How Often Should My Child Have Therapy?

Parents ask this before they ask what the work is. Hafte mein kitni dair? Roz ana hai? They have seen a number on a Facebook page — twenty hours, forty hours, five days a week — and they are trying to work out whether they can afford to be good parents. That number is usually imported from a different model, in a different country, sold as a prescription. It is not ours.

How often your child should be seen depends on the skill, the age, the week you actually have, and how far you are driving. A consultation is Rs 1,500 and lasts up to 50 minutes. Only after that look will we recommend a rhythm, and we will recommend the one you can keep. A perfect timetable that dies in November is not intensity. It is a dropout.

This is not the same question as how long the whole course takes — that sits on how long speech therapy takes. This page is frequency: weekly, fortnightly, a block, a gap, video in between.

There is no honest weekly number before we meet the child

A four-year-old working on two speech sounds is not the same job as a child who cannot yet sit, wait, or ask for help. A teenager who will talk from their own room on video is not the same job as a two-year-old who will not stay in frame. Anyone who quotes a weekly hour count before they have seen your child is selling a package, not making a plan.

Mahnoor Baloch leads first assessments. She will tell you what she saw, in plain words, the same day. She will not diagnose autism or ADHD, and she will not prescribe. Frequency comes after the picture, not before it. If another centre has already sold you a 20-hour week, bring the file as a second opinion. We will say whether that load matches this child and this household. We will not match a number to win the booking.

Weekly versus fortnightly

Weekly is the default for many children who live in or near Multan and are learning a new skill that needs a short loop: try, practise at home, come back, adjust. Speech sounds, a new requesting word, a first-then for the door — those loops go stale if the next adult input is three weeks away and nobody at home is running the move.

Fortnightly is not a lesser service. It is the right service when:

• the home practice is actually happening, so the session is a coaching visit, not the only practice
• the drive would make weekly impossible by week six
• the child needs longer between visits to show whether a skill has stuck
• exam season, a new baby, or illness has eaten the week, and we would rather thin the rhythm than lose you

Twice a week is occasionally useful at the start of a narrow target, then we step down. It is not a personality. It is a short burst. More than that, in our room, is rare, and we will say why if we suggest it. What we will not do is fill the Monday-to-Friday, 2pm-to-6pm window with your child every day because a page on the internet said “intensive.”

Two honest weekly sessions with a tired, hungry child are worse than one weekly session he can use. Frequency is not a moral score. It is a dose. The dose has to fit the body.

Travel from South Punjab

Lodhran, Muzaffargarh, Khanewal: an hour or so each way. Weekly or fortnightly in person is often realistic, with home practice on the other days. Bahawalpur, Sahiwal, Dera Ghazi Khan, Bahawalnagar: that is a day, not a slot. Most of those families do one fuller visit and video in between. Areas we serve sets the road out properly. Do not copy a Multan child’s weekly plan onto a DG Khan week and then blame yourself when Fridays are a write-off.

The hidden cost of travel is not petrol. It is the child who arrives already done, the sibling who sat in the van, the parent who used a leave day, and the weekend that then collapses. A fortnightly visit you keep for a year beats a weekly visit you keep for six weeks. Tell us the true journey. We will not be impressed by a heroic timetable.

If you are stacking school, local tuition and a Multan drive, read tuition overload before you add us as a fourth shift. We would rather be the thing that stays and the tuition that pauses than the opposite.

Online between visits

Video is not a consolation prize. Parent coaching, school-age speech, a review of the home log, a teenager who talks more from their own room — those are often better on a laptop than in a toy cupboard. A first full developmental look, hands-on motor work, hearing, feeding safety, a toddler who will not stay in the room: those still belong in Model Town when we can do them.

The mixed rhythm we use most for distant families is: in-person assessment and a stretch of in-person teaching, then video fortnights, with a return to the room when a skill needs the body or a review needs play we cannot see through a camera. Online versus in person is the honest comparison. Online hours are still Monday to Friday, 2pm to 6pm Pakistan time.

A parent in another city can take the video slot even when the child is with dadi in Multan. That is a legitimate way to keep a father or a travelling parent in the plan. The child does not have to sit staring at the screen. We coach the adult who is on the floor.

Why we do not sell 40-hour weeks

You will see “40 hours of ABA” on international sites and on some Pakistani ads. That figure comes from a specific, intensive, clinic-and-home model of applied behaviour analysis, usually with a Board Certified Behaviour Analyst supervising a team. We do not run that model. We do not have a BCBA. Noor Fatima delivers ABA hours on a plan Mahnoor has set, in ordinary session lengths, not as an all-day package. Intensive 40-hour weeks are a different service, in a different kind of organisation. They are not a prescription we will write, and they are not a standard your child is failing by not receiving.

We say this plainly because parents come in ashamed that they “only” brought the child once a week. Once a week, kept, with five minutes at home on most days, is a serious programme. Forty hours is not the adult version of the same thing. It is another thing. If you need that other thing, we will say we are not it, rather than dilute the word “intensive” until it means “we squeezed two slots in.”

We also do not diagnose or prescribe. Frequency is a teaching decision, not a medical dose of hours. Anyone who talks about hours as if they were milligrams has confused therapy with medicine.

What “more” actually buys

Sometimes more buys a tighter loop: faster adjustment, more coaching, a skill that is on the edge and needs a push. Sometimes more buys a tired child and a parent who hates Tuesdays. The second kind of “more” shows up as missed sessions, a child who cries at the door, and a log that is blank because the week had no air in it.

More does not buy a cure. It does not buy a diagnosis. It does not buy school admission. It buys repetitions with a skilled adult, and a chance to correct the plan. If the repetitions are happening at home, you may need less of us, not more. If they are not happening at home, more sessions can become a way of avoiding the house problem. We will name that. It is not an accusation. It is why home practice that actually happens is part of frequency, not an extra.

Group hours are not “more therapy” in a cheaper wrapper. We mostly work one to one. A short group sit, when we use one, is school-readiness practice — sitting, waiting, a goodbye — not a social miracle and not a way to double the hours. That comparison is group versus one to one.

When to step up, when to step down

Step up for a short stretch when a new skill is just appearing and the home loop is tight, or when a review shows the plan is right but the child needs a denser few weeks. Step down when the skill is turning up at home without a prompt, when the drive is starting to cost the week, or when school load has to win for a fortnight. Stepping down is not graduating. Graduating is a different decision, described on graduating from therapy.

If progress has gone flat, the answer is not automatically a second weekly slot. Flat is a reason to review the goal, hearing, sleep, and the school day — when progress stalls — not to buy more of an unchanged plan. Trying harder at the wrong frequency is still the wrong plan.

Fees, hours, and a schedule you can keep

Our hours are Monday to Friday, 2pm to 6pm, MPS Road, Model Town. That window is also tuition, the van, and every other clinic in the city. We will not pretend we can see you at 8am. If that window is impossible most days, video or fortnightly is the honest path, not a waiting list for a morning we do not offer.

Fees are on the fees page. The first look is Rs 1,500 for up to 50 minutes. Ongoing session fees are talked through before a block, not sprung after you have already bonded with the room. We would rather you kept a fortnightly slot you can pay for than start weekly and disappear when the quarter’s school fees land.

Bring the real diary to the first hour: school finish, tuition, who drives, who is home at 4pm, how far, how much leave you have. Take questions to ask so frequency is a question you ask us, not a number you guessed from a reel. WhatsApp +92 301 6424265. Urdu or English. You do not need a referral, and you do not need to have decided weekly-or-not before you walk in. That is what the hour is for.