Speech And Physical Therapy Assessments

[Josiegirl]

Is it normal for these types of things to be done at a child's daycare as opposed to the child's home? Evidently, the dcps talked with the people that will be involved and said due to their work schedules, it'd be better if the assessment was done in my daycare.
Now this happens to be a family where dcd has told me they can be flexible with their job and sometimes they're done work early on Fridays so they can go away for the weekend. Dcm told the specialists I might have added information to tell them. Now the specialists did ask if it'd be okay but because I felt it'd look bad to say no, I said sure.
So I asked how long the assessment runs and she said the speech/language is about an hour, the pt is 45 minutes.

[craftymissbeth]

I've seen quite a few providers that allow for therapy sessions to happen in their daycares. I don't have experience with it, but I would definitely only do it if there was absolutely no way it could happen at home. Also, it would have to be during a time that's good for my group... and honestly, there really wouldn't be a good time. The only "free" time we have is between 8:30 - 11:00 and we go outside for almost that entire time. I wouldn't feel comfortable at all leaving them inside to do their work.

Hopefully someone with experience can chime in.

[Blackcat31]

I wouldn't allow it. It's a service for ONE child in a setting where multiple children are. TOO much of a liability for me to want to deal with.

Plus, I feel that if a child requires something individual, why can't parents simply step up and do what they need to do for their child. They are the PARENT.

Next thing you know, we'll have parents asking us to schedule Dr visits and bring them there too...

Like I said, I used to allow it but it became too time consuming for me to manage when 2 other parents found out I allowed one child's OT to come so they too wanted theirs too....

[Josiegirl]

The time we scheduled I'll only have 1 other dcg here. And she is the most into everybody else's business type of child you ever saw. I explained I have a small home and when someone else comes in, the kids want to be in on everything. She said she knows because she ran a dc for 10 years. I was hoping to bring my dcg outdoors while the specialist is here but maybe I'll just try to keep her busy. Yeh, right.

[sahm1225]

Well -my dd (she's 2) does her physical therapy in the daycare. We used to do it upstairs w my dh but the therapist asked to come to the daycare (dedicated space/lower level). At first I was worried because I felt the attention needed to be on just my dd and it would be hard to control the kids but we've gotten into a routine and it's worked out great.

My dd has pt at 9am Mondays. All the kids are in the kitchen w me & my assistant having breakfast and them we do story time. We have a dcg 2 1/2 that loves to go to 'work' w my dd, so as soon as the therapist arrive they go over to the play area. I have seen a HUGE improvement of my dd since we started to do it in the daycare.

Now if this was a dck, I would allow the visits ONLY if the times worked for me and I was able to accommodate. It is a full hour of service and at times longer. I would not, however do the evaluation meeting for the parents. For ours, it took almost 2 hours and it was a lot of questions (including medical & personal living arrangements & sleeping arrangements type questions). It is not something us as providers can answer. Call the coordinator and explain that you do not feel comfortable doing the evaluation and that you contacted licensing and are not allowed to have them in the home while you have dck.

[midaycare]

I have a child who gets speech and pt here. About once a month. They are not in the daycare; they use our upstairs space and the daycare is downstairs. Whoever comes has to show me a badge and they are on an approved list. They check dck out and sign her back in when they are done. Not a big deal.

[Sunchimes]

All of the children I care for are special needs kids. I only have 3 kids. All of the assessments and therapy appointments take place here. For the 2 year old, that is because they need to teach me how to do his therapies. I do 100% of his therapy, OT, Speech, and PT. They do minor things at home, like working with his eating and talking to him a lot, but the exercises, compression clothes, aromatherapy, etc are all done by me with the weekends for rest. I'm glad to do it and it has worked well for us for the past year. I love every minute of it and feel like I am making a serious difference in this child's life. I just wish I was young enough to go back to school for OT or Speech.

The second child receives less intense therapies, just speech and PT right now. The therapists tell me what to do and I do it and also teach the mom.

The 3rd is just getting temporary behavioral therapy, but after a month, all of the problems have worked themselves out and I don't think she will be in it beyond the first 3 months.

One of my biggest roles is to be sure everyone is included and to share all information between therapist and parent. The moms tell me what the kids have done at home and what questions they may have. I make notes (I keep a daily journal on each kid) and pass it on to the therapists, along with my own notes and questions. If I see something that concerns me, or if I run across something that sounds useful in my reading (I read a ton of ECI blogs) I talk to the therapists, not the parents. I have taken some liberties in this, but the parents approve of this method, and it has been very effective. In turn, the therapists answer question, suggest new things, etc, and I pass it on to the parents. I don't have any quick drop offs or pick ups. Pick ups have been known to last for half an hour, sometimes more when both moms sit and visit and compare notes. We have a lot to discuss every day-it's how we make sure that the kids are getting what they need and that we are all on the same page.

