What is it like to be an independent pediatric therapist treating children with speech therapy exclusively in their Manhattan homes? Challenging, exciting, rewarding and certainly, exhausting. I absolutely love my work.
I prefer providing therapy in children’s homes to working in an office. Parents and children find it comfortable and convenient and I don’t have office rent to pay. Sometimes my therapy program end late and I grab a taxi or hop on the subway to get to my next client. When things go as planned, I take a healthy, brisk 15 to 30 minute walk through the city between clients. Neither snow nor rain nor heat nor gloom, I’ve become familiar with the people in my neighborhood - postal workers, dog walkers, and doormen.
The worst aspect of my M.O. is packing and carrying therapy materials. My home office, contains my materials, which could easily serve a small army of speech therapists. Before packing for the following day, I first have to unpack (dump, sort, clean, file) the current days material and notes. Packing can take anywhere from 20 to 30 minutes per child. I see up to 6 children per day for clinical hour sessions.
Just as most therapists plan for sessions, I read through each child’s previous progress note and figure out exactly what to pack. Exactly means only taking the necessary pieces of a game, photocopying the exact pages of a workbook, etc. Anything extra will weigh me down! I typically leave homework, which may be a game we played that day, a wordless picture book we read, or oral placement exercises. I have to anticipate what materials I will plan to leave for homework. I can’t assume I will have that specific item in my bag for a child I will see later that day.
The upside to all this work is that I am extremely well prepared for each session. I can move from task to task with ease as my therapy sessions are comprehensive.
My home office is also where evaluations, progress notes, lesson plans, website and blog writing about speech therapy are completed, and where I return new and important parent phone calls. It’s difficult to have this type of phone conversation when I’m out on the street with ambulance sirens and jackhammers in the background. It’s also crucial that I save these calls for after my own children are asleep, so they are usually made around 9:00 PM.
I take care of quick phone calls, return emails and texts in the time I allow between clients. Naturally this may require talking to a current client (who understands I’m in transit), colleague, or my (personal favorite) accountant while I’m walking to my next client’s home.
New clients come to me from my website, pediatricians, pediatric otolaryngologists, other therapists, and most often, parents who have witnessed my dedication and appreciate the results their own child has achieved with my help.
Sometimes student therapists ask if I feel isolated without the camaraderie of other therapy professionals. I have a fabulous support system which includes a number of speech therapists, occupational therapists, reading specialists and a pediatric ENT. We regularly ask each other questions and confidentially discuss clients to maximize our treatment. Most importantly, after a rough session, they are ready to listen, help me regain confidence and assist with a new game plan. I do exactly the same for them.
Therapy life in Manhattan is unique. There are many children that need services and there are many therapists. Manhattan therapists generally state their areas of expertise. For example, an occupational therapist may essentially exclusively provide handwriting therapy. I work with children with articulation delay and young children with language delay. I also provide kindergarten test preparation for private and public school admission.
If a parent calls looking for a speech therapist that specializes in voice, I have six names of which I can refer. If a father calls about his concern for his toddler’s feeding skills, I can recommend two clinics he may opt to visit.
Manhattan parents are educated and generally in the know. When they contact me about their child, they are asking for guidance and interviewing me simultaneously. Am I a good match for their child? Can I explain why I have expertise in the area(s) in which their child is struggling? Do I have availability during the limited time their child is free? I know what skills I have, and I know when to refer to another speech therapist. Parents appreciate my honesty and the information I provide.
As I have experience with speech therapy and have worked along the East Coast, I appreciate how life as a therapist in Manhattan is intense. The rewards are many, and this is where I certainly belong.
*The inscription on the NYC General Post Office at 33rd and 8th. I silently recite this to myself on blustery winter days.
Speech Language Pathologists, would you prefer working out of an office of in your patients’ homes?
By Stephanie Sigal M.A. CCC-SLP, Speech-Language Therapist.