done with feeding therapy, mealtime will become easier and more enjoyable for your entire family.

Who Provides Pediatric Feeding Therapy?

Either an occupational therapist (OT) or speech-language pathologist (SLP) specializing in feeding provides feeding therapy.

Although both SLPs and OTs are qualified for this job, if we had to pick one, we would recommend SLPs because they are generally better-equipped for it.

When you visit an SLP, they will start with an evaluation. They will carefully examine how your child moves their mouth, tongue, and jaw

to chew and swallow food. After the evaluation is finished, they will present you with their diagnosis.

If your child is diagnosed with a feeding disorder, your SLP will create a customized care plan and start treatment as soon as possible.

How Long Does Pediatric Feeding Therapy Take to Work?

How long your childʼs feeding therapy will last depends on certain factors, including:

  • Your childʼs age
  • The frequency of their therapy sessions
  • The type and severity of the feeding disorder

While some speech disorders are easily fixed within a few months, others are more serious and cannot be permanently cured but only managed with therapy.

However, in general, most children experience significant improvements within 14 hours of therapy. Meaning that if your child attends feeding therapy by the traditional standard — a one-hour session each week — it will take three months to see notable improvements.

If that sounds like too long, you can ask your therapist to increase the frequency and length of the therapy sessions.

Is Pediatric Feeding Therapy Covered By Insurance?

The vast majority of insurance plans cover the cost of feeding therapy if these two requirements are met:

  1. 1
    The child has trouble eating due to a documented disease
  2. 2
    That disease is negatively affecting their health

If your child meets those two requirements and you can provide documentation to prove that, then itʼs highly likely your insurer will fully cover the cost of your childʼs feeding therapy. However, the benefits each company provides are different. So your insurer may only cover a portion of the total cost of therapy.

In case your child doesnʼt meet those two requirements or you canʼt provide satisfactory documentation, youʼre unlikely to get any coverage from your insurance provider.

If that happens to be the case for you, consult your childʼs therapist to figure out a way to make your insurer pay for the therapy.

There are various ways to appeal to insurance companies that most people donʼt know about. Thatʼs where therapists can help as they are one of the most qualified experts to help you put up a solid case. Most expert therapists have more than a decade of experience in the healthcare industry, so they know the tiniest of details when it comes to getting a request approved.

Chapter 4: Difficulties in Physical Performance

Does your child have trouble moving because of an injury, illness, or disorder?

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Does your child have trouble moving because of an injury, illness or disorder?

No matter the cause, the treatment your child needs is the same: physical therapy.

Can Physical Therapy Really Help My Child?

“Physical therapy… Isnʼt that just for athletes and adults in recovery?”

If thatʼs what youʼre thinking, itʼs simply not true. Physical therapy (PT) can benefit everyone, from newborn infants with a movement disorder and teens with an injury to the elderly with serious health conditions.

Doctors often recommend PT to children with movement problems because it can help:

  • Decrease pain
  • Improve movement
  • Increase strength

Even a couple of PT sessions can bring significant improvements in your childʼs life. But PT can also take a long time to show results for certain injuries and it cannot fully get rid of movement problems caused by chronic conditions like cerebral palsy. However, the good news is that it can improve symptoms, functioning, and quality of life of patients with chronic movement disorders.

How Does Physical Therapy Work?

As with every type of therapy, the specifics of how PT works differ from child to child. However, for the most part, PT looks and feels like play for every child.

During PT sessions, kids get to engage in fun, age-appropriate games that not only help improve their strength and coordination but also keep them happy, motivated, and optimistic.

So there are two main purposes of OT:

  1. 1
    To improve gross motor skills using exercises that involve large muscle groups, like walking or swimming
  2. 2
    To help the child keep a positive attitude about their condition

Thatʼs essentially what you can expect to get out of PT.

