I'm shocked at the snotty remarks made by some of you. The OP is trying to figure out the best option for her family, maybe it involves less hours and maybe it doesn't, but none of us are in a position to judge.

I'm fortunate enought to work from home with a flex job and an understanding boss, but I took pay and professional growth hits to do it. It's the right option for us, so I can shuttle our child to appointments and other things because my husband isn't able to do much with his job requirements.

I second the recommendations for a nanny to handle the appointments for you, if you're not able to schedule them at her current care facility.

Also, don't feel bad about not recognizing things earlier. My child wasn't diagnosed until age 7 - he did such a great job compensating, I just thought he was lazy but he was actually working so hard to be typical. Now that's a guilt that just never dies!

OP - I would step back and take notes on the helpful suggestions which have been offered and ignore those who way too much time on their hands and are useless. I would say it is key for you to have a good developmental pediatrician with whom all progress reports from the various therapists can be shared periodically. In this way you will have someone who knows your daughter and can discuss with you over time how her development is going. She is still young and you never know who exactly the therapist will be in a given area and how things might click (or not) with her. I do think it is very important for you to meet with the therapists and have a clear idea of her present goals and the strategies being used so you and DH can also follow-up using the same approaches at home. And, it is important that DH be involved with your daughter's therapy, too, since all too often it is the Mom who takes it on plus her full-time job and other responsibilities.

A suggestion is that if the therapists go to day care, be sure that they take the time to show the teachers what to do as it may be appropriate in the classroom setting. My daughter who is a pediatric PT happened to drop off her two at day care the other day and somehow one of the teachers asked her a question about a child who was just starting to walk with a push toy - how to help him do it as her son is off the charts at 17 months motorically - not realizing she was a PT. When she told them a couple of ideas and said her background, they said a therapist does come to work with him - BUT never has shown them what to do. It is important that working with your child directly AND involving teaching staff as appropriate be a part of helping her to move along.

Our daughter has a cognitive disability, but something told me to "front load" the therapies when she was young, and we kept her out an extra year before starting to public kindergarten at age 6. This did work to her benefit, but not always appropriate. I think if you have the time to search for a Nanny or part-time sitter, you might put your feelers out to see who might respond as you never know in the DC area. I do know there is a sitter list at American and Marymount University also has one, but not sure out active it is called "Bernie's List. Also remember that nothing needs to be written in stone. If you start with the school based therapies and make arrangements that work for your family, then revisit maybe at the end of the first school quarter or mid-year when you will see the progress she is making. If you see that the deficits in one area are not coming along as well as others, then you might add in private therapy in one area and maybe readjust how your time is going to be used.

Sometimes you can't have everything you would like professionally and personally. Another of our daughter's had a serious cancer in her late 20s and needs the government insurance and the flexibility that a GS-15 level allows her, but she does find her job very boring at times and really would like the aspect of the private sector in many ways. On the other end there are also young children who need Mom and also balancing mental health stress issues. She has had to make peace with what she might like to do and what is realistic for her to do given this stage in life and even overall in her career, but it did take time. And, it may not be forever. Just do involve DH so it does not become 'your DD", but "Our DD" as well as other siblings, and this means working out arrangements that work for your family on therapies, child care, house work, etc. etc.

Ignore the snarky types.

Not sure whether this has been mentioned, but you can request videos/photos of therapy sessions you can't attend and engage with therapists over email. My partner and I both work full time and this is how we've managed to stay engaged with what's going on when we can't attend.

And I'll second or third the care.com recommendation. We found a nanny on there who had her masters in special ed and was taking a year off to figure out what to do next. She was great, and while we definitely got lucky I've heard from other families who had similar luck.

Good luck - this is doable, you just might have to get creative!

Hi OP,
Yes, its tough managing all this. We have a couple kids with different needs/therapies and it seems our lives are always about logistics.

a couple thoughts:
1) DEFINITELY find out if Child Find therapists can come to daycare. Many do and that would take care at least of some of the therapies, maybe all.

2) therapies don't have to be scheduled in the middle of the weekday. We take my dd to ST at 6:15 twice a week--I leave work a little early, but work most of a day.

3) Use flexibility as much as possible--work from home, etc, to work in the hours.

4) how much therapy does she need? 1x/week for each? You can probably find an OT and maybe PT on the weekends. You can certainly find ST who come to the house or daycare, even if not child find.

5) if you don't want to do the nanny route, you might find a college or grad student willing to pick up your daughter and take her to therapy a couple days a week as an alternative.

6) Breathe. It's hard to take in at once, and a little overwhelming, but you will make it work with some planning.

