Building a Support Network: Reach’s Family-Centered Resource Wall

For parents and caregivers, particularly those of children with exceptional needs, the journey of finding top-quality care and providers who can both celebrate the child’s strengths and interests, while deeply understanding the underlying challenges that are impacting their child’s ability to thrive – can often feel like navigating a complex maze with many dead-ends, contradicting advice, and long wait times to access services. Recognizing these challenges, Reach for the Top Therapy, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies, set out to create a family-centered Resource Wall in their clinic to connect families with the right resources. This initiative aims to not only streamline access to care, but also to foster a community network where families can find support, understanding, and comprehensive solutions.

Sharing is caring: Sharing your journey can help another family navigate theirs

In March, Reach launched a survey to gather insights directly from families. The goal is to pinpoint the best providers for children with disabilities, drawing from the experiences and recommendations of those who have walked similar paths. This approach is rooted in the belief that sharing positive experiences can be transformative, connecting families with places and providers that have the necessary understanding and expertise for children with exceptional needs. When a family is in search of specialized care, the expertise and experiences with these professionals can make all the difference, especially amidst current provider shortages. However, the challenges often go beyond finding the right specialist.

Reach recognizes the importance of collaboration, particularly for complex children. This entails a team dynamic where all the providers involved in a child’s care – in hospitals or therapy clinics like Reach – communicate and collaborate effectively. By sharing perspectives, insights, and roles regarding symptoms and challenges, a more cohesive approach to care emerges. This stands in stark contrast to typical models of isolated care, where all the providers and specialists working with a patient don’t communicate between themselves. As a result, differing opinions and advice can leave parents confused and overwhelmed.

“Specialty hopping” is draining – both emotionally and financially

Many families are probably familiar with this scenario: A doctor refers a child to another specialist, only for that specialist to do the same, leading to a cascade of referrals without concrete answers. This “specialty hopping” not only delays access to necessary care but erodes trust in the healthcare system. Families are left on waitlists, navigating a maze of appointments, while symptoms persist, and the underlying needs of the child remain unsupported.

Additionally, this also has a significant financial impact. Each referral, each specialist visit, and each test incurred in this fragmented journey comes with a cost. This communication breakdown among providers doesn’t just cost families – it affects insurers, taxpayers, and all stakeholders involved in the care ecosystem. It’s a cycle that drains resources, time, and ultimately, hope.

This is one of the reasons why Reach’s Resource Wall is a game-changer for the Dover, NH, community. It’s a source of hope and efficiency in a landscape often clouded by confusion. By compiling a curated list of local, vetted providers and services, Reach is empowering families with a roadmap to navigate the complex terrain of pediatric care. This resource wall extends beyond doctors and specialists; it includes childcare centers, transportation services, haircut salons, local farms, and more. It’s a holistic approach to supporting every aspect of a child’s life, recognizing that their needs transcend medical appointments.

Connecting Community Services

This innovative family-centered resource network is aligned with Reach’s mission to empower families and advocate for children with exceptional needs, supporting a trauma-informed and neuro-diverse-affirming approach. By leveraging the expertise of their therapists and reaching out to local organizations, Reach is building a robust network of support. Over the last six months, Reach has engaged with various community nonprofits and businesses to deepen its roots and understanding:

Dover Children’s Home

  • Dover Children’s Home is a non-profit residential treatment program committed to providing high-quality support and services to some of New Hampshire’s vulnerable youth and their families. Reach’s team sat down with Director of Treatment Services Sarah Gordon and Clinician Savannah Fay to learn about their strength-based approaches to serving youth who have faced significant trauma. This collaboration aims to provide Sensory Groups to support these youths, fostering growth and healing.

Snapology of Dover NH

  • Snapology is a Discovery Center designed to help children explore STEM and STEAM activities through classes and creative play. This partnership allows Reach to host therapy sessions for Occupational Therapy (OT), Speech-Language Pathology (SLP), and Physical Therapy (PT) in a dynamic and engaging environment. For young learners, this hands-on approach is not just therapeutic, it’s fun!

New Hampshire Family Voices

  • New Hampshire Family Voices is part of a network of families and friends of children and youth with special health care needs/disabilities around the nation. Reach’s team met with Associate Director Sylvia Pelletier and Outreach Coordinator Deanna Taylor, who shed light on navigating the healthcare world for children with disabilities. This organization provides contacts for specialists and a lending library of books tailored to various disabilities, offering invaluable resources for families. They are top experts in navigating the complex maze of medical supports for NH.

The Children’s Museum of New Hampshire

  • A collaboration with the Children’s Museum of New Hampshire allows therapists at Reach to have the opportunity to host therapeutic visits during the “Exploring Our Way: Sensory Friendly Playtimes” and regular hours at the museum. This inclusive environment allows children with exceptional needs to thrive, free from the overstimulating noises and crowds, then applying those skills learned with their family during typical hours.

1000 Hours Outside

  • Aligned with the mission of encouraging outdoor activity, 1000 Hours Outside promotes the importance of movement and exploration. This initiative resonates deeply with Reach’s holistic approach to care, recognizing the benefits of nature for children’s well-being – but also with two of its specialty programs “Branch Out” – outdoor peer groups and the Community Sensory Garden program in collaboration with the Dover Public Library and several garden centers in the area.

In essence, Reach for the Top Therapy’s family-centered Resource Wall is a symbol of collaboration, empowerment, hope, and the strength of community. It represents a commitment to providing not just medical care, but a comprehensive support system for over 300 patients with exceptional needs and an additional 600 patients the clinic projects to serve this year alone.