Now, although we canʼt definitively tell what kind of exercises your therapist will use to treat your child, some of the following will most likely be included:

  • Playing on large exercise balls to build strength
  • Running or hopping around to improve coordination
  • Stretching or yoga to develop flexibility

Those were some of the basic exercises commonly used in PT. Your child will also be encouraged to take part in some of the more complex exercises like:

  • Stickers on foot: This game involves using stickers and a balance ball to strengthen core muscles. Hereʼs how it goes. The child puts the stickers onto the bottom of their feet and then sits on a balance ball, facing a wall. Once theyʼre on the ball, the aim is to take off as many stickers as possible and stick them on a blank piece of paper thatʼs hanging on the wall without falling off the ball.
  • Dancing to music: Both children and therapists love this activity. By dancing to a beat, kids get to indulge in a little fun while improving their coordination, flexibility, and balance.
  • Balloon in the air: This oneʼs simple. It involves tossing a balloon and then keeping it afloat as long as possible. Therapists typically use this exercise for kids with leg issues.

Who Provides Physical Therapy?

Physical therapy for kids is provided by pediatric physical therapists (PTs) — all of whom have years of prior training. Some even have a doctorate in physiotherapy.

Pediatric PTs treat all children under eighteen. So if your child is anywhere between the range of a newborn to a teenager, a pediatric PT is the person to see.

During your first visit, the PT will check your childʼs strength, development, and see how easily they can stand, walk, and complete tasks appropriate for their age. Based on this evaluation, they will create a treatment plan and present it to you. If anything about that plan doesnʼt sit right with you, the PT will discuss alternatives and make changes if necessary.

Once youʼre satisfied with the treatment plan, the PT will provide you with a schedule for the therapy sessions and start treatment as soon as possible.

Besides providing therapy, your childʼs PT will also recommend exercises to do at home. Those exercises are usually different from the ones done in therapy.

How Long Does Physical Therapy Take to Work?

As we mentioned earlier, even a couple of PT sessions can bring big improvements.

That being said, the amount of time your child will have to spend in PT to see maximum benefits depends on whatʼs causing their issues. For instance, while minor injuries can be completely cured within a few weeks of therapy, serious conditions like cerebral palsy require continuous PT for life.

Is Physical Therapy Covered By Insurance?

According to the American Physical Therapy Association (APTA), all federally qualified healthcare plans should cover physical therapy and other rehabilitation services.

So yes, as long as your insurance plan is federally qualified, youʼre covered for PT.

However, you may not be able to choose a therapist of your choice. Companies like Medicaid, Medicare, and many other HMOs outright donʼt allow you to go with an “out of network” therapist. Out of network therapists are those who are not a participating provider with your insurance company.

Even insurance plans that allow you to choose a therapist of your choice come with a downside. They pay less than they would with their own therapist. Meaning that you will have to pay the difference between what your PT charges and what your insurance company pays for an out-of-network therapist.

Chapter 5: Difficulties Performing Day-to-Day Tasks

Does your child have trouble performing day-to-day tasks like washing their hands, putting on their clothes, or tying their shoelaces?

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Does your child have trouble performing day-to-day tasks like washing their hands, putting on their clothes, or tying their shoelaces?

Does your child have trouble performing day-to-day tasks like washing their hands, putting on their clothes, or tying their shoelaces? If they do, it is likely because of one of the following issues:

  • Delays in fine motor skills
  • Sensory processing disorders
  • Sensory integration issues
  • Delays in visual-motor skills
  • Cognitive delays

No matter which of those issues is the cause behind the difficulties your child is having, the type of therapy they need is the same: occupational therapy (OT).

What Is Occupational Therapy?

In a nutshell, OT is a branch of healthcare that helps people of all ages perform their day-to-day tasks the right way.

So the main goal of OT is to help make the patientʼs life easier. That goal is achieved by improving the patientʼs fine motor skills, visual skills, self-regulation skills, sensory processing skills, or any other skill that requires immediate improvement in order to make it easy for the patient to perform their day-to-day tasks.

