Hey sallys. I'm not sure if ST and preschool alone is enough for your DD. I only know one child with ASD & that's mine-LOL! Here's a little bit about how we made our decisions: DS was diagnosed at 18 months. At that time the psychiatrist who diagnosed him recommended a integrated preschool for children with special needs. They use the floortime approach and have special ed teacher with therapists in the room. They are affiliated with a daycare so there are also NT kids inthe classroom. The psychiatrist did not mention any other therapies- like ABA. When I asked him about it he though DS was too young and wouldn't understand cause and effect. I disagreed. I called an ABA consultant right after the appointment. We are fortunate to get ABA through our First Steps program so it took a few months to set up and we didn't start until he was 21 months old. DS would never be able to learn the skills he has learned in the past 6 months without ABA. However if your child is milder she may be able to pick up things in the natural environment. Also- the typically 2 year old is learning all day long. For DS to learn someone has to be with him constantly- redirecting him and engaging him. Personally- I would not be able to do that without being burned out. The ABA program also helps out there. As far as a preschool- it depends on the child. However, I do think the child needs to have some basic skills before they will benefit from a group setting. Understanding basic receptive commands, able to imitate others or participate in parallel play, some simple appropiate play skills. We now going to start that preschool that the psychiatrist recommended. He now has language skils, some imitation skills, turn-taking abilities. If we had sent him there 6 months ago he would have wandered aimlessly or stimmed on the fans. Sorry for the rambling, hope it makes sense.
I noticed that a lot of the kids here are in OT, ABA, floortime and various other therapies in addition to speech. My 3 yr old dd, dxed with pdd-nos is just in speech and attends a regular preschool 3x a week in the mornings. Her neuro does not recommend any other therapies for her at this time.
So, I was just wondering how you all came to get your kids into these other therapies - was it the doctor's or clinic's pushing or your own? Her neuro told me that what I'm doing at home ("mommy therapy", including gradual exposure to help her with her many fears), is enough for her needs right now (she is mild and HF), but of course, I'm wondering if I should be DOING MORE. I don't think she needs OT because she is quite skilled at eating with utensils, drawing, running, jumping, dressing, etc. etc. (no real motor issues and very minor, if any, stims), unless I am misunderstanding what OT is for.
Should I be pushing for more therapies/interventions and if so, HOW and with who?? The school will evaulate her and give her any services she needs for free but not until fall.
I've noticed a lot of parents here are taking on these types of therapies themselves at home and I was thinking of giving that a shot myself. I've got a few books to get me started - Overcoming Autism, Let Me Hear Your Voice, and Behavioral Interventions for Young Children and I'm also going to get the Greenspan book on children with special needs - and try to implement an at-home plan (I haven't read any yet and was wondering if there were any other good ones I'm missing, so please suggest titles if you have them).
Is this foolish? Should I be seeking professional help (even though her neuro thinks she only needs ST and preschool)? On the one hand, I want to believe her neuro, but on the other hand, what if he's wrong? That's why I'm thinking if I at least do some floor time or just be more educated in general about "interventions" I could be doing something more even if it's not professional. It certainly couldn't hurt, and may help. Also, her ST is going to be out in August, so I was planning to be her ST for that month, giving her 2 sessions a week just like she would normally get and get some materials from the teacher's store. Otherwise, she'll go a whole month without ST and there's no way I'm going to let that happen.
Am I being crazy mom here or am I on the right track? Should I be looking more to professionals or can I make a difference at home? Or should I just listen to her neuro and not worry about other therapies? I'd really appreciate your insight and advice and stories. Thanks!
Hey Sallys If you feel like you have the strength and energy and determination to do at home therapies GO FOR IT. As long as you are on the same page and NOT CONFUSING her it wont hurt her. I watched the in home sessions Tyler got and then when he went to preschool I went to school and observed them there with him and even have some sessions on tape. I then mimicked at home what they did with him at school and did the "mommy therapy" in our daily lives. Watch out though because it can burn you and her out!
