What autism services can help families feel more supported?

I got a call from a very upset woman this past spring. Her 4 year old son had just received a diagnosis of autism and she stated that she did not even know what she was looking for. I did not get that sense that she was overwhelmed by the numerous options of autism services that exist for her and her son, rather she did not even know what questions to ask at the beginning of her son’s journey with autism.

While there are many different types of services that are offered to autism families, it is common for families to struggle in figuring out what is the best way to utilize those services. Most families start out with little knowledge about what type of services are available, and how they can be used to support their child and their family. The following article attempts to provide an overview of the typical services that are available to autism families. This article will hopefully be of assistance to families in figuring out what is available to them and how they can best be used.

But before we dive in to the different types of Autism Services and how they can help you and your loved ones, let’s take a look at what the Autism Services landscape actually looks like.

It starts with understanding, not fixing

Most families begin with an assessment of their child’s needs. Most people view an assessment negatively as if the organization offering autism services is checking off another box to move on to more important work. However, assessments are the largest portion of the work done by an organization offering autism services. Assessments look at all of the following: communication, behavior, sensory processing, social interaction, and learning. Good assessments develop a rich and detailed picture of a child’s specific profile. This allows for the best variety of therapies and other supports for the child. The initial work of an assessment is very important for the growth of a child with autism and their family. The parent or guardian of the child with autism is involved throughout the assessment process.

A good assessment covers the following areas of development and ability for children with Autism Spectrum Disorders: communication, behavior, sensory processing, social interaction, and learning style. The purpose of an assessment is to help develop a thorough understanding of a child’s strengths and needs. Without a good assessment, any subsequent work with a child including therapeutic work will be little more than educated hunches.

In addition to ascertaining a child’s needs, assessment is crucial in establishing the foundation for all therapy. A thorough assessment of a child’s communication, behavior, sensory processing, social interaction and learning style is essential. A good assessment does

Does ABA therapy deserve its complicated reputation?

Regarding ABA: This is a hot-button issue and there are many families who have had very positive experiences with ABA, and many families who have been negatively impacted by ABA in the past (often due to practice of outdated models of ABA). However, the practice of ABA has undergone huge shifts in the last twenty to thirty years and the practice of ABA today is virtually unrecognizable from the practice of ABA in the past. The goal of ABA today is to increase a child’s ability to learn and complete tasks independently in all settings. ABA can be transformative for children with autism, and has been for many of the children that I have worked with. ABA is typically practiced in a playful fashion, and many different techniques are used to increase communication, reduce problem behaviors and replace them with more appropriate behaviors, and teach daily living tasks (e.g. dressing, using the bathroom, etc.). Many models of ABA are practiced today, but most programs incorporate techniques such as positive reinforcement, natural environment training, and early intensive behavioral interventions.

The way that ABA is practiced today is completely different than it was even 20 years ago. The vast majority of programs today are focused on helping children build skills and to increase their independence. The goals of ABA today are focused on helping children to live their fullest lives, whether that be to go to school, to play with friends, or to go to work as an adult. Good ABA programs today are not focused on making children comply with what others want. Instead, they are focused on helping children to be as independent as possible and to engage in activities of their choosing. Most programs are also focused on helping children to develop skills that will allow them to be as successful as possible in the future. ABA today is also a lot more play-based than in the past, which is great for young children. Many programs focus on helping children to develop communication, social, and academic skills, in addition to managing behaviors and developing coping skills.

The biggest factor in determining whether a child’s ABA program is “good” as opposed to “mediocre” is the frequency with which the child’s goals are revisited and revised. Additionally, it is very important that parents are brought into their child’s ABA sessions as participants as opposed to observers. There are many programs for children with autism in which the families of children with autism receive no benefit from their child’s ABA sessions. This is because families of children with autism are left to sit in waiting rooms while their children work on their skills with an ABA therapist. On the other hand, there are many programs in which families are coached by ABA therapists, are observed by ABA therapists, and are included in their child’s ABA sessions. In these types of programs, families are given many tools that they can use to help their child with autism at home. Such programs benefit the whole household of children with autism and their families, and not just the child with autism who is participating in ABA sessions.

