PlayBig Finds Success/Obstacles Treating Autism

PlayBig Finds Success/Obstacles Treating Autism

PlayBig Therapy & Learning Center is shaking up traditional treatment practices for patients with autism and other neurological challenges in the Tallahassee area.

“PlayBig is the first therapy practice in the nation to integrate developmental therapies with behavioral health therapies in its model, which has had profound results for our young patients and their families,” said Rachel Scharlepp, a Licensed Clinical Social Worker and PlayBig owner.

PlayBig brings licensed physical and occupational therapists, speech language pathologists, behavioral health therapists, and targeted case managers together, treating the patient as a team, under one roof.

Pediatricians and other health care providers have referred hundreds of private and Medicaid pediatric patients to PlayBig.

At last count, PlayBig averaged more than 120 therapy sessions per day. In September, PlayBig treated 166 individual children.

The parents and grandparents of children treated at PlayBig attests to the success of the program.

Annette Woodard’s five-year-old grandson, Chase, has been treated at PlayBig for about two years. She said before PlayBig, Chase was completely non-verbal and anti-social. She said after being at PlayBig for about six months, it was like they “flipped a switch.”

“He came in and said, ‘More chips, please, Nana,’” she said tearing up at the memory.

“I just cried and handed him the whole bag,” she said with a smile.

Kelley Hutto, a licensed Physical Therapist and the other owner/founder of PlayBig, said she has been very pleased and touched by the many local pediatrician’s referrals to her center. “The medical community has supported us so incredibly well. It is referring children they never thought could be referred for therapy, such as older children, really, really aggressive children — children no one else will take. We take them.”

However, there have been obstacles.

PlayBig is not an approved provider for Capital Health Plan (CHP), a local health maintenance organization (HMO), even though doctors within the network refer patients to PlayBig on a regular basis.

PlayBig applied to be an approved provider but was rejected because CHP said there was a lack of need, even though there is a six to nine month waiting list for children needing care, according to Hutto.

Hutto feels CHP is restricting care for children. “Parents are having to pay out-of-pocket for health care because CHP will not expand its network to include more providers,” Hutto said.

According to John Hogan, President and Chief Executive Officer of CHP, “There isn’t a health plan or insurer in Tallahassee that can include every possible provider. We are trying to be as comprehensive as we can be, but there are limits to our ability do that and keep an affordable premium.” Hogan described the treatment provided by PlayBig as nothing new. It’s just packaged differently.

The Leon County School System has also presented challenges to PlayBig. Under PlayBig’s system, children are treated by peer group, with the youngest coming in the morning and patients get older as day progresses. The school system has balked at students leaving campus during the school day.

Dr. Allen Cox, Leon County’s Special Education director, said the school system’s own special education programs, such as those at Gretchen Everhart School, a day school serving special needs children from Pre-K to the age of 22 and smaller programs at Robert’s Elementary and Hawk’s Rise, are also very successful. He said that while the school system welcomes outside providers within the schools, they do not want the children leaving during the day because the school system is accountable for the autistic childs’ standardized test grades and because the schools receive a federal grant based on full-time enrollment (FTE). The Individual with Disabilities Education Grant, a federal entitlement grant, provides Leon County Schools with approximately $8 million annually.

“We are paid for 300 minutes of education a day, so I can’t claim that FTE if the student is leaving,” Cox explained.

But Hutto said, “Some of these children are feral (they are licking themselves or banging their heads on the table), they are unavailable for academic learning. One in 68 children have autism. If you look at it, it’s unrealistic to think we could serve all those children after 3 p.m. We are open 8 a.m. until 8 p.m. We are doing the best that we can. It’s just not possible.”

She said she understands the school’s need for “butts in the seats” for federal funding and has offered to not schedule treatment for the days children are counted.

“But I think our model is exposing weaknesses in the system and children are suffering because of it,” she said.

Cox said, “I’m for all the help we can give children, but we only have that six and a half hour block we can work with them. I love them going to these programs. I’d love it a lot more if they did it after school.”

