Graduation: When Do We Finish with Therapy?

For the children attending therapy services, our goal is to achieve age-appropriate (or above!) scores on the standardized tests compared to their “typical” peers.

Standardized assessments alone do not tell the whole picture.  We should also know that if the child can use improved motor skills, speech-language skills, and self-regulation skills in real life. On the other hand, are the parents reporting generalization of the achieved therapy goals at home, or does the child do well during the therapy sessions but forget the new skills once he walks out the door?  Concerning communication goals, is the child able to interact with family, peers, and strangers and be understood?

Graduate with a full toolbox of techniques

Today, we should be ready to discharge the families from therapy long before the child has achieved all the therapy goals compared to his peers.  If the therapist has done their job well and given the parents the skills, they need and techniques they can use the strategies of recommendation given by the Occupational Therapist or Speech-Language Pathologist as a part of their everyday life. They should continue to grow their child’s language long after they discontinue the therapy sessions.  The goal is that the child should continue to learn along a developmental trajectory just like their peers.  Parents should and the ability to advocate for their children.  If the parents have learned to utilize the strategies and become their child’s first and best teachers, they can take the reins!

Timing is important

The best graduation should be done gradually, not a drastic cut-off of “one day you’re in therapy, the next day you’re out the door!”. The “step-down” plan should help the child and family feel supported as they move to independence. It also allows us to watch and wait to make sure the child continues to progress as therapy time decreases. If the child doesn’t continue to move forward, it may not be time to decrease therapy frequency just yet.

 Ceased to make progress in therapy

 Sometimes, a child has ceased to make progress in therapy, and sometimes it becomes frustrating for all involved.  The first step is always to look for red flags and try to puzzle out what exactly is causing this developmental plateau. For some children, particularly those who have been in therapy for a while, there can be times when all (parents, child, and the therapist) just need a break. Parents also need to be aware of signs that it might be time for their child to head back to therapy, even years after graduation. The last essential thing families need to know is that graduation is not goodbye forever.

Shalini Das

Director, Board Certified Behavior Analyst,Occupational Therapist

Shalini is one of the co-founders of Symbiosis Pediatric Therapy. She currently oversees the clinical and administrative departments of Symbiosis. Shalini has more than 25 years of experience working with children with autism and developmental disabilities.

Shalini completed her Master’s degree in Occupational Therapy specializing in Pediatric Neurology in 2000. She also has her Masters degree in Special Education with a focus on Applied Behavior Analysis from The Pennsylvania State University.Shalini is listed in the RASP list as a Behavior Consultant and an Occupational Therapist.

Shalini has extensive clinical experience with assessment and program development that is designed to treat challenging behaviors, build communication, and functional life skills. Some of the team-based intervention which she incorporates are the Applied Behavioral Analysis (ABA), Early Start Denver Model (ESDM), SCERTS, DIR®/Floor time model, etc.

Shalini has trained & supervised several teams of therapists, parents, and other professionals on evidence-based behavioral strategies to improve the quality of life for the children. She also assists with the development and implementation of evidence-based treatment approaches, in addition to providing clinical guidance and mentorship to the Behavioral intervention team.

Shalini is certified to administer the Sensory Integration and Praxis Test (SIPT) from the University of Southern California and in Neuro-Developmental Therapy (NDT) from NDT Association, USA. She also enjoys working with children in Symbiosis embracing different therapy models while viewing the challenges faced by the children through the developmental framework.

Shalini is the mother of two children and understands the importance of considering the needs and wants of all members of the family when establishing therapy goals. She spends her spare time with her children and husband, reading, traveling, and cooking different recipes from around the world.