Empowering Mothers: The Mental Load of Raising Children with Disabilities

This Mother’s Day, we spoke candidly with mothers and grandmothers about the joys, challenges, and the unseen load of raising children with disabilities.

Parents of children with disabilities face unique and complex challenges that can be emotionally and physically taxing. Research suggests that women are more likely to be the primary caregivers and to take on the responsibilities and emotional labor associated with caregiving, such as managing appointments, sharing observations, assisting in the plan, informing everyone in the child’s life, and advocating for their child’s needs. 

This Mother’s Day, three mothers, two mothers and therapists at Reach, and one grandmother caring for her grandson, have shared parts of their experience caring for children enrolled at Reach for the Top, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies through a family-centered model.

Goodbye toxic positivity, hello authentic feelings and families

Raising all children, especially those with disabilities and higher needs, requires a high level of care, patience, information, collaboration, and dedication. There is no doubt that a mother’s love is unconditional, but it is important to normalize the idea that mothers and caregivers of children with disabilities can feel a wide range of emotions –  from joy to pride, to sadness, anger, frustration, and fear. Amy Rich Crane, Reach’s Executive Director, a therapist, and mother of two children in therapy, acknowledges you can hold space for more than one feeling at a time, and it is natural to feel some grief when realizing your child has additional needs: 

“There is a lot of joy, challenge, and growth that comes from raising all children, regardless of their needs. When parents feel grief, guilt, fear, or other strong emotions arise when learning their child has a disability or significant challenges, or when trying to help them, it is completely normal and acceptable. As a parent, it’s natural to want your child to have all the opportunities, all the successes and not to struggle. So, when you realize your child has greater needs and they may have greater needs for a long time, these feelings naturally arise because you recognize the world is not currently designed for their needs, which can make accessing play, childcare, school, friendships, and so much more, more difficult.  So, yes, it is okay to grieve the life you desire for them, it is okay to have waves of fear that they may be under-supported or mistreated.  Feel those feelings and let them serve as motivation to find your support networks and strategies to move forward, helping your child find success that may look different than the ‘typical’ or original plan, something that works for them.” – Amy Rich Crane

Amy Shaw, a neurodiverse mother raising two neurodiverse daughters who are both followed at Reach for the Top Therapy, has felt guilty and ashamed of her emotional response to struggles in her daily life:

“There was a time when I could not leave them and I lost myself completely. The oldest had severe separation anxiety and the baby had medical needs that only I seemed to understand. My husband would give me such a hard time if I left him alone with the girls, even to go to the grocery store! After coming home from a 12-14 hour day at work, I handed the baby to my husband and locked myself in my bedroom crying. Every day was so hard for me as a parent, I was lost and desperate for help.” Amy Shaw

It is not uncommon for parents of children with disabilities, most often the mothers, to have mental health struggles. They may feel constant worry and anxiety about their child’s health and well-being, as well as concerns about their child’s future and the long-term impact of their disability. It is okay to seek help, and there are resources to support you.

Recognizing and sharing the mental load

The term ‘mental load’ refers to the invisible and often unrecognized burden of mental work that falls primarily on mothers. It encompasses the emotional, cognitive, and organizational labor that goes into managing a household and caring for others.

Mothers and caregivers work tirelessly to ensure their child has the best possible quality of life, and are often responsible for managing the additional appointments, therapies, medications, and carryover of strategies for their children. They are responsible for navigating complex healthcare and educational systems, advocating for their child’s needs, and coordinating care between different healthcare providers, educational providers, and caregivers at home. Robyn Thomas, a therapist at Reach with two of her own children in therapy, talks about wearing many hats as a mother: 

“Having to constantly balance my responsibilities and role within my full-time job and my role as a mother of 3 children at home can be very challenging and overwhelming at times. I find that there are days where I catch myself really missing being home with my children, especially when my children begin telling me how much they miss me while I am gone. Many of the working moms that I know within my support system agree that we all share this challenge, but it is also what connects us.” – Robyn Thomas

Find your village and don’t forget to care for yourself too

We often hear that it takes a village to raise a child, and that is true. The modern 40-hour work week was not designed to accommodate building relationships with your children, chores, making meals, having play dates, extracurriculars, and having hobbies for caregivers, let alone caring for children with disabilities.

It’s essential for parents and primary caregivers of children with disabilities to have a strong support network. Find your village, the community you can lean on, whether it is family, friends, other parents who share similar struggles, or even therapy providers. For Katie MacKinnon, Reach’s Board of Director Chair and mother of Claire, who has been in therapy for speech delays, sensory processing issues, and food aversions, this is a priority:

“Find support right away and don’t feel like you have to figure it all out on your own. Reach For The Top is naturally a great place to start on your family’s journey, but also ask your children’s school staff, pediatricians, and fellow parents in your community for resources and support. By sharing our experiences, we can be stronger together for our children and ourselves.”Katie MacKinnon

Carole Hartigan, who took over as her grandson’s caregiver after 3-year-old Nathaniel’s father passed away, has found her support network in the other family members affected by this loss:

“I see myself as an important advocate for Nathaniel and this role is vital because there are several family members who have become loving caregivers in the absence of his Daddy. We call this “Team Nathaniel”.  Everything and anything I learn in Occupational Therapy, I write down in a group email and send out to inform the “Team” about what happened.”  – Carole Hartigan

Another very important thing is that mothers and parents of children with disabilities take care of themselves. This can include seeking out mental health support, finding time for self-care, and connecting with friends and family. Parents should not feel guilty about needing their own support or for taking time for themselves, as it helps them be better caregivers for their child(ren). It is something that many mothers struggle to prioritize and something that those within their trusted network can help support. 

“One challenge that has been hard for me lately is time management with all the different appointments. I often find myself putting the needs of my family and friends above myself and feeling like there’s just not enough time in the day to take care of me.” Janyce

In addition, caregivers of children with disabilities often struggle to find care that meets their child’s needs and aligns with their parenting and learning style.  Depending on the disability, a child may require specialized care from multiple healthcare professionals, which requires not only high levels of collaboration and communication but finding the right fit.

Make sure that you find a provider that really listens and includes you as a family. Also, make sure they make it fun. Kids are motivated by play, positive experiences, feeling a sense of mastery/accomplishment, and connection. It looks different for each child and family and great therapists understand that and tailor it to their needs.  If something feels off, I encourage you to speak up and see what can be done.” – Amy Rich Crane

Another challenge parents of children with disabilities face is finding appropriate educational support for their children.  Due to many complex challenges in funding, knowledge, and systems, many school districts are missing the mark in supporting the unique needs of children with disabilities, and parents may have to fight for their children to receive the accommodations they need to succeed. This can be a long and frustrating process that parents are often in need of support in, many times the mothers, that then either put countless hours into advocating within their school district or turn to private schools or homeschooling to ensure their child receives a quality education.

“My daughter was diagnosed with ADHD and Anxiety. With this, I pulled her from her private school and went to public. I took everything I had learned about my child and laid it out for the school. I shared my concerns and started the Individualized Education Program (IEP) process, during which I was told my girl was ‘too smart’ to qualify for an IEP or even for a 504,  which covers students who don’t meet the criteria for special education but who still require some accommodations. After two years, a few incidents where her needs were neglected, and a lot of fighting with the school district, I sent her to a new private school.” – Amy Shaw

Reach has partnered with several mothers, school districts, and daycares that have reached out to have in-services on support delivery that is affirming and provides tangible support recommendations so that children and families feel better supported and provide the knowledge gap backed by evidence and clinical experience.  At Reach, we will continue to do all we can to acknowledge the hard work mothers of children with disabilities and exceptional needs put in, how real the challenges are, how normal their feelings are, how important self-care and a network of support is, and to help connect them to resources that can further support their and their child’s unique needs.

