A Mother and Daughter’s Journey

a mother of a girl with down syndrome hugging her tightly

A Mother and Daughter's Journey

Kris Krajewski: Hi, I am Kris Krajewski. I am the director of PT, OT and Speech Therapy Services at MetroEHS. I am a clinical fellow mentor, a speech language pathologist, and a mom. And this is my daughter McKenna. McKenna is a therapy assistant at our Rochester Hills location.

Mckenna Krajewski: So as therapy assistant, they clean, do desk work and sanitize, take temperatures, taking care of clients, make sure they're safe and healthy, help them with their work and special needs. It makes me feel amazing and happy to be there for them. I am very, very proud.

Kris Krajewski: I got teary listening to McKenna talk about it because what, what is most important to me for children or anybody of any age, but in particular my child, is that they are happy. A large part of that happiness comes from feeling connected and having a purpose, um, and knowing that you have somewhere to go where you're valued and you're important. And so I see that happening at Metro with McKenna, with her job as a professional. I'm really proud of MetroEHS for thinking about people at, you know, both ends of that age spectrum, right? We have our little littles coming in at a very young age, and we are still interested in what happens to our kiddos when they get out into the world of work. Um, and to me that's a really important message.

A Family's Journey with a Special Need Diagnosis is a beautiful journey! Listen from some more of our MetroEHS Family's stories > HERE

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April 20, 2021

Metrotelepractice In Metropolitan Detroit

Speech, Occupational and ABA Therapy provided in the comfort of your home via Teletherapy!

Teletherapy

MetroEHS Pediatric Therapy proudly offers excellent therapy to our clients, and service them in a way that suits their individual needs. Speech, Occupational and ABA Therapy provided in the comfort of your own home via Teletherapy! Teletherapy, or telepractice, uses a HIPPA compliant and secure video platform, similar to Skype, to connect a client to a specially trained Speech-Language Pathologist or Occupational Therapist for live, individual treatment sessions. This virtual therapy is an excellent option for families all over Michigan who home-school, have busy schedules, or anyone who otherwise have a difficult time coming into the clinic. Contact us if you think Teletherapy would be a good fit for your family!

In addition to individual families, MetroEHS also offers Teletherapy to schools in Michigan to keep IEP’s in compliance. Please visit our Staffing Page to explore more.

Frequently Asked Questions
  1. Will my insurance cover Teletherapy?
    Most insurances cover Teletherapy, including many BCBS plans. Community Mental Health is not currently covering Teletherapy in the Metro Detroit counties, but this could change in the future.
  2. How old does my child have to be to participate?
    Any age! If a child is young or active, the therapy session will be geared towards “parent training”. The therapist will provide materials and coach the parents to implement the goals and provide feedback.
  3. Do kids find it boring?
    No! Our Teletherapy website offers a variety of picture cards and we always incorporate games to keep clients engaged. Kids also love having the attention of their parent and the person on the other side of the screen. It’s all about them!
  4. What do I need to use Teletherapy?
    You will need internet connection, a computer or tablet with a camera, microphone, and speakers. Headsets are not required.
  5. How will I access the platform?
    Your therapist will send you an email and you will make a free account. When it is time for your session, you will receive another email with a link to the session, you will put in your password, and you will be connected with your live therapist.
  6. What if I live outside of Michigan?
    Due to state licensing requirements, we are only able to provide therapy to residents of Michigan.
May 16, 2023

What Is Intensive Feeding Therapy at MetroEHS and How Does It Work?

What is the Intensive Feeding Therapy Program Like at MetroEHS?

As we dive into the details of the Intensive Feeding Therapy Program at MetroEHS, hear from the experts at MetroEHS and how they collaborate on the most wholistic approach to Intensive Feeding Therapy.

Jessica Hunt (Occupational Therapist/Feeding Specialist):
When it comes to treating children who have complex feeding difficulties and pediatric feeding issues, there's a multitude of things that are typically at the root of the problem. So what's very unique about the program that we have here is that we have involvement from both occupational therapy, speech and language therapy, physical therapy, a dietician, as well as psychology.

Rose Britt (Registered Dietitian):
So it's all five disciplines. Spending time together with the family, with the patient, with each other, all talking at one cohesive time, making a plan instead of grabbing pieces from all over the place and putting them together. I think it makes it a lot smoother for us and the families as well.

