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.