A day in the life of an in-home pediatric occupational therapist

A Day in the Life of an In-Home Pediatric Occupational Therapist

For today’s Day in the Life article, we’re very excited to feature Jamie Schreckler, OTR/L’s day in the life as an in-home pediatric occupational therapist. Jamie has worked in pediatrics for over 20 years and has since started her own private practice in in-home pediatrics. We can’t wait to share what her day looks like! For more Day in Life articles, be sure to check out our full series here.

Having your own private practice and supporting children and families in their homes and community settings is a very rewarding realm of pediatric occupational therapy. It allows a flexible schedule that you set yourself, which has been essential in my life since becoming a mom.

Pediatric home health occupational therapy jobs, through an agency, may be similar in terms of the daily travel and documentation demands. However, when you have your own private practice and are seeing families in their homes, your workday hours are determined by you, so you can work around your own family demands.

After working in pediatric SI (sensory integration) clinics for many years, transitioning to private practice in home occupational therapy was a natural progression. Having had those years in clinics learning along with colleagues provided the foundation that I needed to start a private practice with confidence in my abilities.

Although there are trainings and certifications that could help prepare you for working on your own, I highly recommend this area of practice after having experience working with children among other therapists to gain a strong foundation.

pediatric OT home health

My Caseload

My caseload typically consists of children ages 2 through teenage years, most of whom have sensory processing, developmental and/or self-regulation difficulties. During the school year, my caseload tends to be primarily preschool aged children (as older children are in school full time), and then in the summer, the age ranges vary as most families are more free for scheduling sessions.

Depending on your areas of specialty, your caseload could look very different, and with private practice, you will attract the clients who can benefit from your expertise.

The Week Overview

Although each day of the week is different, my week has a pattern. Typically, I have weekly clients at set times, one morning per week set for new evaluations and/or preschool observations/consultations, and a few hours of documentation and email communication time set throughout the week. I also volunteer at my children’s school at specific times, so I have that built into my schedule as well.

What My Typical Day Looks Like

After dropping my own children at school, I head to my first family’s home. After a one-hour session, I usually leave 30 minutes between sessions for travel time, parent phone calls and preparing my materials for the next session.

I have 4-5 sessions per day on days when I have sessions only and no evaluations or preschool observations. I work in an hour or so for notes and planning each day as well. I usually bring lunch for the car and/or stop at home depending on how close my client’s home were to mine that day.

I am then able to pick my own kids up from school, help them with homework, and do bedtime routines. Then, if needed, I have my evenings to send out treatment summaries to parents, respond to parent or teacher emails, and plan for the next day’s sessions.

Travel Time

So much can happen during travel time! I like to use that time to do phone collaborations with parents and other providers with whom we share clients. In addition, my office is my car, so having time to clean off equipment/toys/materials and repack my bag for the next session is key to staying organized (physically and mentally!). Also, by bringing my laptop, I can start notes for previous clients if I have a few extra minutes.

A Typical Treatment Session

Most of my typical treatment sessions are an hour long and they all look very different! One thing is the same, each session is based on relationship and regulation…oh and PLAY! In each home, we typically have a designated play area (sometimes in the basement, living room, play room, etc.). I also have some type of organizational tool/support/method/routine with each child and family to set the tone and pace of the session.

Sometimes we make a plan on a white board, sometimes with picture cards, and sometimes with words on notecards. Some children are not yet ready for long plans, so we decide together where to start and what to play, with deliberate attention to transitions.

In each session, play is the modality for working on specific family set goals. Most often, family members are a part of each session. Sometimes it could be just one parent or a caregiver, other times the whole family participates. I have even included family dogs in sessions when appropriate and beneficial!

home health pediatric ot

My Evenings

After I have wrapped up family duties each evening, I like to also do the same for my workday. I finish my treatment notes, send them out to parents, and also respond to any emails that came in throughout the day.

Then, I begin packing for the next day. I have a storage closet in my garage that is just for my therapy tools/ supplies (most of which are things for families to trial, prior to considering purchasing for themselves). Most of my planning goes on in my head from the time I leave a session, until the next, so I like to keep a notebook in my purse to write ideas, plans, and questions for the next session on each client (initials only in the notebook to keep with privacy compliance).

When I am packing, I refer to this notebook, and can quickly put my bag together and be organized for the next morning.

Other Important Activities

Although not every day, there are some other important activities that I schedule at various frequencies to ensure I am providing good quality of care and business practices.

I make sure to schedule meetings with colleagues to do case collaborations on a regular basis to get fresh perspectives and insight. I also do consultations on specific cases with other providers, to determine if other referrals are indicated in those cases. In addition, seeking out continuing education tailored to my clients’ needs is essential for best practice.

Creating materials for clients is another task that takes planning and time. These can include but are not limited to picture schedules, social stories, reward charts, and various individualized visuals.

In private practice, you are also responsible for creating a billing system that works for you (unless you decide to hire out for this). I am a solo private practice, so I do all of my own billing and create monthly invoices that I send out to families. Then I have a system for documenting payments for tax purposes. I set aside time each month to do this as well as other clerical things to keep the business running smoothly.

How I Get Referrals

There are a variety of ways to receive referrals to provide OT services. In my private practice, I have maintained my caseload based on word of mouth and building relationships with private local pre-schools. Often families I have worked with for years will do bursts of treatment sessions, over the summer for example, to target new goals.

Building your own website with details regarding your credentials and services will help your business grow if you are in a new area and working on building relationships. Some pediatric OT providers contract with early intervention agencies to build up their caseloads. Offering to do sensory in-services (or other special topics) at private preschools or for parent groups is another way to build awareness of your expertise and availability to help!

The Best Part of the Day

Working as an in-home pediatric occupational therapist requires a lot of independent problem solving and organization but it allows for flexibility to make my own schedule and be there for my family when they need me.

I love working as a private OT practitioner in families’ homes! It is challenging yet incredibly rewarding. The best part of the day is witnessing a child feeling success and being able to help empower parents to support their children to feel that way every day!

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