As Reach continues to expand its network, families gain access to a wealth of resources, providers have the opportunity to collaborate transparently, and the community becomes a more inclusive and supportive space for all children, all while ensuring they reach the right resources sooner.

The Transformative Power of Neurodiverse-Affirming Therapy

At Reach for the Top Therapy, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies, every story begins with a child, a family, and a dedicated team of therapists committed to making a difference. Founded on the principles of inclusivity, empowerment, and a deep understanding of diverse needs, Reach for the Top is not just a therapy clinic — it’s a lifeline for families navigating the complexities of neurodiversity and trauma.

Parent Testimonials: Stories of Transformation

Offering a wide range of therapy services, with 18 therapy options and specialty programs through physical, occupational, and speech-language therapies, Reach for the Top Therapy operates in a distinctive family-centered empowerment model. The families that choose Reach are led by employees with a collective 122 years of experience who focus on meeting the family where they and their child are, bridging any gaps, learning from each child and family, and providing education to carry over the skills to the home environment. 

“This is the second year my son participated in hippotherapy. The minute he got to the barn he found something he was very good at, gaining confidence and bonding with his horse. He still remembers his first horse’s name: Buck. He doesn’t always remember his best friends’ names, so this was huge. It helped him gain strength, and flexibility and he even looks like an equestrian. We enrolled him in the UNH program and the PATH program in Wolfeboro because he had such a great experience with Hippo with Reach. It is always wonderful to watch him riding confidently and joyfully, especially if he is having a difficult time in other areas of his life. I find his OT, Liz, to be exceptional. She is kind and empathetic and shares Sammy’s joy.”

With parents and caregivers involved in every part of the therapeutic process, each program at Reach is carefully designed to cater to the unique needs of neurodiverse individuals, offering a blend of play-based practices and innovative approaches. One mother shared her journey from feeling helpless to empowered after seeking support from Reach:

“A friend referred me to Reach for the Top when my son was 10 months old and still unable to eat or drink, surviving solely on breast milk. As a mother of two, I have never felt so helpless as I did then when I realized I did not know how to take care of my baby. Amy’s expertise, knowledge, skill set, and wholehearted investment guided the rest of my son’s treatment team and ultimately spared him from requiring the feeding tube that his doctors had once felt he would need. With her determination, persistence, and skilled communication she taught me how to get my son to eat and drink. In doing so, she not only changed my son’s life but she restored my confidence as a mother by empowering me with the knowledge and skills to care for my child. Thanks to Amy, my son is growing, thriving, happy, and eating well! My family and I are forever grateful to the amazing team at Reach for the Top!” 

Dedicated to Empowerment and Inclusion

Reach for the Top Therapy is a community driven by a mission to empower families and advocate for children with exceptional needs. Led by seven women that have lived disability experience, and three that also have children currently in therapy, this team understands firsthand the challenges families face in accessing high-quality care. This team, built on inclusion and acceptance, works hard to ensure that every child and family feels supported and valued throughout their journey.

“Reach for the Top has exceeded my expectations of what speech and OT services would be like for my daughter. Everyone from the director, to the office staff and the therapists consistently go above and beyond to make sure she gets the very best care. They listen to my concerns as a parent and take time to talk through challenges as they arise. The Reach team is truly exceptional, and we feel very lucky to be a part of this amazing community.”

Reach remains steadfast in its commitment to building community relationships and securing the necessary funds to serve more children and families. In 2023 alone, Reach for the Top served 490 children and families, providing 8,450 hours of therapy and support. With 260 children still waiting to start therapy services, the need for continued support and advocacy is more significant than ever.

Impact Beyond Numbers

Neurodiverse-affirming therapy goes beyond traditional models by recognizing the inherent value and potential in neurodiverse individuals. The impact of this approach is profound and extends far beyond therapy sessions. One of the primary benefits is the enhancement of self-awareness and self-acceptance, that leads to positive self-esteem. By focusing on and including strengths rather than deficits, Reach’s patients develop a sense of pride in their unique abilities. Improved communication skills are another significant outcome, as therapy helps children navigate their ability to understand and express themselves best.

The practical strategies learned in therapy, that validate and support the child’s experiences, translate into real-life benefits, such as improved communication, regulation, self-care, and coordination, leading to increased independence and a greater sense of control over one’s life. Ultimately, neurodiverse-affirming therapy has a ripple effect on families and communities. This inclusive and compassionate approach not only transforms the lives of those directly engaged in therapy but also contributes to a more accepting and inclusive society that values diversity in all its forms. 

As we envision a future where children with exceptional needs not only survive but thrive, it’s vital to recognize the importance of neurodiversity-affirming therapy. It’s a journey of self-discovery, advocacy, and building a more compassionate world—one therapy session at a time. Whether it’s through hippotherapy, music therapy, nature-based therapies, yoga therapy, STEM-based groups, or parent support groups, Reach for the Top Therapy is paving the way for a brighter and more inclusive future through engagement, connection, and understanding.

Reaching for the Top: Our Top Therapy Milestones and New Year Goals

Reach for the Top Therapy, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies, proudly unveiled its 2023 milestones, in the recently released Impact Report. Amid the challenges presented by a society that often doesn’t cater to those with disabilities, the organization has met 100% of its goals, having expanded its services to encompass an impressive array of 18 specialty therapy programs. These services, delivered by a team with 122 collective years of experience, aim to build children’s skills, empower families, and foster resilience.

