American Academy of Pediatrics Report on Prescribing Physical, Occupational, and Speech Therapy Services for Children with Disabilities

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?