Our clinic could not keep people. New technicians arrived with a smile on Monday and were gone by Friday. Supervisors changed, schedules changed, and my kids had to start over again and again. It was not a bad week. It was the pattern.
Here is what I saw from the inside. Clinics staff big blocks of hours because insurance pays for hours. Most time is delivered by low paid techs with high burnout and little control over their schedules. When authorizations spike, clinics hire fast. When hours drop, people leave. Training is short. Supervision is stretched. Turnover follows.
“Please, not another new person.” That was my child’s quiet request before a session.
Why does this hurt your child? Because learning is relational. Your child needs to feel safe with the person in the room before skills can show up. Every switch resets trust. Sensory notes get missed. AAC buttons are ignored. Breaks become rewards instead of regulation. Meltdowns rise. Home pays the price while the clinic still bills the hours.
We landed there because it was easy to approve. Our doctor recommended it in minutes. Insurance said yes right away. OT and speech were “limited,” “waitlist,” or “not medically necessary.” That bias pushed us into a model built on filling schedules, not on keeping stable people with your child.
If your child has trouble staying focused in therapy, a new face makes it harder. If your child uses scripts or a device, every staff change means re-teaching how to listen and respond. If your child needs movement, a rushed tech may miss the cue and push through.
What helped us was stepping off that carousel and protecting consistency on purpose.
- Ask for a staffing plan in writing. Names, roles, and how many people will work with your child each week. Aim for two or fewer.
- Set rules about swaps. Require notice, the right to decline, and real shadowing before anyone works solo.
- Choose caregiver coaching over more tech hours. Fewer people, more tools that work at home.
- Request OT, speech, and feeding evaluations in writing. Ask for goals tied to daily life: dressing, meals, communication, hair washing.
- Run a short trial. Track sleep, appetite, recovery time after sessions, and willingness to go. If those drop, change course.
When we shifted to OT and speech, we saw steadier faces and steadier gains. A sensory informed OT helped us adjust routines and reduce overload. A speech therapist built functional language and AAC in our kitchen. Fewer hours. Fewer strangers. More calm.
It can feel overwhelming to push back. You are not alone. The fastest covered option is not always the best for your child. If churn keeps resetting your child, that is data. Choose providers who can stay, methods that respect regulation and communication, and goals your child values. Your child’s nervous system is a better guide than any billing code.
