‘Therapy’ – do we really need this word in early child and family support? A question for discussion

I have not seen a universally agreed definition of ‘therapy’ in early child and family support

Peter Limbrick writes:

If we are imagining a sunnier future post C-19 for families whose child has various developmental difficulties, then I would like to play with the idea of dispensing with the word ‘therapy’, so the thoughts below are really questions – questions I have had in my mind for very many years.

Firstly, I value the skills and understanding of the paediatric therapists I have worked with (physio, occupational, speech) and could not have functioned as a teacher or keyworker without my close partnership work with them.

In my thinking, early child and family support has three essential strands – health, education and family support.  I do not include ‘therapy’ in this. I define education as the acquisition in the child of new skills and understanding and I see this as happening from birth (or before). Understanding and skills can emerge naturally, or be the product of interventions, or both.

What paediatric therapists do is partly health interventions (e.g. preventing aspiration, chest congestion, contractures), partly education (e.g. promoting new understanding and skills in mobility, hands, communication) and partly family support (listening, advising).

I see nothing left over that has to be called ‘therapy’.

When babies and infants are given only therapy interventions until they start nursery or school (as often happens in my country), while this can be helpful, it can mean we are depriving them and their parents of teaching professionals who are trained in the science of education – the science of how babies and infants learn. I would want us to start education interventions from the beginning of life.

In my version of the sunnier days to come there will be undergraduate and graduate courses to train ‘early interventionists’ with integrated course content informed by the world of teaching, psychology, therapy, counselling...

The new future will mean we keep some things and get rid of other things. I think we are all agreeing there is much that needs changing. My thoughts on the word ‘therapy’ are offered as questions to be asked in this process.

During recent years I have met many paediatric therapists in my seminars and workshops and I have sometimes asked for definitions of ‘therapy’. I have had very many different answers and I have come to feel no useful satisfactory definition exists.

April 2020

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