Moose has amazing therapeutic support through our local Early Childhood Intervention program. Texas is notably terrible at providing social services for children, disabled, and the elderly. I know that in other states, there are kids like Moose who get more from ECI than we do, yet I can attest that Moose gets the max services available from ECI in the state. So, roll call:
1. Physical therapy - we get PT once a week for an hour. It is direct, hands-on therapeutic intervention for 50 minutes, and ~10 min of revisiting goals, writing strategies, and general admin and planning. This was the first therapy added to our plan when we enrolled in ECI when Moose was about 4 months. We originally started with a solid, but less experienced therapist, and transitioned to the PT guru when Moose was about 8 months. Given that gross motor has been vying for greatest area of delay most of his life, having someone very seasoned in this area has been huge for us.
2. Speech / Feeding therapy - once per week for an hour plus. We added speech to Moose's plan between 6-7 months, but only 2x per month. This was because there wasn't much speech therapy you could do for a small infant, and resource constraints with the ECI program. At around 9-10 months I'd been reading about the links between language and cognitive ability, so I asked our neurologist to write Moose a prescription for 4x/month speech and 2x/month feeding intervention. I was then able to negotiate weekly service with our existing therapist, who I like a lot. This area has been the most fluid in terms of what we do, since language-wise Moose is not technically delayed, but at high risk for cognitive deficits and autism. His feeding issues have been more and more pressing, so we are now focusing all 4 monthly visits on feeding interventions and strategies. Our therapist moved her appointment to attend during the class' meal time.
3. Occupational therapy - we get an hour a week of this, and it's solid hands-on play therapy. This was added to our plan early, but we didn't get a therapist assigned until around 8 months due exclusively to resource constraints at the agency and me pitching a very polite tantrum about that not being Moose and my problem. Our wonderful OT comes at the end of the day on Thursday, so Moose doesn't always tolerate a full hour, but he gets at least 35 minutes, and she stays as long as 75 minutes on occasion. OT/fine motor at Moose's age is still pretty integrated with gross motor and core strength, so it's only recently that we've started to see some hallmark fine motor skills like pincer grasp start to emerge. OT also is where we get our sensory processing support, so there is a lot of strategizing about how to diminish or avoid sensory sensitivities.
4. Developmental services - we see a developmental expert once a week for about 45 minutes. She was She comes to Moose's school to meet with us both, but doesn't always do hands-on with Moose. When she does, it's mainly social play and attention activities like peek-a-boo when he was younger and mimicking and turn taking now. One of the big benefits of this resource is that she's very helpful, so I can often ask her for help with an issue or question, and she'll come back the next week with three printouts and a website for me to look into. I also like that this is a little more one-on-one time Moose gets, and with someone who deals with special needs kids all the time, so she's a good second pair of eyes on how Moose is doing.
5. Nutritional support - this was a fairly recent add due to Moose's failure to progress from bottle to purees or table foods. We saw her once a month for 3 months and now were to once every 3 months. I'm honestly not sure that this part of our plan provides anything I couldn't either intuit or google, but sometimes just having time set aside to think and talk through issues is valuable.
We also have an amazing case worker, who I have put on notice that she has to be my BFF when we age out of ECI because I can't live without her. At this point, I have no idea if the conversations we have are on script for her or not, I suspect not, but she is a special needs mom and former therapist who knows how the systems work, plus she's just a neat woman. She coordinates all of the paperwork and insurance so I don't even have to touch that stuff other than to sign things, and she helps me access the team as a resource think tank when big challenges come up.
I attend almost all of these therapy appointments, first of all because I can and I like spending the little bit of extra time with the guapos. I also see my role as a conduit between each of them and back out to the doctors and researchers. But mainly I attend most of the sessions because these ladies are skilled and knowledgeable, and tolerant of me spending most of the time they're working with Moose being peppered with questions. At this point, there's very little about Moose's development that I won't discuss with each of these professionals, because no matter what it is, someone unexpected almost always knew a kid, or read something, or went to a seminar, or noticed this or that with Moose that sheds some light on the issue.
I am routinely humbled by how little I truly know, and by the willingness of others to contribute or even just listen and empathize. If you aren't making the most of your time with the therapists in your life, I encourage you to start nerding out on a therapist near you stat.
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