Listening, Bridging Gaps, and Expanding Services

In a heartwarming message, Reach’s Executive Director Amy Rich Crane emphasizes the empathetic response of Reach for the Top Therapy to the hundreds of calls received monthly from struggling families in the community: 

“The empathy we feel for families desperate for help to support their children increases at the same rate our waitlist for services has grown. We listen to families’ needs and the challenges they face advocating for their children in a society that was not inherently designed to support those with disabilities or their families, and we aim to bridge those gaps.” – Amy Rich Crane, Executive Director

With a growing waitlist, Reach for the Top Therapy has taken the proactive step of expanding its therapeutic services to 18 specialty therapy options. These programs cover a wide spectrum, including Feeding Therapy for infants to teens, Teletherapy, Pediatric Pelvic Floor therapy, Hippotherapy at a local farm, Aquatic therapy at a local pool, Advanced Sensory Processing Evaluation & Therapy, and a Community Sensory Garden at the Dover Library, among others.

In the new year, the organization plans to reduce the number of families waiting for therapy from 215 to 100 and has raised ⅓ of the costs needed to be able to do so while recently hiring 3 therapists to join the team, bringing a combined 10 years experience to help make this a reality.

Empowering People and Building Resilience

Through a family-centered model as well as a unique trauma-informed and neurodiverse-affirming approach, Reach strives “to build children’s skills and confidence, empower families to be their children’s greatest advocates, and develop their resilience to support them over their lifetime.” – Amy Rich Crane, Executive Director

However, Reach’s mission is not just about therapy – it’s about empowering families as much as it is about empowering therapists to be their best selves. Under the leadership of Executive Director Amy Rich Crane, the organization redefined the not-for-profit model into a “For Impact” model, where employees’ expertise and skills are recognized with adequate and improved salaries and benefits. The organization aims to support its team in living quality lives while ensuring that the necessary supplies are available to help children and families thrive.

This holistic, impact-driven approach ensures that both families and therapists are equipped to navigate challenges and foster resilience, creating a supportive ecosystem that is empowering and nurtures growth and empowerment at every level.

Education and Advocacy 

A non-profit led by seven women with disabilities, the Reach team’s lived experiences continue to show that people grounded in the issues are closest to the solutions.  Through deep understanding and commitment to the disability community, their needs, service delivery gaps, advocacy needs gaps, and best practices – you have those personally invested in care driving program design, delivery, quality assurance, and advancing equity which results in quality outcomes and long-lasting impact. The clinic embodies inclusion, acceptance, and neurodiversity at all levels, with 67% of staff members self-identifying as having a disability, all of whom report feeling supported and valued in the 2023 employee survey.  Reach is listening to families, employees, and the community as a whole to consistently improve and tailor their therapies.

“We are constantly adapting to meet the needs of our community, listening to families’ concerns with barriers to access and inclusion, then actively problem-solving to help meet those needs and strengthen our community.” – Amy Rich Crane, Executive Director

Continuing education and investing in therapists’ skills are also an important part of Reach’s philosophy. To maintain top-level high-quality patient care, the organization provided over 300 hours of continuing education to its team. Moreover, to inspire and support the next generation of healthcare professionals, Reach established partnerships with 10 Universities, resulting in around 2400 hours committed to therapy students in the coming years.

2023 Impact Snapshot: Nurturing Growth and Empowering Families

The Impact Report paints a vivid picture of Reach for the Top Therapy’s achievements in 2023:

  • 490 Children Supported & Families Empowered: The organization’s commitment is reflected in the number of children and families served directly, with quality ensured during this year’s impact survey, where 52/52 families surveyed report Reach is meeting 100% of their three overarching goals in family-centered care and individualized support.
  • 7 NH & ME Counties Served: Reach for the Top Therapy has extended its reach across multiple counties, ensuring that its impact is felt far and wide.
  • 8,450 Hrs Spent in Therapy: The dedication of therapists and their commitment to the well-being of children are evident in the substantial hours spent in therapy sessions.
  • 52% Lower Income Families with State Insurance: The organization is actively reaching out to lower-income families, ensuring that financial barriers do not hinder access to vital therapy services.

Looking Ahead to 2024: Accessibility, Empowerment, and Community Strengthening

A crucial aspect of Reach for the Top Therapy’s objectives for 2024 involves providing more education to the public on disability advocacy, and rights, affirming therapy practices, and trauma-informed care.  Executive Director Amy Rich Crane is currently developing a Learning Summit for therapists, doctors, teachers, and all those who value the family-centered model for this year, she expresses her eagerness to engage in more public speaking engagements, extending an invitation for others to request her presence at schools, organizations, or events to share insights about the organization’s model and values surrounding Diversity, Equity, Inclusion, and Accessibility (DEIA).

Additionally, Reach for the Top Therapy plans to uplift the community and enhance connections and access to related service-based resources, with the introduction of a 20ft x 10ft Community Resource Wall in their Clinic. This initiative will be available for sponsorship with naming rights, reflecting the organization’s commitment to community partnerships.

As Reach takes stock of its achievements in 2023, the vision for 2024 is clear – reducing waitlists, investing in its human capital and top assets by providing improved employee benefits, expanding community connections, and enhancing public education and advocacy for those it serves. The organization’s commitment to making a lasting impact on the lives of children and families is unwavering, and with the community’s support, the journey towards creating a more inclusive and supportive environment continues. 

Join Reach for the Top Therapy on this mission to get children access to care, build skills and connections, and strengthen our community. Visit for more information.

Using Art to Make Teletherapy More Effective

Trained in providing trauma-informed and neurodiverse-affirming therapies, Reach for the Top Therapy continues to show great creativity in session planning to achieve each child’s goals, with unique activities paired with neurodivergent patients’ interests through teletherapy. This is the story of Emily, a 13-year-old, with a combined diagnosis of Autism, ADHD, Depression, and Anxiety, whose journey to use her strengths to develop areas for growth took a turn for the better under the guidance of her therapist at Reach.