All parents are highly valued at Reach and on the journey to supporting children and empowering families.  We recognize that 65% of the time, mothers are there at Reach adding more to their to-do list to support their children and families.  We are encouraging everyone to reach out to a mother this weekend and offer support: 

  • An hour of watching their child so mom can care for themself;
  • Bring over dinner; 
  • Help with a chore;
  • Take something off their plate for a day so they can put time back into themselves;
  • Be their cheerleader, acknowledge their feelings, validate them, and listen. Sometimes they just need someone to listen to all the good and all the challenges, without judging them.

Reach wears red in April, celebrating Autism Acceptance Month #WearRedInstead

“No two brains are the same, and we celebrate that here at Reach. There’s a whole movement happening within the autism community, to move away from just awareness and to focus on acceptance, honoring people as they are. Moving beyond awareness that autism exists, into a mindset that values and celebrates it.  At Reach we are committed to advocating alongside autistic individuals and families, so they feel safe, supported, and accepted for who they are.”– Amy Rich Crane, Executive Director

In years past, the color blue has been established as the staple for Autism Awareness in April, in association with Autism Speaks. More recently, the color red #WearRedInstead has been adopted by those in the autistic community as a way of creating change in the Autism Awareness movement.  To these people, the color blue has a negative representation.  Wearing red is their way of promoting acceptance rather than awareness, to celebrate differences, and to move away from the finding a ‘cure’ mentality.

At Reach for the Top Therapy, we honor autism as we provide trauma-informed, neurodiverse-affirming therapies for families in the Dover, NH area. Reach is on a continuous journey to do better than traditional models have in the past for the neurodiverse population as a whole.  We commit to learning more, sharing that information and applying it, so that we may best support the unique needs of our children, friends, family, and community members who are autistic.

This journey started with gaining insight into the lived experiences and voices of Autistic adults.  Which included inviting an Autistic Adult to share her experiences as a mother of two children receiving services with our staff.  She provided valuable feedback and spoke up about ways that would better support her family in learning new strategies, emphasizing that what works for some families doesn’t work for all, and many neurodiverse might not feel comfortable communicating that.  Ideas were generated, including more ways for therapists to provide information, and ways for families to participate in their child’s therapeutic journey.  These changes improved this mother’s overall experience and began the conversation for how to identify needs and shape delivery to meet neurodiverse families where they are at for future families.

What is autism? 

Autism, also known as Autism Spectrum Disorder (ASD), is considered a neurodevelopmental or brain-based difference, where the structures and connections in the brain are wired differently. Signs that a child or person are Autistic may be identified by their patterns of communication, socialization, sensory processing, and behavior. It is a spectrum disorder, and the characteristics and way they impact the person vary widely among individuals.

Given that every Autistic person is different, just as every non-autistic person is different, there is no way to group one way that autism presents.  In an effort to educate others and capture the shift in how Reach views autism, we will share some examples.  Autistic people have many strengths based on the way their brains work, strengths that others may miss or misunderstand.  For example, with Autism, the part of the brain involved in visual processing is usually larger and has stronger connections.  So noting details and learning visually is often a strength, when others’ instead focus on challenges with verbal and/or nonverbal communication, because it doesn’t align with the receiver’s expectations.  Others may see repetitive behaviors or interests as distracting, when to the person they are helping them focus and engage by regulating an overwhelmed sensory system. They may have sensory processing needs that present as being sensitive to certain sounds, lights, textures, or smells.  These differences are not inherently ‘bad’, but others’ reactions can signal that they are.  Invalidating these very real sensitivities may sound like a parent, teacher, or community member saying “stop doing that”, “it’s not a big deal”, “you’re overreacting” or “don’t be so sensitive” which minimalizes their feelings.  At Reach, we use a lens of curiosity to identify why the child acts in a certain way and then help the family and other caregivers in the child’s life understand the ‘why’ to further support the child.

Autism often manifests in early childhood and is usually diagnosed through behavioral evaluations and assessments. The focus of outpatient therapy at a neurodiverse affirming clinic like Reach, would be to help the child and family understand the child’s needs better, to get in-sync through play, find tools to help the child feel regulated for longer periods of time, help the child and family learn to advocate for the child’s needs and get them met across different settings, and to meet any goals the child and family may set for greater independence in areas like eating, dressing, communicating, and more remembering that it is going to look different for each child and family based on their needs, strengths, interests, and values.

What is the right language to use when talking about autism? 

With the Autism Acceptance Movement, the preferred mindset at Reach, we use an identity-first approach, meaning that therapy clients are referred to as ‘autistic children’ or ‘autistic teenagers’, instead of children or teenagers with autism. By using identify first language, we validate Autism as part of who they are versus something they have, like it is an accessory. Additionally, using words like therapies and support, as opposed to treatments, adds to the positive acceptance message. Most in the community say autism “is part of who I am,” and it is not seen as something that’s wrong or needs to be fixed.  Bottom line for best practice though, when in doubt, it is never a bad idea to ask the individual how they prefer to be addressed.  “Keeping that communication open as people grow in their identity journey” – Amy Shaw, Neurodiversity Advocate and Mother.

Autism is a disability.  

In the disability community, we commonly see neurotypicals (non-autistics) and the non-disabled shying away from the word disability because some associate it negatively. However, the disabled population is taking that word back and claiming it as “part of who I am.”   More people are feeling comfortable self-identifying as a disabled person, advocating for their equal right to exist as themselves in the world.  There is a lot of significance in these movements, in terms of how society treats people and Reach is committed to playing a supportive role in these movements, as it pertains to how we provide support when working with children with disabilities and their families.

“Actively advocating to end use of the color blue and the puzzle piece which signifies Autistics are puzzling and have missing pieces, many within the Autistic community have more recently adopted the rainbow infinity symbol to represent Autism.  They believe because it is a spectrum, beautiful with lots of different colors representing how individualized and unique each person is.  Autism is a part of someone, and should be as valued as any other part of their mind, body, and personality that makes them their unique self.”– Amy Rich Crane, Executive Director

How Reach addresses the individuals’ needs within the community 

“Realizing that your child has needs you may not know how to meet, and the uncertainty surrounding finding the right strategies can be daunting. Which is why, at Reach our therapists are trained in some of the top affirming therapy strategies and models, are actively listening to Autistic voices and lived experiences, are committed to learning more to help families on their journey based on the child’s abilities, interest, and needs. Where the onus to change is not just the child’s responsibility, but a focus is put on how to shape the environment, increase access to support, and help their caregivers and the child understand their body and advocate for the child’s needs.  At Reach we are focused on being a leader in the paradigm shift, with an emphasis on neurodiversity and satisfying the need within the Autistic community for affirming, individualized therapies.” – Amy Rich Crane, Executive Director

Traditional therapies generally use compliance-based methods to shape and train a person with disabilities to ‘fit’ the thought and behavior patterns of the neurotypical world. Despite behavioral-compliance approaches like Applied Behavioral Analysis (ABA) being well-researched and widely accepted in the medical community, Autistic autism researcher Henny Kupferstein (2018), found increased PTSD symptomatology in autistic individuals exposed to ABA. She is one of the academics favoring relationship-based interventions, and she focuses on music as a tool.

Accordingly, Reach strives to embrace a relationship-based model, looking at the interaction between parent and child, and their relationship with their environment, which can help determine what is and isn’t working.

