Break from Therapies?

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Hi everyone. Is it reasonable to take a break from therapies at any point? I think my son (5 years old) and I are both getting burnt out. His speech and occupational therapists are both 50 minute drive each way to and from our home. I am paying out of pocket which is financially draining. Over the summer I was doing twice weekly OT and ST. Now that he is in school I backed off to once weekly. I was pleasantly surprised last week that his speech therapist re-evaluated him because he is doing so well and he scored in the normal range. So she wants to back down to maybe once a month or once every other month to monitor him. That sounded wonderful to me. I feel like backing off of OT too though. I was thinking stopping until the summer and then going to twice weekly over the summer when school is out. It just makes for a long day with school, then drive time, and therapy. Thoughts anyone? I feel like there is no end in sight especially with OT. Is it reasonable to think that we can take breaks or does this have to be a continuous thing and then until what point? I wish we could find an OT closer but there are none that can offer him what this practice has. Advice?

Too much being scheduled can be stressful, and stress is not exactly known for improving ASD symptoms (nor is a stressful mom.) A lot of it is going to depend on what you are using the ST and OT for. IF "normal range" includes speech pragmatics that is really great! Is OT for motor skills,sensory issues or both? If you think he can carry on/progress on his own, you can try scaling back. You can always pick things up, if it is not enough.

Well the speech therapy initially was for actual speech and saying words correctly. That he is now in the normal range based on this re-evaluation. As far as speech pragmatics, this therapist said it would be harder for her to do with him because it is one-on-one speech. Actually he has done sooooo much better with the one-on-one speech for the actual speech sounds and saying words. He was in public school speech therapy that was with a few other kids and I saw NO progression at all (and I am not being harsh really). Once I put him in private pay one on one, everyone was noticing differences within a couple of weeks. So I am at a loss really what to do about speech pragmatics. OT is for gross and fine motor skill delay and also a lot of sensory issues. I know he needs it but.....the long drive makes for a irritated kid (he gets car sick too so that has become an issue). Over the summer, he didn't mind so much because there was no school and he actually looked forward to going. During school year he dreads it. If he were getting these services through public school he would get breaks during any school breaks. I haven't been doing that with him. I just feel we both need a break! Maybe I will just take the month of December off. Or maybe I can find someone closer. His OT has a nice set up though, with fine motor room, gross motor area, sensory room.

It sounds like your child is doing a lot in OT. I am guessing you tried to get the school to provide it, and they turned you down? Maybe get him re-evaluated for OT (and PT maybe for gross skills) at school, and see if they can pick up doing some of it. If he needs it, they are required to provide it.

Getting the *right* speech teacher makes a big difference. We did not do any private pay speech, but when he was in PS it was very clear who was doing a good job and who was not. (They switched his speech teacher a lot) The last one he had was worth zilch. Maybe push harder at school for that, too. Make sure that his speech goals include pragmatics and see what can be done there, so it is not hard for you and your little guy.

He is in private school. The public school said he would only be eligible for drive in speech therapy which I declined because he did so much better with his current ST.

So do most parents on this site just get services for their child through the school? If there are any that do private pay like I am...have you taken any breaks from therapies?

We've done all private pay, from the diagnosis (the school did an assessment but we wanted a more extensive one, and an actual diagnosis). Since the school didn't do any modification or therapy for the first 2 years after dx, we found our own supports. However, it has only been tutoring with a special ed teacher and psychological therapy for dd's anxiety, social skills and organizational skills. All of our service providers are local. She is on a waiting list for speech therapy, through our health region rather than the school (which talked about it but never did it) but while we're waiting the slp suggested resources for us to purchase on our own, and her tutor used them in the summer. Now we have academic modifications / accommodations at school, regular tutoring, and occasional therapy. She is doing much better socially, and has joined mainstream clubs at school and with organizations we trust.
We've been fighting for three years to get our insurance and/or disability credit to cover the services, and remain optimistic. And we have no regrets.
J.

Almost all of my oldest's therapies have been paid for through disabilities services. It is an alternative to dealing with the schools.

Would it be possible to see what the OT does with him and mimic it at home??

I don't think it would be viable for an extended period of time-- you're not trained, and the OT is Not The Mama-- but it might help prevent him from losing ground from taking a short break.

I'm sure conventional wisdom is never stop, never rest, never never never never, but that schedule would burn me out. I don't know about all autisitic kids, but THIS autistic kid needed (still needs, really) massive amounts of unstructured time to de-stress or the results aren't pretty.

I think it's ok to take a break. We stopped private ST and OT when DS started kindergarten -- in theory he was getting them at school but in practice he refused to work with them (many meltdowns about being pulled out of class to go to speech and OT). We ended up pulling him out of public school in November of 1st grade and didn't get around to setting up private speech until the following August. For articulation, this turned out ok -- he actually breezed through learning to say /th/ and /l/ in about two months time. His permanent front teeth had just come in and I think that made a difference. Now he's working through all the r-vowels.

OT-wise, the school OT was able to help him with his grip, but he was still struggling with some of his lower-case letters like "a" when we pulled him. At his new school, the teacher started over with kindergarten-level worksheets. Actually Zaner-Blowser rather than Handwriting Without Tears, which surprised me. But he did these letter worksheets ok without melting down. He can now write all his upper and lowercase letters, but it's still very slow (like 10 letter/min, where a 2nd grader should be at 30 letter/min) and has spacing issues. We'll get him back into OT soon.

If you take a break, you could do the following on your own:
* Get the Handwriting Without Tears chalkboard and kindergarten workbook, and work through all the letters on your own. (The website has some videos about teaching grip, etc.)
* Do some OT games from The Out of Sync Child has Fun
* If you have an iPad, use ArticPix to practice some sounds

I have thought about trying to work on the goals with him at home and see if I can mimic what they are doing. I think it wouldn't hurt especially if I do plan on taking a break from actual therapy.

Thanks everyone for sharing what you have done and also for the ideas. I actually just downloaded the handwriting without tears app on my tablet. He loves electronics so he practices his letters to earn time on tablet to play other games.

I haven't decided what I am going to do yet about OT. I am leaning toward giving it a break and using the summer to go more. It seemed like I saw greater gains this summer when we were going twice a week. It's just not feasible during the school year.

just a tip, hope it helps... go to care.com and look for a special need caregiver that is also studying to become an O.T. or Speech Pathologist. It will be cheaper and they come to you.

We have done both schools and private services for our daughter. The private services were usually done in 8 week blocks - then a break - then another 8 week session, but they were for social skills. I would like to mention that I recently saw an article about a therapist who used a webcam to provide therapy for her clients who had to travel long distances. It allowed her to provide the therapy and no one had to drive. You might ask your therapists if that would be an option?