I’ve been planning to write about therapy for autistic children for a little while. But, it’s hard to know where to begin. So, I’m going to focus on the questions that I ask potential therapists before I decide to make an appointment for my son to see them.
I’m taking this approach because other autistic people have already written excellent posts that relate to therapy and/or autism interventions. I can’t add to these posts in the way of new information as I agree with all of them. So, I would encourage everyone to read these if you haven’t come across them before:
- 10 ‘Autism Interventions’ for Families Embracing the Neurodiversity Paradigm
- Our Autistic Family’s approach to therapy
- What Does Helpful vs. Harmful Therapy Look Like?
In addition to those, I have written another post in which I discussed how I assess autism organisations. Some of that also applies to how I assess whether a particular therapy/therapist is suitable for my son. But, therapy is such a specific component of parenting autistic children that it deserves its own post.
When trying to identify good therapists, one of the things I used to struggle with were the questions to ask. So, in this post, I’m going to go through the questions that I ask potential therapists, and discuss why each question is relevant to the process.
Before I begin, I would like to note that my son is currently not seeing any therapists. There seems to be a common misconception that autistic children must be “in therapy” at all times. That’s not necessarily true or helpful. Autistic children may need to be supported through receiving respectful therapy at various times. But, there are also times when they just need the space to develop at their own pace.
If your child is happy, and they aren’t experiencing distress, they do not have to be in therapy. It’s ok to take breaks when you (plural you – you and your child) need to. Allow your child to be a child. Let them explore in their own way.
That said, my son has seen therapists in the past. This is tricky for me because I don’t want to share details of my son’s needs. Those details are not mine to share. These included speech pathologists, occupational therapists, and psychologists. Each time, I would go through these questions in my initial contact with them in order to figure out whether they would be suitable for my son. I am now comfortable with the therapists that we have built relationships with. If his changing needs mean that he would benefit from receiving additional therapy in future, then he can return to one of the therapists (specialty determined by his needs at the time) that he has previously seen.
But life is unpredictable. The therapists could stop practicing or move out of area, so a list of questions to ask potential therapists is always handy.
Now that all that’s covered, here are some of the questions that I ask and the reasons why I ask them.
1. What do you know about autism?
I ask this because I’ve found that even among professionals that there are certain myths that tend to be treated as fact. When I ask this, I don’t want to hear things like statistics or diagnostic criteria. What I want to hear is whether the therapist realises that all autistic people are different, so that I know that they will be focusing on my son’s particular needs rather than his diagnoses.
I want to hear less pathologising language. I realise that many therapists are still caught up in the pathology paradigm, but even from within that, there is room for using language which shows acceptance. As an example, I once had a speech pathologist apologise to me for the terms that she uses, explaining that those are the “official” words, but that using those words does not reflect her beliefs. That’s what I’m looking for.
2. What is your experience with autistic people?
This is a variation of the above, but worded differently in order to garner slightly different information. I want to know whether the therapist is aware that autistic adults exist. I need to know this because, while many therapists specialise in seeing autistic children, they tend to forget that those children grow into adults. This is important because it links to presuming competence.
I realise that some people may not make the connection between knowing that autistic children grow into autistic adults and presuming competence, so I’m going to briefly explain why I see these two things as linked. If people are working under the impression that autistic children just stop being autistic when they’re older, they tend to focus on the child as a perpetual child. This means that they tend towards presuming incompetence. They treat autistic children as if their needs will never change into those of an adult, and then when it comes time to transition from childhood to adulthood, the person does not have the skills they need in order to do so.
This is a huge problem for many of us as adults. We talk about adulting, and people think that turning a noun into a verb is weird. But, the stark truth is that many of us were never treated as competent people when we were children and we were never shown the things we need to know now that we’re adults. Of course, we can support each other (and we do), but wouldn’t it be better if everyone, whose involvement in your child’s life you can choose, is working towards the same inevitability that your child will one day be an adult?
3. What is your cancellation policy?
This seems like a minor detail, but life is unpredictable. I understand why therapists need notice if an appointment needs to be cancelled. I’m not trying to shirk the responsibility of being organised. But, on the rare occasion when my son gets sick on the day of an appointment, and I have to cancel that appointment, the last thing I need is a lecture about cancellation policies and threats of terminating therapy.
There needs to be some flexibility within the cancellation policy for irregular events such as those because seeing a therapist should not lead to increased stress for anyone in the family.
4. How do you provide feedback?
I don’t mind not being in the same room as my son when he’s receiving therapy once he and I have built a trust relationship with his therapist. I also don’t mind being in the same room if that’s what works best.
What I do mind is when a therapist insists on providing feedback on the session in front of my son. Therapists tend to use pathologising language because of their training, and I don’t want my son to internalise beliefs that he needs to be fixed. So, I prefer a feedback email after the session. I generally choose therapists that are comfortable with email communication because that is most accessible for me, but if email is not an option, then a phone call following the session can work too.
5. Can you give me some examples of the goals you typically set for autistic children who have therapy with you?
This particular question has a few different purposes. Again, I want to see whether the therapist presumes competence and the goals that they set can demonstrate that.
In addition to presuming competence, I want to get an indication on whether they focus on normalisation. If they’re focusing on eye contact, for example, then they tend to have the idea that there is one “right” way of doing things. Too often, that one “right” way is the neurotypical way, and that is not comfortable for autistic people. Therapy needs to help the individual with their specific needs, and not try force them to act as though they have no needs.
The third reason I ask this question is that I want to see whether they take a consultative approach. I want to know that they’re developing goals based on the needs of the person, rather than taking a one-size-fits-all approach which won’t work for everyone.
The above is just a small sample of the questions that I ask, but I feel that they highlight some of the more important issues for me as my son’s parent. There are other questions that I ask depending on specialty or on my son’s needs at the time.
If you have any questions about the above, or you would like to suggest additional questions to ask therapists, please let me know in the comments – either below or on Facebook.