For example, oftentimes the child’s responses to sensory stimuli aren’t fully understood by family members, which can create unwanted stress and anxiety for the entire household. Addressing issues like these and creating awareness around the needs of the child and other individuals in the household can have an incredibly positive impact on the day-to-day.  When parenting any child, child development experts are looking at goodness of fit, how well the child’s temperament, strengths, needs, and preferences match the caregivers, and how in-sync or attuned the parent is in reading the child’s cues and needs, while then helping them meet them with the resources and skills they have.  If there is a mismatch in needs or resources, we try to develop that with both the child’s and caregivers’ participation, understanding, and growth.

Reach therapists use affirming practices such as, the Learn Play Thrive Approach, the Developmental, Individual-Differences & Relationship (DIR floortime) and Social Communication, Emotional Regulation, and Transactional Supports (SCERTS), which promote trust and play-based strategies while capitalizing on their strengths.

“If you can build upon those skills intrinsically through play, engagement, trust, relationship, and fun, it has a much more powerful and positive connection in the brain.  In addition, by using a variety of sensory toys, tools, and experiences, you enrich that learning further, activating more areas in the brain to make stronger connections quicker. We combine clinical experience, lived experience from disabled children and adults, and research, to get to the outcomes sought by the child and family.  This starts by connecting to them, becoming curious about their preferences, skills, routines, behavior, needs, and interests, thinking about the person as a whole and the family as a unit.” – Amy Rich Crane, Executive Director

Reach recently added a sensory room that focuses on co-regulation through each child’s preferred sensory strategies. Research has shown that children learn new skills through play (especially sensory enriched play) with nearly 200 fewer repetitions than by teaching it verbally or by practicing rote activities over and over. For this reason, the sensory room features specialized lighting effects, mirrors, a sensory fidget calming tool kit, a lego wall, obstacle courses which often include a ball pit, body socks, crash pads, a rock wall a light up table, music; all these tools can be used by the child in play, while also developing their coordination, planning, problem-solving and regulation skills, help them get to the just-right energy level and/or regulate big feelings that they need to work through.

Tools are picked based on child’s interest, strengths, and areas of growth, with the mindset that we all can benefit from coaching in learning new skills to be successful.  We use this model, instead of focusing on negative behaviors or challenges that may arise when a child is struggling to participate in their daily routines.  In outpatient therapy and child development, if the activity is not meaningful or have several components of fun for the child, then you’re doing it wrong, because all kids learn best through play.  Even as adults, we know we learn skills faster when we are interested in them, as intrinsic motivation plays a big part in learning.  When working with Autistic children we focus on respecting the way their brain works, meeting them where they are at, highlighting the good, helping them with goals that are meaningful to them, and helping their family advocate for their child’s needs in a world that is currently set up for neurotypical success.

“We want to work alongside Autistic individuals to help them grow their advocacy efforts, because it’s their life. They need to know that they are bright, beautiful, wonderful human beings that may face a lot of uninformed people, even well-intentioned people that may be missing the mark. If someone feels like they’re not being valued, or has shame or guilt being put on them, they need to know they can speak up and say, ‘My brain works differently– I need X, Y, and Z as atool,’ and know they’re being heard.” – Amy Rich Crane, Executive Director

When people ask why we do what we do, it’s all about supporting children, empowering families, and for moments like this, hearing Autistic voices say “At Reach I feel safe, I feel understood, and I feel like we are a team all working together to make change.”  – Amy Shaw, Neurodiversity Advocate and Mother.

Discover Reach’s specialized approach to affirming therapies that support Autistic children and empower their families at https://reachftt.org

To learn more about Autism Acceptance, visit https://autisticadvocacy.org/

How donations bring a non-profit clinic’s specialty programs to life

Donations are a critical source of support for nonprofit organizations, which rely on donations from individuals, corporations, foundations, and other sources to carry out their mission and programs. At Reach for the Top Therapy, the only therapy clinic in the Dover, NH, area offering interdisciplinary trauma-informed and neurodiverse-affirming therapies through a family-centered model, donations are the driving force behind supporting specialty programs for enriched care. 

Last year, Reach received close to $200,000 in grants and donations. These funds helped the organization exceed its goals, increasing the number of children and families served to more than 600 and expanding specialty services to 15 programs. One of the biggest achievements directly resulting from donations is a new multi-sensory room for Autistic and neurodivergent children that aligns with the shift from traditional therapy models to ones that accept and advocate for those with disabilities, that are shaped by the voices and experiences of Autistic adults and children and anyone with sensory processing challenges: 

“We are committed to adapting to the needs of those we serve and doing so in a way that accepts and respects their needs.  With this in mind, we designed a calming space-themed sensory room where children feel comfortable and safe. It is designed for sensory play and equipped with lights, sounds, mirrors, crash pad pillows, fidgets, toys, and a rock wall to help with assessing and meeting each child’s individual needs for regulation. As a complement, we also created a visual space where children have access to assessments and functional vision training to help them strengthen their vision, due to current estimates that over 40% of neurodivergent children have an underlying vision disorder that’s not diagnosed or treated.  With over 80% of what we learn comes through vision, this is a critical need we are prepared to meet at Reach” – Amy Rich Crane, Executive Director

A generous grant of $132,000 allowed the organization to facilitate continuing education for therapists, and to focus on fully developing a workplace culture where everyone can thrive. The investment of funds into therapeutic skill development, hiring, and training ensures that children can continue to get the high-quality, advanced, and specialized care they deserve. Following organizational improvements and staffing changes in the summer of 2022, Reach’s full-time therapist retention rate has steadily remained at 100% with a team that is working together, engaged, and empowered to make big things happen at Reach, including their own growth. The commitment to hiring and supporting the right team members also makes a positive impact on the children and families served who develop strong therapeutic relationships with their therapy team. 

Donations help Reach fulfill its Neurodiverse Affirming Mission

In 2023 Reach looks to expand its fundraising efforts led by the Executive Director, the Board of Directors, and the Development and Fundraising Coordinator, Katie McGrath, who is responsible for drafting grant applications and developing fundraising activities. Although a significant portion of Reachs operational expenses is covered by appointments and insurance payments, what allows the organization to deliver on its mission is the additional donations and support received from donors and grants: 

“Without the additional financial support from donors, further development of specialty programs, parent support groups, and continuing education for therapists wouldn’t be possible. Initiatives like our Giving Tuesday campaign, social media appeals, our annual fundraising event in the summer, and other events are very important to us.” – Katie McGrath, Development and Fundraising Coordinator 

All the accomplishments and work behind the scenes are done toward the same objective: that children with exceptional needs thrive when their families are empowered and their strengths are valued!

Get involved and help Reach continue to expand and thrive

There are several ways you and the community can help Reach expand its network of donors. The first is donating to fundraising initiatives taking place throughout the year. And if you can’t contribute, raising awareness and sharing the campaigns are also a great form of support. Below are some of Reach’s fundraising activities planned for 2023: 

As we enter the new season, Reach seeks to get the community involved in its Amazon Wishlist. This is a simple way to have a proven impact, as any individual can purchase the materials the organization needs for its daily therapy sessions. These can range from toys to stickers, to coloring supplies, or materials for sensory activities. 

NH Gives is a 24-hour statewide online fundraising event, initiated by the NH Center for Nonprofits, designed to “build community and connect donors with local nonprofits.” Reach is currently looking for corporate sponsors to match donor dollars, to increase the impact of every donor dollar given.

