by Kate Wicker

Every parent wants to make sure his child is receiving the best possible care. In the Information Age, that often means hours spent surfing the Internet, quizzing other parents of special needs children, and scanning news articles for any and all types of treatments and therapies that could potentially help.

We’ve taken a look at a variety of therapies available to help special needs children with everything from developmental delays to neuromuscular conditions. Some of the therapies are mainstream, like physical and occupational therapy. Others are on the fringe of conventional medical care but hold promise for certain special needs populations.

Of course, before considering any therapy it’s important to talk to the health care team that has been overseeing your child’s care. Moreover, keep in mind that this only serves as an overview of the therapies offered. Treatments are constantly changing and there’s no such thing as a one-size-fits-all therapy session.

Therapy: - - - - - Pick a Therapy Option - - - - - Occupational Therapy Physical Therapy Speech Therapy Hippotherapy Music Therapy Aquatic Therapy Play Therapy Cognitive-behavioral Therapy Dance Therapy Suit Therapy Vision Therapy Hyberbaric Oxygen Therapy

Occupational therapy (OT)  

What: Focuses on helping children of all ages cope with emotional, social and physical difficulties. OT helps enhance patients’ quality of life by teaching and improving “skills for the job of living.”

Claims: What sets OT apart from other allied health disciplines is that it looks at the emotional and social, as well as physical, aspects of the patient. Through personalized treatment plans, an occupational therapist helps build a foundation for the types of skills that children need to accomplish everyday tasks.

Treatment: OT treatment varies widely depending on a child’s physical, emotional and social needs. For instance, a treatment program for children who have trouble sitting still in school, tying their shoes and dressing themselves may involve an obstacle course that helps improve hand-eye coordination. Sessions also may include therapies that deal with sensory integration, practicing activities for daily living, fine motor coordination, upper extremity rehabilitation, play and social skills. Depending on a child’s age and needs, OT sessions typically are held one or two times a week for 45 to 60 minutes.

Where Offered: A variety of settings in the Atlanta area, including hospitals, private clinics, early intervention programs and schools. Home-based therapy also is available.

Cost: Usually covered by insurance if deemed medically necessary.

To Learn More: American Occupational Therapist Association, www.aota.org 

Physical therapy (PT)

What: Through the use of exercises and physical activities, PT manages and improves patients’ physical limitations and helps them return and/or achieve the highest level of function possible.

Claims: PT is a tried-and-true form of therapy for children with conditions like cerebral palsy, spina bifida or traumatic brain injury, and it can benefit almost any child who has physical limitations, including children who have suffered a sports-related injury. Targeted therapies help rehabilitate the body by conditioning muscles and improving strength and movement.

Treatment: Children typically meet with a physical therapist once or twice a week for 45 to 60 minutes. Therapy sessions may include mobility training, activities designed to boost gross motor coordination, ambulation training (activities that help with children’s walking skills), balance training and wound care. Physical therapists also can help parents choose the appropriate wheelchair, walker or orthotics for their child, if needed.

Where Offered: A variety of settings in the Atlanta area, including hospitals, private clinics, early intervention programs and schools. Home-based therapy also is available.

Cost: Usually covered by insurance if deemed medically necessary.

To Learn More: American Physical Therapy Association, www.apta.org

Speech Therapy

What: Any form of therapy that assists children who are experiencing difficulties with communication, language skills and social interaction. Children with speech delays, past hearing loss, craniofacial disorders such as a cleft palate, functional articulation and/or phonological disorders often benefit from speech therapy. In addition, specially trained speech-language therapists often are part of a multidisciplinary team that provides what’s known as feeding therapy to help children with feeding and swallowing difficulties (also called dysphagia).

Claims: The ability to communicate affects every facet of a child’s life. Pediatric speech-language pathologists can help maximize children’s communication abilities in everyday situations and environments.

Treatment: Speech-language pathologists generally work with children for 30 to 60 minutes once or twice a week. Treatment may incorporate reading, recognition games and other activities designed to advance communication skills.

Where Offered: A variety of settings in the Atlanta area, including hospitals, private clinics, early intervention programs and schools. Home-based therapy is sometimes available.

