Different Home-Based Autism Therapies
Having your child diagnosed with autism can feel like being sucked into a vortex that takes you to a new world where you have very little, if any, control. The first thing that parents are told is that early intervention is crucial. However choosing appropriate therapies from the dizzying array of available options can be overwhelming. While developed countries often offer no-cost or local therapies, access to these services is notoriously difficult because the demand is very high. Wait times can be agonizingly long. Such services, limited as they may be, are simply not available at all in many resource-limited countries.
Services offered by private therapists are commonly the only option for families. While the wait times in the private sector are much shorter if they exist at all, private therapists are hideously expensive. It is not unusual to hear of families having to re-mortgage their houses to pay for therapies.
What if there was a different method, a different approach that was effective, cost less and was able to meet the needs of the whole family? Several studies1,2,3,4 have demonstrated that parent-mediated autism therapies not only improve kids’ outcomes but help address the issues of accessibility, affordability and effectiveness. Below are some of the best parent-led autism therapies:
Developed by Drs. Stanley Greenspan and Serena Weider, this therapy was founded on the science of typical human development. The DIR (Developmental, Individual differences, Relationship) refers to the lens through which human development is viewed. There are six basic self-regulation, intimacy two-way communication, complex communication, emotional ideas, emotional and logical thinking. Floortime refers to following the child’s interest by playfully interacting with young children on the floor. The child’s interests are used to engage and guide the child towards mastery of the developmental milestones. With older children, floortime may consist of verbal interactions. Parents can obtain additional information and access training here.
I was introduced to this therapy shortly after my son’s diagnosis through the online radio show that used to be hosted by Drs. Greenspan and Weider. I guess these days that would be a podcast?
Relationship Development Intervention is also based on human development and the relationship between a child and its parents. It was developed by a husband and wife team of clinical psychologists, Steven Gutstein, PhD and Rachelle Sheely, PhD. The focus of RDI® is to give parents the tools they need to guide their child’s development. Thus parents are the main providers of RDI intervention. Parent coaching occurs through the real life setting of the family home. Parents are guided to develop new ways of thinking and acting so as to maximally facilitate their child’s mental growth. Although parents provide most of the intervention in the home, they work in collaboration with a certified consultant.
More information on this therapy can be obtained here
3. Qigong Sensory Treatment (QST)
This therapy was developed by Dr. Louisa Silva. It is a research-based therapy, with several studies having demonstrated effectiveness in children with autism, as well as Down Syndrome, Cerebral palsy and sensory processing disorders. The therapy is based on the ancient knowledge of Chinese medicine. The specialized massage techniques normalize the sense of touch making children feel more comfortable and open to their environment. Children become more calm; sleep, digestion, communication, eye contact and behaviour improve. Parents give the massage daily to their child for at least 5 months. The simple routine takes about 15 minutes and is easily incorporated into the family’s routine. Parents can also work with a certified therapist for the dual parent-therapist intervention. The wonderful thing about this therapy is that the therapist’s intervention is designed to be of limited duration and thus saves families quite a bit of money.
Dr. Silva’s book on the technique comes with a DVD with instructions. It’s best for parents to form a small group with other parents if they want to teach themselves the technique or to learn from a certified therapist. You can find a list of certified parent trainers and therapists here as well as additional information about this therapy from other sections of their website.
I loved this therapy so much that I became the first parent in the world to be a certified QST parent trainer and therapist. I initially did the training so I could learn as much as possible so I could help my son. I then started sharing techniques with other parents because wait times for government services in our are averaged two years and haven’t improved much in more than a decade.
4. Early Start Denver Model (ESDM)
ESDM is a play-based therapy that combines the principles of behaviour analysis and developmental approaches. The aim of ESDM is to teach skills using a naturalistic, enjoyable and engaging play-based approach.