How Does Occupational Therapy Work?

Since weʼve already discussed the entire OT process in an earlier post, weʼll summarize the process here.

Like every other therapy type, OT is tailored to a childʼs specific needs. Before it starts, the therapist evaluates the childʼs strengths and the tasks they have trouble with.

Once the therapist is done with the evaluation, they then create a program of activities for the child to work on. Hereʼs a list of activities that the program will probably entail:

  • Practicing self-care routines, like getting dressed, combing hair, or reading a book
  • Practicing writing and reading skills with peers or the therapist
  • Practicing holding and controlling objects that are used daily, like pencils, notebooks, and toys
  • Playing with a ball to develop the coordination required for throwing and catching things
  • Organizing a backpack to develop organization and fine motor skills

Now, which of those activities will be a part of your childʼs OT treatment depends entirely on their needs. For instance, letʼs say your child has messy handwriting. In that case, the therapist will include exercises that improve multisensory techniques. Whereas, if your child has trouble maintaining focus, then their OT treatment will include exercises specifically aimed at improving concentration.

Who Provides Occupational Therapy?

There are two professionals who are licensed to practice OT:

  1. 1
    Occupational Therapists: An occupational therapist has a master's degree from an accredited occupational therapy program and a four-year bachelor's degree in a related field, such as biology, psychology, or physiology.
  2. 2
    Occupational Therapist Assistants: An occupational therapist assistant has an associate's degree from an accredited OTA program.

The main difference between the two is that occupational therapists perform patient evaluations, create treatment plans, and carry out those plans. Whereas occupational therapist assistants can only carry out a treatment plan created by an occupational therapist. They canʼt develop a treatment plan or evaluate a patient.

In every other aspect, theyʼre the same. Both gain their credibility by completing supervised fieldwork programs and passing a national certification exam.

Furthermore, both essentially perform the same job: helping children thrive in important areas of their lives. This includes a wide variety of areas, ranging from cognitive and fine motor skills to social development and self-care routines — all of which help children grow into healthy, well-functioning adults.

How Long Does Occupational Therapy Take to Work?

We canʼt answer this question definitively, “How long will my child need occupational therapy?”

There are two reasons:

  1. 1
    Every child responds to OT differently and progresses at a different pace
  2. 2
    The duration of therapy varies depending on the cause of the problem

Consider this example. Letʼs say two children get OT. One child needs help to manage symptoms of autism spectrum disorder (ASD) and the other only needs help with their handwriting. In that case, the child with ASD will need far more frequent therapy for a longer duration.

So how long your child will need OT varies depending on their specific condition.

All that being said, as with every therapy, you can expect to see notable improvements within a couple of OT sessions. But for ideal results, OT typically takes one to three years. If that sounds like too big a commitment, thereʼs no need to worry.

You can just take your child to a couple of OT sessions before deciding whether itʼs something worth investing in the long run. Having worked with hundreds of kids, we can assure you this much: physical therapy is always worth it in the long run. But you donʼt have to take anyoneʼs word for it. A few sessions will show you the difference it can make.

Pediatric OT can help children improve in literally every area of their lives. From improving hand-eye coordination to developing fine motor skills used for daily activities like writing or playing with toys to learning positive behaviors and social skills, thereʼs no impairment or issue that canʼt be improved with the help of OT.

Is Occupational Therapy Covered By Insurance?

The good news is most insurance companies provide coverage for OT. However, they do so with certain conditions and sometimes with limited coverage.

So before you begin OT, itʼs best to get everything cleared up with your insurance provider.

Give them a call to find out exactly what your plan will cover. Doing so will ensure there are no complications later on when you may not be able to make any changes.

We hope this guide has untangled the complexities of all the therapy options you have at your disposal for your childʼs growth.

If youʼre looking for a passionate, committed, and family-centered therapy center that will go above and beyond to help your child live a healthy and fulfilling life, call us at (480) 613-8313.