Balancing therapies: Mistakes to avoid when juggling autism interventions

By avoiding these common mistakes, you can create a more balanced and effective approach to autism intervention for your child.

Balancing therapies for individuals with autism can be a challenging task, as each person is unique and requires a personalised approach. According to mental health experts, while interventions aim to enhance skills and independence, it is essential to embrace and celebrate the child's unique qualities and strengths rather than solely focusing on "fixing" deficits.”

Balancing therapies: Mistakes to avoid when juggling autism interventions (Unsplash)

In an interview with HT Lifestyle, Dr Himani Narula, Developmental and Behavioural Pediatrician, Director and Co-Founder of Continua kids, suggested, “Avoid overloading your child’s schedule, it’s important to provide them with leisure time and adequate time to rest. Effective communication between the team of therapists working with the child is important to prevent contradictory approaches or excessive repetition of interventions. Make sure that you allocate time for self-care and support everyone involved in the family. A holistic approach that combines different therapies is often more effective than solely relying on one approach. Progress in autism interventions often takes time.”

She added, “Setting unrealistic expectations for rapid improvement can lead to frustration and disappointment hence learn to celebrate small victories along the way. Many individuals with autism have sensory sensitivities. It's important to consider these sensitivities when planning interventions, as certain therapies might inadvertently cause distress. Play is a crucial aspect of learning and development for individuals with autism. Incorporating play-based interventions can make therapy more engaging and enjoyable. Regularly follow up with your Development Pediatrician to assess the effectiveness of interventions to determine what's working and what needs adjustment. This evaluation process should involve input from both professionals and the individual themselves.”

According to Dr Narottam Agarwala, BHMS, “When it comes to juggling autism interventions, it is easy to make mistakes that can hinder progress rather than help. Trying to implement too many interventions at once can be overwhelming for the child and he may give up. Every child is different so it’s not correct to assume that a particular intervention that has been effective for someone else will automatically work for your child. Family involvement is crucial in supporting a child with autism. Neglecting to involve the child's family in the intervention process can limit its effectiveness. Often people become fixed on one intervention that seem to be effective while ignoring others, this hinders over all development of the child.”

Asserting that autism interventions require time, patience and consistency to yield results, he said, “Resorting to quick fixes and focusing on short-term goals will not yield any outcome. Setting unrealistic expectations can lead to disappointment and frustration. Inconsistency can hinder progress and make it difficult for the child to learn and adapt. It’s not worth trying interventions that lack scientific research since already there are numerous proven interventions. Ignoring regular evaluation will not let you align the interventions with the child's changing needs and fail to maximise their potential for growth.”

Bringing his expertise to the same, Dr Nihar Parekh, Specialist/Founder of SOCC (Second-Opinion Online Consultation for Children) and Co-Founder of Cheers Child Care, said, “So, when your child is diagnosed autistic or on the spectrum, every parent must start with accepting the fact that this is not a short-term issue. Therapies, multiple therapies, multidisciplinary approaches are going to last for a very long time till the child as an individual can adapt and survive in day-to-day surroundings with normal social interaction and is able to follow with the education system in a healthy way. The parents must be extremely patient. There are going to be good days, good months, bad days, bad months, where the parents will see exaggeration of symptoms. But working near your occupational therapist with your pediatrician which you are with your speech therapist, it will help to overcome those bad days and bad months as well.”

He added, “Overall, I would advise every parent to decide one Captain of the ship which ideally should be your pediatrician or developmental pediatrician who can on bimonthly or trimonthly assessments tell you what therapy is required more Ideally, once diagnosed with ASD or autism, the parent should meet a developmental pediatrician once and sync with their pediatrician and plan out the therapy between occupational therapist, physical therapist, and speech therapist. Now all these three should be preferably a part of the developmental pediatrician’s team. The developmental pediatrician can also help in charting out the number of sessions of each specialty that are required.”

Dr Nihar Parekh highlighted, “Some kids require more of speech, some kids require more of sensory integration via occupational therapy. Some kids require just mild physio to get, you know, kind of used to the surroundings. Every three months, the developmental pediatrician will assess the changes and change the distribution of therapies accordingly. So, balancing it out as per the captain of the ship that is the developmental pediatrician is the best thing that every parent can do. So, if they follow these norms, be patient, be persistent, they will see significant improvement and the child will bloom and blossom.”

Sumana Dutta, Autism Consultant, Certified Special Educator (Autism) and Arts based therapist, said, “There is no one-size- fits-all approach for children with autism. Implementing too many therapies simultaneously can overwhelm the individual and their family, leading to exhaustion and reduced progress. With the guidance of an expert, parents need to prioritize interventions based on the individual’s needs and strengths. Setting realistic and achievable goals helps to celebrate small victories and keep motivation alive. Most of the time, parents are reluctant or not cognisant of their right to ask for properly documented progress reports from therapists."

She further recommended, "Ongoing evaluation helps to assess effectiveness of therapies. Parents must also not make the mistake of focussing solely on academic goals without addressing functional skills necessary for daily life. Integrating functional skills into interventions such as self-care and self-help skills can promote independence and awareness for the autistic child. Another important observation is that parents neglect self-care which leads to burnout and decreased ability to provide effective support. Please remember airline safety briefings: ‘Please put on your own oxygen masks before attempting to help others.”

Dr Pritika B Gonsalves, Child Psychologist Consultant at Humm Care, advised that by avoiding the following common mistakes, you can create a more balanced and effective approach to autism intervention for your child -

1. Neglecting Individualised Approaches: Avoid if one-size-fits-all interventions will work for every child with autism. Each child is unique, so tailor interventions to their specific needs and strengths.

2. Overloading on Therapies: Be cautious of overwhelming your child with too many therapies at once. It's important to strike a balance and prioritize quality over quantity to prevent burnout.

3. Ignoring Self-Care: Remember to take care of yourself as a parent or caregiver. Balancing therapies can be demanding, so make time for self- care to avoid exhaustion and maintain your well-being.

4. Neglecting Collaboration: Don't forget to collaborate and communicate with your child's therapists, teachers, and support network. Working together ensures consistency and maximizes the effectiveness of interventions.

5. Neglecting Fun and Play: Remember that children with autism also need time for unstructured play and leisure activities. Incorporate fun and enjoyable experiences into their routine to promote overall well-being.”

Adding to the list of tips for parents and caretakers, Dr. Isha Soni, Senior Occupational Therapist and Centre Head at Lexicon Rainbow Therapy and Child Development Centre in Pune, suggested -

• Do not overdo

Respect and keep in mind your child's capacity and do the therapy accordingly. Just because another child is doing 'x' number of therapies in a day, do not expect the same from your child.

• Follow an expert's advice

Do not try to do therapies by watching other videos received on social media. Every child is different and it may not be beneficial for your child.

• Do not fall for cure for autism/100% recovery claims

Parents must go ahead only with evidence-based practices (Speech , Occupational therapy and ABA)and not fall for tall claims .

• Research your therapist well

Take your child only to a therapist who is qualified in the respective field and has specialised training or experience in autism. Ask for transparency about what's done during the therapy session.

• Do not do therapist shopping

Autism is a neurodevelopment condition and doesn't give quick results. Have patience and give a few months to your therapist to show some changes in your child.

• Follow home program diligently

Only rushing your child from one therapy to another will not bring about a significant change. Incorporating intervention into your daily routine and following it at home will certainly go a long way.

• Being consistent

Sometimes, a few autistic children show difficult behaviours not easy to handle. The behavioral modification program needs to be followed by everyone at home consistently. Only one person following it will not help. The child is smart enough to get his demand fulfilled from others at home.