How can families balance multiple therapies for a child with significant developmental delays?

Start by agreeing on a small set of shared priorities with all of your child's therapists, then ask them to coordinate so each discipline supports the same goals. The Canadian Association of Occupational Therapists describes pediatric care as child- and family-centred: therapists balance the priorities parents identify with the child's own needs, and work with caregivers to set priorities and monitor progress over time.

Practical ways to keep things balanced:

• Choose shared goals: ask your occupational therapist (OT), speech-language pathologist (SLP) and any behaviour therapist to agree on a few everyday goals, such as asking for help at snack time, that each can work on in their own way.

• Ask for coordination: with your consent, therapists can share goals and reports so their advice fits together instead of competing.

• Fold practice into routines: practice at home matters, and parent coaching is a core part of pediatric OT. Ask each therapist to show you how their strategies fit into meals, dressing, play and bedtime.

• Measure progress: a large review of pediatric OT research gave its highest rating to approaches such as family-centred care, coaching, home programs and goal-directed training, and recommended tracking progress closely for approaches with weaker evidence. If something is not showing change, ask whether to adjust or stop it.

• Watch your child's energy: notice when sessions leave your child tired or upset and raise it with the team.

For children from birth to school entry, BC's publicly funded Early Intervention Therapy program offers OT, physiotherapy and speech-language pathology, and can be part of the plan.

If the schedule feels unmanageable, talk with your child's registered OT, SLP or BCBA about which goals matter most right now.