If you have a child with disabilities, chances are you have been advised to get physical therapy, occupational therapy, behavioural therapy, or numerous other kinds of professional services. I have worked as a therapist myself, and I believe therapy brings many benefits, but I want you to consider this question: What it is that my child actually needs? It is not therapy.
Consider physical disabilities. A child might lie in bed all day because her core muscles are weak. Doesn’t she need therapy? An occupational therapist might recommend a special chair that supports her. A physical therapist might recommend exercises to strengthen her core muscles so that she has the strength to sit. But this child doesn’t need therapy. She needs support to sit. Therapy helps her meet those needs, but therapy itself is not her need.
Or consider a child who can’t speak and has frequent, unexplainable episodes of crying and screaming. Doesn’t he need therapy? A behaviour therapist may work to identify the causes of distress. A speech therapist may help him find ways to communicate his needs. But this child doesn’t need therapy. He needs be able to communicate his needs, and he needs others around him to understand what leads to his distress and support him through it. Therapy helps meet his needs, but therapy itself is not his need.
This is not a matter of therapy being helpful—it can be hugely helpful—but it is important to distinguish between therapy itself and the help therapy provides. Am I splitting hairs? Perhaps, but there are 4 reasons why these hairs are worth splitting:
(1) “He needs therapy” may keep us from considering other ways to meet needs. Consider a common need for travellers to a city where they don’t speak the language. Someone may say, “You need a translator!” That could certainly be helpful, but what if no bilingual friends are available and I can’t afford to hire anybody? My need can still be met in some way, because my need is not for a translator, but to be able to communicate. I could buy a phrase book, use an app like Google Translate, use gestures and pictures, and if I’m there long enough I may even be able to take a language course.
The child who is unable to speak with his voice may benefit from speech therapy. But what if a therapist is not available or the speech sessions are costly? The basic need is not to speak with his voice, but to communicate. The child could be taught to point to pictures on a chart, to use sign language words, or to type.
(2) “She needs therapy” makes the parents dependent on the professionals, instead of collaborators in meeting the child’s needs. Professionals certainly have helpful knowledge, but it is family members who have the biggest impact on the long-term wellbeing of a child. By keeping the focus on the child’s actual needs (to move, to communicate, to learn a skill), parents can be active collaborators. They can seek to meet the needs themselves, in their own creative ways, and they can consult with professionals. For example, an occupational therapist could help recommend an appropriate chair to support a child who cannot sit. A physical therapist could suggest beneficial ways to position the child while she watches TV so that her muscles are stretching in a helpful way. A behavioural therapist might suggest how parents could arrange objects in a room to motivate the child to sit instead of lie down.
(3) “He needs therapy” distances a child with disability from other children. Children with disabilities often have a poverty of experience because their lives are lived separate from typical children. Before assuming that some special, separate therapy is needed, it is good to explore typical settings where these same needs can be met. Instead of seeking “music therapy”, is there a music class available for typical children? It may be that to participate successfully some support may be needed. The support might come in many ways: a peer, an older student, a family member, a volunteer, another teacher. Participating with other students enriches the life of a child with disabilities and gives all children an opportunity to build bridges and find things in common with each other.
(4) “She needs therapy” can make a child an eternal client based on a diagnosis, not on her actual needs. If it is her disability that makes her “need therapy”, when will she ever not need therapy? Most of us recognize this in ourselves. We have back pain, so we get physical therapy, and when our back pain is relieved, we usually do not continue to get therapy. We are in distress, so we go to counselling, but there comes a time when we are well and counselling is no longer needed. A good therapist will help meet a client’s needs and end the services when the needs have been met are no longer relevant.
I say all this not to be anti-therapy. I am a professional therapist myself. But if your child has a disability diagnosis that doesn’t automatically mean he or she needs therapy. Involve your child in typical life. Use the typical resources available to other children and be creative. And if you are struggling to meet your child needs, do seek the help of a professional therapist. Just make sure that the therapist focuses on the actual needs of your child and treats you as a collaborator.
