Intensity of therapy services: what are the considerations?

Research on intensity of therapy services is limited and perspectives often vary considerably among families, therapists, administrators, policy makers, and health insurers. In this commentary, the authors share their perspectives on intensity of physical therapy and/or occupational therapy services for children with developmental conditions. Five considerations are discussed: episode of therapy, readiness for activity and participation, method of service delivery, the distinction between intensity of therapy and practice of activity in natural environments, and the link between skill level and method of service delivery. We conclude that for children with developmental considerations, method of service delivery and intensity of therapy may differ for each episode of therapy based on contextual factors including child and family priorities and goals. In most situations, more than one method of service delivery can and should occur simultaneously.