Neurodivergent Space

Seasoned Mom is a mom to two children with autism, ages 13 and 9. She is also the spouse of someone on the spectrum. Her education background is with teaching birth to third grade children with an emphasis on special education, specifically autism. 

While there is no cure for autism, there are several types of therapies available to help children learn coping strategies. In this blog, I will highlight the types of therapies we have tried and what you can expect. 

The first therapy recommended to us for our oldest daughter was occupational therapy. During these sessions, there are several things that the child and therapist can work on ranging from strength, coordination, fine motor skills and gross motor skills. This type can sometimes overlap with physical therapy but not always. In occupational therapy, she focused on sensory regulation through sensory input, dressing with buttons and zippers, and some overall strength. 

The sensory input could include swinging, climbing, jumping, balancing, pushing or pulling things. The daily skills of dressing with buttons and zippers were practiced on a practice vest that had both types of enclosures. For the overall strength, this was included in the sensory input part. All of the gross motor skills require strength and encourage strength building the more the child completes the tasks. 

The second therapy recommended for our oldest was food therapy. I have previously written a blog specific to food challenges with children with autism. In summary, children practice desensitization with food aversions. This can be very useful for children with ARFID or Avoidant/Restrictive Food Intake Disorder. 

Food restrictions and diets have also been recommended, however we did not see benefit from doing so. Some providers will suggest eliminating dairy and gluten from your child’s diet. Our oldest was dairy free due to intolerance, and so our diets also removed dairy. We later removed gluten from the diet in addition to dairy and saw no improvement in either child. It is commonly recommended for people with inflammation as well, however I struggle with this and saw no improvement in inflammation either. Some parents swear by this diet, but it is a very large time commitment. There aren’t concrete research reports to support the change in diet is beneficial.

Occupational therapy can also be recommended for children who have difficulties drinking from a bottle as an infant. In our case, our youngest had a severe tongue and lip tie which impeded her ability to properly suck and get enough milk without becoming fatigued. The sessions look a lot different for this, where it is simply trying different bottle types and finding the right fit for your infant. 

Autism Speaks offers information on what to expect, who provides occupational therapy and how to find one that is right for your insurance.  

To further occupational therapies at home or at school, the occupational therapist might suggest a sensory diet. This is not a food diet, rather a list of exercises that can aid in sensory input throughout the day. I found this website that is full of wonderful information on what a sensory diet is and how to create one for your child. The name is The OT Toolbox and there are several great links inside with ideas on a balanced sensory diet!

Physical therapies focus on the strengthening of muscles that may be weak. For example, core strength can cause poor posture, poor balance and poor coordination. Both of our daughters have been in and out of physical therapy treatments their whole lives, but also due to another condition called Ehlers Danlos Syndrome. This is not necessarily co-morbid, however we have both. Ehlers Danlos affects muscles and ligaments, causing too loose joints, so our physical therapy focused on strengthening exercises but also how to move the body that protects joints from injury. Physical therapy can also help alleviate symptoms associated with Ehlers Danlos when muscle tightness occurs. 

Speech therapy is another common therapy for children with autism. According to Autism Speaks, speech therapy is not specifically just for verbalization, it can include learning how to use an assisted device for communication as well as strengthening muscles in the mouth, neck and jaw. 

Our youngest has been in speech therapy for about 5 years. She has a delay in the development of letter sounds. She works with a speech pathologist through her public school. This is provided through the Area Education Agency, which is provided in our area for free. Her focus is on the formation of sounds and using them accurately in sentence level or conversational level. 

Mental health, sleep cycle, attention deficit hyperactivity are all areas where medication may be necessary. We have needed pharmacologic assistance with both of our daughters. Through mental health, antipsychotics, antidepressants, antianxiety medications can all be beneficial. National Institute of Child Health and Human Development lists several great options here. Finding a psychiatrist who understands autism and its mental health challenges is important when incorporating pharmacological therapies. Psychology Today offers assistance finding one near you.

Sometimes social therapies are incorporated in occupational therapy. Autism Speaks has been a great resource for us and describes this as providing a chance for children with autism to practice their social skills and gain confidence. We have not used this service, so I can only refer to Autism Speaks.  

Educational therapies are another type of therapy to consider, based in the school setting. For us, the Area Education Agency works with the teachers to develop individualized education plans (IEP). Our youngest has one and her IEP focuses mostly on speech but also allows her to go to a quieter area to work on independent work or to take a break. This is implemented by a special education specialist who works with her teacher and the AEA. Other academic adjustments like how the student receives information, where the student completes their work, if there is an adult aide who assists with keeping the student on task or helps them when they are stuck on a task. Behavioral Intervention Plans (BIP) can be implemented in addition to the IEP, however a BIP only focuses on disruptive behaviors like outbursts, throwing things, refusing to complete tasks. 

Along with the above therapies, a somewhat controversial therapy is ABA or Applied Behavior Analysis. We have not been successful with getting into an ABA therapist, and now our youngest has aged out of most of the early interventions. ABA therapy is somewhat controversial because it initially included punishments in addition to rewards, however it has since been modified to only include rewards. Check out Autism Speaks for detailed information on ABA therapy and how it could help your child. 

And lastly, cognitive behavioral therapy (CBT) is a very important therapy, especially for the parent. Being a caregiver to anyone with special needs can cause caregiver burnout. For the child, cognitive behavioral therapy can help the child identify feelings or thoughts and how to change them. The therapist will always set goals with you and the child for what you expect to achieve with CBT. For the caregiver, CBT helps identify stressors and how to better manage them. It is also important to look into resources for the caregiver such as respite care and sometimes a therapist can assist with connecting you to the right resources. 

For assistance finding the right therapist for you and for your child, Psychology Today offers a comprehensive list searchable by your location, insurance and specialty. It also offers a list of searchable psychiatrists in your area.