I never used this therapy myself but have heard great things about it. You can get more information about it here
5. Training and Education of Autistic and Related Communication Handicapped Children (TEACCH®)
TEACCH was developed at the University of North Carolina by Eric Schopler and his colleagues in the 1970s. Although TEACCH programs are largely classroom based, home programs are available that can be used in conjunction with school-based program.
The TEACCH approach focuses on the individual with autism, and develops a program around their skills and interests. An initial assessment guides the development of the individualized program. One of the Guiding principles of TEACCH is that individuals with autism are different and should not be forced to fit into the mould of what is considered as “normal” whether or not that is comfortable for them. Click here to get more information
6. Applied Behavioural Analysis (ABA)
Applied behavioural analysis is probably the most widely used autism therapy. In simple terms, ABA is the application of behavioural principles to influence a change in behaviour over time. It is based on behaviourist principles that were originally championed by the American psychologist B.F. Skinner and is one of the commonly used autism therapies.
The basic principle is very simple; “rewards lead to a change in behaviour or learning”. This is usually easier to understand and accept in the context of training animals like a dog, for example, that gets rewarded for a desired behaviour like sitting on command. The desired behaviour is reinforced with food.
ABA uses this same principles to set up a structured environment in which children are taught specific tasks and are constantly rewarded for success. The tasks are initially taught using prompts that are gradually weaned. A variety of rewards that are known to be motivating for the child are used including edibles, toys and praise.
In many areas ABA is only available through a therapist working directly with the child with autism, it doesn’t always have to be this way. Parents can also be trained to work with their child. Access to this type of training is not readily available and you’ll have to search for training opportunities in your area.
7. Sensory Integration Therapy
When we moved into our current house, our basement wasn’t finished and we finished half of it for one purpose only, my son’s therapy. When one of the construction crew commented on how much money we were spending on my son’s play room, I was very quick to correct him. It wasn’t a play room, “the room was for my son’s sensory integration therapy”. As you can imagine, his natural question was, “ what’s that?”
Sensory integration describes how information in taken in through our various senses, is processed and organized in the brain and allows us to respond appropriately. Many children with autism have sensory processing challenges and my son had several. His brain processed things like touch, light, sounds, his position in space etc in a way that made it challenging for him to interact with his everyday environment. Feeding was tough because of the textures of different foods, getting dressed, different sounds. Slowly, we worked to change how his brain was processing information.
Practically, what this meant was that our basement was being transformed to include different swings, ladders, a climbing wall, lights, bean bags; all chosen to help my son integrate and process the different sensory stimuli we are all constantly being bombarded with. When the contractor made his comment, I had dragged him into helping me put together a home-made platform swing.
Accessibility and affordability of autism therapies continues to be a challenge fir many families. Effective parent-delivered autism therapies such as these ensure that vulnerable children and their families are not left behind.
1. Nitin, B.; Roma, K.; Manju, M.; Dubey, KT,. Effectiveness of parent-led interventions for autism and other developmental disorders. Indian Journal of Health & Wellbeing . 2018, Vol. 9 Issue 2, p303-307. 5p.
2. Byrne, G., Ghráda, Á.N. & O’Mahony, T. Parent-Led Cognitive Behavioural Therapy for Children with Autism Spectrum Conditions. A Pilot Study. J Autism Dev Disord (2022). https://doi.org/10.1007/s10803-022-05424-2
3. Nicole C. Ginn, Leah N. Clionsky, Sheila M. Eyberg, Christina Warner-Metzger & John-Paul Abner (2017) Child-Directed Interaction Training for Young Children With Autism Spectrum Disorders: Parent and Child Outcomes, Journal of Clinical Child & Adolescent Psychology, 46:1, 101-109, DOI: 10.1080/15374416.2015.1015135
4. Conrad CE, Rimestad ML, Rohde JF, Petersen BH, Korfitsen CB, Tarp S, Cantio C, Lauritsen MB and Händel MN (2021) Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Front. Psychiatry 12:773604. doi: 10.3389/fpsyt.2021.773604
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