  • First Annual Reach Art Auction – August (more details to come)

The First Annual Reach Art Auction will highlight art created by children with disabilities during their therapy sessions with their therapists and family. Not only does this provide a platform to spread awareness of what is being done at Reach through play-based work, but also engages children in a fun skill-building activity, bolstering their confidence.  Reach has also begun receiving pieces of art, donated by local artists for the auction, which is another way the community can contribute.  Contact the Reach team if you are interested in donating a piece of original artwork to be auctioned!

What we can do together

It’s becoming harder and harder to grow in the current economy. Reach has been met with increasing costs of rent and utilities, nationwide hiring shortages, and decreased attendance rates in pediatrics due to atypical and ongoing illness seasons (super-bugs, Flu, RSV, COVID-19), paired with the onslaught of New England snowstorms this year.  So, Reach is making a big strategic transition away from primarily insurance-based revenues to a combined approach based on philanthropy, by developing partnerships with donors that care for the well-being of children and families.  Grants, donor partnerships, and fundraising will provide the increased support Reach needs, so they can continue to grow the opportunities available to the community, continue to hire exceptional therapy professionals, and always be able to provide that one-on-one enriched family-centered care they’re committed to.  Donor support plays a pivotal role in improving the quality of services, specialty programs, and initiatives at Reach. When you partner with Reach for the Top Therapy Services, you give more than money, you give incredible opportunities that help children with exceptional needs thrive within our community.

Join Reach on the mission to help children and families with exceptional needs: Click here to donate today.

Grow your Career through the Junior Leadership Program at Reach

Reach for the Top is a non-profit organization and the only therapy clinic in the Dover, NH, area offering interdisciplinary trauma-informed and neurodiverse-affirming therapies through a family-centered model.  Based on the uniqueness of their service delivery to meet the needs of children and families, they are committed to contributing to the education of the next generation of therapists and leaders.

Through a Junior Leadership Program, therapists with the desire to take on greater challenges outside of typical therapy-based growth and development, are able to interview for additional roles that collectively make it possible to provide the many specialty services available at Reach to meet the ever-changing needs of the community. These additional responsibilities directly support the organization’s commitment to connecting with the community, being informed by their needs, while also building upon the employee’s skillset, inspiring voices and ideas internally and externally that ultimately grow the organization.

Employees in Junior Leadership roles excel at and further strengthen their time management, organization, interpersonal skills, prioritization, and goal-directed persistence through these roles.

The organization also provides a six-week mentorship program for all employees on-boarding that allows each therapist to build a caseload while learning more about Reach‘s core values and therapeutic standards, including best practices in documentation, while also learning about and accessing the vast array of education and mentor-based learning opportunities available. The opportunities for education include sponsored continuing education, weekly lunch-and-learns, case care coordination, and weekly team time to maintain the positive and connected culture Reach has worked hard to develop over this last year.  Reach is committed to supporting each employee by coaching and recognizing individual performance while giving them the tools to optimize their growth.  This supports the employee while meeting the organization’s mission to provide high-quality care.  The current team has shown the highest levels of cohesiveness, inclusiveness, collaboration and professionalism that the organization has ever seen.  Continuing that growth in culture is a priority for Reach in 2023.

In addition to mentorship and junior leadership opportunities, the organization also hosts 4-8 student fieldwork/externships, observation hour placements, and/or CFY placements throughout the calendar year.  Sharing our experience with the next generation of future therapists and learning from each student that passes through and/or joins the team following graduation.

Work on your passions while gaining leadership and communication skills

With hiring and team expansion as another top priority for 2023, the organization has growth opportunities for more experienced professionals and opportunities for new therapists as well.  Over the last year, several therapists at Reach have implemented passion projects, where staff pitch their ideas to the leadership team for program development.  The leadership team then assists in co-creating a roadmap to turn their ideas and passion into a reality, expanding the opportunities for specialty services for both staff and the exceptional children and families we serve.

Rachel Babcock is the Community & Client Services Coordinator and a Speech-Language Pathologist at Reach. Beginning in social media and outreach for the organization, she was afforded the opportunity to expand upon an idea around enriched thematic group activities. After COVID hit, she found that “families communicated worries about their child’s socialization due to limited playgroups or community outings. Many families also wanted a place to meet and collaborate with other parents about their child’s therapies.” Through Rachel’s observations, impeccable organization skills, ability to connect with others, and with the support of the leadership team around her, another specialty therapy service was created.

“Reach’s leadership team is always looking for ways for employees to grow their skills and expand on their interests and passions. I am grateful to work for a team that supports my ideas and passion projects. Some of the highlights of Reach’s leadership style emphasize strong communication skills with employees, always looking for feedback and ways to improve, and an openness to all communication and learning styles.” – Rachel Babcock

Katie McGrath is the Development and Fundraising Coordinator and an Occupational Therapist at Reach. In April 2022, as a new graduate, following 8 months of consistently demonstrating dedication, exceptional communication skills, and a natural ability to engage others, Katie entered the Junior Leadership position as the Development and Fundraising Coordinator. Her tasks include finding donors, researching and reaching out to foundations, drafting grant applications, collaborating with sponsors, and developing other fundraising opportunities, like our upcoming Art Auction this summer. Katie spoke of her experience:

“I believe so deeply in Reach’s mission and I find it so rewarding to work directly with kids, supporting them as they work so hard to reach their goals. On top of that, I’m in a position, with this leadership role, to connect with the community beyond our patients and families, raising awareness about this amazing mission we have here. As a non-profit organization, we do rely on philanthropy to help fill in gaps in funding, so we can continue to expand our services, therapist training, and access to care for the families that we serve.” – Katie McGrath

Robyn Thomas is now the Director of Clinical Services and an Occupational Therapist. Passionate about her work, Robyn has worked for Reach for almost 7 years as an Occupational Therapist.  Under new leadership, Robyn’s skills and passions, including her exceptional attention to detail, were recognized in her first Junior Leadership role as the Quality Assurance Manager in 2022.  Showing many strengths in that role, when the role of Director of Clinical Services was developed, she capitalized on her strengths and put many hours into developing areas of growth, asking questions, improving processes, and showing tremendous growth.  She excels at finding the win-win to support staff and clients with their needs.  Currently, she plays a large role in onboarding new team members, making sure that they feel supported by their mentor, and supporting the mentor in identifying strengths and weaknesses, then tailoring support needed based on communication and learning styles.  She says that mentorship is a “great opportunity for new staff, but also for current staff who are able to support newcomers. They are able to guide and help them, share their knowledge, help them manage workflow while giving the mentor leadership experience and building their confidence.”

Grow in your career as a Student Site Coordinator at Reach

Currently, Reach is seeking a Student Fieldwork Site Coordinator: The ideal applicant is an experienced physical therapist, speech-language pathologist, or occupational therapist. This position involves oversight of the student program and requires close collaboration with the 8 colleges and universities currently contracted for internships. 

Other requirements include:

  • Experience supervising students

  • Excellent written and verbal communication skills, including giving constructive feedback

  • The ability to match staff with students

  • Availability to supervise and provide support to staff members

Stay tuned, because Reach has plans to expand opportunities for additional junior leadership positions later this year.

Learn more about Reach for the Top Therapy Services by listening to the New Hampshire Children’s Trust podcast, New Hampshire Family Now, featuring an interview with Executive Director, Amy Rich Crane: Click to listen.

How Aquatic Therapy Benefits Children with Exceptional Needs

The aquatic therapy program at Reach for the Top is a sensory-enriched approach to Occupational, Physical, and Speech therapies, that focuses on using the properties of the water, to provide input to the brain and body through play.

What does aquatic therapy consist of?