Developing Self-Advocacy and Personal Growths through Creative Expression

Recognizing the unique features of the teletherapy setting and the commitment to serving neurodiverse clients through a strengths-based model, Dual Board Certified Pediatric Occupational Therapist and Reach’s Executive Director Amy Rich Crane is keen on preparing engaging and fun sessions aligned with each child’s interests. To work on Emily’s executive function skills (planning, sequencing, execution, and goal-directed persistence) and self-advocacy skills, Amy introduced a new task that combined creativity and personal interests, inviting Emily to create album covers for two of her favorite artists, Billie Eilish and Taylor Swift, using the digital design tool Canva.

The sessions became a canvas for Emily to express herself artistically, not only selecting colors and graphics that mirrored the styles of the two musicians but also creating two distinct visual identities based on the characteristics she recognized and valued for each artist.  She communicated the differences between each artist’s styles with joy and ease, then her therapist expanded that into understanding different communication styles, and different social expectations others’ are guided by, and through this activity Emily was able to apply that information in an authentic and meaningful way.  It was an opportunity to see her strengths and natural creativity support areas she has been working on; planning, sequencing, task-orientation, and goal directed persistence – that will support her at school and later in life.  

Beyond the creative aspect, these teletherapy sessions became a space for discussions about preferences, communicating to different audiences, and reflecting on how Emily and others’ social interactions are impacting her socially and emotionally, allowing Emily to reflect on, process, and practice skills with tailored feedback. They were able to discuss differences of opinion within the safe relationship Emily and her therapist have developed.  This exercise also served as a valuable lesson in understanding and accepting diverse opinions and celebrating the differences that make us unique – as her favorite artists do.  

How Teletherapy Can Benefit Neurodivergent Patients

At Reach, teletherapy has emerged as a transformative tool for expanding the ways in which the clinic can reach and assist patients, especially during challenging times such as increased cold and illness seasons, snowstorms, and the busy Holiday season. Reach for the Top Therapy’s commitment to teletherapy is distinguished, as the clinic’s team of therapists actively seeks to enhance this innovative practice. Here are some of the benefits of teletherapy: 

  • Comfort and Familiarity: More than an alternative to when in-person therapy isn’t possible, teletherapy is a specialty on its own, especially for neurodivergent patients who often find comfort in familiar environments. Teletherapy allows patients to engage in sessions from the comfort of their homes, reducing potential stressors associated with unexpected experiences on the way into the clinic setting.
  • Flexibility in Scheduling: Neurodivergent patients may have varying levels of energy and focus. Teletherapy provides the flexibility to schedule sessions at times that align with the patient’s most optimal hours, ensuring better receptiveness and engagement.
  • Weather and Health Considerations: Particularly crucial during times of increased cold, storms, and sickness, teletherapy eliminates the need for patients to venture outside, for example, on a snow day. This not only safeguards their health but also ensures consistent therapy sessions even in adverse weather conditions.
  • Holiday Support: The holiday season can be overwhelming for neurodivergent individuals due to changes in routine and social expectations. Teletherapy offers a lifeline during these times, providing a supportive space for patients to navigate and cope with the unique challenges that may arise.

Working on Functional Skills from the Comfort of Home

For Rachel Babcock, MS, CCC-SLP Speech-Language Pathologist, and Community and Client Services Coordinator at Reach, working with a teenage client over teletherapy for over a year has been an incredibly therapeutic experience. Again, the strength-based model aligned with the patient’s interests has proved to be successful.

“He is always eager to join the therapy session on his computer and work on his speech-language skills with me. He has a love for street signs and maps and his eyes light up when I screen share Google Maps to target asking social questions, describing places, talking about past experiences, and visiting them online together through Google Maps. “

Teletherapy has also offered the therapist an opportunity to expand skill functionally into the patient’s home experiences, such as meal and snack preparation. 

“I can work with him in his own home virtually by navigating his kitchen to pack his school lunch or make a snack targeting vocabulary, sequencing, describing, and self-advocacy. I have found that teletherapy has been incredibly beneficial for this client in his use of communication skills with his family members and in his home setting.

Improving Therapeutic Offers Through Ongoing Education

As part of their dedication to providing the highest quality care, Reach’s therapists pursue continuing education. With regards to teletherapy, a notable component of this training is a comprehensive email newsletter curated by Rachel that circulates among the team containing 20 or more resources each month to support their teletherapy practices. These resources include session planning inspiration, recommended readings, research on effective practices, and other valuable tools aimed at enhancing the therapists’ skills and ensuring the best possible outcomes for their patients.

Reach has set a precedent among Seacoast therapy clinics by seamlessly integrating creativity, technology, and empathy to foster growth in patients and therapists. The innovative teletherapy approach, exemplified here by Emily’s creative journey, showcases the power of personalized and inclusive therapy in promoting development. As Reach continues to lead the way in neurodiverse-affirming practices, the clinic’s commitment to specialty therapies, coupled with ongoing education initiatives, serves as a testament to its dedication to providing accessible, effective, and compassionate care for all.

Why It’s Important to Keep Up with Therapy During the Holidays

As the joyous atmosphere of the holiday season approaches, we must emphasize the significance of maintaining consistency in pediatric therapy for children with various developmental, physical, or social-emotional needs. With a focus on ensuring the holistic well-being of its clients, Reach for the Top Therapy Services, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies, recognizes the importance of continuity of care, to achieve sustained growth and progress in children’s lives. Keep reading to discover the benefits of consistent therapeutic care. 

