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Home Health Care Services for the Pediatric Population

Leandre Gerwin, MA, CCC-SLP, Kirsten Keppner, MS, CCC-SLP, Katie Mikkilineni, MS, CCC-SLP

December 19, 2016



What are some consideration for determining if a child should receive home health care services?


It is important to consider the following issues when determining if a child should receive home health care services: 

Respiratory issues:  Children with trachs, ventilators, severe BPD or other lung complications should receive home health services. Children with respiratory problems are very susceptible to illness, especially during RSV season. 

Gastrointestinal complications: Children with G tubes or any child that is on a continuous feed would most-likely benefit from home health services. 

Immunosuppression:  The medical team can help determine if a child’s immunosuppression is such that it makes them eligible for home care services. 

Endurance: Endurance may not be seen as problematic for patients in an outpatient setting however for some children, just the car ride to therapy can cause emesis or great fatigue.  Therefore, if a child has very poor endurance providing home care services may be the best option for them.  

Seasonal considerations: There are children that are considered to be fine when they are outside of RSV or flu season.  These children may be better suited for home care services from October through May. They could transition to outpatient during the summer and then transfer back to home health care in the fall. 

Geography:  Some children can live a significant distance from their pediatrician’s office or hospital.  Although this can be a very subjective criterion it is worth considering when deciding if home care services would be beneficial to the patient.  

leandre gerwin

Leandre Gerwin, MA, CCC-SLP

Leandre Gerwin is a graduate of the University of Cincinnati and has been a practicing Speech Language Pathologist at Cincinnati Children’s Hospital Medical Center for 17 years. During that time she has served medically fragile children, treating both oral motor feeding and language disorders through Home Health Care, the Neonatal Follow up Clinic and the Eosinophilic Disorders Clinic. She is the liaison for the Speech Pathology Department to Home Care for Cincinnati Children’s Hospital Medical Center and has presented at ASHA on the topic of creating and maintaining a successful Speech Therapy service program for Home Care patients.

kirsten keppner

Kirsten Keppner, MS, CCC-SLP

Kirsten Keppner is a graduate of the University of Wisconsin and has been working as a Speech Language Pathologist at Cincinnati Children’s Hospital Medical Center for 10 years.  She currently works as a home health care therapist and an inpatient therapist on the oncology/hematology unit and bone marrow transplant unit. She treats patients with a variety of feeding and language disorders and performs video swallow studies.  She has presented at ASHA on providing services to children undergoing bone marrow transplant and on Home Care speech therapy services. 

katie mikkilineni

Katie Mikkilineni, MS, CCC-SLP

Katie Mikkilineni is a graduate of Miami University has been working as a Speech-Language Pathologist at Cincinnati Children’s Hospital Medical Center for 8 years. She is currently at the Drake Campus and Home Health Care. Her area of interest and expertise is working with children and families impacted by apraxia, autism, speech and language disorders, and dysphagia. Katie has been with the Division of Speech Pathology for 8 years.

Related Courses

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20Q: In the Thick of It - The International Dysphagia Diet Standardization Initiative (IDDSI)
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The importance of using IDSSI to provide standardized language when speaking about texture modification is discussed in this course. Comparisons of IDDSI and the National Dysphagia Diet (NDD), as well as IDDSI standards for pediatric vs. adult patients are presented. Additionally, potential barriers, solutions, and frequently asked questions related to implementation of IDDSI are described.

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This course discusses early verb acquisition, choosing first verb targets, and a variety of strategies to facilitate verb learning using children’s picture books as a therapy context.

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Screening of swallow function is a well-regarded tool to identify individuals who are potentially at risk of dysphagia and in need of full swallow assessment, but the options are many and varied. This "back to basics" course will teach participants to make informed, evidence-based choices regarding appropriate screening tools specific to their particular patient populations and settings.

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