Peninsula Speech Plus have been helping individuals and families for a loooong time. We’ve tried and tested many different ways to support clients and what we’ve learnt is ‘therapy’ looks different for everybody, and a fluid approach to treatment works best for all. Service Delivery or ‘intervention’, incorporates assessment, diagnosis, consultation-liaison, monitoring of skills development as well as traditional ‘therapy’ services.
Where treatment is indicated, there are considerations to be made regarding type and intensity of supports. Treatment goals and schedules require constant adjustment to accommodate the changing needs and priorities of the child and family alongside their social, educational, vocational, recreational, and emotional demands.
“Therapy burnout” and “being over-therapised” are real phenomena – for children, siblings, families, and budgets. Children need time to put new skills into practise and develop confidence in them, as well as just be kids. At PSP this drove our decision to provide a range of service types and frequencies to accommodate and adapt to the shifting needs of families and individuals.
Reasons to change treatment schedules are broad and varied but could be:
People need a period of time to practise and establish new or foundation skills in everyday activities in real life before moving forwards. We distinguish between therapy intensity (frequency of sessions with a therapist) and practice of an activity in natural environments. Skills development and maintenance is most likely to occur within the environmental conditions in which it is usually performed. The time spent in ‘therapy’ is small compared to the opportunity to practice in natural environments and build capacity – intervention needs to support this.
Development driven – Child development is dynamic and skills acquisition optimal when the individual is ready across several domains such as body function and structure, motivation/interest, and environment.
Time driven – a change in family work schedules or childcare availability limits access to services.
Family driven – seasonal sports and practice times wait for no man!
Personally driven – tapping out and taking some well-earned downtime is often needed to sustain motivation for long term success.
Over the years, we have offered families a range of different supports.
Services might look like….
- Cycles of Care: treatment occurs for a defined period and to support the acquisition of a specific skill. This model allows time out for skills to be practised beyond the clinic setting and integrated into everyday activities across multiple settings such as home, community and school. People attend for 6 to 8 weeks or a term before having a period ‘off’ before recommencing.
- A period of group therapy to practise newly acquired skills in a safe environment amongst peers. Some move from individual therapy to group therapy to consolidate their skills in a functional setting.
- Participation in an Allied Health Assistant program to practise new skills in the home and community.
- Attendance of regular fortnightly or weekly therapy either in the clinic, at home, at school or in the community.
- Tele practice sessions – We started to us tele practice with Covid-19. The subsequent lockdowns have proved this to be an effective method of service delivery that overcomes reduced access to services caused by restrictions in time/availability, transport, childcare as well as sudden family illnesses. We have now integrated Tele practice into our everyday practice. We conduct our initial interviews, our meet and greets and whole programs over tele practice.
- Or it could be a combination of everything. We are committed to providing services that are timely, appropriate, and responsive to the goals set.
Our clinicians can consider and accommodate necessary fluctuations across the course of your relationship. In consultation with you, they will guide and recommend adjustments to your service delivery as appropriate.
Talk to your therapist. We have all these options available to everyone and will work with you to find the combination which serves you the best.
References: Speech Pathology Service Access & Delivery. Children’s Health Queensland Hospital and Health Service
World Health Organisation. International Classification of Functioning, Disability and Health (2001)