  1. Ensuring Uninterrupted Progress

For children in therapy for developmental disorders, physical disabilities, or behavioral challenges, maintaining a consistent therapy schedule during the holidays is paramount. These therapy sessions support their specific needs, which sometimes increase during schedule disruptions like school breaks during the busy holiday season. Continuing with their weekly sessions, and even getting in a missed make-up session, positively impact the child’s overall progress. Consistency in therapy aids in maintaining the momentum of progress achieved throughout the year, ensuring that the hard work and efforts invested by the children, their families, and their therapists do not dwindle during the holiday period. 

  1. Promoting Emotional Stability

Festivities and gatherings during the holiday season often bring about changes in routines, social environments, and family dynamics. While these changes are typically embraced with enthusiasm, they can also induce stress and anxiety in children, especially those who thrive on structure and predictability. Pediatric therapy plays a vital role in promoting emotional stability during these times of routine disruption. By providing a safe and familiar space, therapists help children navigate the emotional challenges that may arise, offering coping strategies and emotional support to help them manage holiday-related stress effectively.  Including advocating for their sensory and/or feeding needs and differences to family members who may not understand those needs.  

  1. Preventing Regression

Children may experience regression if therapy is interrupted for an extended period of time. Regular therapy sessions help children consolidate and reinforce the skills they have learned, ensuring that they continue to make steady progress in their developmental journey. By continuing therapy during the holidays, caregivers and therapists can make sure that the child’s developmental milestones are not compromised and prevent setbacks that may occur due to the disruption of routine during the holiday season. 

  1. Supporting Family Involvement

Reach’s family-centered therapy model welcomes the involvement of parents or caregivers, who are crucial to their child’s progress. The holiday season presents opportunities for families to come together and partake in various activities, so incorporating pediatric therapy during this time can foster increased family connection and support. Additionally, involving extended family members in therapy sessions can provide a deeper understanding of the child’s needs and progress. It encourages active participation from the family, fostering a safe environment that extends beyond therapy sessions and into the child’s everyday life. 

  1. Fostering Social Interaction

The holiday season is also a time for numerous social gatherings, festivities, and community events. For children undergoing therapy for emotional, social, and/or behavioral challenges, the holiday period can serve as an invaluable time to work through stress or challenges that arise when different social demands challenge the child’s abilities in a way that adds greater stress, rather than ending in a positive interaction.  Our therapists are highly trained in neurodiverse affirming strategies that help advocate for each child’s needs, preferences, and strengths to bring value to the social interaction, even if it ‘looks different’ than neurotypical expectations portray as successful.  We can help your family and friends embrace your child for who they are and the value they naturally bring.  Moreover, in a play-based therapy model like the one offered at Reach, children can learn cooperation, empathy, and problem-solving skills — all of which positively impact their social interactions beyond therapy sessions. 

  1. Promoting Inclusivity and Sensitivity

Inclusive and sensitive practices are fundamental in ensuring that children with special needs feel valued, understood, and accepted during the holiday season. Festive environments can be overwhelming and too stimulating for children with sensory processing issues, which can lead to discomfort and emotional distress. By continuing pediatric therapy, families, caregivers, and therapists reinforce the importance of inclusion while ensuring their children’s well-being and needs are prioritized while encouraging their participation in holiday activities and community events. This approach fosters a culture of acceptance and understanding, promoting an environment where children with diverse needs feel seen, heard, and celebrated during the holiday season. 

Commitment to Attendance 

As the holiday season approaches, it is crucial to prioritize the continuation of pediatric therapy to ensure that the developmental, emotional, and social needs of children are consistently met. However, the festive season also coincides with cold and flu season, negatively impacting everyone’s ability to attend sessions. Although families and therapists alike may miss the occasional appointment, to improve outcomes and attendance, Reach pioneered a new approach to therapy scheduling that is a win-win. 

The clinic offers two scheduling options: regular recurring sessions (the same day and time) and flexible ‘flex’ scheduling (varies week-to-week, based on availability). Missed appointments are rescheduled to align with the child’s care plan, ensuring that above 50% of scheduled visits are kept in a 4-week period for families to maintain their recurring spot. Suppose a family is unable to make up a visit with teletherapy or another time that same week and is at 50% attendance or below. In that case, they are automatically transferred from recurring to flexible ‘flex’ scheduling. 

“By maintaining a steadfast commitment to therapy during the holiday season, we uphold the well-being and progress of our children. Embracing the significance of continuity, inclusivity, and support, we create a nurturing environment where every child can flourish, regardless of their individual differences, strengths, or challenges. Together, let us celebrate the spirit of growth and resilience, making the holiday season a time of development, connection, and unwavering support for all children.” – Amy Rich Crane, Executive Director 

As Reach for the Top Therapy Services continues to lead the way in family-centered therapy, it exemplifies the importance of commitment to attendance and scheduling flexibility, ensuring that all children and families have the opportunity to access and benefit from continuous therapy services. This forward-thinking approach better serves the needs of the community and also facilitates ongoing growth and development within the clinic, so they are able to serve more. 

The Healthcare World is Burnt out and Short-Staffed: Addressing turnover in healthcare

The pressures of the modern healthcare environment, coupled with unprecedented challenges brought about by the pandemic, have led to an alarming increase in national burnout among healthcare workers. The high turnover rates across all healthcare and education industries (doctor’s offices, hospitals, nursing homes, therapy clinics, schools, and more) are both the cause and consequence of an exhausted workforce struggling to keep up with an increasingly fragile healthcare system. Presented with these external challenges, Reach for the Top Therapy Services, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies, has doubled down on employee well-being initiatives to support itss team while promoting resilience and continuing to support high-quality care.  

