This document provides an overview of integrated therapy. It discusses why therapy is important for children with developmental, communication, behavioral or other disorders. It then describes different types of therapeutic treatments including behavioral, developmental, educational, social-relational, pharmacological and psychological approaches. A key part of integrated therapy is providing treatment within the classroom rather than separate sessions. Benefits include increased practice opportunities, better generalization of skills and enhanced collaboration between therapists and teachers. The document provides tips for discussing integrated therapy with families.

1. INTEGRATED THERAPY:AN
OVERVIEW
ANSHITA SINGH (ASLP)

2. Why Therapy Is Important
 When left untreated, mental, emotional ,developmental
,communication and behavioural disorders in childhood can
cause long-term problems that affect the health and well-
being of your child, so try not to delay when it comes to
selecting a therapist.
 Finding treatment for their developmental disorders and other
health issues will not only help improve their quality of life,
but it also will make things easier at home, in school, and
with friends.
 Therapy also helps build a healthy foundation of skills your
child can use throughout their life.

3. CONT…
 The first step is finding a therapist who not only provides the
type of therapy you are looking for, but that also has training
and experience in working with children your child's age.
 Typically, the therapist will choose the type of therapy or
therapies that will be most appropriate for your child's
particular issue and goals, but you also can have a say in this
decision as well. But first, it is important to familiarize
yourself with the types of therapy most commonly used with
kids as well as the benefits to each. Here are the most
common types of therapy used with children and teens.

4. Types of Therapeutic Treatments
 There are many types of treatments available. These
treatments generally can be broken down into the following
categories, although some treatments involve more than one
approach:
 Behavioural
 Developmental
 Educational
 Social-Relational
 Pharmacological
 Psychological

5. CONT…
 Behavioural Approaches
 Behavioural approaches focus on changing behaviors by
understanding what happens before and after the
behavior. Behavioural approaches have the most
evidence for treating behavioural issues. A notable
behavioural treatment is called Applied Behavior
Analysis (ABA) which encourages desired behaviors
and discourages undesired behaviors to improve a
variety of skills. Progress is tracked and measured.

6. CONT…
 Developmental Approaches
 Developmental approaches focus on improving specific
developmental skills, such as language skills or physical skills, or a
broader range of interconnected developmental abilities.
Developmental approaches are often combined with behavioural
approaches.
 The most common developmental therapy is Speech and
Language Therapy. Speech and Language Therapy helps to
improve the person’s understanding and use of speech and
language. Some people with speech and language disorder
communicate verbally. Others may communicate through the use
of signs, gestures, pictures, or an electronic communication
device.

7. CONT…
 Occupational Therapy teaches skills that help the
person live as independently as possible. Skills may
include dressing, eating, bathing, and relating to people.
Occupational therapy can also include:
 Sensory Integration Therapy to help improve
responses to sensory input that may be restrictive or
overwhelming.
 Physical Therapy can help improve physical skills, such
as fine movements of the fingers or larger movements of
the trunk and body.

8. CONT…
 Educational Approaches
 Educational treatments are given in a classroom setting.
It provides teachers with ways to adjust the classroom
structure and improve academic and other outcomes. For
example, daily routines can be written or drawn and
placed in clear sight. Boundaries can be set around
learning stations. Verbal instructions can be
complimented with visual instructions or physical
demonstrations.

9. CONT…
 Social-Relational Approaches
 Social-relational treatments focus on improving social skills and
building emotional bonds. Some social-relational approaches
involve parents or peer mentors.
 Psychological Approaches
 Psychological approaches can help CWSN cope with anxiety,
depression, and other mental health issues. Cognitive-Behavior
Therapy (CBT) is one psychological approach that focuses on
learning the connections between thoughts, feelings, and
behaviors. During CBT, a therapist and the individual work
together to identify goals and then change how the person thinks
about a situation to change how they react to the situation.

10. CONT…
 Pharmacological Approaches
 Medication might help manage high energy levels,
inability to focus, or self-harming behavior, such as head
banging or hand biting. Medication can also help manage
co-occurring psychological conditions, such as anxiety or
depression, in addition to medical conditions such as
seizures, sleep problems, or stomach or other
gastrointestinal problems.

12. Findings from research
 Over time, families who were given a choice between in-class
and out- of-class models of service delivery (therapy)
preferred in-class models.
 Across disciplines, therapists believe therapies ideally would
be provided in a more integrated manner than they typically
are.
 When therapy is provided in the classroom, teachers and
specialists consult with each other four times as much as they
do when therapy is provided out of class.
 Across disciplines, children generalize more following in-class
than out of-class therapy.

