Private practice or School better?

[waverly]

We've been doing private practice for PT and just started OT. I could push for OT in the school.

Honestly I don't think he would qualify for PT in the school since he has no issues in gym or at the playground, and is doing well academically. I know there has to be an educational component.

I was told by a rude person yesterday that if I wanted PT and OT and didn't get it in the school that it was a parenting fail for not being pushy and mean enough I guess.

But I am not sure it's worth being pushy and mean unless the school provides superior therapy. PT will be phasing out soon. OT at the school would be better for my schedule and money, but I don't mind paying the money if the services are superior through private.

How do I know which one provides better services? Should I take the eval to the school and do both school and private for OT? It may be a fight because I don't think the school cares about sensory or motor planning if it doesn't affect him. And his teacher said his handwriting was ok for her. So I don't know what my point would be except to say here is our private eval - please provide services...

[auntie]

Dec 3, 2017 8:59:34 GMT -5 waverly said:

We've been doing private practice for PT and just started OT. I could push for OT in the school.

Honestly I don't think he would qualify for PT in the school since he has no issues in gym or at the playground, and is doing well academically. I know there has to be an educational component.

The bar for in-school PT is pretty high. If he can access the curriculum- i.e. participate in PE, the playground and move independently it will be hard to qualify for PT. I've known a few kids to get PT for significant hypotonia in their core but it is yet another pull-out. 

I was told by a rude person yesterday that if I wanted PT and OT and didn't get it in the school that it was a parenting fail for not being pushy and mean enough I guess.

I try to avoid shitheads.

Some people, usually mommy-martyrs, judge their own worth by how much they get for their child which is all kinds of wrong. The goal, especially for a bright kid on track to an independent adulthood is to find a balance between getting meaningful and effect services while making sure he doesn't become a guest in the classroom or start to self-identify as "broken" in some way. 

But I am not sure it's worth being pushy and mean unless the school provides superior therapy. PT will be phasing out soon. OT at the school would be better for my schedule and money, but I don't mind paying the money if the services are superior through private.

How do I know which one provides better services?

It's hard to say which is better. A lot depends on the actual person doing the therapy. There are some benefits to IEP-based interventions when the therapist can anticipate what is expected in the coming years, can push-in services to the natural environment for instruction and practice and can work collaboratively with the rest of the team.

For us, the school elementary SLP was better than anyone available privately. MGW wasn't as well known back then and DS's school SLP was already up to speed. She was also able to cobble together social skills groups that were a better fit than what the local private providers could provide. DS's psychologist suggested the school SLP's social skills over the ones offered by his own daughter in his office. The high school's SLP spent 2 1/2 years on maternity leave and gossiped when she was around- she sucked by any metric.

We chose private for the psychologist because schools don't really offer therapy and for reading because I wanted to pick the curriculum rather get the Wilson Reading the schools here use. 

Should I take the eval to the school and do both school and private for OT? It may be a fight because I don't think the school cares about sensory or motor planning if it doesn't affect him. And his teacher said his handwriting was ok for her. So I don't know what my point would be except to say here is our private eval - please provide services...

You would have to demonstrate that that which is noted in the eval is impacting him educationally. Sometimes this is easier than you think. Like when DS was having EF issues and flunked an assignment 3 days in a row when said project was in his backpack or when a kid who is a rule boy can't cooperate with peers on group projects-but unless he's falling over his feet several times a day, motor planning won;t excite them. 

[waverly]

I love your wording auntie. I will be avoiding that mommy martry shithead in the future. You totally have her pegged. Perhaps her son also presents as far more delayed and problems in school. The mom also showed a real lack of knowledge in some areas I would assume to be common knowledge. Although I know I get in trouble sometimes assuming common knowledge.

None of the examples that you listed does he have an issue with, forgetting schoolwork, not being able to work in groups or falling over his feet several times a day. Nothing. He is testing in 99th percentile in math and reading on standardized tests, participating in the classroom, doing his homework and has strong marks in everything except punctuation which is a middle mark. He is in first grade and reading at third grade level. He is doing fantastic in school and speech, so it would be a hard sell that he isn't doing well. He is the highest reader in the class and one of the top three on the math tests.

H and I decided to stay with private for this anyway since all three of us like the place. And cost wise it's just meet the deductible which is lower now with our new health insurance. Thanks for talking it through with me.

[origami]

If I wanted my kids to get real PT & OT we’d have to change schools entirely, to one with a high SN population. Because neither of those services (I’m referring to actual therapy) are offered at the majority of schools in our district. We get “collaborative” OT where we are, which is where someone advises us/the educators about what accommodations can be done in the classroom. It’s nothing like what we get in private therapy, with the big gym and lots of therapeutic exercises. There’s really no comparison. That said, I don’t think it hurts to ask, if it’s free.

