Q: My 11-year-old son has been having social and academic difficulties for a while now and has just been diagnosed as being “on the spectrum.” I do see that he can be rigid, that he doesn’t always make the best eye contact and that he tends not to show too much emotion. We were told to get services for him, and I can understand how he could benefit from occupational therapy, physical therapy, etc. But I get the feeling that the agency is suggesting more services for him at home — under the category of “behavioral therapy” — just to fill their quota for a new government-funded program.
It doesn’t seem to me that my son is so limited that we need to have a “helper” in my home every night, and his siblings are beginning to resent having non-family members in our house all the time.
I generally respect the opinions of professionals, but I’m beginning to question how much this help is really helping! My son doesn’t really like his therapist, whose continual positive reinforcement is getting to be robotic. If I hear one more “Good job,” I think I just might repeat those words back to him — but with a good dose of sarcasm!
On the other hand, my husband works long hours and I appreciate having another pair of hands around to help with the homework. But my son sometimes “goes on strike” and refuses to work with the therapist at all. He feels (probably to a great extent justifiably) that he can do certain things by himself, and feels that the therapist treats him as if he were “dumb.”
When the therapist tries to work with issues of hygiene or scheduling, my son gets resentful and asks what this person is doing. Why is he butting so much into his personal life?
Is it possible that it could be too much of a good thing, that the extra help is just too much?
A: As I have not seen your son’s evaluation, nor have I met him, I cannot give a proper response with regard to the accuracy of his diagnosis. What can be responded to, however, is the question of what interventions for children can be helpful — or unhelpful.
Clearly, many treatment plans for children can appear to be beneficial on paper. However, due to the actual clinicians who implement these interventions, the product may not be as excellent as we might have hoped for.
There are a variety of reasons why this service may not be working well for your son, among them the personality of the therapist or their rapport. One can attempt to change the therapist, but I’m not certain that this is the issue here.
The mixed feelings that you have about stopping the home therapy because you find it helpful should not get in the way of choosing what’s best for your child. Help for you may not be help for him, or for the family unit.
Sometimes an overabundance of outside help can aggravate certain children. Missing individual time with a parent is a loss for children. If the child feels that others view him as needing help with the simplest of things — even brushing his teeth — he can soon come to view himself as a second-class citizen. And continually having non-family members around can feel invasive to some.
However, the issue remains: Certain behaviors need to change. So you need to ask your child how these changes will indeed occur without the help at home in the evenings. Cutting off all behavioral help abruptly is unwise. The first step to take is to determine which services are actually helping your son reach his goals and which are not. A decrease in therapy hours needs to go hand-in-hand with behavior modification efforts made by you and your son, jointly.
Children who are embarrassed that they may need extra help can be encouraged and motivated to participate in various types of therapy. The point here is that behavioral changes in one’s home can be implemented by family members in a successful manner, particularly together with training from behavioral therapists.
Some children’s rigidity and fearfulness stems from trauma, or family dysfunction, and not necessarily because of a developmental disorder. In those cases, play therapy, trauma work and family therapy can be helpful. If that is the case with your son, behavioral work may not even be the most advantageous route to take.
May you have the siyatta diShmaya to find the right direction to help your son.