As the name indicates, aquatic therapy consists of exercises and activities performed in the water, typically in temperature-controlled swimming pools. For children and families receiving care at Reach, the aquatic therapy program takes place at a local pool in the Dover, NH, area every Wednesday from 1 to 4 pm, in 45-minute-long sessions.

The partnership with this local hotel started in September 2022 and the families participating in this program have responded positively. Many parents are amazed at how much fun their children are having as they work hard on challenging skills that they often have more difficulty participating in on land. Robyn Thomas, who started the aquatic therapy program at Reach and is its current Lead and Clinical Supervisor, highlights that this program is designed to use each child’s current swimming ability, so that aquatic therapists can help children accomplish their goals by following the child’s lead, which is a philosophy that Reach highly values. This quieter time at the pool also provides a safe and motivating environment for children to learn and gain new skills through play, which is another one of the distinctive aspects of Reach’s family-centered approach.

Katie McGrath, one of the therapists in the aquatic program, agrees that this is one of the organization’s most popular programs: “Sometimes the biggest challenge is getting them out of the pool, as for some children, aquatic therapy almost makes them feel like they’re on vacation!”

What conditions can be treated with aquatic therapy?

There are many physical, neurological, cognitive, and sensory conditions that benefit from aquatic therapy programs such as arthritis, balance disorders, autism spectrum disorder, attention deficit disorder, muscular dystrophy, cerebral palsy, developmental delays, cognitive disorders, scoliosis, chronic pain, multiple sclerosis, tendonitis, and joint pain, among others.

At Reach, the aquatic therapy program is focused on children with exceptional needs who may struggle with emotional regulation, decreased strength, endurance, and/or balance, high/low muscle tone, delays in motor milestones, anxiety, sensory stimulation issues, and speech and language development. In a child-led model of therapy as play, patients of the aquatics program can use water to build up skills in a fluid environment to help them gain strength, independence, and confidence to participate in life’s activities.

What are the benefits of aquatic therapy?

Aquatic therapy has numerous benefits for children who have sensory processing and self-regulation challenges as water creates a unique, therapeutic environment by providing gentle and consistent pressure throughout the entire body. This creates a very calming effect for many children that tend to seek this out on land in large amounts (i.e., constantly squeezing themselves into a tight space, wrapping up in a heavy blanket, or wearing heavy/compressive clothing materials), increases attention span, and improves body-spatial awareness as this input allows children to be able to better “feel” where they are in space.

Furthermore, the weightless feeling gained from submerging the body into the water helps children develop and enhance their social-emotional skills because it allows children to feel lighter, which makes it easier for them to move in the water. This decreases anxiety, reduces impulsive tendencies, improves mood, and gives children more confidence to explore new ways to move their bodies that they might not be motivated to try on land.

Playing in the water is also very fun and motivating. One unique benefit of the location of Reach’s aquatic therapy program is that the majority of the other children in the water are also participating in aquatic therapy, which creates many opportunities for small social groups of 2 children with their occupational and speech aquatic-trained therapists to form during each session.

Moreover, aquatic therapy is also very beneficial for children participating in physical therapy. Children with low/high muscle tone, decreased endurance/strengthening, acute and chronic pain, motor planning/coordination challenges, and other physical conditions can use the low resistance that the water provides to enhance mobility, decrease pain, increase joint support, improve coordination, promote muscle strengthening, endurance, and enhance breath control, which is very important in speech therapy too. The aquatic therapy program at Reach is, like all the other therapeutic programs offered by the organization, child-led and respectful of each child’s skills and comfort level. For Robyn Thomas, this is what allows for every session to be different and to involve a wide range of activities:

“Typically, we play games, use toys, or do pretend play. One very popular activity that many of our younger children enjoy is scooping and dumping, while diving games are often played with many of our older children as examples. For kids that are more comfortable in the water, they often challenge themselves by creating multistep, underwater obstacle courses for more complex play. While at other times, these kids prefer to play basketball and might invite another child to join in with them. And we also offer poolside activities such as building water marble mazes on a wall for the kids who don’t know how to swim or who aren’t yet comfortable enough to go in the water. No matter what the swimming ability of the child is, there is always something fun for them to explore.”

For therapist Katie McGrath, aquatic therapy allows the children and the therapist to work in unique ways: “We work with a lot of kids that have difficulty with body awareness, and in the water, you get a lot of feedback every time you move. So, this is a fun way to learn and it can’t really be replicated in the clinic environment.”

How to become an aquatic therapist?

All of the therapists in Reach’s aquatic therapy program are required to obtain a specified number of certificate hours in aquatic therapy best practices, while also having the opportunity to expand that training through additional continuing education opportunities and/or mentorship. And as Reach employees are encouraged to pursue their passions, the organization also provides additional support to help therapists fulfill the training requirements for areas of interest. Robyn Thomas, who started the program, saw the Aquatic therapy program as an opportunity to share her passions as an occupational therapist, swimmer, and former lifeguard:

“When the opportunity to start a new program at Reach came up, I was eager and excited to volunteer. I have over 11 years of experience as a competitive swimmer, and swimming has always given me so much joy in my life. Even at a very early age before I started competing, I was always eager to find a pool to swim in. I just loved the feeling of swimming underwater because it is fun, gave me confidence, and made me feel invincible because I taught myself to do unique things like: doing ten backwards somersaults in slow motion, or balancing while walking underwater in a handstand position without my hands ever touching the bottom of the pool. I wanted to share this excitement and passion with the families I provide OT services to at Reach, so that each child can experience this same type of joy and confidence while working on their therapeutic goals in a fun and motivating way.”

Whereas Katie McGrath, who joined Reach last year as a newly graduated occupational therapist, sought training in aquatic therapy before starting this new position, which helped her be more comfortable in the water.

Find your dream therapy job at Reach for the Top NH

As the Aquatic therapy program and other specialty programs at Reach expand, so does the need to onboard more therapists to serve more families in the Seacoast. Currently, with a staff of almost 15, Reach is looking for more physical therapists and speech therapists to join the team. Additionally, a new student coordinator position has been added as an opportunity for any Occupational, Physical, or Speech Therapist to become a junior leadership member of the Reach team as the organization’s student program continues to expand.

With hiring as one of the top priorities for 2023, the organization has growth opportunities for more experienced professionals, as well as opportunities for new therapists. If you’re interested in working as a therapist, or know someone who might be, visit the vacancies below:

Physical Therapy: https://www.indeed.com/viewjob?jk=ae6841a29ff9ee0d

Speech Therapy: https://www.indeed.com/viewjob?jk=0b124c75cac3c060

StudentCoordinator: https://www.indeed.com/viewjob?jk=a5f2b249b6da41c8

Reach for the Top NH is a non-profit organization and the only family-centered clinic in the Dover, NH, area offering interdisciplinary trauma-informed and neurodiverse-affirming therapies.

New Hampshire Non-Profit Wraps up 2022 with 15 Specialty Programs, Over 600 families served in the Seacoast, and nearly $200,000 in Grants and Donations

New Hampshire non-profit wraps up 2022 with 15 new specialty programs, over 600 families served in the Seacoast, and nearly $200,000 in grants and donations

This year was a successful one for Reach for the Top, a non-profit organization which provides outpatient occupational, physical, and speech therapy services focused on a family-centered model. Under new leadership since 2021, it is the only clinic in the Dover, NH, area offering interdisciplinary trauma-informed and neurodiverse-affirming therapies to children with exceptional needs.

The clinic’s strategic focus for 2022 was to further develop specialty programs – like hippotherapy, aquatic therapy, parent support groups and a new life skills room; invest in therapists’ continued education, create new leadership positions, expand fundraising and push for best practices concerning diversity and inclusion of people with disabilities. And data from the yearly roundup confirms that these goals were indeed met.

