Life After the NICU: Suggestions for Parents and Caregivers
It is not uncommon for babies leaving the NICU to be discharged with orders for therapy, or for the need for therapy to arise in the first two to three years of life. Navigating this world may seem confusing and overwhelming, so we’ve tried to make it as simple as possible. Remember that it never hurts to seek an evaluation if you have concerns. At best, the therapist can reassure you that your child is developing normally. If they do recommend therapy, be encouraged that you sought help quickly because the benefits of early intervention are numerous and can have an important impact on your child’s later growth and development.
Choosing the Therapy Setting:
In-home therapy: In this situation, the therapy provider (physical, occupation or speech therapist) comes to your home or your child’s daycare. Consider this: for babies who are immuno-compromised, staying at home is usually the safest place to be because it means fewer exposure to germs. It’s also extremely convenient for the caregivers—no loading your child up in a car seat, fighting traffic, etc. Traveling therapists can only bring a limited amount of therapy equipment with them, so if your child would benefit from the equipment in a therapy clinic, they may get more from their therapy sessions in a clinic environment.
Practice-based therapy: Practice based therapy can include freestanding therapy clinics, who may offer one or more disciplines, as well as outpatient clinics connected to a hospital. Consider this: If your child needs more than one therapy discipline, you may be able to stack appointments back-to-back for efficiency. Clinics typically offer a variety of equipment and toys and your child may enjoy the fun, new environment. Visiting a pediatric therapy clinic, also means coming in contact with lots of kids. While clinics should follow strict procedures for cleaning mats, balls, toys and equipment, your child is still at risk of contracting an illness from being around other people.
Building Relationships with your Therapy Providers
You’ve selected a therapy provider, now what? You are investing precious time, and most likely money into the therapy process so it’s to your advantage to get as much out of it as you can! Here are some tips:
-Be on time! Chances are, your therapist has a patient scheduled immediately after yours, so they aren’t able to run late just because you are. Maximize your time by getting the full session.
-Attend as many sessions as possible. You should always cancel when your child is ill, but you’ll see the most progress when your child gets regular therapy appointments without large gaps in services. Be diligent about attendance and make an effort to reschedule any missed appointments.
-Be present during the therapy session. It’s not uncommon that parents of young children (especially under 2) will be in attendance for the entire session. Resist the urge to update your Facebook and instead, engage with the therapist and your child; observe what the therapist is doing closely, so that you can try and replicate it when s/he is gone.
-Ask lots of questions. If you don’t understand, ask. If you’re uncomfortable or confused, ask. Don’t leave the session with unanswered questions. Also, ask for a home program. Your therapist should be able to suggest activities and exercises that you can do with your child that will further their progress in therapy.
-Advocate for your child. Chances are you’re an expert at this by now! If you have concerns, don’t feel like your therapist is a good fit for your child or just feel uncertain, trust your gut. Don’t be afraid to speak up, ask for changes, or share your apprehension with your therapist or case manager. You have 100% control over the choice of therapist for your child.
Create a Balance Between Play and Therapy
If your child isn’t meeting their developmental milestones or has more significant impairment this can be very stressful and it’s natural to want to do everything you can to help them. When parents carry over therapy into a home program, we often see great progress. However, for the sake of you and your child, avoid becoming consumed by therapy at home.
Choose 15-30 minutes (total) per day that you can build therapy techniques into your natural routine as a family. By integrating therapy into the natural routine of your day, you won’t feel the burden to set aside extra time for therapy and your child will have many opportunities to practice their skills.
Here are some ideas:
-Mealtime. This is a great time to practice speech and language techniques, address feeding issues and work on fine motor skills.
-Diaper changes: At each diaper change, you can perform necessary stretching, and address gross motor skills such as rolling, head control, and building strength in the arms and legs.
-Bath time: Another great place to practice language skills and gross and fine motor skills such as clapping, grasping and sitting.
-Playtime: This is a great opportunity to replicate things your therapist does with your child. You can build in stretches as part of a game, play games that challenge your child’s physical development and involve siblings, friends or even the family pet in encouraging your child’s progress.