Cost: Covered by some insurance companies.

To Learn More: American Speech-Language-Hearing Association, www.asha.org 

Hippotherapy

What: Hippotherapy literally means “treatment with the help of the horse” (the Greek word “hippos” translates to horse). Specially trained physical and occupational therapists use the rhythmic movement of the horse – which surprisingly mimics the human movement patterns of the pelvis when walking – as a tool or strategy to improve neuromuscular function.

Claims: Formally considered an alternative therapy, hippotherapy is gaining popularity and has been shown effective in helping children with conditions like Down syndrome, autism, cerebral palsy as well as children with developmental or speech delays. Proponents of the equine-centric therapy cite a long list of benefits, including improved posture, strength, balance, coordination and attention span. Another perk, according to hippotherapy devotees, is that being outdoors with an animal makes therapy more fun than sessions held in a traditional clinical setting.

Treatment: During a typical session, a child spends time on horseback, supported by walkers alongside the horse. The horse’s gait is modified by a horse handler and therapist, who monitors the child’s response during the session as well as the impact of sensory input. Unlike therapeutic horseback riding where children learn equestrian skills and how to care for a horse, hippotherapy focuses on improving neurological function and sensory processing through the horse’s movement. A horse handler assists during the therapy session.

Where Offered: There are several hippotherapy locations in the Atlanta area. To find a certified program, visit www.Americanhippotherapyassociation.org  or www.NARHA.org.

Cost: The therapy often is covered by insurance, but there’s usually also a stable fee. Fees vary by program and may sometimes be covered by special scholarships offered by programs.

To Learn More: North American Riding for the Handicapped Association, www.NARHA.org or
www.Americanhippotherapyassociation.org 

Music Therapy

What: A creative therapy that uses music and music activities to address an individual’s physical, emotional, cognitive and/or social needs.

Claims: Although music’s potential to heal dates back to the writings of Aristotle and Plato, the discipline found its official roots during World War I, when doctors and nurses observed positive physical and emotional changes in injured veterans when musicians came to play for them. Since then music therapy has become more mainstream and, according to Beth Hampshire, a music therapist with Music Therapy Services of Greater Atlanta, it can help special needs children increase motor, communication, social, emotional/behavioral and/or cognitive skills. Children do not need to have musical ability or talent to benefit from musical therapy.

Treatment: The format and the type of music selected for a session is based on the individual client’s treatment plan. Treatment sessions are generally held once or twice a week for 30 to 60 minutes and may include music improvisation, singing, instrument play, movement, receptive music listening, song writing, lyric discussion and music performance.

Where Offered: Music Therapy Services of Greater Atlanta and Under Musical Construction Inc. are two local organizations devoted to music therapy; however, several other therapy service providers offer music therapy as part of their treatment programs.

Cost: Hampshire reports that the average cost for music therapy is $55 to $75 an hour. According to the American Music Therapy Association, an estimated 20 percent of music therapists receive third-party reimbursement for the services they provide.

To Learn More: American Music Therapy Association, www.Musictherapy.org

Aquatic Therapy

What: Also known as hydroptherapy, this discipline uses the unique physical properties of water to facilitate rehabilitation.

Claims: The buoyancy of water helps children achieve a greater range of motion than with land-based therapy. Likewise, since gravity is taken out of the picture, children can do things they cannot necessarily accomplish on land. For instance, a child with cerebral palsy who cannot walk may be able to take steps in a pool, which not only helps strengthen muscles but also boosts self-confidence.

Treatment: Aquatic therapy usually is conducted in conjunction with physical and/or occupational therapy and sometimes speech therapy. Sessions generally take place in a warm therapeutic pool and last about an hour.

Where offered: Throughout the metro Atlanta area.

Cost: Typically reimbursed by insurance if deemed medically necessary.

To Learn More: Aquatic Resources Network, www.aquaticnet.com

Play Therapy

What: A form of counseling that draws on the curative powers of play to help children with various problems.