Burnout and turnover are a vicious cycle 

Burnout is a state of chronic physical and emotional exhaustion often accompanied by feelings of hopelessness and detachment from work and personal life. The demanding nature of healthcare work makes this a pervasive problem in the industry, as many healthcare workers find themselves working long hours, battling compassion fatigue (where they feel for their patients as they work through their struggles and challenges), and often struggling to find a work-life balance. 

Furthermore, the global pandemic brought to light the vulnerabilities of healthcare systems worldwide.   According to the 2023 NSI National Healthcare Retention & RN Staffing Report, the hospital turnover rate is at 22.7%, compared to 19.5% in 2020. 

The ripple effects of high turnover rates in the healthcare industry are far-reaching, especially for local organizations like Reach. Not only are patients affected by long waitlists and potential disruptions to their care, but healthcare institutions also suffer financially, as recruiting, hiring, and training new staff is costly, especially for a non-profit organization focused on mentorship and extensive training to offer many quality specialty programs. Moreover, the loss of experienced professionals with the great resignation, undermined the knowledge base and expertise, though Reach has been able to keep four therapists with over 10 years of experience each and several with 2-5 years in their fields. 

How to reduce turnover in healthcare spaces 

Having also experienced a surge in medical leaves in the period surrounding the pandemic, Reach is addressing the burnout and turnover crisis head-on: by implementing a multi-faceted approach that proactively addresses root causes and provides comprehensive support to its team of therapists.  

Workload Management

Prioritizing workload management is a key way to prevent excessive stress in the workforce. To this effect, Reach established a 6-week formal mentorship designed to help each therapist build a caseload while learning more about the organization’s core values and therapeutic standards.  At full capacity, a schedule rate of 80% working time, means that the team gets a paid lunch break,  planned documentation time, and weekly Team Time where all members of the team are available to support one another. During Team Time they focus on collaboration and connection, which may include working on projects, playing games, and de-stressing with yoga, a walk, connection-based activities or programming where every staff member is free simultaneously. To promote a supportive work environment focused on interdisciplinary care, support, and quality outcomes, Reach leadership started a Monthly Case-Care Collaboration initiative where therapists actively work through difficult cases, provide second opinions, additional resources and suggestions, and a community of support. Reach has guest speakers come in regularly to discuss important topics like: AAC, Selective Mutism, Trauma Informed Care, DEI, Neurodiveristy and more.  They have weekly Lunch & Learns where a variety of topics from sleep, family-centered education, affirming approaches, social-emotional development and support, regulation, and feeding, for example are taught by experts in the field, community, and clinic. 

Supportive Team and Stress Inoculation  

Burnout is described as a perceptual disorder, based on one’s mindset, and perspective, as well as their practice of self-care, and with the right tools, support, balance, and resilience it can be overcome.  Providing resources is crucial for therapists. Reach promotes well-being at work by creating opportunities for team bonding in spaces designed for stress relief.  For example, our staff office is equipped with a zen garden sand table, singing bowl, metal drum, mandala coloring wall, blue lights, chocolate, coffee bar, and weekly prompts to connect.  These small personal touches matter to this team.  Additionally, Reach offers extra time off for those who choose to develop and run specialty passion projects and programs and annual increases in paid time off for loyalty to our organization, focused on ensuring team members get adequate time to disconnect and recharge.  We encourage staff to plan their week and schedules with what aligns with their personal and family needs and also offer flexible scheduling options when unexpected situations arise. Furthermore, to boost morale and foster team building, Reach organizes an Annual Holiday Party and an Annual Offsite Retreat. 

Workplace Culture 

Nurturing a positive and safe culture that promotes teamwork, with open communication, and mutual respect can go a long way in preventing burnout. The Reach senior and junior leadership team, as well as program leads, seek active feedback and have received consistently positive feedback that the team is authentic, honest, respectful, considerate, hard-working, supportive, consistent, and family-centered.  It takes active work and cultivation, with everyone, at every level, doing their part.  Two years ago Reach leadership began the practice of having employees complete communication profiles and practice adapting feedback based on preferred styles of communication amongst the team, valuing different styles, making room for all voices at the table, and improving overall communication.   

Also, the team recognizes hard work with the opportunity for weekly bonuses for high performers and referral bonuses for employees who refer other high-quality practitioners to join the team.  

Education and Training 

Continuous education and training not only keep employees up-to-date with the latest research but also empower them with the skills needed to navigate fast-paced and high-stress situations effectively. Reach is committed to investing in the continued education of its therapists – in 2022, each therapist took anywhere from 30 to 200 continuing education credits to further develop their skills. The organization is also leveraging weekly Lunch & Learns with internal and external guest speakers, or virtual conferences, to create regular learning opportunities. Through its junior leadership program, Reach offers therapists who desire to take on greater challenges outside of typical therapy-based growth opportunities for advancement into leadership, which not only grows the therapists but the organization with diverse perspectives.  At all levels of the organization, each member participates in mentorship, 1:1 support, and goal planning to ensure each person’s growth is valued and ensure the team is contributing towards meeting Reach’s mission. 

Leadership Support 

Leaders in healthcare need to prioritize the well-being of their teams and create a culture of support and empathy where they lead by example. Beyond emphasizing the importance of work-life balance, Reach helps employees remain motivated and satisfied at work by encouraging them to pursue and lead passion projects that align with community needs. Over the past years, the organization has made a conscious effort to develop a workplace culture where everyone can thrive. In fact, 88% of employees report significant improvement in team culture including communication, values, and respect since 2022, and 100% agree with significant improvements following leadership and operational changes implemented at the end of 2021.  The organization implemented feedback received over the years and in the 2023 survey, improved its scores in employee satisfaction in every area; as this leadership team commits significant time to employee wellbeing and overall leadership practices.  

