My child has an autism diagnosis, where do I start?
Take a deep breath and we are here to help. Your first step was identifying that something wasn't right and you went to see your pediatrician. Either she helped you with the diagnosis or you were referred to a developmental pediatrician. Here is a quick resource to let you know what to do now and what therapies are available to help your child grow and make progress!
What is Speech and Language Therapy? A speech pathologist is an integral part of a therapy team. They will work with your family and developmental pediatrician and make sure the best individualized plan of care is implemented for your child. It’s best to find a therapist that is trained in the DIR Floortime model and many of the modalities listed below. The speech therapist will be working on increasing verbal and non verbal language, social skills, auditory processing and learning.
What is Occupational Therapy? An OT will help your child with sensory integration, play skills, awareness of personal space, response to touch and other stimuli, motor skills like balance and manipulation of objects, self help skills (such as tying shoe laces, buttoning a shirt and general adaptive skills) and self control skills.
What is PROMPT Therapy? PROMPT is a therapy service for children that are non verbal, have a diagnosis of apraxia, dysarthria, pervasive developmental disorder (PDD NOS and Autism) and feeding disorders. A speech pathologist must be certified to provide this service. A2 Therapy Works holds this credential and we love this program. We help the mouth muscles with place and movements to help children produce sounds and words correctly. The therapist teaches the child’s muscles to produce a phoneme correctly by stimulating all of these through touch which intern helps the child produce sounds, words and sentences. https://youtu.be/NaS9MeDU0CE
What is Interactive Metronome? Interactive Metronome is a computer and headphone based therapeutic tool provided by speech and occupational therapists. It helps kids with attention, concentration, motor planning, low muscle tone, organizational skills and auditory processing. During the session, you child sits or stands at a computer with a pair of headphones on. A metronome beat is heard through the headphones and a visual guide is displayed on the monitor. Children are then prompted to match each beat with a hand or foot movement including crossing midline. The program measures to the millisecond how closely the child matches the beat. Over the course of this therapy children learn to focus and attend for longer periods of time, increase physical endurance and stamina, improve fine and gross motor skills, filter out internal and external distractions and improve their ability to monitor cognitive and physical actions as they are occurring. Intereactive metronome is used for many different diagnoses including PDD-NOS, Autism and ADHD. Interactive Metronome can be done in therapy centers or can be set us as a home program. https://www.youtube.com/watch?v=cXLt8Z3K49k
What is Handwriting Without Tears? Children on the Autism Spectrum often have limitations with their fine motor skills. Handwriting Without Tears is a great program to help children learn to write letters, words and keyboarding. It was developed by Jan Olson, an occupational therapist. It’s a program that teaches handwriting with multisensory tools allowing kids to learn handwriting through all styles of learning. We also use it to teach proper pencil grip. There are many items that you can purchase for home including workbooks, wood pieces to build letters, chalk bits and sponges which allow for learning through touch and sound. We love this program! We use it with all sorts of kids! https://youtu.be/7QHop5ihZUE
What is DIR FloorTime? DIR stands for “development, individual differences and relationships”. The long and short of the DIR Floortime model is getting on the floor with a child and engaging them in play based therapy. This technique helps children relate and communicate by forming circles of communication. An example of this would be sitting on the floor rolling a ball back and forth, this would be an engaged moment between a parent and child or therapist and child. Another example is a child is playing with a toy car pushing it back and forth. A therapist would maybe then put a triangle block in front of the car and the car would have to go up the “ramp”. That is adding to the child’s play skill and engaging in a circle of communication.
The founders of this program are Dr. Greenspan and Dr. Weider. The program works on self regulation and interest in the world; forming relationships, attachments ad engagement; 2 way purposeful communication; developing a complex sense of self; elaborating symbolic thinking; emotional thinking and the expression of thematic play. This technique is fantastic and we see children make much progress when we implement Floortime “play therapy” into our sessions. https://www.youtube.com/watch?v=6c_5fVsjhwQ
What is ABA? Applied Behavior Analysis was developed by Dr. Lovaas and is often called Lovaas Therapy. You can read about this online for hours but the easiest way to understand it is your child will increase his learnings and positive behaviors with repetition and rewards. This program was developed to help children with ASD learn.
