Hand to Hold's Official Blog: Written by Parents for Parents

Home-based vs. Clinic-based Therapy

Enjoying the therapy swing during an OT session

Enjoying the therapy swing during an OT session

When we brought our former 23-weeker home from the NICU, we knew we had a long road of therapy ahead of us. After all, he was a 23 weeker, with bilateral grade 4 bleeds and at a high risk for developing CP. We knew he would need therapy. Before we left the NICU, we had been prepped on the Early Intervention (EI) program in our state and eagerly awaited our first appointment to hear how we would proceed with therapy.

Shortly after his EI evaluation, our son started home-based physical therapy. At the time, he was on full-time oxygen and had to have a monitor hooked to him 24/7. We continued with home-based therapy until we moved out of state when my son was 18 months old. It was then that a chance meeting led to a connection with a clinic-based program. Before our move, I hadn’t ever considered going out of our home for therapy. Why would I? We had a great therapist coming to our house, which made life with a medically fragile child just a tad bit easier.

However, after touring the clinic and talking with the therapists, I decided it might be time to venture out of the house. (Keep in mind that our son was now 18 months old, off of o2 and monitors and his doctor had cleared him to go to a clinic.) Immediately we noticed that our son responded so much better to his therapy sessions. Each session seemed to show a pretty significant improvement than the time before. Today, at 22 months, we’re still at the same clinic and have no plans of moving our therapies back home. We do all of our therapies in a clinic with the exception of a bimonthly play therapy.

While a clinic-based setting seems to be the most beneficial for our son, it hasn’t always been. And it won’t always be the best for every child. This post is intended to help you sort through your options and empower you to make the best decision for your child.

Benefits of Both Types of Therapy

Home-based therapy:

  • Therapist travels to you. This is especially important if you have monitors, feeding tubes, and other medical equipment that may make traveling with your child cumbersome.
  • Because it’s typically just one adult coming to your home, by choosing home-based therapy you’re drastically reducing the amount of germs to which your child is exposed.
  • Home-based programs are easily able to show you how to incorporate daily exercises into your home life.

Clinic-based program:

  • Equipment (therapy swings, walkers, standers, etc) can make a world of difference. In our case, our son thrives after spending 15 minutes before each session in a cuddle swing.
  • Often times, it is easy to have therapists cross over at a clinic since they work together all day and are in the same place. This means that the OT can observe while your child is participating in PT and vice versa. The resulting benefit is that you can get two different angles on one issue.
  • While there can certainly be distractions in a clinic, often times the therapy rooms are free of windows, open doors and children are able to have their sessions uninterrupted. The therapy rooms are designed specifically to reduce distractions and to enhance the therapy sessions.

Questions to Determine Which Settings Are Best

  1. What is your child’s immune system/overall health like? Can they be around other children? (Be sure to get a doctor’s input on this. Also, you’ll want to ensure that any therapist, whether in-home or out-of-home, is willing to follow any rules you may have to keep your child healthy.)
  2. What works best for your family’s schedule?
  3. What are your child’s needs? What types of therapies does he/she require? Would special therapy equipment help meet their needs? (Don’t be afraid to ask for a therapist’s opinion when assessing their needs.)
  4. Is your child easily distracted at home? Perhaps you have other children at home, do they often distract your child during sessions?
  5. Do you feel comfortable in your home routine and with incorporating therapy exercises at home?
  6. What does your insurance cover? And what can your family afford? If you’re interested in a certain program, don’t hesitate to call them and inquire about your costs. In many cases, they will be able to tell you an approximate amount you’d pay and whether or not they’re in-network or out-of-network with your insurance company.

For those who have done both types of therapy, can you add any other helpful tips? Please share if you have a preference between home-based and clinic-based programs.

DISCLAIMER: I am not a medical professional, just a mom who has been to more than her fair share of therapy sessions! For true medical advice, please seek a professional.

Lindsay Franks About Lindsay Franks

Lindsay Franks (NC) is the mother to Pierce, a 23 week preemie. Despite the odds, Pierce overcame a 4.5 month NICU stay. Today he is a healthy and thriving toddler. Pierce works hard in daily therapy, but has already come so far. Lindsay blogs about her family on her Little Baby Pierce. In addition, she founded and runs Pierce's Project, a non-profit that supports families of micropreemies in the Charlotte, NC area. You can find her on Facebook or follow her on Twitter.

Comments

  1. LOVE this post – and Pierce’s Project – AND Lindsay. What a wealth of knowledge and inspiration this family is!

  2. Sharon Desserud says:

    The other factor to take into consideration is parental stress. A visit to the home when you’ve spent weeks in hospital with your baby can mean staying in jammies, seeing what you could use in your own home. And in Canada, avoidance of snow storms, chilly damp weather or transportation issues in general.

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