If you are a parent of a young child with autism spectrum disorder (ASD), you may be juggling multiple services and interventions during the week (such as occupational therapy, speech therapy, social activities, applied behavioral analysis (ABA). You may be wondering how to gauge your child’s progress in these interventions. You may also be wondering how you will pare down these interventions once your child enters school. For instance, how much intervention is TOO much intervention? And how do I know which interventions are really making a difference and warrant continuing once my child enters school?
Is My Child Making Progress?
First things first: let’s address how to know if your child is progressing in treatment. Generally, you want to be working with providers who set concrete, measurable goals that are reviewed regularly (preferably with parent input, so that you agree on goals and are apprised of your child’s progress toward them). Best case scenario, your provider offers you a written document (that highlights your child’s goals and progress toward them) and takes “data” that can be used to determine progress over time. Once your child meets a goal, a new, more complex goal might then be set; thus, you will see your child progress from basic skills to increasing complex skills. If you do not know what goals your provider has set and/or what type of progress your child is making, do not be afraid to ask straight out; that way, you can make a more informed decision regarding whether you want to prioritize treatment with this provider.
The other progress marker to look for, is a treatment that involves “homework” or tasks to work on at home between sessions. This not only provides more opportunities for your child to practice their new skills, but helps to transfer skills from the therapy to the home setting. Homework is also a way of involving you (the parent) in treatment and teaching you the skills you need to foster your child’s growth outside the therapy setting. Thus, more rapid and robust progress is made.
Bottom line: Stick to interventions that involve measurable goals, provide clear evidence (or data) that your child is systematically gaining more complex skills, involve “outside of session” practice, and are offered by providers that are transparent regarding their work with your child. If you find that one or more of these pieces is missing, it may be time to talk to your provider and/or seek advice from your primary care provider or another professional that knows you and your child well.
How Do I Fine Tune My Child’s Treatment Plan?
On to our second conundrum: how to pare down interventions when your child enters the school system. Inevitably, much of the time your child spends in the many interventions he or she is enrolled in will now be taken up by the school hours. In addition, school districts offer many of the same interventions you may have been receiving in the community (such as speech, physical, and/or occupational therapies and/or social skills intervention). The first rule of thumb, in this situation, is to maximize the services your child receives in the school setting. You can then supplement any gaps with community services; when doing so, remember to use the markers of an effective intervention (as outlined in the first part of our discussion).
Of note, more intervention is not necessarily better intervention; it will take a great deal of your child’s energy to attend school all day (or even half day), and they will need some “down time” during the week. Thus, prioritizing outside-of-school interventions becomes increasingly important. Remember that your child will be gaining a wide variety of social, communicative, academic, and functional skills in the classroom setting; in essence, a great deal of intervention is built into your child’s school day.
Finally, remember that nothing is permanent. If you decide to discontinue a treatment, and then later decide that your child would continue benefiting, you can re-commence treatment.
In sum, it can be difficult to decide which treatments are effective and warranted, especially after your child begins school and has fewer hours in the day for outside treatments. It will be helpful to remain “in the know” regarding your child’s treatment goals, to maximize practice opportunities outside of therapy, and to have frank (and frequent) conversations with your community providers regarding your child’s progress toward goals. Thus, you can feel more confident in your ability to prioritize treatments. Finally, do not be afraid to “schedule in” some down time; kids need time to be kids, to play, and to relax. Just like all of us, children with ASD benefit from having a good balance of work and play.