How much therapy is the right amount of therapy?

How much therapy should my autistic child be receiving?

This is a really important question, especially when applying for the NDIS or trying to make your NDIS funding stretch as far as possible.

Unfortunately, there is no simple answer. Here's why:

1. Every child is different.

All autistic children have unique strengths, challenges, interests and personalities. Every child is different in how they learn, and what gives them purpose and belonging.

Every family supporting an autistic child is different.

Each family is different in their make-up and family culture, in what gives them joy, and in what creates stress.

These unique attributes make it impossible to make specific therapy recommendations that will suit all children and all families.

2. Autism is different.

Autism is different to other areas of health and medicine that may have fairly standard recommendations that apply to large number of people.

While the origin of autism may be biological, the therapies and supports that create positive change are most often educational, environmental and social.

So what do we know?

Considerable research over the past three decades have provided good evidence to help us understand more about this area. We would like to credit the work being done by Professor Andrew Whitehouse, Professor of Autism at Telethon Kids Institute and The University of Western Australia, who recently wrote about this topic. We have summarised Andrew and his colleague, Sarah Pillar's insights, in this easily digestible resource below:

We do know these 4 things:

1. Early therapies and supports are important

Early experiences (including therapy) can help shape early brain development and helps in the development of more advanced skills.

Early therapy can also provide a way for parents to receive important advice and guidance at a time when this is particularly needed. 

2. There is no ‘standard amount’ of therapy

Some children need more ‘intensive’ supports, which may require subsantial weekly therapy time.

However, many children do not require such intensive supports, and may benefit best from only a small amount of therapy weekly, fortnightly or monthly.

3. ‘More’ does not necessarily mean ‘better’

Research evidence does not indicate that more therapy leads to better outcomes for all children.

4. Quality is as important as quantity

We should rather focus on the ‘quality’ of therapy.

It is important to find therapists who are qualified, have current knowledge and skills, and who have access to supervision. Of course this is easier said than done as parents are often making decisons based on wait times.

The quality of therapy is every bit as important as the amount of therapy a child receives, so make the best decision you can.

How much is the right amount of therapy for my child and my family, right now?

Evidence tells us that the answer to this question emerges through a partnership between the child, their family and the therapist. 

How much therapy is needed is determined by the child’s goals, strengths, challenges, and family context.

It is only by weighing up all of the information available that a shared decision can be made as to what is the right amount of support now.

Ongoing monitoring and review of support gaps or successes is important so you can make any necessary changes to achieve better outcomes - this can be done in time for your plan review or even half yearly.

What else should I know?

There are a number of other considerations that can be important families when making therapy decisions.

1. Sometimes we have to “slow down to speed up”

Taking time to slow down and consider which supports will have the biggest positive impact on a child is very important.

It can be easy to get caught up in one course of therapy and just keep going. We are all time poor and often parents are juggling work and supporting the rest of the family as well. You can only do your best.

2. Community connection is ‘therapy time’

It is important that the time a child spends in therapy adds to their participation and connection with their community, rather than takes away from it.

Time spent at the local playground, visiting friends, or attending school are all a part of connecting a child with their community and is as valuable as time spent with therapists.

This seems like a very appropriate time to intro The A List - an online platform where young autistic people can find social options. 

Therapy needs change over time

As children grow, and their families grow with them, they will have different needs.

A child's environment will change, and their goals will evolve and change focus.

Any therapy recommendation for a child and their family is specific to a ‘snapshot’ in time. These will change as life progresses.

Family wellbeing is important in supporting autistic children.

Children are surrounded by their family, and that environment plays a major role in their development and wellbeing.

Children tend to learn and participate best when their family have skills and resources to manage stressors, as well as having strong connections to formal and informal social supports (friends, extended family, counselling, support groups etc).

Understanding how the family environment can be best structured to support the child – including through managing time demands on parents and children - is a very important consideration.

How do I Find Therapy?

MyCareSpace can help you find therapy providers with capacity.

Many parents and carers face frustration when trying to spend their NDIS therapy funding on therapies like Occupational Therapy, Physiotherapy, Psychology and Speech Therapy because there is a shortage of therapists in most metro areas - not to mention the more remote areas.

MyCareSpace will try and give you both face-to-face options and online therapy options (where applicable) or at least let you know what kind of wait times you may be facing.

CREDIT:

Read the full version of this amazing article published by CliniKids Director, Professor Andrew Whitehouse and his colleague Sarah Pillar.