So what therapy would you recommend?

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Hi everyone. I've been lurking for the past few weeks, while I learn as much as I can. My son, 22 months, has a lot of red flags and I'm 99.9% sure he's on the spectrum. Non-verbal as of yet, but a lot of his symptoms seem a little mild. His behavior isn't terrible. He doesn't throw huge tantrums. Just quite a bit of repetitive behavior and unusual play. He's on vacation with my wife for the next month, so I can't get his formal diagnosis quite yet. I'm sure many of you are rolling your eyes a bit, knowing I'm just another parent looking for answers in a world where nothing is concrete.

Many of the other forums and blogs I've read from parents all pretty much say the same thing. Get ABA therapy now! However, I see my kid as a pretty free spirit, and am not sure that reward for conformity seems all that inspiring. I've read through some of the older posts here, and it seems many of you aren't too fond of ABA. So I wanted to go directly to the source and ask those that have actually lived with ASD.

For those of you that went through it, would you recommend it? For everybody else, what would you recommend doing? Do you recommend intensive therapy at all? Special needs preschool? If you had a toddler on the spectrum, what therapies would you be advocating for? Thanks all!

The thing about ABA is that it teaches the person that they are fundamentally flawed. Their natural way of expressing themselves is constantly "corrected."
A parent would have to intervene like any other parent. Like if a kid kicks a guest, you tell them not to." But to teach someone that their way of being needs to be concealed and replaced by a facade is soul destroying. At least it was for me.
I'm hoping that as our various autistic mannerisms become more widely known and less feared, that parents will feel less of a need to modify their children.

That's kind of what I was thinking. Thanks for taking the time to reply. Did you try other therapies that you enjoyed more? How long ago did you take ABA?

My mother is a self taught ABA specialist, so only informally. But her corrections were and remain a constant. She just can't stand to see me not be "normal."

I received my diagnosis only as a young adult. In hindsight, according to my parents my behaviour as a young child was rather a-typical, but they did not send me to any form of therapy. I'm very happy for that. Just accept the child as it is, let it grow up and find its own ways, don't try to "fix" it. Only when serious difficulties arise should therapy be considered, in my opinion. I fully agree with androbot1:

That's interesting. With all of this reading about how important early intervention is, I hadn't considered that approach. I don't necessarily care if my kid is "normal" or not, but I do want to do what I can to help him avoid major problems.

Some people think that if you intervene early you can make the child pass for normal. And thus no longer autistic.
But the child will always be autistic no matter how they are perceived. It's nice to be able to pass sometimes, but it certainly isn't worth the fuss of an all out ABA regimen.

I disagree with that sort of ABA. However, I am still a proponent of it when it is used properly. ABA should never be used to stop expressive or coping behaviors such as stimming. It should be used to teach communication, whether that is verbal speech, sign language, or some other alternative communication so that the child can effectively communicate his/her needs without hurting themselves or others.



I don't understand how correcting a kid for kicking someone relates to ABA being "bad". Correct me if I'm wrong, but I interpret that as saying if you believe the behavior is not an expression of a kid's natural "way of being" (special needs or NT), then it is fair game to correct them. But if you believe the behaviour to be because of the kid's natural "way of being", then it would be absolutely catastrophic to the child to correct them. If that interpretation is correct, then I see two big problems.
First, how does one determine if a behavior is just a behavior or if it is a kid's "natural way of being"?
Second, what if kicking guests is the kid's "natural way of being"? Isn't it wrong then to correct them for doing that?

Never forget that regression can occur at any time. Just because a kid can use language effectively doesn't mean they always will be able to. But yeah, you want to engage kids in communication. I think sometimes that therapists can be a little too enthusiastic with this, though. Sometimes, for me, I just don't have anything to say.


I think it's more of the social importance that sets the bar for correction. For example, you can't let the kid go around kicking people regardless of the validity of the expression. The kid will end up in jail. Whereas if a child does not want to talk, does it really matter. Listening and thinking are underestimated. And eye contact shouldn't matter either.

I think it's safe to say that all behaviour is a natural way of being. It is the social consequences that should determine if correction is necessary.

Google "Floor Time Therapy". It's a lot more constructive than ABA and seems to work well with young children based on some feedback I've seen here from parents with young autistic children.

Good luck

I've heard great things about floor time. I'd definitely look into it before ABA.

For later on especially - remember to include sensory integration stuff. I'd put sensory integration therapy ahead of most others. It's by far what has helped me out the most in my life is sensory integration occupational therapy.

Doing some therapy isn't a bad thing. MAKE SURE not to have therapy take over your life and your kids life with therapy. Let your kid be a kid. Have therapy be fun. Learn on what things will need more work and work on them. Have fun together. Play on swings and splash in water. Dig in sand. Build next to each other and turn that into building things with each other.

You can do things that are like therapy just playing together - that's the idea behind some styles - but its also something you can just do on your own. Think about whether that's what you want to do too? Do you want the order for you or do you want the free-spirit of you needing to make up what to do as you go along?

