Frequently Asked Questions

Where do you provide therapy?
Our therapists come to your home, school or daycare. We also offer additional appointments in our Sterling, VA clinic. We service the following Loudoun and Fairfax County zip codes: 20105, 20129, 20134, 20147, 20148, 20151, 20152, 20158, 20163, 20164, 20165, 20166,20167, 20170, 20171, 20172, 20175, 20176, 20189, 20180, 20190, 20191, 20194, 20195, 20197, 20132, 20141, 22066, 22095
Why do therapy at home or in-school?
Services in clinics are less representative of a child’s daily life. After all, life doesn’t take place in a clinic, right? Providing therapy in natural environments such as your home, school and in the community leads to what we call a better “generalization of skills.” That means that the behaviors and abilities a child learns can be applied and demonstrated in all types of settings with all types of people. Our therapists use your toys, materials and environment as well as incorporate your family’s routines. We have a small clinic in Sterling, VA for infants and a limited number of clients that live outside of our service area or who we are unable to accommodate for in-home or in-school visits.
What are routines-based interventions?
Routines-based interventions (RBI) integrate therapies into natural activities. For a young child this could be working on transitions at school, participating in circle time in the classroom, getting dressed or requesting a snack. When developmental interventions are embedded in children’s regular routines and activities, skills learned are functional and meaningful for children and their caregivers. (Kashinath, Woods, & Goldstein, 2006) RBI is for infants, toddlers, preschoolers and older children with developmental disabilities.
Who should be present for in-home therapy?
Parent participation in sessions is very important. However, this looks different for every family. For a young child working on routines based interventions, the therapist and parent work together throughout the session. This can include younger and older siblings as well, since life doesn’t happen in a vacuum.
For an older child working on speech articulation or handwriting, they may work primarily with the therapist and take some time at the end of the session to discuss skills learned with the parent.
What does in-school therapy look like?
This depends on your child’s age and needs. For our infants through preschoolers, the majority of the session will take place in the classroom, focusing on teaching skills through classroom routines. For our school-aged children, sessions typically take place outside of the classroom in a smaller room. Both will involve collaboration with the child’s teacher and suggestions for carryover for the week. The therapist will connect with the parents following each session and a therapy note will be emailed.
How can we make progress faster?

You can speed up your child’s progression in therapy in three main ways:

  • Family participation: For home-based therapy, ensure that one family member or caregiver is present and can actively participate in sessions to learn the techniques used in therapy.
  • Communication and carryover: In the school and daycare setting, we will work closely with your child’s teachers for maximum carryover into the classroom. Communicate with your child’s therapist regularly to discuss techniques and progress. We highly recommend a home visit every eight weeks to facilitate carryover into the home.
  • Consistency: Children who receive consistent weekly services and have involved families make the most progress. We have a firm cancellation policy in place to service families who desire maximum progress.

Do I need an evaluation?
An evaluation is required for all new clients. If you have a recent speech or occupational therapy evaluation from another practice (within the last six to nine months) or a school IEP with recent testing, we can usually use that to begin services in that discipline. The evaluation should reflect your child’s current skill level as it will dictate therapy goals and diagnosis codes. You will be asked to send us your current evaluation for review before your first appointment. If an evaluation is not complete, one will be completed during your visit and a report will be written.
How long is a therapy session?
Sessions are a full clinical hour which include 50 minutes of therapy plus 10 minutes of parent wrap up, documentation and scheduling.
Do you take insurance?
Little Hands Pediatric Therapy is not an in-network provider with any insurance company. At the end of each month you will receive a Superbill which you can submit to your insurance company. Therapy may be reimbursed under your out-of-network benefits. We recommend contacting your insurance carrier to review your benefits. For your reference, a list of commonly used codes is here. And of course, we are always here to help you through any questions or issues you may be having.
Why don’t you take insurance?
Taking insurance would not allow us to provide the high-quality therapy in natural environments that we offer. Therapy would need to be clinic based and could limit us to 30 minute sessions for speech therapy.
Do you charge for phone calls to my child’s network of care providers including pediatricians, psychologists, school therapists, etc.?
No, we believe that collaboration with other professionals is part of our job. We strive to create a team approach.
Can you provide an in-service or training for the staff at my child’s daycare or school?
Absolutely. We provide continuing education for daycares and schools in the area. Please see our Educators page for more information.