Choosing Treatment and Services

For_Parents

Your knowledge of your child's signs and symptoms can help you choose the most effective therapy.  When your child is first diagnosed, it can be overwhelming. There are many options for treatment and it can be difficult to figure out the best route to take for your child and family as a whole.

One important thing to remember is that all behaviorally-based treatment programs are different.  Each child can show different symptoms and signs, which means that each option should be carefully examined to determine which one is the best fit for your child.

If your child is non-verbal, has severe speech delays, maladaptive behaviors, or you have other needs, Autism Matters is a good option due to the focus on intensive behavioral intervention, communication and speech-language disorders.  

Listed below are general things to consider when choosing an early intensive behavioral intervention program for your child:

  • Intensity:  number of hours per week 

How many hours per week does your child need?  Although much depends on your child's symptoms, research shows that 25 to 40 hours per week are optimal to reach best outcomes for children.  This is particularly important in the beginning stages of intervention.  Some parents are worried that 25 to 40 hours is too long for their 2 or 3-year-old.  This is a valid concern, however, not having them in therapy for these hours is an even bigger concern.  Early intervention is extremely important for children.  It is important that children are learning communication, language and play skills for the majority of their day.  For children, this learning often does not take place naturally.  It takes highly-trained professionals and specific teaching techniques to effectively build the skills your child needs.

  • Placement:  in-home versus center-based 

Once you make the decision to enroll your child in an ABA or VB program, you are faced with whether or not to choose a home-based or center-based program.  How do you know which format is best for you?  The answer is that there are advantages and disadvantages to both.  It usually comes down to your preference and your child's unique symptoms.

The advantage to a home-based program is that you do not have to drive to the treatment location.  Everything is conducted in the comfort of your own home.  In addition, you can see/hear what is going on all of the time.  You get to know your child's therapists at a deeper level than you would if he/she was in a center-based program.  The disadvantage is that your home becomes a therapy center with people constantly coming in and out.  This can be hard on the family as a whole.  Parents also have to buy all the therapy materials over the course of treatment.

With the center-based program, on the other hand, the materials are typically provided for your child.  There are new toys and materials coming in all the time to keep them interested.  If they show a range of signs and symptoms, kids can receive other therapies (speech/OT/feeding/psychotherapy) throughout their day without you driving around from place to place.

Consistent training and supervision of staff is also an advantage of a center-based program.  Experienced, supervising professionals are on staff at all times to assist behavior therapists working with your child.  This can be a great asset with challenging symptoms and specific teaching questions that arise.  Having all staff under one roof allows for on-going, regular staff oversight and training.

In a center-based program, there are multiple children there with varying diagnoses.  This leads to natural opportunities for social interaction throughout the day.  Children can practice skills with other children in short group times that mimic those that occur in most preschool and early school-aged settings, such as circle time.  These groups, however, should be brief and have a specific therapeutic purpose.

The disadvantage is that all the social interaction in a center-based program is not always appropriate.  Therapists have to constantly be aware of this and reinforce positive, socially appropriate communication and play.

  • Child/Family Challenges 

Choosing the appropriate program for your child should depend largely on the challenges you face on a day-to-day basis.  If your child is not initiating interaction with you (i.e., pulling your arm to have you get something for him/her), not talking at all or not talking at an age-appropriate level, presenting with challenging behaviors, not communicating his/her needs, has feeding issues (i.e., picky eater) and/or all of the above; he/she needs to be enrolled in an intensive behavioral intervention program with a strong emphasis on speech-language pathology.  This means that an SLP must have a significant, on-going role in the development of your child's program.  Behavioral intervention is crucial for learning. Speech-language pathologists are masters-level trained professionals who understand communicatin and speech disorders, as well as anatomy and physiology of the oral musculature.  Therefore, a child with the issues listed above needs both professionals to be on the same page and have substantial input on day-to-day programming.

  • Transition Planning 

After some children reach a certain skill level (approx. 2-3 years of therapy), it is often appropriate to cut down on the intensive hours and start the transition into school or other appropriate settings.  In this case, children are typically enrolled in a half-time program. Children in a transition program typically continue regular individual speech-language therapy sessions.  The half-time program should be designed to fill in any missing language and social skills and set children up for success in the classroom.  The other half of the day is spent in school.  Over time, children typically transition into school full time.

Throughout this transition process, it is important to have a speech-language pathologist (SLP) and Occupational therapists on staff to collaborate regularly with the ABA therapists. ABA early intervention programs can be limited in terms of advanced language treatment for children who are in the "transition" stage.  SLPs understand typical language development across the lifespan and are therefore an important part of the transition process.

For more general information on autism and other treatment options, take a look at the websites listed below:

Center for Disease Control
http://www.cdc.gov/ncbddd/autism/index.html

Autism Speaks
http://www.autismspeaks.org/whattodo/what_is_aba.php

National Institute of Health
http://health.nih.gov/topic/Autism