Houtrow, A., Murphy, N. & Council on Children with
Disabilities. (2019). Prescribing physical, occupational, and speech therapy
services for children with disabilities. PEDIATRICS,
143(4), 1-14. https://pediatrics.aappublications.org/content/pediatrics/143/4/e20190285.full.pdf
The American Academy of Pediatrics recently published a
clinical report that provides their members with guidelines for prescribing
physical, occupational, and speech therapy services for children with
disabilities. The report is available for free download at the URL listed
above.
Although this report does not exclusively focus on therapy
services for children from birth to three or birth to five, the authors
recognize the importance of natural learning opportunities within the context
of everyday activities and the important people in the child’s life. Not
surprising, the authors still provide that outpatient/clinic-based services may
be necessary for children with more complex needs and their examples use a very
traditional multidisciplinary approach.
The authors acknowledge the lack of available research for
prescribing frequency and intensity of therapy services for a specific
diagnosis and only cite one study for one diagnosis (i.e., unilateral
hemiplegic cerebral palsy). The report states that dosage is largely “subjective”
however, the authors provide guidance for how physicians can prescribe
frequency and intensity of therapies. Since physician must determine medical
necessity for therapy services to be reimbursed by insurance and Medicaid,
coordination among early intervention programs, physicians, and families is
essential and this is reinforced in the report.
How can the field of early intervention use the information
in this report to coordinate with physicians?
How does your program work with local physicians related to
prescriptions for therapy services?
What strategies have you found most successful in fostering
physicians’ understanding about how early intervention works with families to
determine frequency and intensity of services?
In addition to more research, what does the field of early
intervention need to assist with service frequency/intensity decision?
