Clinical vs. Home Therapy: What is Best for My Child?

Tips to choose the best location for your child's success


Published:

Since my son, Ben, was 6-months-old, weekly sessions of occupational, physical and speech therapy have been part of his life. These sessions have taken place at our home and at a therapist’s office. In recent years, we have had the flexibility to meet therapists at the playground, science museum and local pool, but those first few years, I was flying by the seat of my pants finding out about therapy and what worked best for Ben.

There are positives and negatives to therapy at home or at a clinic, but many times the reasons are specific to what works for your child and your family’s lifestyle, and what is practical. Whether this is your first experience with therapy or you are thinking about making a change, use these tips from parents and an occupational therapist to help guide your decision-making process.


The Comforts of Home Therapy

Kim McElrath-Ray, 39, an attorney with Legal Aid, lives in Smithfield with her husband, Jeff Ray, 47, and their two boys, Elliot, 11, and Josh, 9. When Josh was first born, he underwent a liver transplant leaving him susceptible to germs. Doctors insisted on limited contact with other people, and home therapy was the only option. Josh’s intellectual disabilities required that he receive therapy.

“(Home therapy) allowed me to limit Josh’s exposure to germs. Therapists used hand sanitizer and took off their shoes when they arrived at the house,” says McElrath-Ray.

Ashley Morgan Deaton, occupational therapist and co-owner of One Step at a Time Therapy Services Inc. in Mount Ulla, sees value in allowing a child to learn how to use his or her physical environment, such as the bathroom or stairs, with home therapy.

“Information the therapist gains from these observations can be used in decision making, goal setting, and initiating conversations about the ways that progress can be enhanced based on the family's routines,” Morgan Deaton says.

Other advantages to therapy at home, include increased parent involvement and the freedom to meet at a park or a museum, but it can require a designated area in the house. When Rebecca Smoot, 44, chose to do therapy at home with her daughter Ella Smoot, who was a micro-preemie and has cerebral palsy, the Charlotte mom specifically created a room for therapy sessions.

“I converted a room in our house with mats, a simulation ball and swing,” Smoot says. And like McElrath-Ray, she too offered therapists hand sanitizer and a place to put their shoes.

Home therapy means no driving and unloading for an appointment elsewhere, but some people find having therapists come and go through the house to be intrusive. Before choosing in-home therapy, consider your child’s learning style: Are there distractions such as siblings that may keep him from getting the most from a therapy session? Is he too comfortable at home to buckle down and do the work? Also, be sure your insurance covers home therapy sessions.


The Clinical Setting

Therapy at an office offers a group effect of sorts. McElrath-Ray noticed that as Josh got older and was not at risk for health issues, he needed social interaction with other children that therapy at home didn’t offer. He was able to take risks and try new things with a therapist without his parents observing.

“Josh was so much more motivated,” McElrath-Ray says. “And we saw him jump into what he was doing. He was inhibited by my worry. Now he is trying to run.”

Therapy at a clinic also gives parents the opportunity to meet other parents who may offer support. Another child in therapy can be a motivator for a child to work harder, but traveling to therapy appointments does mean that child-care arrangements will need to be made for siblings or they may have to come along.

“A clinic setting may work for a child who needs the benefit of large equipment that they may not otherwise have access to,” Morgan Deaton says. A clinic typically provides wide-open areas with mirrors, large mats, swings, benches, tables, treadmill and ladders.

Some children may have trouble carrying over new skills learned at a therapist’s office to the home environment. Morgan Deaton cautions that children with autism can have difficulty generalizing one skill to another environment.

“If a child with autism works in the clinic on broadening the variety of food textures he will eat, he may associate these trials with the clinic and not be as cooperative or open to the same food trials at home.”

No matter the location of therapy, a child has to build a relationship with their therapist. Ella now receives physical and speech therapy at a clinic. It can take Ella awhile to get comfortable in a new environment, but “consistency is key, and trust is earned between my daughter and her therapists,” Smoot says.