[waverly]

Dec 4, 2017 8:06:44 GMT -5 origami said:

If I wanted my kids to get real PT & OT we’d have to change schools entirely, to one with a high SN population. Because neither of those services (I’m referring to actual therapy) are offered at the majority of schools in our district. We get “collaborative” OT where we are, which is where someone advises us/the educators about what accommodations can be done in the classroom. It’s nothing like what we get in private therapy, with the big gym and lots of therapeutic exercises. There’s really no comparison. That said, I don’t think it hurts to ask, if it’s free.

Thanks. That is what I was thinking. If OT at the school just did a few hand exercises and called it a day/ I mean he really needs the motor planning, sensory, core etc portion of it not just a small part.

I am not sure if the mom I was talking to was confused/ unaware of the difference between EI and school age or had issues with private pay therapy from her personal financial standpoint. She also has a friend in the system so her idea of a "parenting issue" of a parent not pushing hard enough may very well been someone pulling strings for her behind the scenes. Not that I don't think the school district isn't good- I do just that I couldn't figure out where the her attack came from and thought there was possible insecurity on her part.

[sahara78]

I've found that no matter what you do, someone will criticize or question the decision. Unfortunately, when dealing with special needs there are no (or very few?) definitive treatment options, so many people think they know best. (I'm still bitter about the SLP that questioned center-based ABA, when it's the only real option in my town. Argh.)

[waverly]

Dec 4, 2017 11:14:52 GMT -5 sahara78 said:

I've found that no matter what you do, someone will criticize or question the decision. Unfortunately, when dealing with special needs there are no (or very few?) definitive treatment options, so many people think they know best. (I'm still bitter about the SLP that questioned center-based ABA, when it's the only real option in my town. Argh.)

This is true.  I guess she said it so out of the blue, and in such a weird manner that all I could do is stand there and nod like I agreed with her.  It wasn't like I had asked her advice or said oh I really want the to get PT at school or anything like that, so it seemed to be in no context.  So I really had no idea what she was trying to say at the moment because she didn't clarify it either.  I kept waiting for there to be more to that sentence and how it applied back to her I guess, so it took me a while to realize she was just straight up insulting me. 

[auntie]

waverly ,

Not saying this is the case for your friend, but sometimes this sort of opinionated exchange is the result of poor social skills and a lack of empathy. Little apples sometimes don't fall far from the parental tree.

[waverly]

Dec 4, 2017 12:37:09 GMT -5 auntie said:

waverly ,

Not saying this is the case for your friend, but sometimes this sort of opinionated exchange is the result of poor social skills and a lack of empathy. Little apples sometimes don't fall far from the parental tree.

I would have no way of knowing but I think it's a possibility that there is something a little off. I also don't know her sons diagnosis, and he is young, but it could be headed to autism maybe.

[akafred]

I think you should just accept that she said something stupid and grant her the grace you would like others to grant you when you put your own foot in your mouth as we all do from time to time. Who knows? She may have been beating herself up over it for days now. Why did I say that? That was stupid!

[waverly]

With time I am getting over it. I doubt very much she regrets what she said to me because this isn't the first conversation she has taken into that competitive space. I can understand though that likely most competitiveness comes from a place of insecurity.

And yes I have definitely stuck my foot in my mouth many times! And I do feel bad for it.

[waverly]

Well I dropped off the private OT eval at the school. I could use some help since I have been taking him to so many appointments. I still plan to do private therapy but even if they could do some hand exercises at a bare minimum. Actually at a bare minimum if the OT and teacher could read it for better understanding of him.

I am not looking forward to another team meeting just because they are stressful but it is what it is. And if it helps him great, and if they don't offer services we at least have the private set up. It's a step forward for me to just drop it off.

[waverly]

No dice. The school refused to provide services anyway.

[origami]

Jan 23, 2018 16:03:51 GMT -5 waverly said:

No dice. The school refused to provide services anyway.

I'm sorry to hear that. The same thing happened to me.

[akafred]

I'm sorry, waverly. Hopefully he'll make good progress with private OT. FWIW with OT I would almost always go private unless your district is very unusual. Most schools don't have as robust OT programs as private. For example they don't touch sensory. Gross motor is also iffy. Most are limited or nearly limited to fine motor.

I don't know anything about ST or PT so maybe they are more robust.

[waverly]

Jan 24, 2018 7:21:20 GMT -5 akafred said:

I'm sorry, waverly. Hopefully he'll make good progress with private OT. FWIW with OT I would almost always go private unless your district is very unusual. Most schools don't have as robust OT programs as private. For example they don't touch sensory. Gross motor is also iffy. Most are limited or nearly limited to fine motor.

I don't know anything about ST or PT so maybe they are more robust.

Not sure on PT. I doubt it's very robust.

ST seems to be similar to private, but he's been doing one letter all year, so even though he has a hearing loss I'm kind of feeling like he really doesn't need speech anymore. However, she doesn't want to discharge him I think as a just in case. But I'll cross that bridge at the next IEP.