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Therapy? Which One and How Much is Too Much?

Read on for suggestions about which therapies to use for your child  and how much therapy is sufficient.

Read on for suggestions about which therapies to use for your child  and how much therapy is sufficient.

I’ve been working with parents and families for nearly two decades. I have not, in all these years, met a mom or dad that said: “Parenting is a piece of cake!” 

It is the most important, yet underrated, job in the world. It is a tremendous responsibility for a young adult (in most cases) to be the sole provider for a small being. Parents feel responsible not only for their child’s safety, but their emotional wellbeing, life choices, heartache, and possible bad decisions, too. 

Many parents doubt themselves. They have doubts about the way they raise their children and whether it is the best they can offer. 

These doubts reach new heights when parents start to notice their child is not quite the same as other children. Their child may not communicate as much, perhaps not responding when they call his/her name. 

Parents fear the unknown, they start searching for answers, and Google eventually convinces them to consult a specialist, urgently. The visit to a developmental pediatrician is always a nerve-wracking experience—maybe because as a mom you can sense when a big change is imminent. There may not be scientific research that provides empirical evidence of a mother’s intuition, yet all moms will be familiar with this feeling. 

Pediatricians will usually conduct a series of developmental tests on your child and ask you, the parents, a list of questions. If you receive a diagnosis for your child,  you will usually be informed of suggested therapies and a follow-up visit. 

It is a good idea to ask for a list of recommendations from the specialist you consulted. Just keep in mind that these are suggestions, not a therapy roadmap you have to adhere to. Parents are the true experts when it comes to their child, that is, until your child becomes their own advocate. 

Parents have different reasons and motivations behind their decision to seek an expert opinion, so please see a list of suggested actions that may help with this sometimes-challenging experience: 

Give yourself space and be kind to your own feelings of loss 

Although you have unconditional love for your child, there is no denying that parents may experience a feeling of loss when they receive a diagnosis. To start “therapy” for a child may seem surreal, especially if your child looks (and for the most part acts) similar to his or her peers. 

It is normal to go through all or some of the phases of acceptance—to deny the doctor’s diagnosis, to get angry about a diagnosis you are not familiar with. Next, you may engage in some subconscious bargaining, where you believe that if you follow through with one suggestion the diagnosis might just not be true. Most parents admit to feelings of sadness or depression; they feel catatonic, incapable of making a decision about the best therapy route for their child. These cycles can be short or long, and you may go from one feeling to the next before you reach some form of acceptance. 

Please know that this is perfectly normal and nothing to feel guilty about. The important part of acceptance is that you will soon realize your child is still your precious son or daughter. He/she wants you in their world and he/she wants to share his/her perfect uniqueness with you. 

Get to know your child—again 

Many neurodivergent adults advocate for acceptance and respect. They have a voice and they are proud of who they are—yet most remember feeling misunderstood. Keep those feelings in mind as you support your child in navigating the neurotypical world.

A child diagnosed with autism spectrum disorder (ASD) probably experiences the world in a very different way than you. Colors are brighter, sounds may be heard more acutely, and your child may struggle to enjoy the mundane. He/she may hyperfocus and engage in his/her special interests for hours. Your child may prefer nature to human interaction and find beauty in what is often overlooked. 

As parents, we want to show our children that we are interested in who they are, how they see the world, and in the things they choose to share with us. So get to know your child’s interests; make time to sit with him/her. Perhaps there is a way to engage in his/her (harmless) self-stimulatory behaviors (stimming). For example, line objects up with your child and look at objects from the side of your eye. 

You might be surprised at how much children will open up when they realize you are not telling them what to do and how to do it, but rather wanting to share their joys and uniqueness. 

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Implement therapy that feels right for you and your child 

This is difficult to write about and it is merely an opinion. As the ultimate expert, you know what innately feels right and what doesn’t for your child. 

Once you start to explore therapy options, you may want to ask the organization or school if you can sit in on some of their sessions. Observe the children during the sessions—do they have frequent opportunities for breaks? Are there times they can engage in their interests without any demands being placed on them? Do they look genuinely happy? 

It’s extremely important for us to remember that reciting the alphabet correctly is different than learning what letters are and enjoying the process. Make sure you feel comfortable with the therapist’s ability to teach and engage your child through play.You may also need reassurance that your child will receive frequent movement and sensory breaks. 

Is all this therapy needed? 

Another controversial topic is how much therapy a young child should receive. There are articles backed up by research that state: “Early intervention is key for reaching developmental milestones”. Yet, we should remember our brains are always evolving. Plasticity will ensure learning happens at any given age. 

Yes, we want to provide our children with the best we can possibly afford throughout their lives, but we don’t want to exhaust our child. We want him/her to learn in a fun and engaging manner, not recite alphabets or colors without understanding the function of doing so. 

I would recommend starting with the kind of therapy that is absolutely crucial, according to your pediatrician. As a parent, your opinion of your child’s challenges should help inform your pediatrician’s recommendations. 

  • Should your child’s main challenge be not being able to communicate, ask a speech therapist for advice on simple strategies to implement at home. When the speech therapist provides you with good exercises, ask for one session a week where you can sit in and learn how to generalize exercises to the home environment.
  • If there’s a situation where your child struggles with oral motor or fine motor skills, make an appointment with an occupational therapist and follow the same steps above
  • Your child struggles with certain behaviors, transitions, or anxiety? Work on ways he/she can share this with you. Create visual choice boards, visual schedules, a “zones of regulation” chart, and keep structure and routine consistent in your home

I won’t comment on Applied Behavior Analysis (ABA) therapy as there are many articles in Autism Parenting Magazine that detail the benefits and challenges of this type of therapy. 

Remember to keep normality in your home 

Although this is easier said than done, try to remember that your child should still feel that home is indeed a safe haven. Too much therapy may increase anxiety. 

A child needs time to process what he/she has learned in therapy. Parents should help their child stay in a calm state of mind to enable better rest and sleep.

A child diagnosed with ASD will go through ups and downs. At times there will be progress and sometimes he/she will regress; this is true of all children. Don’t let this discourage you as a parent. You’re doing your best to help your child thrive by educating yourself on different strategies that you both will benefit from. 

Please don’t feel pressure to undertake 40 hours of strict behavioral therapy programs, speech therapy multiple times a week, and occupational therapy. It will not only be overwhelming for your child, but possibly for your entire family. Your finances may suffer and you could potentially increase stress on your relationship with your partner, child, and his/her siblings. 

Remember to take care of yourself today—for your child’s sake. 

This article was featured in Issue 124 – Autism Around the World


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