Claims: Since open and free communication is inherent in play, a broad range of social, behavioral, emotional and other developmental issues can be addressed through play therapy. Play therapy has been shown to promote creative problem solving, improve social skills, encourage communication, and foster learning and acceptable behaviors. Play therapy is especially beneficial for children ages 3 to 12 since toys can serve as a vehicle for expression when a child is unable to fully communicate with words.

Treatment: Play therapists use toys and activities to help children communicate. Sessions are typically 30 to 50 minutes and are held weekly. Research suggests that it takes an average of 20 play therapy sessions to resolve the problems of the typical child referred for treatment.

Where Offered: Licensed or certified mental health professionals who are also play therapists practice in both private and public settings throughout the metro Atlanta area.

Cost: Often covered by insurance.

To Learn More: Association for Play Therapy, www.A4pt.org 

Cognitive-Behavioral Therapy (CBT)

What: A form of psychotherapy that emphasizes the role of thinking in how people feel and behave. CBT is used to treat depression, anxiety disorders, phobias and other mental disorders.

Claims: CBT is based on the idea that our thoughts rather than external influences such as people and events cause our feelings and behaviors. CBT provides long-term results because treatment stresses education and helps patients unlearn unwanted reactions and behaviors and instead discover new ways of responding to situations. CBT has been used with children and adolescents to treat a variety of conditions with good success, according to recent research. In particular, children suffering from post-traumatic stress disorder experience positive outcomes with CBT.

Treatment: CBT is a structured form of therapy that encourages the Socratic method. In other words, therapists ask a lot of questions in order to fully understand a patient’s concerns. Patients also are persuaded to ask questions about certain situations. For example, a child who is experiencing social difficulties from being teased at school might benefit from asking questions like, “How do I know the kids are laughing at me? Could they be laughing at something else?”

Where Offered: Certified cognitive-behavioral therapists generally work in private practice. Visit www.nacbt.org to find a local certified therapist.

Cost: CBT falls under mental health care, so insurance coverage depends on your benefits for mental health services.

To Learn More: National Association of Cognitive-Behavioral Therapists, www.nacbt.org 

Dance Therapy
(also called movement therapy / therapeutic dance)

What: A creative therapy that uses choreographed or improvised movement to promote healing.
Claims: Dance therapy embraces the mind-body connection. Mental and emotional problems are often expressed in the form of muscle tension and constrained movement patterns. By moving the body in creative ways, tension and anxiety can be released and muscle rigidity is reduced. Dancing also is a form of creative expression and allows people to think in new ways. Physically, dance helps develop gross motor skills, coordination, balance and flexibility.

Treatment: For children, treatment often takes place in a group setting and lasts about an hour. Treatment sessions may include a broad spectrum of approaches, such as expressive movement, creative dance, role-playing, and a blend of structured and improvised movement experiences.

Where Offered: Some of the larger therapy services such as Therapy Works and Kool Kidz Inc. offer dance therapy/therapeutic dance as part of their programs.

Cost: Not typically covered by insurance.

To Learn More: American Dance Therapy Association, www.adta.org

Vision Therapy

What: Likened to physical therapy for the eye, vision therapy offers a nonsurgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency as well as some reading and learning disabilities. With regards to learning disabilities, vision therapy is specifically directed toward resolving visual problems that interfere with reading, learning and educational instruction.

Claims: Vision problems can interfere with learning and can subsequently adversely affect a child’s self-esteem. Proponents of vision therapy do not claim that vision therapy can directly treat learning disabilities; rather, they assert that vision therapy can improve eye function, thus making children better equipped to succeed in the classroom. Although vision therapy is considered a well-established field within the optometric profession, there are some ophthalmologists who question its validity.

Treatment: A progressive program of vision “exercises” or procedures that are performed under the supervision of vision-care professionals. Sessions are generally conducted in an optometrist’s office once or twice a week and last from 30 minutes to an hour. Optometrists use various medical devices during sessions, including therapeutic lenses, prisms, computer software and patches.

Where Offered: Find local providers at www.vision-therapy.com. 

Cost: Vision therapy is still a new field and often is not fully covered by insurance.

