How To Stretch Your Therapy Dollars

Stretch Your Dollar

OK, so you’ve got a diagnosis for your child, and the diagnostic team prescribed 25 to 40 hours per week of individualized therapy for your developmentally-delayed child.

Occupational therapy, physical therapy and speech therapy each cost about $120 per hour (or more) in my region.  A home-therapy program in Applied Behavioral Analysis or Applied Verbal Behavior costs about $20,000 to $30,000 per year.

Where I live, insurance companies are not required to pay for therapies related to a developmental delay.  All of my son’s therapies outside school have been out-of-pocket expenses.

In my home state, an early intervention program usually provides 6 hours per week or less for a child with global delays.  After age 3, a child with global delays is eligible for about 12 to 15 hours per week of public preschool, but not all of those hours are dedicated to individualized therapy.

How are you going to get the quantity and quality of therapy that your child needs without going bankrupt?

The truth is that plenty of families do go bankrupt pursuing therapies for a child with special needs.  But it may not be necessary.  I’ve learned several tricks to stretch my family’s therapy budget while maintaining a healthy quality of life for all of us.  Here are some suggestions that may work for your family, too.

1. Know what you’re looking for.
There are so many different types of therapies and school programs based on all kinds of philosophies, it can be tempting to try a little bit of everything.  But that’s not cost-effective.  The first step in the therapy process is to isolate specific goals for your child and for your family.  Then identify your family’s unique values.  Find the therapy that fits in with your goals and values.

My husband and I realized during the evaluation process that our son needed relationship-based therapies, not behavior-based therapies, to make developmental progress.

Find a different school district2. Pack up and move.
School districts may offer the same services on paper, but the delivery of services can vary widely in practice.  It is worth asking around and visiting programs in other school districts to get a better idea of what’s out there.  It is even worth considering a move to another state and a career change if better services are offered there.

We had a negative experience in our original school district, but we found an excellent program in the next county that fit our son’s needs.  We sold our house in the old school district and rented a condo in the new district.  Our stress level was suddenly alleviated: we no longer had to fight for what our son needed.  It turned out to be one of the best decisions our family could have made, because our son made rapid progress with the extra support, and even “graduated” out of special ed within a few years.

On the flip side, a friend of mine moved into our old school district because one of the special ed programs there was tailored exactly to her son’s special needs.  What works for one family may not work for another family.

3. Ask for homework.
If your child is already receiving services through a school or private clinic, always ask the therapists and teachers for extra therapy exercises that you can do at home.

If your child is not eligible for services in a particular area, you can still ask for home exercises in that area.

My son no longer qualifies for occupational therapy at school, but I asked for and received written suggestions for fine-motor exercises to help him at home.  Even if you and your child only do the exercises for 5 minutes at a  time, the extra practice will reinforce your child’s developmental skills.  As a caregiver, you have access to the child’s “teachable moments,” so you really are the best person to be helping in this area.

Price compare4. Compare prices.
I have found private speech therapists who charge from $70 per hour to $250 per hour.  The speech therapist who charged $70 per hour worked out of her home office, which was ideal for my son, since he had a phobia of anything that looked like a doctor’s office.

She even had a glass door for her office, so once my son became settled, I was able to step out of the office and observe everything from the other side of the door.  She earned my respect and gratitude.  She was the most creative speech therapist I’ve ever met – she taught me as much as she taught my son!

5. Ask for a discount.
Some private schools, clinics and non-profit organizations offer a 5 to 10% discount for pre-payment of several therapy sessions.  It sure doesn’t hurt to ask.  In some cases it may even be possible to barter services, such as IT support or advertising, in exchange for therapy.

Five Steps to getting started with Play Therpy6. Parent training.
This is the least expensive way to get those 25 to 40 hours of therapy every week.  Parents with no previous therapeutic experience can be trained in play therapy, Brain Gym, Applied Behavioral Analysis, as well as some types of recreational therapy.

My husband and I learned how to use play therapy techniques in everyday activities, so that every experience became an opportunity for growth for our son.  We’ve had therapeutic breakthroughs in some surprising places: attending worship services, volunteering together at a nursing home, visiting a noisy, crowded amusement park.

7. One therapy at a time.
Instead of loading up on a different therapy every day of the week, consider trying one therapy for a 6 month block.  At the end of the 6 months, you should have a folder full of home exercises and notes from the therapist that you can continue to use at home while you start a new therapy.  You can always go back to the previous therapy if it was more effective.