Your child will be followed by therapists and given a large binder with his learning programs where his progress will be tracked. What I like about this program is there is a lot of data being kept on your child so you can tell what is changing and what progress is being made. Children may do this anywhere from 5-30 hours a week. This is a great program when done properly and worked in with DIR Floortime as well as speech and occupational therapy. I really like this blog that gives you free handouts and explanations of how to set up an ABA program. http://www.iloveaba.com/p/free-resources.html
We don’t provide ABA set up currently at A2 Therapy Works but we are happy to work with you in finding resources and we will help add to the program with speech, language, social language and fine motor goals. https://www.youtube.com/watch?v=iyCx-OLzgJw
What is the Hanen Approach? Hanen Approach “It Takes Two to Talk” is a program used by parents and therapists to help engage children with Autism to learn and communicate. I like how this program is child centered and has a lot of the DIR Floortime techniques worked into the program. You’ll learn the “OWL” strategies which stands for “Observe, Wait, Listen”. The OWL strategy helps you follow your child’s lead and allows him to learn through things that interest him. Jumping into their world instead of making them do something you want to do is the basis of this program. Waiting is the hardest part because parents (and therapists!) sometimes want to jump in and help their child. Try to count to 10 in your head while you are waiting for a response from your child. The “3 A’s” in Hanen are “Allow, Adapt and Add” which teaches parents to “allow” your child to take the lead on what they are playing. “Adapt” and “add” means that once you have jumped into their play sequence you can change it a bit and add to it therefore increasing their play and communication repertoire.
What is Fast ForWord? Some language impaired kids have trouble processing language. It often may sound fast or garbled to them or they may have trouble discriminating between sounds. Fast ForWord is a computer based training and Fast ForWord says that it improves auditory integration, attention to task, working memory, phonemic awareness, reading skills and listening comprehension. With any program, it’s a good idea to look at independent research. It should be noted that the Journal of Speech Language and Hearing published a research article which concluded that Fast ForWord was not more effective at improving general language skills than regular speech and language services. It showed that all kids made gains no matter what the intervention—speech and language services or Fast Forward. Always important to look at research!
What is the Beckman Oral Motor Protocol? Oral motor skills are functions that control secretions, swallowing, sucking, feeding and speech. This program helps kids that have trouble in speech development, articulation, hypsensitive mouths which lead to being a picky eater or messy eater. This program also helps with drooling, bruxism (tooth grinding) and gagging. A speech pathologist or occupational therapist must be certified in this technique. A therapist will use her hands on a child’s face to help manipulate the muscles in the mouth and face. Research on oral motor therapy efficacy is mixed but I’m a believer that you see what works for your child and that a plan of care should encompass a variety of therapies and modalities. https://youtu.be/KKxbexuV804
What is the Alert Program? I love this program for self-regulation. We can all use this sometimes! The Alert Program was initially developed for children ages 8-12 with learning and attention difficulties but it has now been adapted for kids starting before preschool. It’s a great program that introduces the “sensory diet”. We use this program for kids with Autism whom are both verbal or non verbal. The engine analogy is a great way for kids to learn about self-regulation by noticing if their “engine” is going into high, low or just right gears. If kids are non verbal, we use pictures and the Alert Program has some products you can use at home as well. https://youtu.be/NPEwwzAT_lc?t=38s
What are PECS? Whether your child is non verbal or can use some additional visual stimuli, PECS are a great addition. PECS stands for Picture Exchange Communication System. It’s a group of pictures that you can purchase or search online that helps your child communicate through picture. It’s an augmentative or alternative communication intervention. It starts with children handing someone or pointed to a picture of an item they want. It’s a great way to reduce frustration for a non-verbal child. You’ll often times see PECS being used at schools. You can purchase “boardmaker” for your child or your therapy offices will also be happy to make you a communication board with their boardmaker.
What is the PLAY Project? I love this program because it’s right here in our backyard. Dr. Solomon, a developmental pediatrician in Ann Arbor, Michigan developed this program based on the teachings of Stanley Greenspan and the DIR Floortime Model. The Play Project is an acronym for “Play Language Autistic Youngsters”. It’s shown to help increase parent and child interactions, increase social interactions of a child with autism, improve social-emotional development and behavioral compliance with children on the autism spectrum. https://youtu.be/29_m1hupR-4
What is AAC? Augmentative or Alternative Communication is there to help if a child is non verbal or on her way to becoming verbal. PECS (as mentioned above) is a way to help reduce frustration by communicating via picture exchange or pointing at pictures. The next step up with this is a computer or ipad based program. Our favorite is "Touch Chat". It is pretty user friendly in terms of set up but your speech or occupational therapy can help you with it. You can buy it through itunes. It's not cheap but it's a great program ($149.99-$299 depending on the program). You can also purchase Touch Chat "lite" via itunes for $9.99.