“His physical therapist says that it’s not sensory.”
“His old OT never did that.”
I often hear these types of phrases from the parents I work with. Since it is fairly common for a parent to interact with many different therapists in different settings, conflicting information is bound to arise. I mean think about it- they’ve got the school therapist, the private therapist, the teacher, therapists from other disciplines, their cousin’s best friends’ uncle…etc. So, who are they supposed to listen to?
Ok, wait, that’s probably not the best way to decide things. But let me tell you the funny thing about therapy, especially occupational therapy:
There’s no ONE way to do things.
We didn’t get a handbook in school entitled “How to Fix a Pencil Grasp in 34 Easy Steps”. (I wish we would have…that would have been awesome.)
Instead, we learned about theories of occupations, biomechanics, kinesiology, anatomy and physiology. We learned all of this so that we would have the tools to problem solve through any situation.
But here’s the annoying part for parents- we all find a different way to problem solve.
So yes, a child’s school therapist is going to say to do things one way. And while I might be searching for the same result in the clinic setting, I’ll probably go about it in a different way. We all tend to form unique opinions on different interventions based on our own experiences.
Now, there is another issue in play here: Neither therapist wants to look like they are the one doing it “wrong”. And since parents can become lost in the confusion of it all, therapists often criticize the work of other therapists that they don’t know.
I think this criticism comes in two forms:
1. Competition With Other Therapists
Private clinics are all vying for the same clients in a certain area. Of course they are going to say their evaluations are more thorough, their equipment is cooler, and their therapists are smarter.
2. Therapists are People Pleasers – We want the parents to like us best.
We took jobs as therapists because we wanted to help people. The idea of someone doing it “better” or claiming what we are doing is “wrong” gets us all up in arms. So we pick at each other as a defense mechanism.
Yes, I’m guilty of both of these situations.
Sometimes I’ll get a report from another clinic and read it over thinking “What?? Why did they write that goal like that? Why did they only do that test? Why are there 59 goals on this Plan of Care?” (True story… 59 goals, really?!)
But then a parent will tell me that another clinician read over my report and didn’t understand why I reported things a certain way. And then I get all huffy and defensive.
It’s silly, really, because we all do things so differently. Clinics all have different standards for reports and goal writing. I’ve worked at places with great expectations for evaluations, as well as pretty poor, churn-them-out-as-fast-as-you-can standards.
So, what would be my advice to parents? In an ideal world, the therapists would be collaborating together and working in harmony. But if you happen to have two therapists that are disagreeing about a course of therapy, just ask them why. It seems simple, but you would be surprised by the reasoning behind certain recommendations.
Listen to the evidence behind their stance and base your decisions on what sounds right for you and your child. I love a good debate regarding intervention strategies… especially pencil grips. (What, you don’t?) But honestly, if a therapist has no real reason besides “that’s just the way we do it here”, then I’d be looking elsewhere.