Burnout and turnover in healthcare remain one of the most urgent challenges for professionals and organizations in the sector. By addressing the underlying causes of burnout and turnover, and promoting healthy work environments, healthcare organizations like Reach can ensure the well-being of their workforce, improve patient outcomes, and contribute to the resilience of the healthcare system. The clinic’s ability to overcome post-pandemic challenges remains an invaluable resource for the Dover, NH, community. Reach’s commitment to empowering patients through quality trauma-informed and neurodiverse affirming care, specialty programs, community partnerships, and a dedicated team, will continue to guide its journey toward making a lasting impact on children and families in NH.  

Reach’s team demonstrates day in and day out that they are committed to helping each child and each employee become their best self while focusing on their strengths and overcoming barriers to success.  If you are looking for the opportunity to change lives and are open to having your life change in positive ways too, apply to join Team Reach! 

Sometimes kids are loud and that’s okay: Embracing the playful noise of pediatric therapy

As adults, we often don’t realize that our world is not exactly made for children. A lot of pressure is put on parents and children alike to play by “grown-ups’ rules” and many social spaces are deemed inappropriate places for children to be children. Add children with exceptional needs to the mix, and the world can seem even more unwelcoming to little ones. Reach for the Top Therapy Services, in Dover, NH, works to provide the opposite: a safe and welcoming environment where children’s needs are prioritized, as well as support in advocating for children and their needs in the community. 

Pediatric therapy environments play a crucial role in the development and well-being of children facing various physical, cognitive, sensory, and emotional challenges. At Reach, the therapy spaces are designed with children in mind to provide them with the tools and support they need. In this atmosphere, noise levels can often rise to high levels when children are having fun and equally, when they are dysregulated, which may be disruptive for parents and family members participating in the therapy sessions, or even other children, who can become overstimulated. Below we explore some reasons why pediatric therapy spaces can sometimes be loud, and why it is often a sign, the children and families are in the right place, and that noise is okay.  

Diverse Therapeutic Needs 

One of the primary reasons why therapy environments can get noisy is the diversity of children they serve. Families that work with the Reach team seek therapy to support their children through a variety of challenges that can be physical, developmental, sensory, or emotional. As therapists work with these children, they adapt their methods and techniques to suit each child’s unique needs, leading to a dynamic and vibrant environment. 

Play-Based Therapies 

For young children, play is a natural and effective way to engage in therapy. Reach values the play-based and relationship-based approaches as they have strong outcomes in pediatrics, because children learn best through play, nearly 200 times faster than skills taught without including play. Engaging in play can help children build trust with their therapists, express themselves, and learn new skills. However, the excitement of play can often become loud and energetic, which is a positive thing, that also may increase the overall noise levels in the clinic. 

Emotional Expression and Communication 

As a neurodiverse-affirming clinic, Reach is a safe space where children are encouraged to freely express their emotions and thoughts. Therapy sessions often awaken a wide range of feelings in children, such as frustration, fear, or excitement, which can lead to increased outbursts and dysregulation, because they feel safe to feel and process those emotions. This is expected, natural, and valuable for the child-therapist relationship, as it allows professionals to gain further insights into a child’s inner world, enabling tailored approaches and support. 

Sensory Stimulation 

Sensory integration is a significant aspect of pediatric therapy, especially for children with sensory processing disorders. At Reach, therapy spaces like the new sensory room or the sensory garden are deliberately designed to provide a variety of experiences, including tactile, auditory, and visual stimuli. These sensory-rich environments aim to help children regulate their responses to different sensations and adapt to various environments. Consequently, the presence of sensory equipment and exposure to different stimuli can contribute to a noisy atmosphere, but it is essential for children’s therapeutic journeys.  

Group Therapy Sessions 

Group therapy sessions are a common practice at Reach for the Top Therapy Services. These sessions encourage interaction, communication, socialization, collaboration, and play, which can lead to increased noise levels. Although it may appear chaotic at times, group therapy provides valuable learning opportunities and helps children develop essential social skills together in a more natural and inclusive way.  Peers accept other peers energy and arousal levels and learn how to adapt, request space or tools to be able to stay regulated and participate, or advocate for their needs in the relationship or group, as they would with peers at school and in the community. 

Parental Involvement and Education 

Reach’s family-centered therapy model frequently involves parents or caregivers, who are crucial to their child’s progress. Families are encouraged to actively participate in therapy sessions, learn techniques to support their child’s development at home, and engage in therapeutic play with their children. The inclusion of parents adds another dimension of emotions, activity, and interaction to the therapy environment which may raise the volume of the sessions. Reach believes that pediatric therapy environments are vibrant, noisy, and lively for good reasons. The energetic atmosphere is a testament to the dedication and commitment of therapists in tailoring interventions to meet the diverse needs of children. The activity and noise in these environments are not a sign of disorder but rather a reflection of positive engagement, emotional expression, and collaborative learning. With therapy, children develop essential skills that will shape their future as they grow, learn, and overcome challenges in lively settings. Embracing the noise and energy of therapy environments ensures that children receive the support and guidance they need to thrive and reach their fullest potential.  If environments seem consistently too overwhelming for a certain family, we always encourage families to let us know, as we have more secluded treatment areas, as well as tools like noise-canceling headphones that can support both the child and/or the caregivers. 


Reach for the Top: Serving Children and Families Through Positive Growth

When it comes to pediatric therapy, Reach for the Top Therapy Services, the only therapy clinic in the Dover, NH, area offering trauma-informed and neurodiverse-affirming therapies led by six women with lived disability experience, stands out. After a leadership change nearly two years ago and restructuring one year ago last June, the changes have made a significant and positive impact. The current high-performing team, led by Executive Director Amy Rich Crane, continues to prioritize the well-being of children and maintain its mission of providing top-quality care through a family-centered model with twelve specialty programs. 

