Finding that “perfect" therapist for your child with Down Syndrome can be a frustrating endeavor. Babies who have disabilities usually begin multiple therapies in the first three months of life through some form of early intervention services and/or private sources. When you are just beginning this journey, it can be difficult to know if your therapist is right for you and your child.

Things to look for in a therapist: (not listed in any particular order)

Does the therapist wash her hands or wear gloves when touching your baby’s mouth.

When my son was about 2 months old we had our first meeting with the occupational therapist because he had some feeding issues due to his cleft palate. Before we could start working on his problems feeding, she had to do an assessment. Guess how she assessed the strength of his suck. You guessed it; she put her ungloved, unwashed finger in his mouth and tried to get him to suck. Needless to say, I was appalled. Being that I was still intimidated by all that was going on in my life at that point, I did not say anything to her. She came back one more time. That visit did not go any better... She brought him a special bottle (called a Habermann Feeder) to help with his feeding problems. Without going into detail, the session was no better (no more hygienic) than the first. After that I spoke with our service coordinator and requested a new OT.

It was hard for me to do because I thought, “Well, this is a free service, maybe I should just be happy with what I can get." In the end, that did not cut it though. My son’s health was more important.

The point? Make sure your therapist washes her hands anytime she manipulates your child’s eating utensils and never let anyone stick their ungloved fingers in your baby’s mouth. Even if they wash their hands before, there are always germs left under the nails, etc.

Children with Down Syndrome(such as my son) usually have weakened immune systems, so it should go without saying that extra care should be taken to ensure your child’s health. Call me picky or paranoid, but I want my baby to stay healthy

Does she seem knowledgeable? The therapist should, ideally, have a firm knowledge in several areas. First of all, they need to know “normal" development. This is so important. For instance, if a child has been sleeping through the night and all of a sudden, between around nine and twelve months of age he starts getting up in the middle of the night again, (this is around the time a baby acquires the new skills of pulling himself up, standing, etc.) the therapist needs to know that is part of normal development. This baby has learned something new and if he wakes up in the middle of the night, he’ll want to test it out again. He now has a whole new perspective of his world outside the crib. Someone who does not know “normal" development would not know that. They also need to know of the ways in which a child with Down Syndrome tends to compensate for his musculoskeletal differences. This is the only way she can effectively teach you and your child the proper way for him to move.

If the therapist walks in with a couple of Xeroxed pages, starts reading from them and seems like she has never done this before…RUN! Seriously though, you may want to consider asking for a new therapist. I understand that people have to learn, but I also believe that a therapist (new or seasoned) should walk into an appointment prepared enough so she doesn’t need a “cheat sheet". In the end, you want the best for your child.

Does your child’s therapist seem to enjoy kids? Most of the therapists we have had genuinely seemed to enjoy working with Sam (and his 4 year old sister). I believe that if the therapist is uncomfortable with kids, or not genuinely interested, the kids can tell. Sammy was naturally drawn to the therapists who were most open and playful with him.

Ideally, the therapist would have kids of her own, in order to know typical child behaviors.

Don’t be afraid to ask for credentials and qualification

Ask about work experience. You don’t want a therapist (for a child with Down Syndrome) who has just transferred from geriatrics to pediatrics. That might be great for your grandmother, but not for your child. The two areas are as different as night and day.

Know that an occupational therapist can not effectively do the job of a physical therapist and vice versa. The two are not interchangeable. They can complement each other but not replace each other.

On a final note, you will be seeing this person at least once every two weeks, if not more, so just make sure you are happy with her and don’t be afraid to speak up.