27 Responses to "PlayBig Finds Success/Obstacles Treating Autism"

  1. As both a local practitioner and a parent of a child with a disability, I find these comments disheartening. We all have the right to express our viewpoints, but let’s keep it classy. There’s no need to attack one another. Aren’t we all on the same team with the same ultimate goal? It’s about our precious children who need well-informed, highly qualified and experienced professionals working together as a team. For those who share testimonials of your child’s great strides and amazing progress in their therapies, I cannot express how wonderful that is to read about. If you attribute your child’s progress to Play Big’s program, that is indeed your experience to celebrate. But let’s not slam a well respected SLP and owner of STS for stating her views. I don’t believe for a second she’s trying to promote her business. C’mon, this certainly would not be the forum she’d choose for advertisement. She made a point to commend Play Big for various aspects of their business. And she pointed out several other facts (not personal opinion) about Play Big as well. No, their therapeutic approach is not a ‘novel’ or innovative one by any means. No, their approach is not individualized based upon each client’s need (that comment made by a parent/previous client of Play Big). Yes, they’ve been subject to investigations involving Medicaid fraud. I can’t imagine that investigation is wrapped up. My guess is they’re still knee deep under investigation with one of this magnitude. My point is this, instead of slamming Ms. Marks or anyone else for that matter, let’s just all please keep our ultimate goal in mind. So many are sharing their success stories with Play Big. Yay! I pray for continued success for your children. But please, please be sure you’ve done your homework. Know the certifications, level of experience, qualifications & supervision requirements of all therapists working with your child. Understand Medicaid law. It’s not a matter of “Medicaid doesn’t understand our model.” It’s law, and there’s a reason for it. Please do your homework before chosing your child’s therapists, and please stop berating one another. We should all share our views to gain critically important information that may help guide us down what at times may seem a difficult path, but one we’ll never give up on.

    1. Thank you disheartened! I could not have responded with a better post myself. We should all keep in mind what the ultimate goal is here. It’s to put our children with special needs first and to stop trash talking one another! We all need to be better informed with respect to therapy our children receive. One facility may work for some, but not for everyone. 🙂

  2. Let me get this straight. Capital Health Plan will not help pay for therapy because there is not a need? Let me state some facts here:

    1. The covered therapy has a wait list of months to weeks.
    2. The 2 full time school speech therapists at Hawk’s Rise elementary school have roughly 150 kids they are working with, it would be laughably impossible for them to give any one-on-one therapy to a child on a weekly basis.

    The current model of paying for therapy seems to be either “Be Rich” or “Go out and beg”. We’re doing the begging option.

    Wouldn’t it be better in the long run if these kids could get therapy so that they could communicate and, as a result, go out and get jobs and support themselves? Otherwise, they’re a burden on the social security system. We can either pay a little now or pay a whole lot later.

    Capital Health Plan doesn’t care, because they’re not going to pay one cent more than they are legally required to pay…nor should they. I don’t know if the answer is level-headed regulation to require more help for kids in need or less regulation to encourage more competition in the marketplace.

    I loved the implied threat from CHP that health care premiums will go up if they have to provide coverage. Thanks for the warning, buddy.

    I’m still flabbergasted that CHP says there’s not a need for more providers even though current care providers have schedules that are choked with kids clamoring for some help. They’re saying “There’s no smoke” when the house is engulfed in napalm.

  3. Well, this comment section sure went well. Not.

    Looks to me like the children come last with the above crop of commenters.

  4. Ms. Marks, what exactly do you mean by a “non-educationally relevant model”? Apparently you’re not fully aware of all the services PlayBig provides in regard to IEPs. You should not speak of something you have no knowledge of.