Keep reading to know more about all of Reach’s achievements in 2022!

A consolidated mission, record fundraising results and thriving children and families are the top milestones of 2022

One of the key accomplishments of the year was the revision of Reach’s mission and vision under the mantra “Nothing About Us, Without Us”, which expresses the conviction that people with disabilities know what is best for them. This reflects the values of the five women with disabilities that lead the organization, and Reach’s mission now emphasizes tailoring services to the needs voiced by those served, with a focus on empowering the family, and providing trauma-informed, respectful, and affirming therapies, all to ensure the child thrives.

Due to the success of this family-centered mindset, in 2022, the organization gathered several parent testimonials highlighting the positive impact of therapy, including more participation in extracurriculars, the ability to make friendships, developing healthy family routines and relationships, fewer expulsions from school, and lots of growth.

“Starting OT services at Reach was one of the best decisions I ever made for my 6-year-old son. His therapist knew right away how to ease his anxiety about overcoming challenges and creates endless opportunities for him to have fun while working on skills that he has been struggling to master. I, myself have learned how to understand my child better and we’ve formed a deeper connection because of our experiences here.”

And to bring its refreshed mission to life, Reach expanded the platforms and ways of making donations, with the fundraising teams securing five new major donors. As a result, in 2022, Reach received nearly $200,000 in grants and donations to support and develop specialty programs, and to focus on fully developing a workplace culture where everyone can thrive. These funds allowed the organization to increase the number of children and families served to more than 600, and to expand the offer of specialty services to 15 programs.

Agile leadership and continued education were key developments this year

On the human resources front, Reach also achieved notorious developments. Not only did the organization grow its board of directors to nine highly skilled and passionate individuals that are ready to push it forward strategically, it also created additional junior leadership opportunities, bringing more voices and passion to the decision-making table. In 2022, junior leads’ initiative was rewarded with additional paid time off. And to support new-hires as they acclimate to the organization, this year also marked the creation of a new onboarding mentorship program.

Following the leadership changes last year and the updating of Reach’s core mission and vision, the teams worked on alignment and healthy communication using the DISC assessment, which describes four main personality profiles: D is for Dominance, I is for Influence, S is for Steadiness, and C is for Conscientiousness. The goal was to ensure that everyone shares a positive, growth-centered, team-focused mindset and understand differences in communication styles, which is of value when hiring new staff.

Moreover, investment in learning and training for therapists is one of the top priorities for Reach as it ensures that children and families are getting high-quality care, and it allows the therapists to further their passions and skills. In 2022, each therapist took anywhere from 30 to 200 continuing education credits to further develop their skills, and everyone participated in knowledge sharing sessions with the team following completion of the course, sparking new thoughts, strategies, programs, and outcomes. The organization also developed a quality assurance program to provide support to therapists and the administration relating best practices in documentation and overall compliance.

2022 was the year to connect with the community and raise awareness about the inclusion of people with disability

And finally, nobody would know 2022 was a great year for Reach if it weren’t for the organization’s efforts in communications, advocacy and spreading awareness, governance and structure, further supported by consultants Gayle O’Connor from HR-ROI, Christine Strong from Strong Resource Group, and Molly and Maria from GoodWork. The most visible achievement of the year is the design and development of Reach’s new website, which captures and promotes the work that is being done, thanks to collaboration with Kelly at TapHouse Media.  Reach’s social media efforts were also more thoroughly developed thanks to a new junior leadership position, focused on community and client relations.

Other initiatives carried out in 2022 include participating in in-house and public events around the topics of therapy and disability. For example, Reach’s Director Amy Rich Crane was part of a local trauma panel with 3 organizations and 2 police departments this year, talking about Reach’s efforts in trauma-informed therapies and spreading awareness of the need for care and support available. Moreover, the organization welcomed nine guest speakers throughout the year to talk about their disabilities, diversity, inclusivity, best practices, and unique ideas for pushing the needle forward with therapy.

Reach also established a new partnership with the University of New Hampshire (UNH), three local schools in Dover, and other non-profits as part of efforts to strengthen the community and spread disability advocacy awareness. The partnership with UNH is in addition to Reach’s collaboration with over 8 graduate schools, of which Reach consistently contributes to the next generation of students learning, which also brings in the latest ideas and research into the clinic with graduates that could later join Reach’s staff.

A growing team and reaching more families are on the horizon for 2023

Next year, Reach aims to further develop the leadership mindset where everyone’s voice is heard, and families also have a say in some of the organization’s decisions. Being a family-centered therapy clinic is the cornerstone of Reach’s identity and it has been proven this is a successful model. One of the key goals for 2023 is to expand hiring and bring on new members to the great team of experts already working in the organization.

Efforts to continue raising funds to offer quality services and additional specialty programs are year-end priorities, as is continuing to strengthen partnerships with local organizations that support Reach’s activity. In the end, all the accomplishments and work behind the scenes is done toward the same objective: that children with exceptional needs thrive when their families are empowered, and their strengths are valued!

What type of therapy is right for my child?

Reach for the Top now has 15 specialty therapies to choose from


Reach for the Top, a non-profit clinic in Dover, New Hampshire, provides therapeutic services to children with exceptional needs. Under new leadership since 2021, the clinic went from offering 7 specialized therapies to 15, all with family-centeredness at the heart of what they do, but now using a trauma-informed and neurodivergent affirming foundation as well. In this family-centered clinic, which is one of the things that sets it apart from otherin the Dover area, families can choose and combine more common approaches with innovative specialty services to develop a custom and individualized plan to supporting their child. 

What types of therapy are provided? 


Occupational therapy 

Occupational therapy helps children better navigate their environments through sensory experiences and play-based activities. Once children feel comfortable with their bodies, they are able to interact effectively with their peers and community, build friendships, play, and meet their own self-care needs, being able to gain independence is caring for themselves during daily routines, from feeding themselves, to dressing, bathing, hygiene, sleep, and more. Developing a sense of mastery while gaining independence in self-care areas is crucial to developing their executive function skills and in developing their self-esteem. 


Speech therapy 

Speech therapy encourages communication and language development to help children express themselves to their fullest potential and connect with their family, friends, and others in their community. Speech and language therapists teach children the tools to effectively interact with others, whether it be through verbal language, sign language, pictures, written language, technology or a combination of several. This allows them to build relationships, communicate their needs, and gain independence, creating a future of success. 


Physical therapy 

One of more commonly known types of therapy is physical therapy, where therapists help infants, children, and teens develop their gross motor skills, i.e., crawling, walking, running, jumping, climbing, working on strength, posture, endurance, speed/efficiency with motor tasks, coordination, and more, in order to be able to navigate their environment, play, and participate in their everyday routine activities that are important to them and their family. 


What specialty therapies and services does Reach provide? 

1. Hippotherapy Hippotherapy is the use of a horse’s movement to build strength, improve coordination, and so much more. This specialty approach to therapy can be beneficial for children with neurological conditions, as it facilitates the improvement of musculoskeletal system alignment and can also decrease pain and/or help children use their body more effectively during daily tasks.  It also provides tons of proprioceptive and vestibular sensory input to children that seek movement.  Being in the barn and with the horse helps children work on sequencing and following directions, safety concepts, and animals have a regulating therapeutic benefit of their own.  The children work on fine motor, gross motor, and vision-based skills at the barn, just like they would at the clinic. We have an excellent relationship with a local farm, have more therapists trained in this therapeutic tool, and have been able to expand this service to more families this year! 


