Private therapy vs. "free" services from state funded org

[Anonymous]

Our DC who is in a private preschool qualifies for free OT via a local organization. We do have perfectly fine health insurance, though, and there's a side of me that wonders if it's better to just go the private route. I get the sense that the local organization is going to involve a lot of extra paper work, home visits and state involvement especially once DC starts kindergarten as they keep mentioning that they will ensure he continues therapy in school and have a file ready for him. They keep pushing the "it's free" angle and talking about him getting therapy at school. The co-pay isn't the issue for us. It's the quality and whether or not the organization is going to give us a lot of trouble with paperwork and extra testing to fulfill their own requirements. For those of you who have been down this road, did you regret either decision?

[Anonymous]

Take free and you can supplement with private.

You will find many OTs work through local organizations and provide private services to private clients. Being a private OT does not mean it is the best quality either.

[Anonymous]

Do both.

[Anonymous]

"Free" services far surpassed private, for us. And the PP that mentioned that many of the providers who provide the free services are also doing private is correct, in our experience.

Do the free, supplement with private if you feel you need it.

[Anonymous]

OP here. thank you for your replies. What I'd also like to know is what you've had to deal with in terms of state involvement. I was in private therapy myself as a child and my parents did not have to subject me or themselves to all kinds of meetings, IEPs, testing, etc. Basically, loads of cooks in the kitchen to resolve a minor issue that isn't going to ruin a child's life. We'd rather not have our child labeled anything unless it's completely necessary, i.e. if DC has difficulty holding a pen the proper way it doesn't mean he's learning disabled. I held a pencil in an awkward manner and still made it to college and grad school.

[Anonymous]

Anonymous wrote:OP here. thank you for your replies. What I'd also like to know is what you've had to deal with in terms of state involvement. I was in private therapy myself as a child and my parents did not have to subject me or themselves to all kinds of meetings, IEPs, testing, etc. Basically, loads of cooks in the kitchen to resolve a minor issue that isn't going to ruin a child's life. We'd rather not have our child labeled anything unless it's completely necessary, i.e. if DC has difficulty holding a pen the proper way it doesn't mean he's learning disabled. I held a pencil in an awkward manner and still made it to college and grad school.

If you child has qualified for OT through DC early intervention/early stages, the deficits must be pretty significant for his age. They are conservative and tend to not qualify borderline cases.

Whether to take a pass and use a private provider should depending on your eventual plan for school (public, private, charter). It can be easier to get an IEP and accommodations set up from the get-go when a child is 'in the system.' It is also possible that if you do intensive work now your child won't have any gaps or deficits by the time school starts.

The label stigma is something that never bothered me that much -- they are a means to an end. The end is getting my child the supports and services he needed to be successful in school and life. We took advantage of the public services and always supplemented with private, FWIW.

[Anonymous]

Anonymous wrote:OP here. thank you for your replies. What I'd also like to know is what you've had to deal with in terms of state involvement. I was in private therapy myself as a child and my parents did not have to subject me or themselves to all kinds of meetings, IEPs, testing, etc. Basically, loads of cooks in the kitchen to resolve a minor issue that isn't going to ruin a child's life. We'd rather not have our child labeled anything unless it's completely necessary, i.e. if DC has difficulty holding a pen the proper way it doesn't mean he's learning disabled. I held a pencil in an awkward manner and still made it to college and grad school.

So I'm not sure the org you're referring to - naming it would help people tell you the involvement level of things - but as a PP said, they're highly unlikely to go find problems where none exist. They don't gratuitously give out services and more often than not place barriers in front of children trying to qualify rather than over labeling disabilities (there are some exceptions, but this doesn't sound like one of them).

That said, if you don't want to "subject" yourself to meeting with people who at least seem to be trying to help, go private, leave the services for other people who are fighting to get them. There are certainly more hoops to jump through when someone else is paying (though insurance is no cake walk either lots of times, FYI). You have to weigh relative hassle and it sounds like for you this ranks as a bigger hassle than it may for other people. But if you have a kid who requires intervention at this stage, it seems likely he'll continue to need some assistance through the early years (K and up), and it's not a bad idea to start working with the relevant departments sooner than later should you ever want him to have support (such as minimal pull out or an accommodation until his skills improve) in school.

But doubling up often isn't a bad idea.

[Anonymous]

I for one understand why you would want to avoid the juggernaut of state-funding services if you can. But I have also heard from numerous sources that free services tend to be superior in quality to private. In OT especially there is a lot of snake oil. If you find one who does both, that might be the route to go if you want to start out private. In the end, and especially if your insurance is paying for it, I see no harm in starting with a carefully vetted private provider and making sure that what they are doing is evidence supported.

[Anonymous]

We went all private. Good choice for our child.

[Anonymous]

Be sure if you go the private OT route, you get in writing exactly what the OT is for. Your insurance may require that the OT evaluation and the person providing the OT is the same for them to pay so be sure you check your insurance.

Private OT was useless for us since they spent a lot of time for "sensory integration". Free school OT worked on the fine motor deficits that actually helped.

[Anonymous]

We never tried private, but had great luck with Montgomery County's free services. I didn't find the paperwork onerous, and the only tricky part was navigating the transition from I&T to school-based services.

[Anonymous]

If day I spend about two hours per year in paperwork and meetings.
More like four hours the first year and in the transition year into school. Everyone we dealt with in those times was professional, helpful, and seemed very focused on helping my child.
I certainly didn't find the paperwork onerous or their questions and process too involved or intrusive. (And I'm pretty guarded and private as a rule.)

Granted, DSs delays are pretty straight forward and we haven't had to fight over major disagreements in service, but I've been pleasantly surprised at the process

[Anonymous]

^^pp - eeck. Sorry for all the typos. On my phone and tired

[Anonymous]

The best speech therapist DS ever had was his free public school speech therapist. The private ones were expensive and not very good. There was no extra paperwork beyond a signature here and there. There were a few evaluations, but these I looked forward to since they were markers of my child's progress and helped me understand his needs better.

The free state-funded occupational, physical and play therapists were all qualified and experienced as well, but we didn't try private ones so I can't compare.

[Anonymous]

Op, I don't believe anyome can make accurate generalizations about what whether private or early intervention (I assume that's what you're referring to?) therapists are better. Some therapists work for EI and also for private pay clients. Dealing with insurance can be way more of a PIA than dealing with EI. If I were you I would do both. You can always stop with EI (or school-based) services if you want, or just have your plan say you are getting private services but stay "in the system" so your kid can get accommodations that they need.

If your child has delays you should not worry about labeling them as having delays--you should just worry about getting them the help they need.