8. Substitute a less expensive therapy with the same goals.
At one therapy clinic, occupational therapy is $60 per 30 minute session, but music therapy is $25 per 30 minute session.  The music therapist incorporated all of my son’s speech, emotional and occupational therapy goals into each session (find a board certified music therapist in your home state here).  We supplemented the music therapy by buying a used XBox and Beatles RockBand game, so that our son could sing and play drums on increasingly difficult songs.  He still has difficulty with the guitar part of the game, but is highly motivated.

Another less expensive way to pursue therapeutic goals is through private lessons in gymnastics, swimming, rock climbing, yoga or tennis.  In my city, a 30 minute private gymnastics lesson costs about $15, and the coach will work on our son’s fine-motor and gross-motor goals.  We tried yoga for 2 months, and the instructor suggested that we buy Yoga Pretzels by Tara Guber and Leah Kalish to continue yoga at home.

9. Scholarships, grants and research studies.
A handful of charitable organizations, such as Easter Seals, offer scholarships or grants to families to pay for therapy or recreational programs.  Universities and research hospitals sometimes sponsor studies that include therapy for a specific period of time.

10. Katie Beckett Waiver.
The Katie Beckett Waiver, also known as the Medicaid Waiver, is intended for children with a permanent disability.  The waiver entitles the child to Medicaid coverage for medical bills, therapy, prescriptions, respite care and medical supplies.  Here are application instructions for the waiver: http://www.specialfriends.org/Waiver.html

How are you stretching your therapy budget?  Please share your creative therapy ideas in the comments below.

Karen Wang

Written on 2012/02/06 by:

Karen Wang

Karen Wang is a Friendship Circle parent. You may have seen her sneaking into the volunteer lounge for ice cream or being pushed into the cheese pit by laughing children. She is a contributing author to the anthology "My Baby Rides the Short Bus: The Unabashedly Human Experience of Raising Kids With Disabilities"
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  • http://facebook.com/profile.php?id=9220101 Jo-Ann Tsang

    thank you so much for this article! i found the information about the Katie Beckett waiver to be especially helpful. it didn’t even occur to me that something like that existed. we paid so much just on copays last year for our son, this has the potential to be a big help for us! you are an angel.

  • http://facebook.com/profile.php?id=1556774338 Karen Wang

    Also keep in mind that there is a parent training section on every IEP. The school district can provide specialized training for parents if it is written into the IEP.

  • http://facebook.com/profile.php?id=100000038181650 Tina McDonald

    While not a physical therapist, I used to do the work for an orthpaedic clinic doing physical therapy referrals, and you can tell actually tell just reading the docs and physical therapists notes on whose doing their exercises for the most part. For adults and children, you don’t get results unless you actually DO the homework and on a regular basis, not just at the therapy office. SO watch them to make sure they are doing them, and if a child absolutely positively hates an exercise, ask to find one that either hurts less to do for a while to work up to if its a pain issue, or try to find ways to make it more fun. Bribery on a score or chore card works, too!

  • http://facebook.com/profile.php?id=100000038181650 Tina McDonald

    And DO try to find a hatha yoga (more gentle, & easier) class that will accept kids. Did you know most of the physical therapy exercises are actually based on yoga poses?? For occupational therapy, warming the hands beforehand helps lessen the pain, and you can find paraffin baths really cheap at overstock stores. Chinese health or medicine balls can be found on amazon with videos on how to use them on youtube, and squishy balls (that are less messy than the therapy putty) can be found at dollar & discount stores (most kids really like the ones that walk down walls after they throw them), as well as jacks and dice, larger size crayons and pencils, and magic tricks. You can buy foam covers for pencils & crayons in the crochet aisle at craft stores , as well as online at medical supply shops that help small hands grip “tools”. Teaching kids crafts is a great form of occupational therapy where they can see & be proud of their results.

  • http://facebook.com/profile.php?id=1216045564 Yolanda Baker

    Thank you for this article. You’ve touched on a few items that I did not think about when I wrote my book on reducing medical expenses. I can offer you and anyone else reading this a free preview copy of my book. I also offer free webinars on cutting medical expenses via tax deductions. Please let me know if I can be of any help.

  • http://www.shoutsltherapy.com sherley jackson

    I’m an SLP and sometimes asking a school based therapist if she will take a private client can help reduce cost. We often will take 1-2 patients when parents share their stories. Also, check for therapists who are experienced but starting a new practice, often they are trying to build a client base and will offer quality services at a lower rate to show their appreciation. University Speech therapy clinics have graduate/doctoral student clinicians that provide therapy under well qualified professors. These students work extremely hard and the expectations are very high.