Kris Krajewski (Director PT, OT, and Speech Services/SLP):
Each of our disciplines really does have something to offer to this process, but when we work all together, we have the ability to help our kiddos make more progress more quickly.

Kayla Daniels (Physical Therapist):
At Metro, we really take a whole body approach. We don't just look at one aspect of the child. And a lot of people don't think of physical therapy as part of the feeding team, but in order to eat, you have to use all of these posture and muscles, you have to hold yourself up. You have to hold your head up to be able to swallow. So really focusing on all of those aspects of your body is really important to be able to make the progress.

Azari Haygood (Psychologist):
As a psychologist on staff for the Intensive Feeding Program, I offer mental health services to the families and to some of the clients. It's very stressful for a lot of these families. It's stressful for the clients that we see. And so, I offer just another support for them, where I'm helping them kind of overcome some of the stressors that they're experiencing around feeding.

Rose Britt (Registered Dietitian):
It's not just me telling you what to do. There's so much more going into that, and you get to really listen to the families and hear why it's not working and problem solve together.

Kayla Daniels (Physical Therapist):
The impact you can make, not only on the child's life, but on the family's life as a whole is huge.

Azari Haygood (Psychologist):
Seeing that improvement in their family's lives feels really great all around.

Jessica Hunt (Occupational Therapist/Feeding Specialist):
One in 23 children have a pediatric feeding issue. And so, to truly be able to address all of the aspects of that in one place, that's where we get to make a difference every single day.

Kris Krajewski (Director PT, OT, and Speech Services/SLP):
It's like when you have a jigsaw puzzle and you're missing one piece, you can still tell what the picture of the jigsaw puzzle is going to be, but when you have all of the pieces together, integrated into this treatment, the result is just something so much more beautiful.

April 14, 2026

When Should Physicians Refer a Child for Integrated Pediatric Therapy?

Why Integrated Therapy Models Can Improve Functional Outcomes in Pediatric Patients

Pediatric patients with developmental, neurological, behavioral, and sensory conditions rarely present with isolated deficits. In clinical practice, delays in motor function, communication, regulation, feeding, and adaptive behavior frequently overlap, influencing one another in ways that can complicate both diagnosis and treatment planning. Yet despite this reality, many children still enter care through fragmented referral pathways, receiving services across separate disciplines without a unified plan of care.

For physicians, this can create a familiar challenge: a child may be referred for speech concerns, but underlying sensory processing difficulties, motor impairments, or behavioral barriers may be limiting progress. Another patient may be receiving occupational therapy while untreated communication deficits continue to interfere with participation, safety, and family routines. When care is siloed, treatment goals may be addressed in isolation rather than in the context of the child’s overall functional development.

An integrated therapy model offers a more clinically aligned approach. By coordinating services such as Applied Behavior Analysis (ABA), Occupational Therapy (OT), Speech-Language Pathology (SLP), and Physical Therapy (PT) under one interdisciplinary framework, integrated care supports shared functional outcomes rather than disconnected discipline-specific objectives.

The Clinical Problem With Fragmented Pediatric Therapy

Children with autism spectrum disorder, global developmental delays, neurological diagnoses, genetic syndromes, feeding disorders, and sensory-behavioral challenges often require support in multiple developmental domains at the same time. Traditional referral patterns, however, can delay this process. Families may be referred sequentially, moving from one specialty to another over the course of weeks or months. In the meantime, opportunities for early, coordinated intervention may be missed.

This fragmented model can contribute to delayed progress, duplication of effort, inconsistent treatment strategies, and increased caregiver burden. Parents may be left trying to reconcile different home programs, communication methods, and therapeutic priorities across providers. Physicians, in turn, may receive updates from multiple sources without a single cohesive picture of the child’s functional status or trajectory.

What Is an Integrated Therapy Model?

An integrated therapy model brings multiple pediatric disciplines together within a coordinated plan of care. Rather than treating communication, mobility, sensory regulation, and behavior as separate issues to be addressed in parallel but independent tracks, the interdisciplinary team collaborates around shared goals tied to everyday function.

These goals may include functional communication, feeding independence, improved transitions, school readiness, social participation, gross motor mobility, or greater independence with activities of daily living. The emphasis is not simply on increasing therapy volume, but on aligning interventions so that each discipline reinforces the others.

For the referring physician, this model can improve both clinical clarity and continuity of care. Instead of scattered recommendations, the result is a more streamlined treatment course centered on measurable, meaningful progress.

