February 11, 2014

How Do We Fit Therapy Into Our School Day

I received the following email from a reader.  My reply encompasses answers to some questions from other readers.  It is very long so I will be posting in parts over the next few days.  I have omitted names to protect the privacy of my readers.

"Hello! I am mom to 7 beautiful kiddos (13- 8 months) and 1 in heaven. My little baby, M, was born last June with Down syndrome. I am a homeschooling mom, too. I came across your blog and felt very inspired. Like your little one, my M is doing so well and is so alert and happy. She also had a healthy heart and has not had any of the health issues so many little ones suffer. 

Okay, so my questions for you.....how do you fit therapy in your school day? How much therapy? Are you supplementing nutritionally with any vitamins and herbs? What in particular is working for you? Somedays I just feel so overwhelmed and am not sure how to manage, schooling, housework, and therapy. I get lost in all the Down syndrome research and blogs and I sometimes wonder if all that is necessary when she is surrounded by so much constant stimulation and lots of love. M loves tummy time and inches around. She spends most of the day on her tummy engaged in all the activity around her. Thank you in advance for any help/advice you can offer! You truly have a beautiful family. God bless!"

Hi, T.  

Congratulations on the birth of your precious M.  What a blessing I am sure she is to your family and all those who know her.  I am happy to hear she is doing well and has settled into her place in your family.  When Addison was a few weeks old we met his geneticist for the first time.  She said there is no real way to make a definitive prognosis for a child with Down Syndrome.  But she went on to say there are three things she looks for that will positively influence the development of a child with special needs.  She calls these "gold stars" and there are three main areas she looks at.  
#1 The child's health.  As we have seen first hand in our friends children who have Ds and complicated health issues, long hospital stays and health struggles can cause great delays.  A child who doesn't have to deal with health struggles has a far greater chance of reaching childhood milestones at the same time, or closer anyway, as their peers without Ds. 
#2 A strong family with siblings.  Children in general, and children with Ds in particular, love to mimic and keep up with their siblings.  Being surrounded by typically developing siblings is a huge plus to aid in development.  I would add that homeschooling is a bonus because your little one is with those siblings 24/7. 
#3 Parents who are proactive in seeking out and carrying out therapy and treatment.  
From your email it seems M receives all three gold stars.  You are already ahead of the game just by being who you and your family are.  On the days you feel overwhelmed, please find rest in that.  Furthermore, I believe God makes no mistakes.  Your family is the perfect one for M and she is the perfect baby for your family.  Just as M does not have Ds by some freak accident, but rather by a choice made by her creator, neither was she put into your family by a fluke.  God chose to put her there because that is the best place for her and she is the best thing for your family.  God has a special purpose for Ds in M's life and in the life of your family.  You can only carry that out together.  Rest in the beauty that God has it all under control so you can breath and let Him do His thing.      

How do we fit therapy into our school day?  

This is really a good question.  Because as a mother to an infant we are already faced with a larger work load than there seems to be hours in the day.  As a homeschooling mom we don't have the luxury of 9-4 with all the other kids in school.  And as a mom with special needs we are faced with many more demands on our time.  Nursing Addison alone takes 2 full hours a day.  Add in 2 hours for therapy and an hour for yoga and that is the bulk of my day without even considering my husband, home, other children and even my own needs.  This is not to say it isn't doable.  In fact, it isn't as hard as you might think.  But it takes a whole new way of thinking.
1.)  As Christians we are not just praising and worshiping and living out our faith at church or during devotions, but rather we talk and share and make the Lord part of everything we do with our family every minute of our lives.  We've been homeschooling for essentially 22 years.  And in that time homeschooling is not something we do at a set time, but rather it is part of our life.  We are always schooling and learning and teaching and growing, even when we never make it to the school table.  Our philosophy on life also has carried into Addison's therapy and this new life we call down syndrome.  We truly try to make every waking moment count towards his development.  He is a happy and content child who will gladly sit and entertain himself, but we try to never just let him lie.  Even if he is on his own, say during our family dinner, he is on a blanket next to my chair practicing rolling over or sitting with a boppy behind him (in case he tips) picking up toys and playing with his toes.  This is one way we work therapy in.  Therapy is just part of our every day,  much as teaching is something always happening.  Even during play time the games we play are geared toward his development.  Our youngest daughter, who is 2, mimics the therapy exercises and games we play with Addison when she is playing with him because they have become a natural part of her day.

