What comes after the diagnosis?
Having had a therapy clinic for over 10 years, I have had the privilege of working with many families that have gone through the process of receiving an ASD diagnosis, and deciding what interventions will benefit their children the most. Often times a diagnosis will be the first step into a world that can be confusing and frightening. But with the right tools, it can also be the first step in empowerment, education and progress for your child.
The actual process of receiving a diagnosis can be difficult. Professionals will be talking about your child in clinical terms and that, in itself can be overwhelming. It is likely that you will feel like asking the question “don’t you see anything positive and special about my child?” The most important thing to remember is that your child is the same child they were before the diagnosis. They have special gifts and strengths that a diagnosis cannot change. But, identifying challenges and labeling them can be an important part of accessing much needed services and funding sources.
In my experience, the children that make the most progress are those that belong to families that are willing to take a risk. Those families that are willing to listen to the professional’s opinion, weigh the options and design a program that fits their child and family. It does require time and energy on the part of the family, which can be in short supply when you have a child with special needs. But if you take the best of all different types of interventions and put it together, it is often more successful than choosing only one path. It is distressing when I hear families tell me that they have been given one option. I have yet to meet a child that is one-dimensional. Each child is unique and complicated, and needs a variety of approaches. Just ask yourself if you have learned everything you know using just one approach, or have you learned in a variety of different ways. Your children are no different!
I will try to cover a few different options that can be included in a program of intervention. This is by no means an exhaustive study of the alternatives out there. I have, however, had personal and/or professional experience with each. This is not to say that you should try them, only to give you an idea that there are many paths available to your child and family. The only intention of this article is to provide information and a “jumping off” point. You can research on your own what combination would best suit your family, or if any of them at all would be a good fit in your particular situation. However, I do suggest that an individualized approach is a key to success.
Sensory Integration Therapy – This happens to be my specialty, so I say up front that I may be biased toward recommending this type of intervention. I have seen many children with ASD and all have had sensory challenges. Sensory integration is a theory that was developed by A. Jean Ayres PhD, OTR in the 1960’s. Sensory integration refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses to build skills. Those skills can be anything from learning how to play, interact with family and friends, ride a bike, write your name, dress yourself or brush your teeth. Everything that we do requires us to use sensory input efficiently and effectively. This type of intervention is play-based and can be provided by an occupational, physical and/or speech therapist. Most of the time it is an occupational therapist that will be the sensory integration specialist. It is important to find a provider that has certifications, experience and/or training in this area specifically (look for my article How To Choose A Therapist).
Play Therapy – Play is the “occupation” of childhood; it is a child’s job and what is developmentally appropriate for them to be engaging in on a daily basis. Play has gotten a “bum rap” as being frivolous and only to be engaged in if you don’t have anything else to do, or you can fit it into your schedule. On the contrary, it is essential for the development of academic, social and life skills. This type of intervention taps into the innate drive of each child to play and connect with others. Floortime/DIR and Play Project are all programs that are worth investigating.
1. Floortime- The Greenspan Floortime Approach is a system developed by the late Dr. Stanley Greenspan. According to their website, Floortime meets children where they are and builds upon their strengths and abilities through creating a warm relationship and interacting. It challenges them to go further and to develop who they are rather than what their diagnosis says. In Floortime, you use this time with your child to excite her interests, draw her to connect to you, and challenge her to be creative, curious, and spontaneous—all of which move her forward intellectually and emotionally. (As children get older, Floortime essentially morphs into an exciting, back-and-forth time of exploring the child’s ideas.) See their website at www.stanleygreenspan.com
2. Play Project The philosophy of the Play Project is that all parents will be supported in developing a joyous relationship with their children with autism spectrum disorders in a way that will help each child reach their full potential. Their mission is to train a global network of pediatric professionals to deliver an evidence-based, cost effective intensive developmental intervention to families of young children with autism spectrum disorders. See their website at www.playproject.org
ABA Therapy – Applied Behavioral Analysis (ABA) is a therapy that uses behavioral principles to teach skills. There are many skills that a child needs to learn that can best be taught using a behavioral approach; it can be very effective for discreet skills such as activities of daily living (ADL’s), such as dressing, toileting, brushing your teeth, etc. It is an intense program and typically requires many hours of ABA therapy per week. According to the Center for Autism and Related Disorders (CARD), Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation from Behavior Analysis, and the procedures and technology derived from those principles, to the solution of problems of social significance. Many decades of research have validated treatments based on ABA. You can find more information on www.centerforautism.com
Integrative Medicine – The Duke University website gives a great definition of what integrative medicine is designed to provide to families. Integrative medicine is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. Employing a personalized strategy that considers the patient’s unique conditions, needs and circumstances, it uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease and help people regain and maintain optimum health. www.dukeintegrativemedicine.org
Complementary Therapies
1. Neurofeedback - Neurofeedback is direct training of brain function, by which the brain learns to function more efficiently. We observe the brain in action from moment to moment. We show that information back to the person. And we reward the brain for changing its own activity to more appropriate patterns. This is a gradual learning process. It applies to any aspect of brain function that we can measure. Neurofeedback is also called EEG Biofeedback, because it is based on electrical brain activity, the electroencephalogram, or EEG. Neurofeedback is training in self-regulation. It is simply biofeedback applied to the brain directly. Self-regulation is a necessary part of good brain function. Self-regulation training allows the system (the central nervous system) to function better. Neurofeedback addresses problems of brain disregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficits, behavior disorders, various sleep disorders, headaches and migraines, PMS and emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy. Learn more about neurofeedback at www.eeginfo.com
2. Essential Oils- Essential oils have enhanced lives for thousands of years, offering a variety of benefits from cosmetic and dietary purposes to spiritual and religious use. They are naturally occurring, volatile aromatic compounds are found in the seeds, bark, stems, roots, flowers, and other parts of plants. They can be both beautifully and powerfully fragrant. Essential oils give plants their distinctive smell; essential oils protect plants and play a role in plant pollination. In addition to their intrinsic benefits to plants and their beautiful fragrance, essential oils have long been used for food preparation, beauty treatment, and health-care practices. Information taken from websites www.doterra.com and www.youngliving.com
3. Nutritional Interventions-A gluten-free/casein-free diet is also known as the GFCF diet. It is one of several alternative treatments for children with autism. When following this strict elimination diet, all foods containing gluten ( found in wheat, barley and rye) and casein ( found in milk and dairy products) are removed from the child's daily food intake. Some parents of children with autism report their children are allergic or sensitive to the components found in these foods. Some seek allergy testing for confirmation. Yet, even when no allergy is confirmed, many parents of autistic children still choose to offer the GFCF diet. Among the benefits they report are changes in speech and behavior. You can find more information on www.webmd.com
The important point is that there are many options available to your child and family as you begin your journey. Keep an open mind, learn from others, research on your own and find what works best for your child.