Why Integrated Care Can Produce Faster Functional Gains

One of the primary advantages of integrated pediatric therapy is simultaneous skill development. A child is not required to “complete” one form of therapy before another begins. Instead, deficits across domains can be addressed concurrently, which is often more reflective of how development actually occurs.

For example, a child working on expressive language in speech therapy may also need occupational therapy support for sensory modulation and motor planning, while ABA helps reinforce communication attempts across routines and environments. In a coordinated model, those interventions are not separate—they are mutually reinforcing. This kind of overlap can accelerate the acquisition and generalization of functional skills.

Integrated care also improves goal setting. When therapists across disciplines are aligned around outcomes such as feeding, social participation, transitions, mobility, or independence, treatment tends to be more efficient. This reduces contradictory strategies, minimizes duplication, and makes progress easier for both families and physicians to follow.

Another important factor is treatment intensity without fragmentation. Children with complex needs often benefit from more frequent intervention, but high therapy intensity can become burdensome when services are spread across unrelated systems, schedules, and locations. Integrated models can increase intensity while preserving continuity, making it easier for children to receive comprehensive care without overwhelming families.

Reinforcement Across Disciplines Improves Generalization

Generalization remains one of the most important markers of meaningful pediatric progress. A skill demonstrated in a single therapy session has limited value if it does not transfer into the home, school, or community environment. Integrated care helps close this gap.

When one provider introduces a communication strategy, self-regulation support, mobility goal, or feeding intervention, the rest of the team can reinforce that same skill during their own sessions. A child who practices requesting in speech therapy may use the same communication system during ABA and OT. A sensory regulation strategy introduced in occupational therapy may support participation during speech sessions or improve tolerance for physical therapy tasks.

This consistency can speed carryover and reduce the risk that gains remain context-dependent. For physicians monitoring developmental progress, that translates into more functional outcomes rather than isolated clinical wins.

The Importance of Early Multidisciplinary Access

Early intervention is well established as a major factor in pediatric outcomes, but access delays across disciplines remain common. A child may begin one service while waiting for another referral, evaluation, or authorization, even when needs in multiple domains are already evident.

Integrated models reduce that lag by allowing children to access multiple specialists earlier in the care process. This is especially important for patients whose communication, sensory, behavioral, and motor needs are intertwined. Earlier multidisciplinary involvement can support developmental momentum, reduce avoidable decline in function, and improve long-term participation outcomes.

For physicians, this means that an integrated referral may be appropriate not only when a child is already receiving multiple therapies, but also when the clinical presentation strongly suggests interconnected needs from the outset.

Which Patients May Benefit Most From an Integrated Referral?

Integrated therapy is particularly valuable for pediatric patients whose presentation crosses traditional discipline boundaries. This often includes children with autism spectrum disorder, global developmental delay, speech and language delays with behavioral or sensory components, neurological conditions, genetic disorders, feeding difficulties, and motor impairments that affect participation in daily routines.

It may also be the right model for children whose progress has plateaued in a single-discipline setting, especially when underlying barriers appear to involve multiple systems. In these cases, coordinated treatment can help identify whether communication, regulation, sensory processing, strength, endurance, or adaptive functioning is limiting advancement.

What Referring Physicians Can Expect

From the physician’s perspective, integrated care can simplify the referral and follow-up process. Instead of navigating feedback from multiple unconnected providers, physicians can expect more coordinated communication, a unified plan of care, and reporting that reflects cross-disciplinary collaboration.

Families also benefit from reduced navigation burden. When care is organized around the child rather than around separate service lines, it becomes easier for caregivers to understand treatment priorities and implement strategies consistently. This can improve adherence, engagement, and follow-through outside the clinic.

Most importantly, integrated care better reflects how children function in the real world. Development does not occur in isolated domains, and pediatric therapy is often most effective when treatment recognizes that reality.

A More Functional Model for Pediatric Referral

For pediatric patients with complex developmental, behavioral, sensory, and physical needs, integrated therapy models offer a more coordinated and clinically meaningful path forward. By aligning ABA, OT, SLP, and PT around shared functional outcomes, interdisciplinary care can reduce fragmentation, support faster skill acquisition, and improve generalization into daily life.

When multiple developmental domains are affected, a multidisciplinary referral is not simply convenient—it may be the most appropriate model of care.

To refer a patient, visit https://www.metroehs.com/referrals