To make the best therapy decisions for your child, be sure to evaluate changing needs with age and health and as the child’s personality blossoms.

“You can get great therapy in either environment,” Smoot says. “It is a matter of skill and creativity of the therapist and what works for the child and parent.”​


Vanessa Infanzon is a freelance writer and mom to three boys. She writes at eSpeciallyBen.com.

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November 2017

Step back in time with a 19th-century costumed interpreter and watch the millstones at work grinding corn into meal. Registration encouraged online. Tickets available at the...

Cost: $5/adult, $3 ages 7-16. Free for ages 6 and younger

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Historic Yates Mill County Park
4620 Lake Wheeler Rd.
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Celebrate the wonderful world of exotic animals and reptiles. Enjoy live specimens, presentations, raffles, vendors and much more. Purchase tickets online.  

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N.C. State Fairgrounds, Kerr Scott Building
1025 Blue Ridge Rd.
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Take part in a class that teaches individualized ways to foster motor development for your child. Learn about tummy time alternatives, best positions for your baby, how to help your child learn to...

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Open Arts
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Morrisville, NC  27560
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Join Mindful Families of Durham, a Buddhist-inspired spiritual community that supports area parents, caregivers, and their children in the practice of mindfulness and the understanding of the...

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Erwin Road
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Open Arts
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Kicks off the holiday season with local art, music, food, and family activities at various locations in Durham’s historic downtown district. Presented by the Durham Arts Council with support...

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Downtown Durham
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Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
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Crowder District Park
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Horseshoe Farm Nature Preserve
2900 Horse Shoe Farm Rd.
Wake Forest, NC
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Search for salamanders, owls and more. Ages 10-13. Register online.

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Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Raleigh, NC
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Park West Village hosts Winter Wonderland in the District. This year’s event will take place the weekend of November 17th. Take the family to enjoy train rides, magical winter lights, live...

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Park West Village
3400 Village Market Place
Morrisville, NC  27560
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Telephone: 919-234-6710
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Gov. James B. Hunt Horse Complex
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Saint Raphael Preschool
5801 Falls of Neuse Rd.
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Make crafts celebrating turkeys. All ages with adult. Meet at the Cardinal Shelter. Registration not required. 

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Saint Raphael Preschool
5801 Falls of Neuse Rd.
Raleigh, NC  27615
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Contact Name: Sarah Rapp
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Read With Me Book Shop
111 E. Hargett St., $110
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Sky Zone Durham
1720 Guess Rd., Ste. 90
Durham, NC  27701
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Saint Raphael Preschool
5801 Falls of Neuse Rd.
Raleigh, NC  27615
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Harris Lake County Park
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New Hill, NC  27562
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Telephone: 919-387-4342
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Kids ages 6 and younger enjoy stories. Take part in an optional arts and crafts session after storytime for $5.

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Read With Me Book Shop
111 E. Hargett St., $110
Raleigh, NC  27601
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Meymandi Concert Hall
2 E. South St.
Raleigh, NC  27601
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5801 Falls of Neuse Rd.
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Contact Name: Sarah Rapp
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Cost: Free

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Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, NC
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Cost: Free

Where:
Cary Crossroads
333 Crossroads Blvd
Cary, NC  27518
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Cost: Free

Where:
Saint Raphael Preschool
5801 Falls of Neuse Rd.
Raleigh, NC  27615
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Telephone: 919-865-5725
Contact Name: Sarah Rapp
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A wonderfully kid-paced hour featuring music, play and dancing with toddler stars singing on the mic at Cotton's gently amplified & participatory music show. Children delight in...

Cost: Free with admission

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Pump It Up Raleigh
10700 World Trade Blvd, #112
Raleigh, NC  27617
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Cost: Free

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Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, AL
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Telephone: 919-856-6675
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See a contemporary re-imagination of Tchaikovky's timeless music. Purchase tickets online.

