We have been trying to make a few changes in our therapists and therapy schedule recently and it's been weighing very heavily on my mind for a few weeks now. Here is the deal:
Speech: We got 30 visits of speech from our insurance for the year and we just used up the last of those last week. Our speech therapist was okay, but the sessions were only 25 minutes and it took me 20-30 minutes to drive there...each way. Since this was through insurance we were stuck as the only other therapist that was in network was over an hour away without traffic and we know how lovely LA traffic is! The topper on it was that for the last 2 weeks the therapist had been pushing us to try unthickened liquids (not just water) saying that we would know if she was aspirating and that her coughing was an indication that she was aware and keeping the liquid from going into her lungs. Well, I'm not a doctor, but the other speech therapists that are involved with Sweet Pea have been shocked when I tell them this. Especially since I voiced my concern about her swallow study showing "silent aspiration" which means that there were no indicators!
With our insurance benefits coming to an end I had been working with our regional center coordinator to get speech services through them. I was VERY nervous about this process as I have heard horror stories about getting speech services approved with our recent budget cuts. When we had tried to get her speech services around 14 months, before we went through insurance, they were claiming that she wasn't 50% delayed and we had to wait until then. Daddy and I were so frustrated because we knew that she was 50% delayed without any question! So I was preparing myself for battle and expecting the worst. I just have to say that I LOVE our service coordinator! He got it approved without ANY fight! We went from having to drive 20-30 minutes each way for a 25 minute session twice a week to having an in home or at daycare 60 minute session twice a week with someone that isn't telling us to have Sweet Pea drink thin liquids! She even asked to borrow our DVD of the evaluation that Sara Rosenfeld-Johnson did on Sweet Pea in May! She may not have experience with Sara's protocol, but she is at least willing to listen. I'd say that is a big check in the success column!
Physical Therapy: We have been getting more and more frustrated with our physical therapist. She changes our appointments, leaves early, won't write reports when needed and is just not that pleasant of a person to work with. Oh, and on the therapy front...she doesn't even do much with Sweet Pea! She will spend an entire session having her chase a cell phone and going from sitting to standing. We have been doing this for months now! Seriously!?! That is all you want to do in 50 minutes? No wonder Sweet Pea doesn't like her sessions and cries the moment she sees the PT a lot of the time! So, I finally decided that enough was enough and looked into switching therapists. We lose the convenience of it being in home or at daycare, but I believe that we will gain so much more by having it be productive time!
Back in June we had our local support group play date at this place called NAPA Center and I fell in love with the facility and the therapists that we met that day. We are hoping that NAPA will be able to take over all our services eventually, but we are moving one by one at this point. They aren't approved for speech yet so we can't use them for that, so we started with PT. Hopefully their speech services will be approved by regional center in a month or two and in the meantime I can meet their speech person and see if it seems like a good fit. If not, then we will probably only have them provide OT and PT.
Today was our first session of PT at NAPA and the Sweet Pea took to the therapist immediately. She knew how to push Sweet Pea just enough without pushing her over the edge. We had a full hour of PT where I feel that Sweet Pea actually worked for a good 45 minutes! That has NEVER happened before! The therapist spent a good amount of time evaluating Sweet Pea and determining what her strengths and weaknesses are so that she knows what to focus on. It appears that her right leg may have more tone, but that she can't integrate it as well. By integrate I mean that she uses the right leg as one unit instead of movable pieces that work together. That explains her signature crawl and the therapist pointed out that even when she is walking or standing, her right leg is more of a peg leg. Her left leg is what she does all the movement with. I found that interesting as no one had ever mentioned anything of the sort before, but watching her it made perfect sense.
I will need to remember my camera next time because the setup at NAPA is really great. Pictures will describe the place much better than my words. They have an area where they can hook her into a belt with bungees that help support a portion of her weight, but allow her to practice standing and weight bearing. She tolerated this for over 15 minutes straight where she normally will only stand for a few minutes. It was amazing to see her so happy to be mobile and standing and I look forward to her being able to use the supports that they have at NAPA to gain the confidence and stability in order for her to do it without additional supports.
At the end of the hour Sweet Pea was still smiling and waving and crawling all around. For the first time in a strange location with a new therapist I never imagined that the session would go so well. We have our next session on Friday as a make up for next Tuesday (when she will hopefully be getting her ear tubes) and I hope that the next session is just as good as today!
Summary: I need to listen to my gut more and not be so slow to make these changes when I feel that they are really in the best interest of Sweet Pea. I REALLY wish that there was a "try before you buy" with the therapists, but at least in our situation, you rarely get the chance to meet with a therapist before you have to get approval to use them. It's a hassle to switch, but it is definitely worth it if the therapist isn't a fit for your child. Friends and family...please remind me of this sooner next time! :-)