One of our biggest queries or complaints that we receive from parents is that their child is not the same at home than he or she is during therapy. They get reports from Speech therapists, Occupational therapists, teachers, you name it that states that Jimmy is able to name all his colors and even associates different objects being those colors. When he is home and I ask him to get something orange out of the fridge, he brings back his water bottle. If I’m lucky.

Okay there are a few things happening here. Firstly, rest assured, you are definitely not alone. One of our biggest focus areas during home therapy is to ensure that our kids are generalizing from school to home, therapy to an outing and play parks back to the home environment. The issue with true generalization is that we don’t always know what is happening in one setting – ie what strategies the person is implementing, how often, how consistent and how Jimmy is responding to these. Jimmy knows as he is in all these sessions and environments. He knows who follows through, who is easier to potentially manipulate a bit easier and who’s buttons he can easily push…often…

Our answer would be to have a nanny or someone that is familiar with Jimmy and has received adequate training to go with him to all these different environments. It is then possible for this person to learn from other therapists and keep track of what works and what doesn’t. It’s easy to establish if a behavior is maintained by what we do as adults. We usually ask our therapists to fill in a simple ABC chart. You can download this on Google for free, but we also have a template available for you on our website (www.aimsglobal.info). We all know consistency is key – that has been drilled into our minds since we said we wanted children or wanted to work with children. A routine for any child that is maintained consistently is always a good idea. The problem is Jimmy has 5 professionals that all believe whatever strategy they are implementing combined with some words that no one can pronounce is definitely what he needs and should receive by everyone. The next therapist believes the opposite strategy should be implemented and Jimmy sees these inconsistencies. Sometimes (most of the time) it also confuses him and thus he might be seen as “acting out” or pushing buttons, but it might honestly be him crying out for help – for some form of plan to help him cope through all of this mayhem.

Like I mentioned, first prize would be to have someone that you trust that can determine which strategies work best for Jimmy. Then requiring the therapists to be consistent with that. Many times on this road parents feel that they have to always adhere to what professionals are requiring them to do – like oral motor exercises fifteen times a day. Brushing their child with an OT brush three times a day in a specific way, singing a specific song with just the right amount of intonation. I mean, seriously?! Of course we ask our parents to be consistent, but we have to remember that most of our parents have full-time jobs, another child or two and trying to have a little bit of a social life too.

So, if you are unable to have a full-time person with Jimmy that can support him and quite frankly all the professionals working with him, then we need a plan B. We would recommend that you have to remember that you are in charge of your child’s program. If any therapist doesn’t have an “open door policy” it should be alarming. If possible we would suggest at least once a month to sit in all therapy sessions and doing an observation at school. You can also implement a communication book that you require all therapists and teachers to write down what they did today, which strategies they used to support your child and in what way. They should add recommendations from they want other therapists to generalize in their sessions and these should be respected and implemented if an agreement can be made with the entire team.

In the end of the day – we, as professionals, all want what is best for each child, right? If you feel (and trust that instinct of yours) that a teamplayer is not on your side or your child’s side, he or she is probably not and potentially more worried about their ego and their reputation as a specific therapist than what works for your child.

I have a personal story on this topic that I would love to share. I worked with a child in a country that I should probably not mention. I was trained in a specific therapeutic modality in a different country by a company that I used to work with. I administered some strategies that I was allowed to use, seeing that I was trained in this modality, received the certificate and thought it would make a difference to a specific child I was working with. Now, just to add here, that I used the modality in a much more child-friendly and holistic manner than what I was trained in. The child was not speaking before I started working with him and said six words after 10 days of supporting him gently, in his own way and time. Unfortunately, I asked the Speech therapist if she could maybe generalize some of the words in her sessions. She immediately took offence as, sadly her ego took over and she probably felt threatened and inadequate (which makes no sense to me – I would be thrilled if anyone could support any child I am working with more). She then contacted the company that I used to work with to try and get me reprimanded for utilizing a specific therapeutic modality. Long story short, nothing came from it, except maybe more time wasted that we could have focused on the child – that needed us to work together.

Although working in the field of autism is the best career choice I have made, it has also made me into a determined individual that will go the extra mile for any child on the spectrum. As I know that you, as a parent will go the extra mile for yours. With that should come teamwork from the people that you employ. Go team!