  5. Ms. Marks, your comments on a story about PlayBig just demonstrate how desperate you are to toot your own horn for your own business, STS. All under the guise of wanting to be so friendly, welcoming and helpful to your peers, PlayBig. They don’t need your fake comments about their work in the community, as PlayBig, its owners and staff have been well established as multi disciplined providers in the Tallahassee-Big Bend commnunity and north Florida for a long time. They don’t need anybody’s help to get patients in their doors. In fact, all of the staff who work there have patient schedules filled to the max. PlayBig has a long and full waiting list of parents who’s children treat with other providers, but who want to move their children’s services to PlayBig so they don’t have to spend numerous hours and multiple days away from school getting the needed services here, there and everywhere. Parents and others know the truth about you and your business and the limited services you provide. We also know the truth about your adversrial position against PlayBig since you run your mouth about PlayBig so freely to parents and others in the community. To assume or insinuate the owners of PlayBig post comments as anonymous persons, clearly shows this. Someday the truth about you and your business will all be exposed.

  6. While I appreciate that there are options in the community I have taken my child to play big and it-while presented as treatment based on the individual needs- seemed to me that it was a one treatment fits all. They insisted on the headphones and sweatband and swinging – which only made my child more irritable. While I tried to discuss my concerns with the team I was made to feel that I wasn’t wanting the best treatment for my child. I will not be shamed into having my child get a treatment that only makes him worse. We transferred to another proviider and the progress has been amazing.

  7. Though I typically refrain from responding to people who lack the courage to use their name, I will make an exception.

    PlayBig is not competition – it is an asset. I believe I said this in my comment. There’s absolutely nothing remotely concerning about PlayBig’s presence. In fact, PlayBig is a great resource for many children we see, and as my first post suggests, we are collaborative at STS.

    While it’s fashionable to demonize the school district for perceived shortcomings, I am fully capable of considering what is realistic and idealistic. I have found that when approached with a collaborative spirit and positive attitude, strong bonds are formed between school personnel and outside therapy resources. I’ve been invited to participate in more than fifty IEP meetings to represent a student’s needs in the non-educationally relevant model. My experiences have been productive and satisfying for both the school personnel and parents involved. Openly criticizing the school district personnel, and characterizing their comments in the harshest possible terms does not lend credibility to PlayBigs position. I would hope a more mature dialogue could be established to hopefully open the door to possibilities. This is what I, and other local providers, would hope for BigPlay.

    CHP is historically judicious when inviting entities to join their panel of providers. This is necessary for quality control and economic purposes. My practice saw CHP clients for four years, experiencing tens of thousands of dollars in losses. There are numerous Therapy entities who have applied for this honor over a period of decades without success, so I knew it would take time to establish my practice as being worthy of an invitation. After expanding regionally and investing much effort promoting the practice in the public, investing in the community with pro bono services, partnering with charities, and demonstrating that STS was an honorable, success driven practice – after three applications – STS was finally invited. PlayBig can take the same steps and hopefully stand a good chance of being invited as well. However, as with the schools, it is never a good idea to set an adversarial tone if your ultimate purpose is growing a collaborative working relationship.

    Finally, as the owner of the largest private Clinic in the region that is well known for welcoming children presenting with the most severe disorders in behavior and the most profound cases of autism, I trust any implication that I am “disgruntled” will be viewed in context by informed readers without an agenda, and summarily disregarded.

    PlayBig could be an incredible resource for other therapy practices, and practices like mine are eager to refer clients to places where additional gains may be realized. Hence my clear focus on “collaboration” in my first post. It will be up to PlayBig to decide if they are interested in forging strong bonds with peers in the community. My sincere hope is they will.

    1. “While it’s fashionable to demonize the school district for perceived shortcomings, I am fully capable of considering what is realistic and idealistic. I have found that when approached with a collaborative spirit and positive attitude, strong bonds are formed between school personnel and outside therapy resources. I’ve been invited to participate in more than fifty IEP meetings to represent a student’s needs in the non-educationally relevant model.”

      So you are a partner and have a “strong bond..” with the school district and you feel they do a good job. What do you mean by a “non-educationally relevant model”?

    2. Ms. Marks, perhaps the parents did not use the name to protect the identity of their child. Accusing a parent of not having courage to put their name is quite assumptive of you and very off-putting to me.
      Perhaps family and friends do not know that their child goes to therapy, as ASD is not a disorder that presents physically and that IS PlayBig’s specialty. Perhaps they don’t want their child to be targeted or to be stigmatized or to be stereotyped. Not every person understands ASD and how children present and how wonderful children with ASD are.Just a thought.