2. Brace clinic For children in need of orthotics, hand, ankle, leg braces, or other medical supportive devices, Reach for the Top runs a brace clinic in partnership with an Orthotist Prosthetist focusing on being fitted for the right equipment to support mobility, posture, decreased pain, and much more, to help children with physical challenges fully participate across environments with the tailored support they may need 


3Infant Torticollis and Plagiocephaly Program Torticollis is when infants have head tilt and difficulty turning their necks, and plagiocephaly is when the back and/or the side of a baby’s head is flattened. Reach for the Top offers a specialized therapy program to address these conditions, which are highly treatable through therapy, a home program with focus on stretching through play, positioning, and sometimes corrective helmets, which Reach can have assessed at the clinic by a specialist. 


4. Therapeutic Listening & Quickshifts Therapeutic listening is a sound-based therapy developed to support children and teens who experience difficulties with sensory processing challenges. It provides stimulation to the auditory system through the use of specifically created music that stimulates the nervous system and the areas of the brain, which can have dramatic effects on the child and is a one of the unique supplemental specialty therapies provided 


5. Sensory Garden Through generous donations from Lowes and in collaboration with the Dover local library, Reach therapists and children have been able to put in and continue to cultivate a sensory garden, that has flowers chosen to activate different parts of the sensory system, and components to help children use their bodies, follow directions, and connect with nature. Our children, families, and therapists, love to focus on getting outside, jumping, climbing, digging, and using their senses to feel connected to themselves, others, and the Earth. 

6. Feeding therapy Feeding therapy supports parents and their children to ensure health, wellness, and participation in family mealsSome feeding and swallowing concerns are addressed in speech therapy and some are addressed in occupational therapy, regardless feeding therapy focuses on creating positive eating and drinking experiences to improve the childs overall mealtime routine and create positive associations with food. At Reach for the Topour feeding therapists have some of the top training available, including  in the SOS approach, food chaining, the Get Permission Approach, infant latch and transition to foods, transitioning from tube feeds to oral feeds, post-tie release, and the SOFFI protocol. 


7. Teletherapy Services During the COVID-19 pandemic, Reach was able to get additional trainingcomputers, and develop a teletherapy program where therapists are continuously supported in providing best-practice virtual occupational, physical, and speech therapies, to children and families within their home to help adapt to the family’s needs, continue care during mild illness, and overcome transportation challenges, including during bad weather. 

8. Aquatic therapy Reach’s new Aquatic therapy program is a sensory-enriched approach to Occupational, Physical, and Speech therapies, that focuses on using the properties of the water, to provide input to the brain and body to help with regulation, participation, strengthening muscles and developing motor skills, and speech and language development, all through play. We find so many of our children find a real connection to the world through water and can learn some skills faster than on land.  We partnered with a new facility this year and have had the ability to provide more appointment times with more space and fewer costs to family, a real win-win!


9Neurodiversity and Trauma Parent Support Groups & Networking Reach developed a new parent support group program this year, where during thematic social groups for neurodiverse children and those impacted by trauma, the parents were able to connect in person, or via electronics, connecting them to other parents that are navigating challenges, systems, and therapies as they try to find the path that works best for their family. 

10Thematic Social Groups  Reach developed structured social groups where children that struggle with making friends and connecting with others were able to come to group with their 1:1 therapist and make those connections more naturally through play and not through drills. The children have weekly themes with fun games, art projects, motor challenges, and snacks to develop those skills with the support of their therapist in the context of play with friends. This approach aligns with a neurodiverse approach where the child is supported, while their unique traits are celebrated, not eliminated. 

11. Trauma responsive child-led therapy While all the therapies available at Reach for the Top are performed through a trauma informed lens, services offered also include specific trauma responsive therapies with DIR/ATTAcH/SAFE PLACE trained therapists that focus on supporting children and families that have endured adverse childhood experiences and need collaborative care, with focus on safety, attachment, sensory challenges secondary to trauma, and considers trauma precautions, as they focus on participating in meaningful and necessary routines at home.  Reach also commits to an ongoing trauma education and consultative mentorship with a professor from Northern Arizona University to further our skills in this area.


12New Life Skills Room Thanks to a donation from Lonza Biologics, Reach was able to turn their feeding room into a comprehensive life skills space with a countertop and the necessary supplies to prepare simple meals; a cash register and shopping games to practice many necessary skills; a letter writing mail station to work on writing, communication and bill paying; a laundry washing and drying station; and other fun tools to help bridge the gaps and prepare children for chores and early adulthood through practice and play. 

13. New STEM & Nature Nook Space Thanks to a donation from JPAC, Reach was able to create a new space in the clinic where STEM (Science, Technology, Engineering, and Math) concepts come alive with hands-on building and learning toys and activity kits, with problem solving science experiments that develop a child’s thinking skills and an area with all natural materials that can be weighed and categorized, used to make crafts, be used in imaginary play, as part of sensory bins, and for math concepts. Enriching children’s lives with natural materials that can be found at home and outside, and with fun ways to learn skills that will lead to a lifetime of problem solving. 

14. Animal Assisted Therapy Reach is in the process of getting a certified therapy dog for the clinic. Adding an animal to therapy uses the power of the human-animal bond to help children feel more relaxed in sessions, to work on social, communication, and regulation skills.  

15AAC Evaluations for Devices In 2023 we plan to start monthly AAC Clinics to allow our therapists the necessary time to evaluate, analyze and interpret, and write up their findings to help more children gain access to their devices in quicker time. Supporting our children, families, and staff in making this happen, so that children with communication challenges can use other strengths to find a way to communicate where they feel confident, successful, and get their needs met. 

How do I know what type of therapy my child needs? 


Choosing a type of therapy that will follow your childs development is something you dont have to navigate alone. At Reach for the Top, families are invited to be part of the team, starting with the initial intake and then the first visit – an evaluation where the therapist will ask questions to determine what concerns the family has, how it is impacting the childs daily life, as well as strengths and interests the child has. 

Skilled observation by a therapist then determines what factors may be impacting the childs ability to participate in necessary tasks, and together with the parents, or caregivers, they co-create meaningful goals that are within the clinics scope of practice and are meaningful and necessary to the child and family. Health insurance coverage is also taken into account at this stage of the evaluation, so that families can make informed choices.  

The therapeutic team at Reach for the Top is always available to answer questions and provide insight into what therapy might look like. The goal is that every family feels like they gain a better understanding of their childs needs as they relate to the childs overall development and co-create a plan to help their child become successful, in a respectful, holistic, connected, and playful way that honors their strengths, interests, and values.

Nothing About Us, Without Us

“Nothing About Us, Without Us” – Meet the women leading the first family-centered therapy clinic in Dover, New Hampshire

Reach for the Top is a non-profit organization that provides therapy services focused on a family-centered model. Led by five women with disabilities, this is the only clinic in the Dover area offering trauma-informed and neurodiverse affirming therapies under the mantra “Nothing About Us, Without Us”, expressing the conviction that people with disabilities know what is best for them. This slogan became the rallying call for the 2006 United Nations Convention on the Rights of Persons with Disabilities, which emphasizes how people with disabilities must be valued as integral and essential contributors to every sector, industry, and community.

Living with disabilities, women behind the wheel at Reach draw upon their personal experience and passion to make the organization a safe space that empowers children and families to co-create the therapeutic strategies that will work for them. One of the things that set Reach for the Top apart from other clinics is that families not only participate in the therapies, but they also participate in decision-making. Following a transformational approach adopted under new leadership in 2021, this team knows very well the importance of inclusion, and these women seek feedback constantly to make sure that everyone’s voice is heard so that the therapy model can be continually tailored and improved.

