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Step #8: Start Speech & Occupational Therapies

Jump To:
Speech Therapy        Occupational Therapy

Speech and Occupational therapies are probably the most common (and effective) companions to programs in Behavior Modification. Review the following descriptions for each of the services and give careful consideration to integrating them into your child's program.

Speech Therapy

Speech and language therapy should be viewed as the central part of your child's treatment, especially for those who are nonverbal. Impairments in speech, language, or feeding can have far-reaching consequences, affecting every aspect of your child's life. Impairments in these areas have a direct impact on communication, learning, play, and the proper consumption of food. Parents need to realize that the following issues are not easily overcome, but they can be improved or entirely corrected. Proper diagnosis and therapy is critical to the outcome of the treatment. Review the following descriptions of "speech" and "language" to better your understanding of meeting your child's needs.

Speech: The ability to pronounce words. There are a variety of reasons why children may have difficulty pronouncing words; inability may be related to one or more of the following: 

    Articulation Disorder: The child has a problem pronouncing a particular sound or a few sounds.
    Phonological Disorder: The child has difficulty understanding the sound system itself and the speech rules.
    Oral-Motor Deficits: The child shows deficits in strength and movement of the jaw, lips, tongue, and cheeks.
    Apraxia: The child has difficulty coordinating oral muscles to make a sound or string of sounds
    Stuttering: Disruptions or breaks in the smooth flow of speech.  

Language: Language refers to the content of what is spoken, written, read, or understood. It is categorized into two areas: receptive and expressive language. Receptive language is the ability to comprehend someone else's speech or gestures. Problems with receptive language may include difficulty understanding vocabulary, concepts, sequences, directions, and conversations. Expressive language is the ability to create a message that others will understand. A child who has difficulty expressing him or herself may be taught to use a variety of communication modes such as speech, manual sign, gestures, pictures, facial expressions, or communication devices.

Choosing a Therapist

Although most school districts offer speech services (including initial assessment), parents may find more benefit in having their children treated by private therapist (outside of the school). Although the qualifications (training and experience) are usually equitant, there are a number of important distinctions to consider:

Speech/Language Services (through the school):

Child may have significant needs but will not qualify for appropriate services if test scores aren't low
     enough. (Testing performed by the school)
Feeding and oral-motor deficits are usually not addressed because they are not defined as an
     "educational necessity".
Amount/hours of therapy is dictated by the school district and is usually split between one-on-one
     and group therapy sessions. The result is less focused attention and treatment on individual children
Parents are isolated from the treatment (that is, they have no idea what's being addressed and how,
     usually are not involved in any aspect of the therapy, and are given infrequent progress reports).

Speech/Language Services (through a private, licensed practice):

    Child will be given an unbiased assessment and provided with services appropriate to his or her needs.
    Feeding and oral-motor deficits can be addressed.
    Amount/hours of therapy is established by the parents and the recommendations of the therapist.
    Parents are in control and plugged into all aspects of the treatment, including participation in therapy.

For some, this may not be an issue; that is, parents will be allowed to seek a private therapist and receive funding if their school district does not have the appropriate Speech/Language services available. If this is not the case, our recommendation is obvious: If possible, pursue a private therapist. Benefits include control, involvement, and a higher level of service. If funding a private therapist is not possible, parents are still encouraged to obtain a formal assessment from a private Speech/Language Pathologist. This may serve as your only justification in obtaining the best/most appropriate services from your child's school district.

Occupational Therapy

Occupational Therapy or "O.T." is a health care service that deals with a child's ability to function in everyday life activities and occupations that provide meaning to one's life. O.T. is extremely important to children who have difficulty performing or participating in tasks such as self-care, going to school, playing, social interaction, working, and living independently.

O.T. benefits children with autism by attempting to improve the quality of life through successful and meaningful experiences. This may be accomplished through the maintenance, improvement, or introduction of skills necessary for the child to participate as independently as possible in meaningful life activities. Such skills include coping skills, fine motor skills, self-help skills, and socialization and play skills.

Once again, these services (including initial assessment) are usually provided by the school and are generally perceived as adequate. However, parents may want to consider private therapy for the same reasons described in the Speech/Language section if the child is severely disabled or challenged in a specific area.

Occupational Therapists use a variety of theories and treatment approaches when providing services. They may also use a combination of approaches to meet specific needs. Such approaches may include the following: 

    Developmental theories
    Learning theory       
   
Sensory integration
   
Play theories, and more

The following is a list of qualifications for those seeking Occupational Therapy (from a private practice):

    Formal education (degree) in Occupational Therapy
    Formal training and experience in performing Occupational Therapy
    Personality, patience, and enthusiasm

NOTE: Check with your insurance provider because some plans cover Speech and Occupational therapies, especially for patients with feeding/oral-motor deficits. Remember, health care providers draw the line between education and health care needs as well.



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