Friday, August 12, 2011

Therapy Schmerapy

Confession Time

We enrolled J-man in an ABA-VB program in June. 

There. I said it. 

I can hear some of you thinking "so? what's the big deal?"

Ahhhh...  well, if you are thinking that, you might not be aware of the thorny issue of what kind of therapy is the "right" kind of therapy for kids on 'the spectrum'.  Recently I received this email from a reader (I have those???) who asked me how I knew what therapy was the right therapy for J-man?  I can't remember exactly what I emailed back (probably something unbelievably wise and smarty-pants), but in reality... I have no idea.  In fact, if I am honest with myself, I am not sure I have made the right therapeutic choices. 

You see, the options are many.  Some therapeutic options are well researched, well documented, and well marketed.  Some are back-alley and sketchy.  And when I first fell down this rabbit hole, it was very difficult to know which way is up.  Which way is the right way.  AND the thing is... the right thing for J-man might not be the right thing for another child.  So how do you weed through all of the options and even have a clue what is "right"? 

And the opinions... oh the opinions... it seems like every parent, professional and specialist has an opinion about what is the best... most effective... most appropriate therapy.  And what are not the best therapies...  That tends to result in different therapy "camps".  Camp RDI.  Camp Biomedical.  Camp ABA.  Camp Floortime.  And I have spent most of my time at the Camps CP, Flootime, and RDI.  Camp ABA held no appeal for me.  To be truthful, I am still not 100% for Camp ABA.  So why enroll J-man in a program I have real reservations about?

First of all, I have come to believe that there is no such thing as the "perfect" therapy.  The appropriateness and effectiveness of a therapy is wholly depends on who is delivering it and what you are trying to accomplish.  For example, the Communicating Partners approach is perfect for relationship building and engaged social communication.  ABA (discrete trial) is good for developing compliance and teaching discrete skills, but not so great at engagement and generalization.  And ABA/VB is the more sophisticated sibling of traditional ABA, combining some of the elements of more relational approaches but with the behavioral structure of traditional ABA.  Each area best serves different purposes.

Secondly, I also believe that there is nothing wrong with taking combined approaches.  Why not do pieces of each?  Why not take the best of all of them and combine them to address the needs of J-man?  I mean, isn't the best therapy individualized and adapted for J-man's needs? 

So when J-man turned four,  we took a good look at his progress.  Some areas were much better.  Other areas seemed stagnant.  With consultations with the Camaratas and examination of different programs, we found Partners and decided that we would try J-man in the program part time, continue a CP approach at home, Speech and OT twice a week, and see where we ended up after 3 months. 

J-man LOVES Partners.  He is constantly challenged and stimulated, which is perfect for him.  When he entered the program I was upfront and honest about my concerns.  About whether he would fit with what the program had to offer.  About his strengths and his challenges and what his needs really are.  And what our expectations for him are. The staff were very open to our concerns and issues, and to how my current 'home program' might fit into what they do.  In essence, they have said and done all the right things.  We are very pleased. 

We are taking a chance on doing something I would not have normally signed on to because being flexible and open is more important than holding on to some preconceived ideas about what is the "right" therapy for J-man.   And so far we have not been disappointed. I might get kicked out of some of my other camps, but I hope not.  I hope that my CP peeps don't drum me out for trying ABA/VB. 

In the end, what is the "right" therapy?  I guess it is the one that works for your family. 

Once again, the wonderful folks at Best of the Best SOS Research have featured me in this month's addition Therapy and Special Needs Kids.  Check out these awesome writers and get their take on the whole therapy world!


Niksmom said...

I am with you 100% on this: "In the end, what is the "right" therapy? I guess it is the one that works for your family." AMEN! I hope whatever choices you make for your sweet boy, others will allow for the fact that you are his parents and *might* just know a smidge about what you're doing! LOL

Pia said...

GAH! Maybe a smidge! Lord knows I don't go into anything blithely. There is usually much agnst and gnashing of teeth. And then hovering like a chopper over a police chase. I am sure the therapists think I am a nutjob. Which is just fine with me, thankyouverymuch.

Martianne said...

"We are taking a chance on doing something I would not have normally signed on to because being flexible and open is more important than holding on to some preconceived ideas about what is the "right" therapy" is oh so true! I've never believed in traditional counseling. But as we make headway with OT and behavior therapy for our ADHD/SPD son, I am actually considering this third piece that was recommended.


View My Stats