Family guidance isn't a bonus feature

This is one area where I think programs are structured quite poorly. Most programs list out Parent Training and Family Guidance separately as if they are extra features that are added on top of the child’s therapy. As if, if the program has the time, they can add in some Parent Training and Family Guidance for you and your child. However, families do not stop being families when they leave the clinic. In fact, in all likelihood, a child will spend many more hours with their family outside of the clinic than they spend with their therapist in the clinic. So, families need to have tools and support that they can use outside of the clinic.

For many families the therapy that their child received in the clinic was very helpful. However, what was even more important to the families was the family guidance that they received on how to deal with their child’s behaviors and on how to support their child’s communication in daily living activities. Many families reported that what was most helpful to them was to gain more insight into and understanding of their child’s behavior and to have tools and strategies to support their child’s communication in order to increase their child’s ability to communicate and to behave in safe healthy ways. Families with this kind of support are able to continue to work with their child outside of the clinic and support their child in very meaningful ways.

• Learning to read your child's early stress signals before a meltdown gains momentum

• Knowing how to adapt communication strategies at home, not just in a clinical setting

• Having concrete tools for transitions, which are often the sharpest friction points in any day

• Feeling less alone in the relentless day-to-day, because someone is actually coaching you through it rather than just reporting on your child's progress

Social development deserves its own conversation

Most people recognize that teaching a child with autism to develop his or her social skills is important. It is often the most important goal of teaching social skills to a child with autism. Many children with autism are very interested in having friends and are very motivated to learn the skills to make friends. Other children with autism are less motivated to have friends, but it is still very important for them to learn how to interact with others in order to have access to and to receive services in a world that was not designed to meet the needs of people with autism. The social skills that are most important for a child with autism to learn are the skills that will allow him or her to have interactions with others, to understand the perspective of others, to be aware of and to follow social cues, to develop and to maintain relationships, and to understand and to follow the social rules and expectations of others.

A critical part of developing skills for social interaction is to support a child’s social development. For many children with autism, they are eager for connection and want to have friends; however, they may lack the skills for establishing and maintaining social interactions. Many children with autism have wonderful potential for forming meaningful social connections when given appropriate support. For many children with autism, there is tremendous potential for forming meaningful connections with peers when taught appropriate social skills. Support for social skills for a child with autism can be very challenging, however with the right support, children can learn, practice, and generalize a wide array of social skills.

(Also, when I said ‘low-pressure’ several times there, you might wonder how a program for a child with autism could possibly be low-pressure. Well, yes, it is a truism that every child with autism is different, and if you were to survey a number of different programs, you would likely hear about a wide range of approaches and degrees of intensity. But, at the end of the day, that is what you are looking for – a program that is low-pressure for your child. So it would be wise to ask in your interview how the program maintains low pressure for kids.

Finding the right local support

There are several things that you should take into consideration when searching for autism services, but one of the biggest things is the location of the services provided to your child. Even if the services that your child is receiving are able to travel with your child, the commute to and from the location of the services are provided cannot. It would be difficult to attend a program three towns over on only the sporadic occasions when your child and family are in the area on a Tuesday. Looking for autism services in your area would allow you and your child to attend on the bad days as well as the good. Here at Bierman Autism Centers, we build our individualized programming for each child after a thorough assessment. We involve families as participants and not just observers and the goals of programming are revisable and living as opposed to concrete and never changing after the initial assessment. For AnchorLink to assist you in searching for autism services greater boston, click here: https://www.biermanautism.com/location/massachusetts/.

Type of support	Who it helps most	What to look for
Comprehensive assessment	Newly diagnosed children, families without a clear starting point	Covers multiple developmental areas, includes meaningful family input
ABA therapy	Children who need structured skill-building across communication and behavior	Play-based approach, regularly updated goals, parent involvement built in from the start
Parent and family training	Caregivers who want to extend support well beyond clinic hours	Practical, personalized, not just a packet of handouts
Social development programs	Children who want connection but struggle with the mechanics of social navigation	Small group settings, naturalistic practice, genuine skill generalization

What families actually need

What families need are tools that they can use after a session of service and that will help them to apply what they learned in that session. And what families need most is to have support as a family for their child with autism. The best autism services are those that treat not just the child with autism but the whole family and that help the family to become confident and to become fluent in supporting their child with autism.

The best autism services support an entire family in learning to manage and respond to a child with autism. These programs will help a family to increase their sense of confidence and fluency in addressing the needs of their child and will support them on and off of the clinic’s campus over the long haul. They will help the child with autism to learn to identify and address his or her own needs.