2.)  Which brings me to my second point.  Everyone in our home (and friends and neighbors who visit frequently) know what he is working on at the time and bring it into their play and visit with him.  Addison has 10 therapists so I don't have to do it all myself.  For example, one of the things we feel is very important to his development is reading.  Every time someone plays with him they have to read him a book, too.  This is great for Addison and our early readers.

3.) Routine/schedule is very important.  And there are two things to look at here.  

First, guarding your time.  I have always guarded our schedule very carefully anyway.  My husband and I feel too many interruptions into our family routine are not healthy for developing children, family relationships, nor conducive to homeschooling.  But now we are even more adamant about limiting interruptions into our weekly routine.  This is key because we don't have any fluff in our days.  To skip something is a big loss.  Additionally,  we do have many necessary interruptions with doctors and therapy sessions so we must limit the unnecessary interruptions.  In the month of January with Addison's eye and ear evaluations, therapists appointments, 9 month check up, surgery a visit to the doctor with another child who had bronchitis, sickness for other kids, church events, etc... we did not have any 2 days in a row that we were able to actually sit at our school table. Those things were unavoidable.  Friends asked to drop by for visits and neighbors wanted to come see us.  There were things going on at our church and lunch invitations.  But we had to explain that right now we need to use what time is available for tending to our kids.  I have found people are very understanding of this.  For that particular issue of finding time for visiting and fellowship (which are both very important) we set aside Sunday afternoons when everyone knows we will be at home and they are welcome to drop in to chit chat and visit and catch up.    
So the second thing is having a good schedule and sticking to it.  Only you will know what works for you and your family but really mapping it out will help you see where things, like therapy, fit in.  For our family the schedule looks something like this.

Monday - Friday

7:00 wake, dress, personal devotions and chores
8:00 Wake Carmella, nurse Addison and family devotions
9:00 kids make breakfast, eat, start independent school work while Addison has an hour of therapy
10:00 -12:00 Addison naps while I do individual instruction with other children
12:00- 12:30 Nurse Addison while we have our sign language lesson
12:30-2:00 Addison has an hour of therapy while the big girls make lunch, kids eat, story time and settling kids for naps
2:00-4:00 Instrument and piano practice, independent school work, project time, and running (8 of us are runners and are training for a race coming up in March)
4:00-4:30 Addison nurses while Allen and I visit and catch up.  Kids have free time 
4:30-6:00 we get little ones up from naps, work on house or family projects, spend one on one with kids and make dinner together.   
6:00-7:30 ish Addison naps while we eat dinner.  He doesn't nap every evening so on those nights he plays on the floor in the dining room while we eat, practice our sign language and work on scripture memory.  
7:30 getting ready for bed, reading with kids, prayer time, showers etc...  On Sunday and Wednesday nights the 6 oldest kids play board games together while we read to the three youngest and put them to bed.
8:30 After the youngers are in bed, I get Addison up from his nap and we do an hour of yoga.  This is not only excellent for him but is great for reducing the stress of being a homeschool mom and caregiver to a child with special needs. 
9:30 I nurse Addison and we visit with our three oldest girls until bedtime.

The weekends look a bit different.  Saturdays there are usually projects abounding, things to fix, wood to cut... Saturday night our big girls babysit while we have our weekly date night.  Sunday mornings are about worship.  Sunday afternoons are visiting time with friends and neighbors. 
4.)  Our three oldest children sit in on Addison's therapy sessions so they are all trained in his daily exercises.  This is really helpful because I can leave therapy in their hands if one of the other kids needs me for something else.  They love to do therapy with him and are grateful to do what they can to help Addison reach his greatest potential.  Your 13 year old should certainly be capable of following through a therapy routine with M.  I actually think it is beneficial for Addison to have different people doing therapy with him because different people approach the same thing differently.  We've been working on pulling up for a long time.  Tonight Allen was playing with Addison and just did one little thing different.  That was the key.  Addison instantly pulled himself up and kept doing it over and over when none of the rest of us have been able to get any results.

Stop back next time when I will discuss some things that are working for us in the realm of being a family affected by down syndrome.



  1. This was very educational. You do such a great job writing.

  2. Busy but sounds like you are doing amazing! Addison will thrive with such a caring family. Hugs!