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Balancing outpatient therapies

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    Balancing outpatient therapies

    Hi everyone-
    I'm excited to start MP next month, and I've been working on a schedule. I have two sons, 5 and 2, who both have Down syndrome. I've been working on lessons with my older son, James, throughout the summer using a different program. Now I am setting up my calendar for the school year. James hasn't had outpatient therapy since March, when everything shut down for Covid. My younger son, Ben, has Early Intervention, which has been done via teletherapy since March. It's been a real struggle. I usually end up taking a week off a month to reset, and he's usually willing to be cooperative again afterwards. But there is no word from EI as to when, or even if, home-therapies will resume. He has therapy four times a week- PT, OT, Speech, and Developmental. When James was in Pre-K, I would schedule Ben's therapies for when he was in school, then James would get his outpatient OT and Speech, when he didn't have school. His IEP can be updated to include home therapy, *when and if* they allow in-home therapy again, and I'm wondering what to do.
    What do others with more than one kid with disabilities/special needs do? I try to include Ben in the lessons, but developmentally he is probably closer to 1, so he can be pretty disruptive. And I'd like to take "field trips" once a week, but again, with Covid, I have no idea what's going to be open or available for us to use. I'd just like to hear other parents' experiences.

    Good morning, Teresa. I noticed no one responded, so let's see if we can clarify the challenges you're facing.

    To recap:

    James, age 5, has Down syndrome but has received no therapies from March onward.
    Ben, age 2, has Down syndrome and is receiving teletherapy 4x/week.

    Ben's teletherapies leave Ben very unsettled and disruptive; is that correct? Is it the therapies that then require another week each month to reset? If yes, I wonder if a home plan with once-a-month consultation might be more effective. Could you approach the therapists and request that they send goals for you to target at home?

    Much of OT and speech & language can be accomplished at home and turned into Ben's playtime. Obtain the goals and methods from his OT. Examples: Hide tiny toys in bins of hard pasta for him to find and give him fun foam in the tub if sensory issues are being addressed in this way. Use the recommended Supply List from Levels A and B for fine-motor and visual-motor play. Keep his play oriented around fine-motor and hand strength. For speech & language, play word games, use large picture cards to teach speech and vocabulary, have face-to-face conversations each day, and use a mirror to work on speech sounds prescribed in order of difficulty. Teach him oral language in a structured way through Level A. This takes only 30-45 minutes each day. Address Ben's therapies or Level A first each day while James plays. Then when Ben is tuckered out, send Ben off to play in a safe enclosed area, perhaps with rotated, developmental toys each day to keep his interest while you work with James. (This approach worked for us many years).

    As for field trips, with littles, your field trips can be the neighborhood park or playground if it is open, or you might invest in new outdoor play equipment to keep the play private & distanced. We set up a ball pit in a wading pool in our basement with a little-kid slide for motor planning to slide into the ball pit. When mine were little -- twins both receiving PT, OT, Speech & Language ages 18 months-5 years -- our PT "prescribed" a daily playground! She said, "Swing, climb, push, chase, run, kick balls, toss balls. Get them out of the double stroller, take them each by the hand to step up onto curbs and back down." Everything became "PT" influenced by the developmental goals set for each child.

    For around the home, it sounds as if the main issue is trying to occupy Ben while you teach James, so others may have other suggestions.

    If I missed the questions, feel free to clarify!