The only time my parents and therapists meet are during the original assessments and at the 6 month reviews, when papers need to be signed.

I know this wouldn't work for most daycares, but it has provided a niche for me. Since the kids are here 48 hours a week, it is important that I do their therapies here. For the most part, there isn't a lot of time at home for the parents to do them. It's easier for me to tell them than for them to teach me. For example, I had an 11 month old with physical delays. He had made no effort to crawl. The PT suggested we put him on all fours, holding him up under his belly, then scoot around the floor with him, showing him how to crawl. I had 9 hours a day to do this, the parents had a couple of hours before bed. If it had been left up to them, he still wouldn't be crawling because of the small amounts of time they had together. Because I had the time to do it, he is now crawling, walking, running, climbing-completely on target for his age.

As for the other kids, the only one that is a problem is the 3 yo. She is the typical child and very jealous of the attention the other two receive. (One is her younger sibling.) She is very intrusive and my biggest problem is getting her to back up and watch silently. Silent is not her default mode-ever. All but one of the therapists are very tolerant of it, and she has actually learned to do a few of the therapies with the younger kids.

In my experience, the initial assessments last about 1 1/2 hours. The 6 month reviews last about 45 minutes. Therapy visits are either 45 minutes or an hour, 2-3 times a month, depending on need.

Apparently, I am the only dc in my area willing to do this. As a result of this, the therapists have told me that they will keep me supplied with kids. I have an opening coming up when school starts, and they have already started making a list of which children would benefit the most from being with me. It's so hard to get kids in this small town that it's almost worth it not to have to advertise and beg for kids.

[Leanna]

One of my little guys gets speech therapy four times a week for 30 minutes each session. His speech therapist does all of his therapy while he here. He is here from 7-3:30/4 daily so it only makes sense that he gets his therapy here. Plus, the therapist lets me know things I can do with him to help him reach his goals. The therapist and DCM keep a notebook in his backpack and share notes and questions.

Sometimes the therapist needs to work with him alone and she pulls him aside; other times she joins in whatever we are doing.

This little guy has gone from having fifteen or so word approximations to speaking in full sentences with a great vocabulary. I love seeing the growth right before my eyes!

[Angelsj]

:hug: BlackCat, cause here we go again ::

I am teasing, but we do run different programs. I have several therapists or evaluators show up here each month, depending on the children's needs. We have had speech, behavioral, developmental, physical therapy, etc...

1. They need to work around MY schedule. Do not show up at naptime, and do not interfere with what we are doing. You can work within our realm.
2. Do not push the other children away. If you cannot answer their questions for the first two to three minutes, you have no business being here.
3. If you need to have the kid alone for an extended period of time, that will not work here. I need to be able to watch what you are doing with that child, so you will have to figure out how to make it work where I can still watch ALL the children.

For the most part, we have had wonderful experiences. I had one try to tell the other kids to go away and leave *kid* and therapist alone. Um, no. She didn't last long.

[Blackcat31]

:hug: BlackCat, cause here we go again ::

I am teasing, but we do run different programs. I have several therapists or evaluators show up here each month, depending on the children's needs. We have had speech, behavioral, developmental, physical therapy, etc...

1. They need to work around MY schedule. Do not show up at naptime, and do not interfere with what we are doing. You can work within our realm.
2. Do not push the other children away. If you cannot answer their questions for the first two to three minutes, you have no business being here.
3. If you need to have the kid alone for an extended period of time, that will not work here. I need to be able to watch what you are doing with that child, so you will have to figure out how to make it work where I can still watch ALL the children.

For the most part, we have had wonderful experiences. I had one try to tell the other kids to go away and leave *kid* and therapist alone. Um, no. She didn't last long.

LOL! no worries!

I admire and respect the type of program you run. lovethis

It just doesn't work for me. I used to be open to it but it became too much of a hassle and kind of became more of a pain to manage than not, so I stopped allowing it.

I serve a completely different type of family now than I used to have in care so it really isn't an issue for me. Most my families work very flexible schedules and work their child's outside needs into their day and thus have little or no impact on our daycare day.

I am definitely NOT against it...just not something I would do at this time.

Ask me again in 3-5 years and my group rotates/changes...who knows then. kwim?

If I did allow it, I like the rules you have implemented.

Anyways, if allowing a OT to come in and it works...AWESOME!

Sunchimes sounds like she has an awesome thing going on too!