Advocating for a world where children with exceptional needs thrive

Amy Rich Crane has worked at every level within Reach for the Top, from treating therapist, to Clinic Coordinator, and is now Executive Director, growing alongside the organization and current team. She is committed to family-centered care and to ensuring each family’s voice, needs, and participation are included in every session from evaluation to discharge.

Experiencing Sensory Processing Challenges since a very young age, receiving an Anxiety diagnosis following her father’s suicide as a child and ultimately diagnosed with Ehlers Danlos Syndrome (EDS) at age 30, Amy believes that “feeling ‘othered’, ‘broken’, unable, confused and ashamed of being different, in the past” led her on her own journey to wellness, and has pushed her to advocate for those that have felt similarly, that were excluded, couldn’t find answers, dismissed without care, or misunderstood: “They are the people I feel I can most authentically connect with and enjoy learning from each of their individual experiences. Connecting with them and seeing them achieve their goals and dreams is the most rewarding and fulfilling experience and pushes me to continue to advocate alongside those with disabilities.”

As a patient, a therapist, and a mother with a child in therapy, Amy recognizes the positive impact that therapy has had in her life: “I have had physical and occupational therapy for orthopedic injuries, strength and physical challenges, on and off, from my teens through my 30’s. I have learned much about my body, how to advocate for my needs, and also how difficult it can be to fit in the recommended home exercises needed to progress. As a mother, seeing your child struggle, show signs of physical challenges and wanting to help them thrive has furthered her belief in finding therapy services that support the child and family.” Being a dual-Board Certified Pediatric Occupational Therapist with several specialty areas of practice, Amy considers an engaging play-based model with the family highly-engaged, to be the best approach to help children reach their greatest potential, and for this reason, she adapts each session, her strategies, and family education to meet the needs and interests of each child and family, with the goal that they leave every session feeling a little more empowered and successful than when they came in and that they have fun in the process.

Much like Amy, Reach’s Director of Clinical Services, Robyn Thomas, has experienced how this approach provides such a strong, positive, and powerful impact into the lives of others: “From a young age, I knew that I had a passion to have a career in which I could work with children and their families. Before becoming an Occupational Therapist, I had always been drawn to finding opportunities that allowed me to connect and play with children and their caregivers through summer camps, nannying, before/after school programs, etc…” Her involvement in Reach for the Top began as she became interested in the organization’s strong values towards family-centeredness and neurodiversity, qualities that both personally and professionally she strongly believes in, as a neurodiverse person who has been dealing with ADHD, non-verbal learning disability, and anxiety throughout her life.

Robyn also experiences disability through the lenses of a mother with a child in therapy: “My oldest also has a diagnosis of ADHD and my middle son was born with a posterior tongue tie that has been removed twice, and holds a diagnosis of expressive language delay with motor planning challenges. My experiences lead me to really become more understanding and compassionate for others who are challenged by their individual differences. Both of my children have learned to appreciate the value of setting goals for yourself and accomplishing them. And, as a mom, it is so much fun to be with the in the moment they overcome a difficult task or challenge for the very first time.”

With a Bachelor’s Degree in Psychology and a Master’s Degree in Occupational Therapy, Robyn utilizes her over eleven years of experience as a competitive swimmer and lifeguard to develop Reach’s Aquatic Therapy specialty program. For Robyn, “being on a swimming team helped me set goals for myself, it taught me discipline and the joys and pride that came with accomplishing something that was difficult, yet fun to go through that process at the same time.” This mindset helps her, alongside other therapists at Reach, to create a therapeutic environment providing fun, motivating, and meaningful experiences so that children can enjoy learning, connecting with each other, and reaching their goals with their families.

For Rachel Babcock, a speech-language pathologist and the Community & Client Services Coordinator at Reach for the Top, the clinic’s play-based approach to therapy with children is what drew her in: “I am a child at heart and see the value in learning through play. I believe teaching communication skills in a playful learning environment is the best way to foster each child’s strengths for building speech-language skills.”

Struggling with mental illness stemming from traumatic experiences during her childhood, Rachel regularly sees a therapist and a counselor to continue to learn about managing an anxiety disorder: “I have learned so much about my brain and body’s needs through positive self-talk, breathing strategies, healthy eating habits, exercise, and mindfulness, which has helped me continue to grow and be more confident.” She considers that this first-hand perspective helps her as a speech-language therapy: “I see children face the trauma of not being able to communicate their feelings, being unable to be understood by their parents, unable to talk to others to make friends, or feeling less than others because they stutter or have a voice that sounds different from their peers. Having an anxiety disorder, I feel connected and committed to supporting my clients who feel constant worry or fear about their voice not being ‘good enough’”.

At Reach for the Top, each therapist works hard to provide family-centered care in a way that is authentic. The teams value each other’s strengths as therapists and build off of them through teamwork and collaboration. An example of this is Katie McGrath, a Board-Certified Occupational Therapist and Reach’s Development and Fundraising Coordinator, who works closely with Amy, the Executive Director, to look for and organize opportunities to raise funds to support the social work done by the organization. 

Katie truly values the culture at Reach that supports constant learning and growth: “There is not a day that goes by that I do not learn something from one of my co-workers, whether it is from asking direct questions or observing the work they do. We have incredible support when it comes to accessing resources and training to help us provide quality care that meets each family’s individual needs. We also are encouraged to pursue our passions and find a way to bring it to Reach and the families that we support.”

This learning mindset is precisely what brought Katie to collaborate with Reach: “After completing a fieldwork as a student in outpatient pediatrics, I knew that I wanted to find a job after graduation in this setting. I also knew that opportunities to continue to learn were important to me. I could tell immediately that I would be able to combine the two at Reach.”

Katie is also on her own journey dealing with a disability, and regrets not having accessed therapy growing up, as she and her family were not aware of her needs: “I knew people in my life with a diagnosed anxiety disorder and thought that it would be unfair to say that I had an anxiety disorder because, to me, it did not seem like my anxiety kept me from participating or being successful in the things that were important to me, so it ‘didn’t count’. Recently, I learned more about high functioning anxiety and have been going through a life changing revelation.” Having recognized the way her anxiety impacts her life has given Katie a lot of perspective when working with children. She is able to look at surface level behavior and recognize that it may be stemming from anxiety.

Reach’s Office Manager, Karen Begin, shares a similar journey. After years of acquiring multiple chronic health issues and growing up in an era of soldiering on, Karen has recently been opened to the idea of not having to endure her symptoms without support. She is cared for by a team of doctors and specialists to help with chronic pain and with medicine, dietary changes and low-cost accommodations to support her joints and vision at work, she is living with much less pain on a day-to-day basis.

For Karen, another source of relief is: “the strategies and support of the wonderful women at Reach to help me with this on a daily basis, has been nothing short of amazing.” Because of this journey she brings empathy to her work when helping families access services at Reach, and accompanying them through their journey of achieving their goals and reaching their child’s full potential.

Leading with passion, perspective and openness

Through their work, as therapists, administrative staff, and leaders, these women embody Reach’s commitment to provide holistic, family-centered specialty programs all under one roof, by dedicated therapists with a passion for continual growth, to support children that have exceptional needs in ways they might not otherwise have access to, all while collaborating with and empowering their families and advocating for a more inclusive world, where those with exceptional needs are valued.

By bringing a personal perspective to their practice and decision making, the leadership team at Reach feels as connected, authentic, and supportive as they’ve ever been. With different stories but similar paths and challenges, each of the women working behind-the-scenes are focused on being at their best to provide the very best care – working hard and learning along the way, while laughing all day as a team and with the kids.