A few weeks ago I ran into a mom at a school function and she described the 3 week research she did to find the “right” centers and read their websites. She described her experience with 2 intakes at two different centers and then after the first session with a third center how she finally realized she had no idea what her child was doing in the sessions. Her process sounded so similar to being “drowned in information” and yet having no idea how to extract the meaning from the information even when it was laid right out in front of you. There is no “manual” for how to do this.
As stated before the approaches of the different programs are described on the websites of the different therapy centers for children with Autism Spectrum Disorders all similarly. So most information on the websites of the different programs is similar and in the end does not help much in finding a good therapy center for a child with Autism Spectrum Disorders and their family. Only the conversation will give you a signal for the quality of the work with children with Autism Spectrum Disorders and their families.
How They Work – Get Past the “Approach” and Look at the Details
Follow up by asking for a general sense of how a typical session would be set up for a child of your son’s/daughter’s age. This gives you a sense for how the therapist actually works with kids of that age and will help you to rule out certain approaches or practices that you know would not work for your son/daughter. In addition, ask how the provider would handle a child who was upset or resisting in a session. Every child has moments of upset and every child resists from time to time. This gives you a sense for the culture of the provider and whether or not they are practicing in a trauma-informed manner.
Asking about a center’s approach to how they handle moments of stress, upset or refusal to engage in a session with a child can give you a sense of the culture of the center and whether they use trauma-informed practices. Yes, being trauma-informed is great to hear, but it’s also something that a center does on a daily basis. So it’s great to get a sense of how a center would handle a child who is refusing to engage in a session, or a child who is upset, and how a center would support a child in these moments.
- What therapy model do you use, and what does the research say about it?
- How do you adapt your approach as the child grows or their needs change?
- What does a “hard day” look like, and how do you handle it?
- Is this a one-size approach, or is every program genuinely individualized?
Ask the staff question most parents FORGET to ask.
It is also very important to ask how long has the team been at the center doing their work with children with autism? What is the center’s staff turnover rate? Chances are if there is a lot of turnover then the center’s boasts about their “evidence-based” practices mean nothing. It is like a famous chef opening up a restaurant but then never steps foot in the kitchen.
Similarly, you should ask about the supervising person for your child’s sessions. Find out how often they meet with the therapist, and how they conduct their supervising sessions. It is very important to know that your child’s therapist has good supervision, unlike some centers where a supervisor technically can cover 12 kids, but in reality only checks in with the lead therapist every other week for 20 minutes.
Because “progress” is a word that can mean almost anything
Another pet peeve of mine is how most clinicians describe their clients’ progress to their parents. How many times have you heard a child’s therapist or clinician describe how a child is “doing great,” “growing” in some way, or how “strong” a child is? The description of progress provided by many clinicians to parents does not give the parents any sense of what their child is working on and how he or she is progressing. In addition, these types of descriptions are very general and can apply to a wide variety of children with a wide variety of needs. As a result, parents may not get a clear sense of whether or not the work that their child is doing in session is translating to progress outside of the session.
Your goals should be specific, measurable, and reviewed often. As a parent, you should meet with your child’s therapist on a regular basis to review progress towards these goals. Ask your child’s therapist how he or she sets goals for your child’s sessions. Find out who sets these goals, and how often you and your child’s therapist will meet to review data that shows your child’s progress.
| What to ask | A reassuring answer sounds like | A red flag sounds like |
| How are goals set? | “We do a full assessment and set goals collaboratively with your family.” | “We follow a standard curriculum for kids at this level.” |
| How often is progress reviewed? | “We review data weekly internally and meet with families monthly.” | “We do formal reviews every six months.” |
| How do you track data? | “Every session is documented with specific behavioral data.” | “Our therapists take notes and report back to supervisors.” |
| What if progress stalls? | “We adjust the program and bring the family in to discuss.” | “Some kids just take longer.” |
Family involvement is crucial – be sure to get clarity on this critical point.
• Will you receive training, and will that training be of any use in helping your child and in helping you support your child? This should be a part of the program and not something that you have to pay extra for. How will the techniques that your child learns in sessions be carried over to your home, to your car, to dinner table, to grocery store, etc. Can you observe your child’s sessions? This would be wonderful to have the option to do so. If your child were to learn a new skill in a session and then not be able to use that skill in your home, would the staff help your child and help you support your child in learning that skill. This is one of the hardest parts of working with children with autism to teach them to generalize their skills.
I’ve found that the best autism therapy center for a family is a center that can support a family in helping a child with autism to apply in different environments the skills that he or she is learning in the center. This is arguably the hardest part of autism therapy to master, even for very good programs with good, evidence-based approaches. And this is why, when asking a center about their approach to a child’s therapy, a very important question to ask would be: How will you support my child’s and my family’s in having the newly learned skills in the center translated to home, to be applied at the dinner table, in the car, at the grocery store, etc. This is something that a center can do in many ways: training parents and other family members, having parent coaching sessions, including in the program of the child with autism in the center’s sessions of parent coaching, and having in the center’s sessions of the child with autism observations by the family members.
- Ask for a parent handbook or written overview of your expected involvement.
- Find out whether sibling or caregiver training is offered.
- Get clarity on how communication happens day-to-day, not just at formal reviews.
It is also important to pay attention to how a program treats you and your questions during the intake process with the staff at the center. If you feel like you are being pushed through the intake process too quickly, and your questions are being brushed off, it is likely that your child and your family will receive the same type of treatment once your child is enrolled in a program at the center. This would be a very sad situation, because it would mean that you would not be able to get the answers that you need to your questions, and that your child would not be making as much progress as he or she is capable of.
One last thing before you decide
Pay attention to how the center treats you and your questions during your initial meetings with the program. If you get the sense that your questions and concerns are being dismissed, don’t expect things to change once your child starts sessions. Typically, a center’s treatment of parents during intake is indicative of how they will treat your child and your family once your child starts sessions. And if you are typical, you will be confused by how your child’s program is operating and will need to ask a lot of questions. A good center for children with autism will welcome your questions and relax a little when you come prepared with a list of questions for your child’s treatment team.
I also would recommend Bierman Autism Centers and their ANCHORLINK autism therapy needham ma services to anyone looking for the best autism therapy providers in the greater Boston area.
So in summary – ask all of the hard questions and make sure that you get all of the hard answers. Your child will thank you even if they can’t say thank you yet.