DEAR ERI COMMUNITY: I currently have a client with Rett Syndrome and this is my first case in my career to treat the child. She presents with very high functioning skills, she is able to transition from the floor to stand via bear stance, she can walk over uneven surfaces with out falling over, she can gallop and increase her walking speed without falling. She has a #3 DAFO on one foot and a #4 DAFO on the other. Cognitively she does not follow verbal commands and requires hand over hand assist to stay on task. This child is 10 years old and the previous therapy place was seeing her on a weekly basis. I reached to them to ask their recommendations and opinion on realistic goals and if she requires continued therapy on a weekly basis. The therapist philosophy was to treat this child on a weekly basis due to her progressive neurological decline and that if she saw the child, that the child would not regress. I treat what I see, I also work in an outpatient clinic which insurances drives to see improvements. Is skilled services required at this time with her current presentation?