As Susan wrote about so eloquently, the period of time around an autism diagnosis is acutely distressing for parents. One of the first things parents are generally told to do is to go home and immediately gather a team of competent therapists to work with their child; whether this is done through a school district, early intervention, or privately, this is a daunting process - and would be even without the overlay of grief and anxiety. Parents then discover the variety of treatment strategies available to them; sometimes this may give them a burst of hope for their child, but my sense is that initially it's nothing short of overwhelming. So Susan has asked the therapists contributing to The Family Room to do what we can to help parents figure out what to look for and what to ask when searching for good therapists.
There are many ways to approach working with a child with an autistic spectrum disorder. I have read recently that, really, any of the most popular strategies will result in positive gains, assuming the child is receiving enough of it as soon as possible, and the parents are involved in the treatment as much as possible. This is not to say that I have no preferences when it comes to treatment, but the fact is, it is going to be up to the parents to determine whether they are most comfortable with DIR/Floortime, RDI, SCERTS, ABA, PECS, and/or TEACCH, to name a few big ones. Some families will find that one clearly resonates with them immediately and others will need to ask the diagnostician, their pediatrician, other parents, and the Internet for advice before making the decision. Of course, you want to find therapists with experience, proper license, and good training. But here are some additional things to look for - and pitfalls to avoid - when searching for your therapists:
1. If a therapist suggests to you that you have "wasted time" by not getting help earlier or by taking part in another type of treatment, do not hire that person. A good therapist has no interest in making you, the parent, feel guilty or incompetent.
2. Similarly, consider all statements about missing out on your child's "window of opportunity" to be scare tactics. Yes, those neuronal connections develop quickly in the early years, but they continue to develop throughout the life span. By waiting two weeks for your first session because of that family vacation you already had planned, you are not harming your child.
3. When a therapist or treatment center has a blanket policy of not allowing parents to take part in therapy sessions, consider this a red flag. If your child seems to be overly distracted by your presence in the room and needs a period of time alone with the therapist to establish a relationship before introducing you back into the sessions, so be it. But for a parent to be denied all access to view and participate in therapy, and for no coaching to take place? When the parent asks for it directly? Not good.
4. Pay attention to the attitude of the therapist when you make the initial contact. Does he/she try to sell you on a particular treatment, assuming it works for all children, or are you asked questions about your specific child? Be cautious about one-size-fits-all approaches and those who feel they can treat all children with one treatment approach. You want to find therapists who see your child as a unique individual; the good therapist will meet your child where he or she is and build from there.
5. Find therapists who are willing to take the time required to establish a positive relationship with your child before expecting any learning to take place. There are children who will walk in the door and feel comfortable, connected and ready to learn. Then there are others who need a lot of time with a therapist - time without demands, when the pair can simply work up to joyful interactions at the child's own pace. This might involve spending a session lying on the floor together, listening to the child's favorite music, and requiring absolutely nothing of the child. The child may start the session cautious and disengaged, but by the end of the hour may be cuddled up with the therapist, stealing glances and smiling at her. This time is well-spent because within a few weeks, the pair has formed a trusting relationship in which the child is willing to take some risks and move outside of familiar patterns. Now learning can take place.
6. Be sure you are getting consistent communication from your therapist and find out if he/she communicates regularly with other team members via phone calls, email, sharing notes, etc. A therapist operating as a cooperative member of a larger team is going to have a greater impact on your child's development.
In the end, you want to work with professionals who respect you as a parent and love your child for being the amazing individual he or she is. When these qualities are in place, so much growth can happen for your child.
To reach Jordan directly, email: Jordan [at] communicationtherapy [dot] net.
Thank you, Jordan. This is exactly what I wish we'd known on day one.
Posted by: Susan E | March 06, 2007 at 10:06 AM
All excellent points - pity I didn't know that [those] a few years back, it would have saved us all a lot of grief.
Best wishes
Posted by: mcewen | March 06, 2007 at 04:45 PM
Great article Jordan - I'm sure many parents will benefit from it!
Posted by: Liesl Wenzke | March 11, 2007 at 05:38 PM