What is his diagnosis? I hear a lot about anxiety with PANDAS/PANS

It really depends on the child. Mine did not do well with in home services and did better with office appointments. Usually the first bunch of sessions you are in there but at some point, you transition out and the child should be comfortable. Kids behave differently with parents. Mine will not work when I'm in the room.

Once you find a good fit for a provider, stay in the session the first few times, then leave for 5 minutes, come back, then expand to 10 minutes, etc.

At that age we had a SLP who came to our house, and my daughter often chose to sit on my lap for the whole session. As long as you cooperate with the provider, I don't understand why such a young child would need to be separated from you-and if the provider is seeing your child in such distress, he or she should be coming up with solutions to help your kid.

My kid has done private speech since age 2.5. The therapist suggested separating only after we had been seeing her for a year. Your therapist is asking too much. Plus, a good therapist who specializes in very young children should first focus on making the sessions fun before they become "work." Find someone else. Post your location and we can make suggestions.

Anonymous wrote:OP here...yes, they wanted us to separate from him. The first two sessions, they allowed us to be with him, but the last three sessions, they insisted on separating us, which has resulted in worse and worse tantrums/cries. We called them today to see if we can be in the room with him and have yet to hear back. Maybe we need to find another therapist.

PP again. I do think separating is a mistake, especially for a child that age who has difficulty separating. And how can you follow through as effectively at home if you haven't been able to observe the session? If they are focused on making him separate to the point that they can't work with him effectively, I (personally) would find someone else.

And, yes, when he gets comfortable with a new person then maybe you would try separating so he has more practice with it. But that should not be the main focus of speech. Plenty of other ways to work on separating that are less expensive than a speech session.

Anonymous wrote:OP here...yes, they wanted us to separate from him. The first two sessions, they allowed us to be with him, but the last three sessions, they insisted on separating us, which has resulted in worse and worse tantrums/cries. We called them today to see if we can be in the room with him and have yet to hear back. Maybe we need to find another therapist.

You need to find a new therapist.

A good therapist might ask to separate, or discuss separating, but they won't "insist". Instead they'll work with the parent to find a solution that works for everyone.

I would find another therapist. I have had two kids get varying degrees of speech therapy over the years, and my daughter in particular is highly anxious about who she will do anything with. I have never had a therapist try to separate me from my child during a therapy session, in fact, they usually wanted me in the room so that they could show me what they were doing so I could use the same strategies at home.

OP here...yes, they wanted us to separate from him. The first two sessions, they allowed us to be with him, but the last three sessions, they insisted on separating us, which has resulted in worse and worse tantrums/cries. We called them today to see if we can be in the room with him and have yet to hear back. Maybe we need to find another therapist.

Anonymous wrote:Maybe he is a smart kid and doesn't like the therapists. We switched speech therapists a few times as my child sent clear signals he didn't like some. He would refuse to go and with ones he liked, he'd happily jump in the car and go. One was filling in for our regular and he kept leaving the room to go to the other therapist room to look for her. It may not be what you think and it may not be a good fit. That is how speech delayed kids communicate. Listen to them.

It took us a couple of tries to find a therapist as well. At his age it may be helpful to go in with him.

Anonymous wrote:Are they expecting him to separate from you for the session? That would be a mistake. Can you find someone who will start off being more of a coach to you? Because frankly one or two hours of therapy a week is not going to do much. It's the time you put in in-between using the strategies with your son that really gets a pay off.

It is helpful.

Will the ST meet you at home? Or at an alternative location where he feels more comfortable?

OP, if your child is this fearful it may take a few sessions for him to feel acclimated.

Consider an incentive to make him feel calm like a favorite stuffed animal or toy to bring with him.

Are they expecting him to separate from you for the session? That would be a mistake. Can you find someone who will start off being more of a coach to you? Because frankly one or two hours of therapy a week is not going to do much. It's the time you put in in-between using the strategies with your son that really gets a pay off.

Maybe he is a smart kid and doesn't like the therapists. We switched speech therapists a few times as my child sent clear signals he didn't like some. He would refuse to go and with ones he liked, he'd happily jump in the car and go. One was filling in for our regular and he kept leaving the room to go to the other therapist room to look for her. It may not be what you think and it may not be a good fit. That is how speech delayed kids communicate. Listen to them.

If he's that anxious, the therapist shouldn't be 'working with' him initially, only playing. And you should be taking the lead, talking to the SLP and leading everyone in playing cars or trains or whatever.

Establishing trust comes first, then therapy.

You may need to switch therapists if he's already developed an aversion and go slower.

DS is almost 3 and has been in the infants and toddler's program. He is very fearful of strangers (especially those who need to touch him e.g. doctors). We just started with private speech therapy and he already developed a fear of it. It is an in home practice so it does not resemble a doctor's office, but he cries whenever we drive up to the therapist's house. He cried so much during his last visit that he threw up all over himself and we had to leave right away. He has some sensory processing issues and we are seeking to find a private OT on top of the county's OT to help with his sensory issues. However, what should we do in the mean time with the private speech therapist to get him adjusted?