Would I do intensive therapy if I had a toddler on the spectrum? No.

Would I do a special needs preschool? Personally no, but that's me. I think a lot of kids do well with special needs schools.
I think a lot of kids do well with mainstream. (Personally I'm planning on homeschooling with lots of socialization opportunities outside of the home; but that's what fits best for me in particular)
I would definitely say special needs schools are something to look into depending on your child though. I wouldn't rush your child to school too early though.

I do like the idea of floortime. Just a guess, but I'm thinking it would be harder to get assistance to get that approved than ABA. I see a lot of folks here that didn't get a diagnosis until later in life. Do you wish you had a diagnosis at an earlier age? Do you wish you had more therapy? If we don't get therapy, is he going to learn skills on his own? Did you all?

I can't say what to recommend for your son, because I haven't seen your son, and I don't know what he is like.
For myself as a kid, spending many hours a week doing ABA with a therapist would have been horrible torture, and I think I would rather undergo electroconvulsive therapy that takes less time to administer.
I can't stand to spend that much time with people, much less people forcing me to interact with them and speaking in horrible high-pitched, rising voices.
I think that I would have been much lower functioning than I turned out to be, if I had done ABA.
The way that I learned speech was through ESL one-on-one tutoring for ~1 h per schoolday, and also I had some language foundation from learning to read around age two.

ABA is well-researched and its efficacy as widely accepted in the scientific community. Floortime isn't completely discredited, but more research is needed before it can be called as effective as ABA.

That said, make sure you have a competent therapist (lots of people call what they do ABA in order to get customers). Also, make sure they understand your goals and are willing to work with you. Make sure you tell them you don't want him indistinguishable, don't stop harmless stimming, and don't use aversives under any circumstances, etc.

If he is autistic, early intervention could be the difference between living independently and needing lifelong care.

Definitely look into speech therapy. Autistic or not, by 22-24 months, your son should have a vocabulary of at least 50 words (more if he's read to frequently), and should be beginning to construct two-word sentences. The sooner you get him help for his speech, the easier it will be for him to make progress; the window for teaching a child to speak easily is narrow. Young children start out with many more neurons in the brain than they will eventually need, and as pathways get used and reinforced, others become neglected and unneeded. By about age three, a process called pruning has begun, at which point, neuronal connections that have never or rarely been used, get pruned back (removed) to make space for the neurons that are used more frequently. This is why adults have so much more trouble than children learning a second language, and why it's vital that you kickstart your son't speech as soon as possible.

If he doesn't seem to be making any progress verbally, a picture exchange system called PECS can be helpful; you give him a collection of specialised cards and teach him to hand you the picture of whatever he wants or needs; this helps facilitate communication, and can cut down on frustration-induced tantrums that stem from not being understood.

I also agree with others here that Stanley Greenspan's floor time is very effective; you introduce the idea of communication and sharing with others in his domain (on the floor) and at his pace. It's similar to ABA, but more naturalistic in that the benefits and consequences for behaviour are directly resultant from the actions performed, rather than extrinsically provided (ie given by someone else and unrelated to the task performed).

As far as getting his diagnosis, I would start looking for doctors and getting a recommendation from your son's paediatrician now, while he's still away. The process of finding someone can take weeks to months, so the sooner you get started, the better. Good luck, let us know how things go!

My son got diagnosed just after his second birthday. We saw signs such as him running along a wall back and forth with his cheek really close to the wall but not touching and his eyes would be turned to look at the wall and he would just run up and down and it would simulate him and also slight tantrums and his speech was behind. So after the diagnoses we initially interviewed the 4 different organizations with my son being diagnosed with asd they were able to suggest and also tell me what they would offer. Where we live in canada the child receives 23000$ up to the age of 6 then it lower. So my son goes for 10 hrs a week and works with a interventionist, be sure to really see who the person is if you use one also experience is a great asset for the interventionist to have because they get instructions from you speech and occupational therapist so if you child seems to breeze through the work they will have more ideas on ways to learn then someone who may not have the knowledge and just wait around until the next program comes. Also my son works directly with a speech therapist 2 hours a week and a occupational therapist 2 hours a week. And at this point all of my son's previous symptoms seemed to have gone away he just turned 4 a month ago only thing is he is still delayed in his speech. But I am in a spot myself wondering now if my son may have been misdiagnosed. He used to have tantrums if we drove past but did not stop at his favorite stores or if I ever pulled a u turn no matter where even the drive way it was cause him to get very upset plus lots more and now it's been about 4 months nothing no tantrums nothing he is speaking but for his age it's still behind. So last night I just went on a frenzy searching everything to see if I could maybe see another opinion then what we all are dealing with and I found this site. Read what the doctor writes and how she even writes a treatment that one of her clients had received. I feel.you should see it because it really does put another option in as for treatment. We have had it installed in our heads this is how we help our kids but maybe there is more ways and even easier on them. Let me know what you think