  8. CHP has had decades of contracts with Tallahassee Memorial Healthcare and all the resources they provide,

    This would interfere with that contract.

    As for the Leon county school board, they obviously do not know the laws of special needs kids and young adults.

    I was told by many G.E school that ASD children would do better outside G.E. school as they are overloaded with children that have more behaviour problems such as the juvenile justice system, the resources are teachers and parents of special needs children and adults,

    Play Big has and does have my vote and our son will be attending especially if l.c.s.b. does not pull it together, there are schools that any parent can go to through several grants despite the funding that the l.c.s.b.

  9. Ms. Marks comments above signify why parents need alternatives and progressive minded therapists. I am astounded that she would say that the School District somehow shouldn’t be bothered by meeting a child’s needs unless of course they go to Gretchen Everhart. Clearly this individual needs to do a google search on IDEA. It is not the 1970’s anymore. Goodness, this comment is more appalling than Dr. Cox’s suggesting its all about the FTE. By the way, the LCS funding received per FLDOE website for IDEA is $18.8 million not $8 million. The schedule of the budget addressing IDEA funding presented at a very recent LCS Board meeting speciously left out any detail of funding (in) or where and how that funding was spent (out). There is money available to provide what most children in other comparably sized districts get – therapies and services to meet their academic, social and emotional needs without having to be put in a special school. That’s why IDEA funding is provided and its there to support the least restrictive environment (LRE) mandated by this Federal law. . Ms. Marks you are doing no favors for some of our most vulnerable children. Your comment sounds like sour grapes. Please retire!

    1. “Parent” – Obviously your characterization of what I said is grossly inaccurate. I was simply expanding upon a single comment made by the District representative. Of course I don’t think all children should go to Everhart. That’s a ridiculous contention.

      I’m quite comfortable with the good my practice has done, and will continue to do, in the community. As always, we’ll do it without the need for ugly and rude parents posting ananymously on public forums. It does not do any favors to your credibility, and to some it could reflect poorly on PlayBig. Those of us who have been around the block a time or two know that it’s not uncommon for ananymous posters to be the actual business owners themselves. It would be embarrassing if readers suspected this is the case.

      1. I have no association with Play big. I have never set foot in their facility. You stated in your comment: “The School District cannot be asked to undermine their own ability to meet the needs of their students, and further disrupt the sanctity of a teacher’s classroom, to accommodate the practice hours of a single business entity. Further, accommodating non-educationally relevant activities are not within the school district’s mandate.” These were your words. They fly in the face of what the law requires and you are promoting and passing along false information about what children are entitled to under these laws. You expounded in great detail and implied that GE’s program is comparable to Play BIg, which of course implies that that is where these students should be. This is not rocket science, accommodations and therapies are provided at other school districts around the country with no backlash or retaliation to the providers that try and introduce innovative and proven interventions. And I am sorry if I offended you, I don’t believe my reaction was “knee jerk” or “rude”.

    2. “Parent” – Obviously your characterization of what I said is grossly inaccurate. Your characterization of what I think and feel has no basis in fact, and is quite rude. I was simply expanding upon a single comment made by the District representative. Of course I don’t think all children should go to Everhart. That’s a ridiculous, nonsensical contention.

      You are obviously very passionate, which I applaud. However; please refrain from building a straw man out of your unsupported assumptions and knee-jerk emotional reactions, then suggesting that your straw man somehow represents my professional ethics and beliefs. Whoever you’re describing and demonizing in your post is not representative of me, nor any person who would ever work for me. I’m quite certain I have over 25 years of experiences that debunk your rude insinuations.

  10. It would also appear that there have been “obstacles” at the state level as well, namely the Agency for Health Care Administration and the Attorney General’s Medicaid Fraud Control Unit. An administrative law judge found “AHCA was not substantially justified in taking the action to suspend Petitioners’ Medicaid payments.”