13. What Is Integrated Therapy?
 Individual educational plan (IEP)/therapy goals are
developed through a problem-solving approach.
 IEP-based instruction/therapy is provided during regular
classroom activities, routines, and transitions through
support, consultation, and modelling with teaching staff.

14. Integrated Therapy: As a Model
 An Integrated Therapy model:
 Helps assure IEP goals/therapy goals are integrated into classroom
instruction and routines.
 Promotes collaboration between therapists and teaching staff.
 Helps children generalize behaviors in the classroom and at home.
 Enhances learning opportunities in transitioning from one setting
to the other (e.g., from classroom to playground).
 Allows regular coaching and mentoring opportunities.
 Provides additional opportunities to exchange information between
therapists and teachers.
 Helps in understanding respective roles and expands knowledge
base.

15. Ten Really Good Reasons Why Therapies
Should Be Integrated
1. So that children learn the skills they need in the places
they will use them.
2. So that children have in creased practice opportunities.
3. So that children's social relationships are fostered.
4. So that a child does not miss out on any classroom
activities.
5. So that teachers can see what therapists do to help kids
and expand their skills.

16. CONT…
 6. So that therapists can see whether or not the
strategies they develop are feasible.
 7. So that teachers and therapists focus on skills that
will be immediately useful for a child.
 8. So that therapists can work with teachers to address
problems as they arise.
 9. So that assessment can be done across a variety of
routines.
 10. Because it is the right thing to do

18. Where Do Therapists Work with Children?
 In classrooms
 During lunch time
 On the playground
 Walking to the bus
 On field trips

19. What Do Therapists Do with Children in the
Classroom?
 Work with children on IEP goals within the context of
activities and routines
 Introduce and implement interventions
 Collaborate with classroom staff during instruction
 Model practices and strategies for implementation in the
classroom
 Provide training/consultation to classroom staff
 Provide feedback to classroom staff
 Monitor (measure) child progress

20. What is your Consultative Style?
 A critical component of integrated therapy is consultation, or
the communication between adults about a child they work
with. There are basically two types of consultative styles
among professionals: expert and collaborative.
 The expert style of consultation involves the specialist
independently (a) assessing a child to identify needs, (b)
recommending strategies or solutions to others, and (c)
evaluating whether needs have been met.
 The collaborative model of consultation involves the
specialist, teacher, and family identifying needs, developing
solutions, and evaluating progress together.

21. Talking with Families About Integrated
Therapy
 1. Ask the family about previous experiences.
 When talking with families about how therapies will be
provided, it is important for professionals to first
understand the families past experiences and concerns
with the provision of therapy. Families who are used to
therapy being provided in an isolated manner are likely
to be sceptical of integrated approaches

22. CONT…
 2. Ask the family what they want their child to get out of
therapy.
 Sometimes families are caught up in the mind-set that more
therapy is better and don't really focus on a specific goal or
purpose for the therapy, or how the therapy is going to improve
daily life.
 By asking this question, professionals can help the family focus on
the goal, not the therapy. For example, a family may want their
child, to receive regular speech therapy so that she child can
communicate better. The next question the professional asks is
when is communication a problem for him/her. This ties the
concern to daily routines or specific times of the day when the
child needs the skill.

23. CONT…
 3. Tell the family that when therapy is integrated their
child has the opportunity to learn skills when and
where the skills are needed.
 Back to the previous example, the parents might say that
communication is especially a problem for their child at
mealtimes because she/he can't tell them what they want.
The best time to work on communication then would be at
mealtimes, not in a therapy room.
 When children learn a task in one situation or setting
(therapy room) the child has the extra task of transferring
that skill to other situations (home and classroom). Therapy
is most effective when provided in context.

24. CONT…
 4. Do the math with the family
 By integrating therapy into the classroom, teacher can
see how the therapist works with the child and
implement those same strategies into the rest of the
week when the therapist is not present.
 Lets say receives 45 minutes of speech therapy in a day,
and 135 minutes in a week. If the teacher is able to work
with child on communicating her wants for 10 minutes
out of every hour, so it will be approx. 10*6=60 minutes
daily and 360 minutes in a week.

25. CONT…
 5. Inform the family about the models of service
delivery.
 Discuss the pros and cons of each model so that parents
can make an informed decision about how services are
provided. Whatever decision the family makes, it is
important for professionals to honour that decision: this
is their child.

26. Reference
 Technical Assistance and Training System (TATS)
 R.A. McWilliams
 Stay Scott
 ASHA
 Sherri Marlette
 Center for Diseases Control & Prevention

27. Learnwith Anshita