Cost: $35-$55

Where:
Durham Performing Arts Center
123 Vivian St.
Durham, NC  27701
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Cost: $15 and up

Where:
Fletcher Theater
2 E. South St.
Raleigh, NC  27601
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Cost: $15 and up

Where:
Fletcher Theater
2 E. South St.
Raleigh, NC  27601
View map »


Website »

More information

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Cost: $35-$55

Where:
Durham Performing Arts Center
123 Vivian St.
Durham, NC  27701
View map »


Website »

More information

Catch this comedy classic on the big screen—as the symphony plays the charming and delightful score by John Williams live. Purchase tickets online.

Cost: $14-$29

Where:
Meymandi Concert Hall
2 E. South St.
Raleigh, NC  27601
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Cost: $25-$45

Where:
Umstead Park
8801 Glenwood Ave.
Raleigh, NC  27617
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Sponsor: Fit and Able Productions
Telephone: 919-673-4689
Contact Name: Travis
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Celebrate what you're thankful for. Play a game and make a pine cone turkey craft. All ages with adult. Drop-in program. Registration not required.

Cost: Free

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, NC
View map »


Telephone: 919-856-6675
Website »

More information

Toddler Time is a special time for ages 5 and younger to bounce under the supervision of their parents, and without interference from the big kids. Purchase tickets online.

Cost: $7-$10

Where:
Sky Zone Durham
1720 Guess Rd., Ste. 90
Durham, NC  27701
View map »


Website »

More information

Shop more than 20 local vendors offering amazing gifts this holiday season. Enjoy daily raffles with proceeds benefiting local animal rescue Paws in the City. Kids can enjoy crafts...

Cost: Free

Where:
Cary Crossroads
333 Crossroads Blvd
Cary, NC  27518
View map »


Website »

More information

The Raleigh Boychoir makes an appearance before its big Christmas concert.

Cost: Free

Where:
Quail Ridge Books
4209-100 Lassiter Mill Rd.
Raleigh, NC  27609
View map »


Website »

More information

Kids ages 6 and younger enjoy stories. Take part in an optional arts and crafts session after storytime for $5.

Cost: Free

Where:
Read With Me Book Shop
111 E. Hargett St., $110
Raleigh, NC  27601
View map »


Website »

More information

See the classic holiday story brought to life onstage featuring favorite characters Santa and Mrs. Claus, Hermey the Elf, Bumble the Abominable Snow Monster, Clarice, Yukon Cornelius and...

Cost: $15 and up

Where:
Fletcher Theater
2 E. South St.
Raleigh, NC  27601
View map »


Website »

More information

Take a 30-minute tour to view the main power drive and milling machinery. Tickets available inside the park's visitor center. Online registration encouraged.

Cost: $5/adult, $3 ages 7-16. Free for ages 6 and younger

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, NC
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Telephone: 919-856-6675
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Explore the historic nature of Leigh Farm Park with a friendly guide. Venture inside the historic farmhouse while being captivated by tales about life at Leigh Farm throughout the years.

Cost: Free

Where:
Leigh Farm Park
370 Leigh Farm Rd.
Durham, NC  27707
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Sponsor: Durham Parks and Recreation
Telephone: 919-560-1116
Contact Name: Natalya Buckel
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See the classic holiday story brought to life onstage featuring favorite characters Santa and Mrs. Claus, Hermey the Elf, Bumble the Abominable Snow Monster, Clarice, Yukon Cornelius and...

Cost: $15 and up

Where:
Fletcher Theater
2 E. South St.
Raleigh, NC  27601
View map »


Website »

More information

Catch this comedy classic on the big screen—as the symphony plays the charming and delightful score by John Williams live. Purchase tickets online.

Cost: $14-$29

Where:
Meymandi Concert Hall
2 E. South St.
Raleigh, NC  27601
View map »


Website »

More information

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