    The order only addresses the administrative actions taken by AHCA, and paragraphs 29, 44, 108, 109, and 118 are of particular note.

  11. I commend the efforts of PlayBig as they have, indeed, tapped into a model that can benefit many children. However, on behalf of my own practice, Southeastern Therapy Services, and my peers in the community (Progressive Pediatrics, etc.) I feel it’s very misleading to suggest PlayBig as being a novel approach or first of its kind in Tallahassee. For almost nine years, STS has managed to effectively collaborate with professionals, caregivers, and schools to meet the needs of our school-aged clients. We’ve also done this without being the focus of Medicaid investigations and violating the rules of therapist supervision with the Florida Division of Medical Quality Assurance. As was mentioned by a contributor from CHP above, there are several resources in Tallahassee that offer children these services, and more. Indeed, a dynamic model of therapy, covering needs across the spectrum of disorders with which these children often present, are the life’s work of the experienced and knowledgeable therapists who have been addressing needs at several established practices for many, many years. There is a strong sense of collaboration the providers in Tallahassee have maintained, in spite of what could easily be a “competitive” relationship, which has fostered a healthy respect and open lines of communication for all entities involved in caring for children. PlayBig’s young therapists would be welcomed into this community of providers, which might help them avoid making errors in billing and supervision that previously interrupted their operations. The School District does provide a very similar intervention model at Gretchen Everhart. The physical education program incorporates the student’s specific needs as outlined in a child’s Individualized Education Plan, and group activities replete with gross motor intervention strategies are regularly provided. The School District cannot be asked to undermine their own ability to meet the needs of their students, and further disrupt the sanctity of a teacher’s classroom, to accommodate the practice hours of a single business entity. Further, accommodating non-educationally relevant activities are not within the school district’s mandate. This is where the private practices should offer as many before and after school options to parents/caregivers possible. As with STS and other practices, extended afternoon and weekend treatment hours are at times required. When working together, the parents, caregivers, schools, various specialists, and clients can indeed develop efficacious treatment plans without asking any one entity to sacrifice what is not reasonable or even possible. As I know my peers in the community share in my excitement that PlayBig is offering another exciting resource to our community, I believe it is equally important to resist misleading the public by stating a treatment approach is “novel” – as this can cause great confusion and frustration for parents who are vulnerable and desperately seeking the one thing that can “cure” the child they love.

    1. I do have a direct connection with Play Big and I have no shame posting with my real name. That being said, I also find it disturbing that you believe Leon County Schools should be able to direct the therapies or times of any special needs child attending their schools. Our children already have huge obstacles to overcome and the times of their therapy shouldnt be one of them. The school board is legally obligated to provide the necessary accomadations for them.

      In regards to the article leaning towards PlayBig being one of a kind, its because they are. Yoou wanted to promote your facility, I get that, but im sorry Playbig is absolutely, without question, one of a kind. It isnt the therapy that is one of a kind and that isnt what the article was claiming. It isnt even the huge play gym, the sensory intakes, the swings, the playground outback or even the therapies all in one building that is unique. What makes them unique and one of a kind, is that they care! They cry with parents, they celebrate birthdays with cakes and balloons, they remember that they were supposed to ask if there was another episode last night. They are unique because they take the time to explain to the parent, to tell them its ok to feel that way, and they actually listen when we talk! You may believe they are not unique, or one of a kind, but i assure you, every parent that has ever walked through their doors, does think they are unique and one of a kind. We just get lucky and get all of our one of a kind therapists, in one unique and wonderful building.

      Oh and on a side note, bringing up an illegitimate, completely biased, illegal, farse of an investigation to show their hurdles, is just slightly childish dont you think?

