Autism & Developmental Challenges

Intervention and Treatment for Developmental Challenges

Because your child’s developmental difficulties may have multiple components, a comprehensive intervention strategy will probably be a multi-disciplinary one. This may include clinical consultations geared towards developmentally appropriate caregiver-child interaction, speech therapy, occupational therapy, mediated play with peers, home-based and educational programs, bio-medical approaches and possibly other techniques. Getting started as early as possible and pursuing an intensive program of intervention will increase the likelihood of success for your child.

Your Role in Your Child’s Intervention

Your role in your child's intervention is critical. A child learns best when he is motivated to learn, when the learning is orchestrated by his emotions and desires. And no one is more qualified than you to tap into your child’s emotions and desires, thereby helping him connect to and learn about the world around him.

D.I.R. Floortime

D.I.R. is the Developmental, Individual-differences, and Relationship-based Model. Floortime is the application of the DIR model into practice or as an intervention. This approach, pioneered by Drs. Stanley Greenspan and Serena Wieder and their colleagues, involves meeting your child at his current developmental level, and building upon his particular set of strengths to help him develop. The approach suggests following the child’s lead: tuning in to his interests and desires in interactions and play to harness the power of his motivation and help him climb the developmental ladder. It also involves tailoring these interactions to the child’s individual differences in sensory reactivity, processing and motor planning.

An important part of this program is engaging in developmentally appropriate interactions at every opportunity. This is often referred to as “floor time,” which literally involves getting down on the floor to play with your child. By following your child’s interests, joining what he is doing and wooing him with warm but persistent attempts to engage his attention, you can lead him to climb the developmental ladder. Through playful, engaging interactions, you can help him want to learn to pay attention, want to engage in some sort of dialogue and want to take initiative, even before he speaks in any meaningful conversation. By entering into your child’s world, you can help your child learn to relate in a meaningful, spontaneous, flexible and warm way. This does not happen overnight; adopting this approach involves making a commitment to spending a considerable period of time on the floor, playing with your child and becoming a part of his world, even if his activities are limited. It involves responding to his every utterance or gesture, in an effort to spark a response - the beginning of two-way communication with your child.

A Word About Applied Behavioral Analysis (ABA)

Applied Behavioral Analysis (ABA) is an intensive, structured approach to teaching which involves the use of a technique known as discrete trial training. Skills, or lessons, are broken down into small, measurable tasks. A behavioral therapist works with a child using repetition, feedback and rewards to help the child master these tasks.

Many professionals and public institutions recommend this approach, in part because changes, defined by a child’s mastery of tasks, are easily measured. For some children, especially those who have great difficulty learning how to imitate, behavioral techniques can be useful at an early stage in an intervention to help jump start the child’s ability to pay attention and imitate, and may be one component of the child’s broader intervention program. But parents should be cautious about using a behavioral approach exclusively to drive their child’s intervention. Such an approach does not deal sufficiently with the child’s underlying processing capacities and important aspects of relating and thinking.

As you plan and, over time, refine, the intervention program for your child, remember that success should be measured by the growth of your child’s ability to be related and spontaneous, and ultimately, to think for himself.

Traditional Therapeutic Services

Therapies may include some or all of the following:

• speech therapy and oral motor therapy
• occupational therapy (be sure the therapist is trained in sensory integration techniques)
• physical therapy
• services of a special education teacher or inclusion specialist
• interactive, developmental play therapy (for insurance purposes, this therapy should be referred to as psychotherapy)
• peer play: as soon as your child is ready, it is very important for him to have regular playdates so that he can practice his social skills.

There are many ways for your child to receive professional services. He may receive services at home, attend a typical school with the support of an aide and/or other therapists, or attend a special education school where services are integrated into the program and a continuum of inclusion services may be offered.

When choosing professionals to work with your child, seek out those who respect your opinion and who see your child’s possibilities as well as his difficulties.

Alternative Therapies

In addition to pursuing traditional therapies, there are numerous alternative therapies which can be explored. While many parents view such therapies as optional or complementary to the child’s core of traditional therapies, some find alternative therapies to play a more central role because of the profound impact a particular therapy may have on their child’s progress.

Because of the lack of definitive studies on alternative therapies, parents need to review their options with their primary physician and therapeutic team, and most importantly, observe carefully to see how a particular treatment affects all aspects of their child.