We're in the same boat and have chosen to do everything we possibly qualify for and/or can cover by insurance or state funding. For us this means a combination of free services through DS"s school district, private speech and OT that is mostly covered by insurance and private behavioral therapy covered by a mix of insurance and funds provided by our local county (we don't live in the DMV). My thought is that more services are better and even though some aren't as high quality, DS and we get something from each experience so why not take advantage of the opportunities.

I'm not really sure what you are asking, OP.

On the one hand you are asking about limited involvement for a simple problem like holding a pencil incorrectly. Of course any sane and rational person would say grab some weekly therapy, and why would you need home visits, IEPs, doubled-down on private/county services. To even ask is ludicrous. So presenting the problem on that level is kind of silly.

If however, in fact, you have a child with actual delays (which is what we all assumed you meant) then I think the solid consensus is that most people consider that county services offer a good foundation (brought to your home, which is super convenient), and that supplementing with private therapy enriches and doubles your therapeutic gains. Very young children often are successful at this stage from the double dose of private/county and overcome their delay so even thinking about Kindergarten/IEPs/permanent records is just spinning up things in your mind.

Try to stay in the present and with the problem. It sounds like you have a child with delays, and a young child. He could benefit from therapy, and the county offers therapy free at your home. Supplementing with private therapy offers additional benefits. Why not do both if you are lucky enough to have good insurance. Worrying about paperwork and IEP meetings sounds like your anxiety talking, not what's good for your son.

^^meant to add that having public services in preschool will help secure an IEP in elementary school.

We're in MoCo. Take the free services if they're offered but supplement with private if you can afford it. Our experience was that the free services were woefully inadequate for both of our children. They were provided in a group format (once out of infants and toddlers) and lacked the intensity necessary for improvement. Some of the county therapists we saw were very knowledgeable, but the county tied their hands in many respects. We supplemented with private for speech and OT.

I don't know why people above claim private therapists are inferior to publicly funded. As with any medical professional, some are better than others. We had great experiences with 90% of the professionals we worked with. Perhaps the difference is we weren't limited to in-network providers. Check your out of network coverage.