To Learn More: www.vision-therapy.com or www.visiontherapy.org

Suit Therapy

What: Uses a form-fitting suit called the TheraSuit™ (the only suit design that has been researched and proven to be safe), which consists of a cap, vest, shorts, kneepads and specially adapted shoes. All of the suit components are connected to each other through a system of adjustable straps and elastic bands, which helps provide extra resistance and targeted therapy to isolated muscle groups during OT or PT sessions. Suit therapy is most often used with children who have cerebral palsy, but it also has been used to help children with developmental delays, traumatic brain injuries and other neurological conditions.

Claims: Suit therapy can help to re-train the central nervous system, sharpen fine motor skills, align the body to as close as normal, increase range of motion, improve balance and coordination, and strengthen muscles. A growing body of research shows suit therapy can produce positive outcomes for children with cerebral palsy in particular.

Treatment: Suit therapy employs intensive and frequent therapy sessions. The founders of TheraSuit™ set a guideline of three hours a day for five days a week for three weeks. Sessions often begin with range-of-motion exercises, stretching and other activities. Then the child is fitted into the suit and performs a series of exercises using the suit and its attached elastic bands, which are connected to what’s known as a Universal Exercise Unit. A child should only be treated with suit therapy by a licensed physical or occupational therapist who is qualified to rehabilitate neurological disorders, according to Kim Chastain, a board-certified orthopedic physical therapist and founder of Therapy 4 Kids, which offers suit therapy locally. Check licensure at www.sos.state.ga.us/plb.

Where Offered: Various metro Atlanta locations. Visit www.Suittherapy.com and click on the TheraSuit™ Clinics link to find additional local suit therapy providers.

Cost: According to Sharon Gaiter, an occupational therapist who oversees the suit program at Kids In Motion, the suit program is often covered, at least partially, by insurance if a policy covers PT and OT for traditional therapy. The cost for three weeks of intensive suit therapy ranges from $5,500 to $7,500.

To Learn More: Therasuit LLC, www.suittherapy.com or email kim@orthosports.org for a free PDF guide to choosing an ethical and safe suit therapy clinic.

Hyperbaric Oxygen Therapy (HBOT)

What: A medical treatment that delivers pure oxygen at higher-than-normal pressures to patients sitting or lying in a special chamber. HBOT has long been used in conventional medicine to treat a wide range of conditions such as healing chronic wounds. More recently, HBOT shows promise in treating conditions resulting in some kind of brain deficit, including autism, cerebral palsy, near-drowning and traumatic brain injury.

Claims: HBOT is based on the premise that extra oxygen can prompt dormant or damaged brain cells to be revived. By increasing blood flow to the brain and its damaged cells, HBOT can help jumpstart the brain. Although there isn’t hard scientific research to back up HBOT’s efficacy in treating conditions related to brain deficits, there is substantial anecdotal and empirical evidence to suggest that patients often see improvement in speech, memory and other cognitive abilities after undergoing a series of hyperbaric oxygen treatments. HBOT is most effective when combined with physical and/or occupational therapy.

Treatment: Each treatment takes place in a specially designed chamber and lasts about an hour. To increase patient comfort, music and movies can be piped into the chamber. Patients may experience minor ear discomfort, and ears may pop like they do when on an airplane or underwater. A minimum of 40 treatments is recommended to maximize positive outcomes.

Where Offered: ProHBO Hyperbaric Medical Services. Also, check out the “chamber search” feature at hbomedtoday.com. Just keep in mind that the site lists all HBOT chambers and doesn’t make a distinction between those that have the appropriate training. According to Christopher Grant, certified hyperbaric therapist and founder of ProHBO, you want to look for certified staff with medical backgrounds as well as training in hyperbarics. A physician should be involved as well.

Cost: ProHBO charges $175 per treatment. To date, insurance does not cover HBOT for neurological conditions. However, Grant reports that Medicaid recently has been approved to cover HBOT for brain injuries. This will take some time to go into effect, but it does suggest that HBOT is a viable treatment option for patients suffering from brain deficits.

To Learn More: www.Hyperbaricmedicalassociation.org and www.HBOT.com