OP: I didn't read this entire thread. But, I am full time working mother and primary breadwinner in my family. Now 6 year old daughter who has/had issues very similar to the ones you've described. If I could have, I would have stayed home with my kids (SN or not), but that was not an option for me. I managed to do it with a very supportive husband, some WFH and sick leave to go to appointments, and - as someone else said - prioritizing treatment. Not just because of my work schedule but because we felt like it was right for DD. Our daughter has had some public, some private, services. We found a good developmental ped that took our insurance (we traveled to Kennedy Kreiger from Silver Spring because we couldn't afford to pay out of pocket). We also found an OT who just really "got" our daughter. She got speech in school, and OT/PT in school (through an IEP). We sent her to private school for one year pre-K that provided therapies during the school day in the classroom. She is now going into public first grade, has a wonderful IEP team, and is going amazing. We do/did one therapy at a time. Once a week, off and on as needed. That's about all she can take, and all I can take, at a time. I still work full time. I have advanced in my career that is financially the best thing for both of my children. I am so happy about how far our daughter has come and I am happy I didn't spend much more time thinking I should be doing more, more, more to try to change her and keep up with the more wealthy stay at home parents who could afford to do so (afford financially and mentally). Good luck OP, just practice acceptance of yourself and your daughter -- and if you just continue to do what you think is right for her and you, you will be amazed at how much can change in time.

I'm still think you could do it without a nanny as your situation seems very similar to mine...and I make it work. My DS gets 1 hour OT, 1 hour of speech and 4 hours of ABA weekly. Right now he is not in Child Find, and spends all day in a daycare center. On Mondays and Fridays, I leave a little early (2:30ish) from work to pick him up from daycare and meet the therapists for ABA and speech at my home. I make up the hours of work after he goes to bed those evenings. His OT goes to his daycare to do the therapy on Wednesdays, and his ABA therapist does the other 2 hours of her therapy on Tuesdays at his center.

Starting next month, he'll be in Child Find where he'll get all of his speech and OT in the mornings while in Child Find. In the afternoons, he'll receive his ABA 1 day at his daycare, and the other day at home...so I'll only have to leave early 1 day a week.

Why is this sort of scenario not do-able for you? Am I missing something?

I haven't read all the responses because some are just mean! Is your child's diagnosis new? Are you trying to add all of this to your child at once? All of this was recommended for my son. However, we have found that PEP 1/2 day and then neurotypical preschool in the afternoon works best for him as PEP includes speech and OT. I have a ST go to him at school in the afternoon also. It does cost a little more but we have found it cuts down on transitions and allows him to be in a familiar environment which is more productive for therapy. Good luck with figuring it all out! I also need to work. My sons needs will not go away anytime soon and I need to be able to pay for therapies. I can't put the entire financial responsibility/stress on my husband.

I have made small sacrifices to my career and family finances for my kid's needs -- how can you not? I do not think its possible to work on full cyclnder, 100 percent with a kid who has significant needs.


But you can continue your career, with modifications, and you can make money. How can you not? Many of us work because we need the money and insurance for our children.

Jesus, what is up with all these posters being so bitchy today? Did you wander in from the random-insult festival of General Parenting?

OP, my husband and I both work FT and one of our kids gets OT, PT, and ST every week. Here's how we do it. He gets 1 hour of OT over the weekend at home, and one hour of ST on a weekday morning 7:30-8:30. One of us gets to work a little late that day. The rest of the therapy is at daycare. He is at Easter Seals, which works well because they have therapists on staff, but therapists should be able to go to wherever your child is in daycare. They send reports on each therapy appointment so we know what's going on, and every so often we schedule a time to go observe.

When he starts school he will continue with the same # of hours of therapy at home and the hours that are currently at daycare will be at school through his IEP.

It's not easy but you do not have to quit your job or go part-time if that's not doable for you. Don't let the assholes who are calling you a bad parent get you down. You have to get your kid the services s/he needs but you do not need to sacrifice your career and your family's insurance and financial stability to do it.

OP -

Ignore the judgmental pricks on this board. Prioritize the interventions. Work with the childcare facility and Child Find to see if any services can be offered at child care center or if transportation can be provided. I actually knew a friend that did this for her daughter in MCPS in at your child's age. She was picked up at Preschool by school bus, taken for her services at the nearest Elementary school, then brought back by school bus to Preschool.

Use flextime and leave (including FMLA) to get by. Looking forward though, realize even once a child is in school, there are IEP meetings, parent conferences, and continued private services. Life becomes a juggling act and you just keep juggling the best you can. It's not always easy or always pretty - you just do the best you can.

Anonymous wrote:Also, the school services aren't enough. We had to supplement privately. Sounds like you want this to be easy, I guess we all do. It's not

+1

Also, the school services aren't enough. We had to supplement privately. Sounds like you want this to be easy, I guess we all do. It's not