QUALITIES OF EXCELLENT AUTISM CARE & TREATMENT

With the range of programs and services available to parents of children with autism, it can be confusing and overwhelming to choose the most appropriate therapy option. In my experience working with families, there are several highly effective therapy programs that are significantly improving the quality of life of children with autism and related disorders. Regardless of the 'brand' of therapeutic approach, there are principles common to highly effective programming that seem to make the most positive impact.

1. Treatment is Heart-Centered – all caregivers (parents, babysitters, therapists) and service providers should ideally be coming from a place of supportive, loving energy. (Not to be confused with celebrating for no reason)

2. Family Priorities are established in the intake process to guide treatment objectives. Parents should feel competent setting goals for the family and be given tools to monitor progress toward those goals.

3. Treatment goals are directly related to functional improvements in Quality of Life for the child and the family. (A child in Florida does not need to know what a sheep is when he doesn’t know another person is in the same room with him.)

4. Progress is measured by spontaneous and independent demonstration of skills and behavior. It does not matter what a child is doing when prompted if we don’t see spontaneous generalization and use of skills.

5. Priorities guide treatment planning. Parents understand they don’t have to do everything at once, nor do they have to do everything before the child turns 5 years old. The medical establishment unnecessarily stresses parents by drilling this false notion into their psyche. People grow and develop throughout their whole lives. Otherwise none of us would have learned to drive a car.

6. Don't believe 'conventional wisdom'. Science is important and critical thinking is imperative. However, be aware that it takes decades before the cutting edge research is distilled into textbooks which are used to train the next generation of therapists. The majority of professionals diagnosing autism and making treatment recommendations have little real-world experience in the homes of families who live with an autistic child. In addition, it is rare to find a diagnosing professional who has a good idea of the pros and cons of various treatment modalities. Just because a PhD or MD says ABA is the ‘only’ effective autism therapy does not mean it is true (it is not). It just means it is the only one they have heard much about and they probably learned about it in their doctoral or medical school program at a continuing education seminar.

7. Autism can be thought of as a disorder of Regulation – therefore, treatment programs that emphasize ‘bottom-up’ as well as ‘top-down’ processing modalities seem to support regulation of the brain and nervous system more effectively than one or the other in isolation. Self-regulation and Co-regulation can be addressed through a combination of various body-mind (i.e. HANDLE® and MNRI®) and cognitive-developmental approaches (i.e. RDI® and Miller Method®) that are very successful at getting to the root of many of the processing challenges children with autism tend to have.

8. Teaching skills (i.e. academics, ABA, etc.) should be addressed after Self-Regulation and Co-regulation are in progress or developing. (Self-regulation is not to be confused with “Compliance”, which often happens in place of mindfulness and self-regulation.)

9. Parents who understand the concepts of regulation, co-regulation, and experience-sharing communication are able to use daily natural teaching opportunities with their child with autism. Children who are provided with daily natural co-regulatory experiences will make more rapid progress in various aspects of functioning, since co-regulation is a foundation to communication and independent functioning. (Co-regulation is often non-existent in individuals with ASD. Instead a pattern of compensation develops and ‘pseudo-coordination’ or ‘pseudo-conversation’ ensue.)

10. Be mindful not to ‘over-therapize’ the child with autism. Remember that children with autism are children first. It is not ‘normal’ for a child to spend dozens of hours each week in one-sided therapeutic interactions (which much of autism treatment can be without understanding co-regulation, which is mentioned in #9). It is important that children with ASD are provided with competent roles and participate in family life like their siblings. We hope for children with autism to turn out ‘normal’ as adults when much of their childhood does not provide ‘normal’ experiences if they are over-therapized.