Top Therapy Services That Need to Be Considered With Autism
Recently, parents of a 3.6-year-old child diagnosed with autism with an Individualized Education Program (IEP) in a US public school district approached me for some general tips on parenting a child with autism.
I am a physical therapist with a special interest in the educational impact of a diagnosis like the autism spectrum, attention deficit disorder, learning disabilities, and sensory dysfunction. In simple words, kids who struggle in school in areas which appear to come naturally to their neurotypical peers.
This mother was a recent immigrant and a first-time mother. She was not aware of the laws that were in place for children with special needs in US public schools. She was happy that he qualified for special services and that the IEP team identified his communication and behavior to be his primary areas to be addressed. However, even after a year of attending preschool, she had no concept of how she could communicate with him and nor did she have any idea about how she could help with his sensory seeking behaviors.
As children spend most of their day in school, I encourage my parents to work collaboratively with the IEP team in school in addition to the recommendations that I provide them regarding home activities. I was disturbed to find out that though their child qualified to receive special services, other than being placed in a preschool classroom for autism, he did not receive occupational therapy (OT), physical therapy (PT) or speech services.
This in spite of the IEP team writing in their reports that he was significantly delayed in all developmental domains. The mother had requested for OT and speech services at the beginning of the school year, however, she was verbally informed that her child did not require these services. The mother pursued the matter and reached out to the district OT via email and was eventually informed that he did not require these services as the therapists consult with the class teacher.
When the parents met for the IEP meeting at the end of the school year, they did not even think of bringing up the subject of speech, OT and PT services. They signed their consent.
I was involved in helping this child after the IEP was signed. As I always do a very comprehensive assessment of strengths and challenges faced at home, school and in the community along with any therapies in any of these environments, I identified that their child was not getting the services that he needed, based on the IEP data. Even though the speech therapist clearly identified that he was significantly delayed in receptive and expressive languages- he did not qualify for services. Additionally, they had not invited the school OT and PT to screen their child and provide their professional opinion on providing services.
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As I am very familiar with the law that regulates special services and challenges faced by school administrators in ensuring that the services are being provided, I am in a unique position of helping parents navigate the special service journey. The biggest challenge is differentiating between educationally relevant services and medically related services. There is a lot of confusion about educationally relevant services amongst school administrators, teachers, and therapists themselves. I am confident that I can help this child in receiving all the services that would help him make the most of his school experience.
I am writing this to increase awareness amongst parents with special needs about resources available to them to better understand their child’s needs.
I helped the parents in the language that needs to be used (nonconfrontational and objective instead of emotional and blaming) to revisit their child’s related service eligibility criteria. We were successful in requesting an addendum IEP meeting. I joined the IEP meeting via phone and was able to be a part of the decision making process. OT, PT and Speech evaluations were approved.
All school districts, provide parents with a list of resources, however, very few parents actually look at the resources that are available to them. Most of these resources are FREE to parents. These resources are usually mentioned in your child’s IEP. If you feel you cannot locate these resources in the IEP, don’t panic- you can always call the special services director or your child’s case manager to find out where the resources are listed.
Parenting a child with special needs is challenging, and when your child has autism with sensory processing dysfunction, it becomes even more confusing, challenging and overwhelming. Looking at school documentation seems to be like “noise” and most of the time does not make sense to parents. It is understandable when parents feel overwhelmed just looking at the number of pages in their child’s IEP.
I would like to emphasize that his parents were not successful in getting the district to evaluate their child in spite of being part of the IEP team. However, when they found out that the family has an advocate who is knowledgeable about eligibility criteria and the federal law IDEA, they approved all three evaluations.
At the time of this article, speech, OT and PT evaluations have been submitted. An addendum IEP date has been finalized. I will keep the readers posted on the changes in this child’s educational programming.
If you are one of the parents who needs help understanding your child’s educational needs , please call me for a free 15-minute consult to find out if my consultation service may be of value to you and your child.
Services include but not limited to:
1. Review of IEP documentation to ascertain that your child receives the services that he needs based on the data collected ( or not collected) by the IEP team.
2. Help you understand how to prioritize your child’s goals based on your concerns, teachers concerns and data available.
3. Ensure that there is a goal that corresponds to every challenge or need that is identified by the school team.
4. Help parents track their child’s progress based on the quarterly reports that the school sends them on a regular basis;g., is the school giving an objective, measurable improvement of the goal, or just a letter or number to indicate progress or lack of progress?
5. Help parents identify if evidence-based strategies are being used by the school therapists in achieving the annual goals that they listed in the IEP. If your child is NOT making progress in the goals that the IEP team projected as “achievable” by the end of the school year- there is a possibility that the placement, strategy or training of the therapist needs to be revisited.
Below are links to a few fact sheets Bala co-authored with other school-based therapists. They are all available on the American Physical Therapy Association website.
- Selected Assessment Tools for Evaluation of Children With Autism Spectrum Disorder in School-Based Practice
- Practice Recommenda tions for the School Based Physical Therapy Evaluation of Children With Autism Spectrum Disorder
- Strategies for Physical Therapist Collaboration with School-based Teams for Children with Autism Spectrum Disorder
- FAQs on Response to Intervention (Rtl) for School-based Physical Therapists
- Physical Therapist’s Guide to Autism Spectrum Disorder
Bala Pillai PT, DPT, MA, PCS is a board-certified specialist in pediatric physical therapy. She has 30 years of experience in physical therapy and more than 20 years in providing pediatric services in medical and in educational environments. This unique experience has helped her understand the distinction between providing functionally-based services and providing medically-based services in outpatient or hospital-based environments. Bala earned her undergraduate degree in physical therapy from Bombay University (India), a post-graduate diploma in rehabilitation (PGDR-PT) from All India Institute of Physical Medicine and Rehabilitation (AIIPMR), post-professional master of arts in Developmental Disabilities from New York University and Doctorate in Physical Therapy from Northeastern University. She serves as a member of three committees through the American Physical Therapy Association (APTA)’s Section on Pediatrics: the Practice Committee’s Autism Task Force, and the School-Based Special Interest Group’s Subcommittees on Intervention for Students with Autism and Response to Intervention.
Bala is certified in Test Edge, Educational Kinesiology, and Kids Yoga, interventions that use breathing, visualizations, and movement to integrate both cerebral hemispheres. She was sponsored in the Summer of 2009 by the Indian Physiotherapy Association (Bombay) to present “Introduction to Neuroscience Applications in PT Practice” to the PT community in Bombay and to the rehabilitation students and staff at AIIPMR. Bala has also presented many one-day and half-day seminars during public-school professional days on Movement-Based Learning Readiness Programs. She was also a guest speaker at the New Jersey Education Convention 2011 where she presented a one day workshop on Learn How Motor Skills and Academics go Hand in Hand: A Hands-On Presentation.
This article was featured in Issue 86 – Working Toward a Healthy Life with ASD