Innovative Approaches and Positive Impact 

Over the past year, Reach has embraced innovation by further developing established programs as well as introducing new programs that cater to the diverse needs of children in therapy and the Seacoast disability community. Among these are the Sensory Community Garden, a partnership with the Dover Library with donations from the Greenland Lowes, an outdoor therapy group called Branch Out, highlighting the benefits of outdoor play, problem-solving, and connecting to peers in nature, as well as continuing the Aquatics program at a new, supportive location.  

The organization has also recently unveiled a new multi-sensory room for Autistic and neurodivergent children that aligns with the shift from traditional therapy models to ones that accept, empower, and advocate for those with disabilities through relationship and play-based approaches, over more traditional authoritative behavioral approaches. Moreover, Reach has formed a relationship with another community organization, collaborating with Granite State Music Therapy to establish an innovative music therapy group, which will increase Reach’s specialty therapy programs to 15 opportunities and 3 therapy departments, 18 expansive options for Seacoast families by year-end.  

Countless client stories serve as a testament to Reach’s dedication and effectiveness. By highlighting a few of these testimonials, including those from grateful parents, Reach can showcase the profound positive impact it has had on families and children with exceptional needs: 

“Through therapy, I’ve learned a lot about Jack – what his stims are, what helps him and what makes things worse, as well as the ways I can help Jack to grow and thrive using different adaptations. Miss Robyn has taught Jack and I both so much and it’s helped tremendously both at home and out in the community,” said Janyce Legrand, whose son has been attending therapy at Reach for the past two years.  

Amy Shaw, who has two neurodivergent daughters and recently discovered her own neurodivergence, praises Reach’s support to her family. “With the help of professionals like Reach, I was able to keep on fighting the everyday battle and work towards a more bio-psycho-socially healthy family. Reach For The Top not only cares about the children but the entire family unit. I feel supported enough to express my needs and they lovingly support me, even on my bad, barely holding it together days.” 

Community Partnerships and Generous Donations 

One of the organization’s greatest strengths lies in its community, and donations are the driving force behind supporting the clinic’s specialty programs for enriched care. Reach is incredibly grateful for the support it receives from individuals, local businesses, foundations, and the community, in order to carry out its mission and programs. Beyond the generous $10,000 from the New Hampshire Charitable Foundation for operational support, and the $6,250 grant from Saint Mary’s Bank that is supporting hippotherapy program fees, the themed peer groups, and the new Music Therapy Program, Reach received a notable donation of $2,000 from Rand Whitney, a local Dover business owned by the New England Patriots owner Robert Kraft, and $1,000 from NESPN television personality, Charlie Moore ‘The Mad Fisherman’. Such contributions from esteemed community members solidify Reach’s reputation and enable it to continue its important work. 

Last year, Reach received close to $200,000 in grants and donations which helped the organization exceed its goals, increasing the number of children and families served to more than 600 and expanding services to 15 programs and initiatives. Fundraising activities remain strong in the current year, as the team prepares to host its first Annual Reach Art Auction this fall, which will highlight art created by children with disabilities during their therapy sessions with their therapists and family. Reach continues to seek new relationships while developing established relationships with businesses and donors that share our values and are moved by the opportunity to empower children with disabilities so they can thrive and further support their families as they advocate for their child’s rights, development, and abilities. 

Investing in the Team’s Education and Expansion 

To further enhance its capacity to serve children and families, Reach recently hired four new therapy practitioners, growing to a 15-strong team. These dedicated professionals bring a wealth of experience, with a combined total of 32 years of serving children and families. Their expertise will contribute to Reach’s continued growth and enable the clinic to meet its target of helping over 700 families this year. 

Additionally, Reach facilitates continuing education for therapists, and one of its biggest commitments over the past year, with changes in personnel and policies, includes continued efforts to fully develop a workplace culture where everyone can thrive and continue to be an employer of choice. The investment of funds into therapeutic skill development, hiring, and training of therapy personnel, administration, and leadership ensures that children can continue to get the high-quality, advanced, and specialized care they deserve from employees whose growth is consistently valued.  

The commitment to hiring and empowering the right team members makes a positive impact on the children and families served, who develop strong therapeutic relationships with their therapy team, as well as on the overall team culture. In fact, 88% of employees report significant improvement in team culture including communication, values, and respect since 2022, and 100% agree with significant improvements following leadership and operational changes implemented at the end of 2021. 

Values and Standards Guide Continuous Improvement 

Moreover, Reach maintains a strong focus on its values and standards while ensuring open communication and collaboration with its team members. The clinic values the input and voice of its employees, further evidenced by the newly established junior leadership program, encouraging contributions and perspectives.  There are certain non-negotiable outcomes that must be met to ensure the organization is successful and meets its financial and community-based goals, but the plan to get there is flexible, tailored to find the win-win for families, employees, and Reach, with clear targets and personal goals for each team member. 

Reach for the Top Therapy continues to empower children and families through new programs, community partnerships, active fundraising, and a dedicated team. With pent-up demand, we continue to seek team members that fit our niche and growth mindset culture, with several opportunities for employment to meet community needs.  The clinic’s ability to overcome challenges felt from our post-pandemic economy, foster trauma-informed and neurodiverse-affirming practices, and maintain a family-centered approach makes it an invaluable resource for the Dover, NH, community. Reach’s vision of transforming lives and reaching new heights is continuously shared through positive impact stories and will continue to guide its journey toward making a lasting impact on children and families in NH. 

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

To learn more about Autism Acceptance, visit