      1. PlayBig is definitely one-of-a-kind, and we’ve looked. When it looked like I might have to take a job in another town, my wife scoured the southeast for a similar program. There isn’t one. Ultimately we decided if we moved we’d just make a day trip once a week to Tallahassee to get my son to PlayBig. Fortunately, we didn’t move, and he’s been able to continue uninterrupted. After two years at PlayBig, I can attest to the value of their program. My son is intellectually gifted but was years behind his age-peers in coordination, communication, sensory perception, and emotional maturity. We tried other therapy programs and they were a joke. At PlayBig we’ve found therapists who are skilled, have a plan, and truly care about not just my child but my whole family. He is now nearly at grade level on all fronts.

        We also use the Gardiner scholarship to help pay for therapies and to cover the costs of homeschooling. The public school system style of education certainly has value in its own right, but it has no place for students like my son. That style works fine if your child is quiet, calm, and compliant, but mine is anything but. He learns better when he’s able to move about, bounce around, and voice his ideas out loud. Loudly. He often takes instruction better outside at a picnic bench. He’s also ahead of grade level in most academic subjects. You just can’t get that in the public school. I’m glad the public school system exists; I believe it’s an important community service. And I got a great education there myself as a kid, but it doesn’t work for my kid.

        As for Ms. Marks’ comments, it makes one wonder if perhaps she is the individual responsible for the ridiculous allegations against PlayBig that resulted in the unfounded and unjustified AHCA and Medicaid investigations. Many families had their therapies disrupted, suspended, or even halted indefinitely as a result of that buffoonery. Bringing that nonsense up is not childish, it’s vindictive and hateful. I don’t know who initiated that complaint, but they should be grateful their name has been kept secret. Some of these families are desperate to get their child(ren) help, and desperate people should not be trifled with. All that aside, Ms. Marks’ self-righteous comments here do her business no credit, and I certainly will not be recommending STS to anyone based on her attitude here.

  12. This is the very reason I utilize the Gardiner Scholarship for special needs children, instead of having my child in the public school system. My child attended a Leon county public school for 4 years. She received a small amount of therapy while attending. With little progress from school based therapy, We decided to take action and 2 years ago she started at PlayBig receiving OT,PT, Speech & Play Therapy. She was missing several hours a week of school and I was getting back lash from the school that she was missing too much instructional time. I reminded them that this is medical therapy and you must treat this as any other medical appointment, it’s the law! Last year was the icing on the cake…I was informed in my daughters report card that she would be held back in the first grade with out my knowledge that she was even in danger of being retained. I applied for the Gardnier scholarship and was approved within days. She now attends PlayBig Learning Center where she has thrived. She is on grade level and her Learning Coach is wonderful she comes to the child’s level and meets them where they are. Shame on Dr. Cox and Leon County only being worried about the money. I urge all parents to take charge of your child’s education. You have a say in what your child education looks like, and just because they don’t fit the mold doesn’t mean they don’t deserve a quality education.

    1. Hello Carissa 🙂 Well you know I absolutely agree with everything you have said. Mine has thrived at Play Big and the Gardiner scholorship helps make it possible. Without Playbig and all of his therapists and learning coach, he wouldnt be where he is.

  13. When students need therapy to access state standards, LCSB is required by law to include it in the IEP plan, and extend the school day if necessary so the kiddo gets the 300 instructional minutes. Mr. Cox failed to say that as leader of the school staff charged with assuring students with disabilities get what they need, he absolutely can allow children to leave SD property during school, he must do so or LCSB is discriminating. The FTE argument is specious since if it is in the IEP/504 plan it is counted in the 300 minutes.

    I suggest parents give written notice 10 days in advance that they are going to get private therapy there, and will be sending LCSB the bill. Then request in writing a reasonable accommodation of waiving any penalties for being absent, and move their instructional time to later in the day and even after school if that is required.

  14. Maybe LCS will consider implementing this program into the curriculum at the schools where this program comes to the schools to solve the logistics and insurance obstacles. This looks like it would be beneficial to many children and families.

  15. Dr. Cox should be ashamed! Kids are more than a score. This is a perfect example of over testing. I run Opt Out Leon County. My girls do not take the test. You are the parent and have every right to take your child out of school for therapy or doctor’s appointments or just because they are sick. Testing is the reason that recess has disappeared from elementary school. Kids need to play.

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