Why is she in regular ed preschool rather than special ed preschool? In special ed preschool she should receive OT, ST, PT etc. I am unaware how others get in home ABA and floortime etc because it wasnt available to us when my son was diagnosed. I know generally it can depend on where you live and what is available as well as what insurance you have if it is covered or not.
Not all therapies work for all kids. Each kid may respond differently. If she doesnt have fine motor issues with tying shoes, using utensils, holding a crayon, or paint brush or pencil, cutting with scissors picking up small objects and so on what about sensory issues? OT's work with sensory as well. calming exercises proprioception and so on I would consider (especially if your insurance covers it) getting her evaluated by an OT and PT and see what they think. If the child isnt at least 33% delayed normally they dont provide services because the child "COULD" catch up on their own.
How comfortable are you with her neuro? There are always second opinions. Hard to say what your child may or may not need when each child is so different from the next. You know your child best, if you feel she needs more keep pushing and asking and advocating for her!
Hi sallys,
i would contact you health insurance co and your ped. since she's not receiving therapy in a school based setting yet, they should beable to offer you atleast a consult for OT and PT, this will serve as a good starting place when it comes to having the IEP, having an outside evaluation. we were denied services for OT based on the fact that he receives it in a school setting and our ABA is provided by the school district. I started a home program based ( a mix of both floortime and ABA) and it is exhausting but well worth it !
You want the therapies that meet your daughter's developmental needs. She sounds like she doesn't need OT for skills, but it would probably be a good idea to consult with an OT about sensory integration issues and just to make sure the OT agrees with you about the skills.
When my boys were 2, they both started in early intervention. Through EI we got speech a couple of times a week, OT once a month, and "special instruction" twice a week from 2 different people for my severe son, and one person for my high functioning son. One of the special instruction people had a special interest in Greenspan, and the other was one that I requested, who had a special interest in verbal behavior, a type of ABA. It was the verbal behavior ABA person who saw my son.
For my son, we started an "ABA program" with our own money. We had the verbal behavior consultant that was paid for through EI, at least some of it, and we hired and trained therapists that we paid for. Some of the therapists had some experience, and some didn't have any, so we trained them. We were trying to get to at least 20 hours for him.
For my other son, he didn't seem to need as much formal ABA time. So the verbal behavior consultant saw him once a week at first to get us started, until he turned 3, and then we did mostly "incidental teaching" after that as far as the ABA went with him. When he was 3 he started an integrated preschool in our school system, a class with half typical children and half delayed children. He went to preschool every day from 8-3. He received speech twice a week at school, and OT once a week because when he was 3 he was not potty trained, drinking from a cup, or eating with a spoon, so he tested delayed in adaptive needs so they had to give him OT. He quickly learned all those skills at school, I had just had too many other things going on to pay much attention to them up to that point. He got OT for the first 2 years he was in preschool, but last year, the OT said he didn't need it anymore, and I agreed. Next year, since he is 5, he will go to kindergarten, he will be in a regular kindergarten class and will still receive speech therapy. I'll let you know how it goes for him, but everyone expects him to do well.
I would highly recommend verbal behavior ABA to you, just because it concentrates on language. I think much of the more basic ABA programs, like Lovaas, would be too basic for your daughter. I would suggest asking around in your area for a verbal behavior consultant, or an ABA consultant that is familiar with verbal behavior, someone that is familiar with using the ABLLS. The ABLLS is the best part of verbal behavior, it is an Assessment of Basic Learning and Language Skills. It is an assessment, but it is also a guide for therapy. It is said when a child completes the ABLLS they have all the skills necessary, language and otherwise, for entering kindergarten.
ABLLS http://www.difflearn.com/prodinfo.asp?number=DRB%20173&t op=
http://www.autismteachingtools.com/ (This is a great website by a Mom of two high functioning boys who are now in elementary school and doing very well. She did a lot of her ABA programming during the course of the day.)