What Is Developmental Therapy for Autism?Many experts agree that people with autism, while they're very different from one another, share "core deficits." These include difficulties with social and communication skills and emotional engagement. Of course, many autistic people also have other difficulties ranging from sensory disorders to motor issues, but because these difficulties are not shared across the spectrum they are not considered "core" deficits.
Traditional therapies, such as speech, physical and occupational therapy, address specific areas of need which are generally NOT considered "core" concerns. Behavioral therapy, such as ABA, is intended to address outward behaviors and to teach concrete skills. Pharmaceutical and/or biomedical intervention treats physical differences which may underlie core deficits.
Developmental therapies are intended to directly addresses autism's core deficits. To achieve this goal, they recommend that therapists and parents work with the child's own interests or actions to slowly build engagement, interaction, communication, affection, and then specific skills such as logical reasoning, symbolic thinking and more. [Note: developmental therapy is generally first recommended for very young children, but the techniques are applicable through adulthood.]
Most practitioners of developmental therapy recommend that treatment for autism should also include additional therapies as necessary, including speech, PT and OT. Some are also advocates of biomedical interventions -- while others, generally those from more traditional medical backgrounds, recommend against biomedical therapies.
Pros and Cons of Developmental Therapies for AutismIt's important to note that developmental therapies are extremely child-oriented, which means that there is no one-size-fits-all approach. In addition, they demand a great deal from parents. Developers of these therapies see the family as the key to an autistic child's development, and they want to see parents take on the lion's share of actual, day to day intervention. But because there is no specific curriculum or single "approved" approach (after all, each child is unique), parents are called upon to be very creative, engaged and energetic -- and must be willing and able to become a therapist to their own child.
When a parent is personally and financially available, developmental therapy can be terrific. Speaking from my own experience with Floortime, I can say that therapeutic play can be fun, exciting and fulfilling. But there is a danger that parents who take on developmental therapy in their own home can become exhausted, overwhelmed, and even guilt-ridden. This is especially the case when, as so often happens, mothers leave their careers to care for their autistic child -- and find that they may not be cut out to be fultime therapists to their own offspring!
Of course, help is available -- but very little of that help is supported financially through insurance. And while it's possible to convince a school district to provide developmental therapy for a preschooler, it is a gargantuan task to push a district into individualized developmental programming as a child moves into elementary school.
Unlike behavioral therapies, developmental therapies are relatively new -- and relatively poorly researched. While there is evidence that developmental approaches can be effective, no one has actually compared developmental therapies head to head. And there is very little research comparing the relative outcomes of developmental versus behavioral therapies. It may be the case that the outcomes depend largely upon (a) the child's constellation of issues, deficits and strengths and (b) the parent's ability to provide a great deal of high quality engagement.
All this said, however, developmental therapies have several great advantages.
- First, their impact is almost instantly obvious. After just one or two sessions, parents see that their child really CAN engage with them, even if on a very simple level -- and that engagement is inspirational.
- Second, if you have the inclination, it is possible to do a creditable job of developmental therapy in your own home for very little money (just invest in a book and set of videos).
- Third, if you enjoy pretend play, developmental therapy can be a lot of fun.
- Fourth, again, if you enjoy the process, developmental therapy can be a terrific way to build a relationship with your child with autism.
- It's really impossible to injure a child through developmental therapy; the worst that happens is that nothing really comes of it!