Autism Spectrum Disorder Therapy

Autism Spectrum
Disorder

Literature is now suggesting that 1 in every 59 children born will receive a diagnosis of somewhere on the ASD spectrum and this is an alarming statistic. ASD impacts individuals across a wide plethora of functions. One of the most common symptoms would be a lack of social reciprocity, which could coincide with limited ability to initiate joint attention, sharing interests, or lack of initiation of social interaction.

Clients would frequently have difficulty with expressing their own facial gesture and / or not understand the facial gestures of others. Their non-verbal communication may not match their verbal communication. Some may not speak at all, using grunts and sounds, while others may have an extremely wide vocabulary, but not master the art of skillful conversation with rhythm or timing. In early development there often would be limited opportunities in entertaining creative, imaginative play that could lead to difficulties in abstract thinking and visualization of new ideas to become an active problem-solver. Stereotypical behaviors such as finger flicking, hand-flapping and jumping up and down may be more evident in some autistics than others. What they all have in common are difficulties in sensory processing, which can be supported through a variety of therapeutic interventions.

As Sensory Processing does not have its own diagnostic code in the medical industry, many children in early development are being diagnosed on the ASD spectrum when they simply share in the sensory processing continuum of difficulties. As behavioral therapies are frequently the only course of therapy open for public funding, these kids are placed in 20 to 30 hours per week of behavioral therapies, when this is absolutely contraindicated for a child who is essentially struggling with sensory processing difficulties. It is important that they do not receive an ASD diagnosis to prevent patterning their behaviors into ways that are not integrative and will ultimately impact their future capabilities of becoming social. Another conundrum is that too frequently non-verbal clients are diagnosed on the spectrum, though they could be more likely have a diagnosis of Apraxia of Speech, which does not impact their thought process as autistics may experience.

Two very important theories that should be considered in diagnosis:

Central Coherence – processing information in specific contexts resulting in piecemeal processing (Happe, 1999; Pellicano, 2007, 2010)
Theory of Mind (ToM) – to understand one’s own mental state as well as the mental states of others – essential in the building of empathy.

Our Unique Evaluation

A comprehensive process that includes individual differences as it relates to the Greenspan DIR/Floortime Model Individual Differences will include an in-depth look at their sensory profile and assigning reasons for the different “behaviors” that may be observed. We focus on the reasons for behavior, which ultimately would change if targeted at the core of the issue.
The DIR/Floortime model considers the stages of typical development, including the formation of abstract thinking, theory of mind and the art of play in early development
Different layers of sensorimotor development are discussed as it relates to social-emotional development.
Standardized testing as well as clinical observational norms are used
All ages, from infant to adult
From reflexes formed in utero to executive functioning
Chases the “why” of continued stereotypical behaviors
Considers social and emotional functioning
Connects developmental delay to behavior patterns from mild to extreme meltdown behavior.

It is an extensive evaluation completed with selective care over 2 direct hours, complimented by a range of questionnaires completed by the family. The comprehensive report will include recommendations that will serve as a roadmap of interventions with opportunities to meet with family / client on a regular basis to assess functional outcomes.

As occupational therapists, we are not diagnosticians, but we certainly are the experts in sensory processing and developmental delay. Our evaluation supports the multiple facets of ASD, as well as sensory processing delays across the continuum of difficulties.

Our Unique Intervention Program:

We consider 3 phases of development that would be targeted successively according to the mild, moderate or severe spectrum of needs within which each client’s specific individual differences will be respected and upheld. The frequency and duration of each phase will be determined by the individual differences of each client.

We also work with adults and the developmental program below will be adapted to match the needs of the client.

Phase 1: Foundation

Typically, these skills emerge in utero and at birth and develop into increased refinement over the first two years of life.
Strong emphasis on modulation / regulation to assist with fight/flight/fright behaviors
Sensory Modulation, reflex integration, sensory registration of information, sensori-motor skill, emotional regulation
May consist of intensive periods of 10, 12 or 15 consecutive days each (except weekends), as well as combinations of weekly occupational therapy visits to our center
The weekly visits as well as intensive programming will also include DIR/Floortime sessions to start working on social-emotional skill from the beginning, especially as it pertains to regulation, engagement and two-way communication
Weekly visits, especially the DIR/Floortime sessions, will be attended by the parent to gain the knowledge of utilizing Floortime techniques at home to equip the parent, while we empower the child.
It is the most intense part of our program, as once the foundation is formed, we can follow up with developing skill
Possibility of doing home programs for long distance (and local) clients would depend on the profile of the client
We also review video footage from long distance clients and feedback is provided by video according to the needs and concerns stated

Phase 2:

Organizing the adaptive response to the sensory stimuli.
Ocular-motor skills, oral-motor skills, visual-spatial skills, praxis (Dyspraxia), bilateral integration, coordination and timing, emotional regulation
May consist of intensive periods of 10 or 12 consecutive days each (except weekends), as well as combinations of weekly occupational therapy visits to our center
DIR/Floortime sessions will focus on increasing two-way communication, imaginary, abstract thinking, theory of mind and constructive play skills with parent attending
Speech Language services would be added to the weekly services as the clients would have achieved more regulation and readiness to receive maximal benefit.
Possibility of doing home programs for long distance (and local) clients would depend on the profile of the client
We also review video footage from long distance clients and feedback is provided by video according to the needs and concerns stated

Phase 3:

Consider laterality and interhemispheric organization
DIR/Floortime sessions will target symbolic thinking, building empathy and becoming logical in problem-solving ability with parent attending
Impact on executive functions
Emotional regulation for social skills
May consist of intensive periods of 10 or 15 consecutive days each (except weekends), as well as combinations of weekly visits to our center, including occupational and speech language therapy.
Possibility of doing home programs for long distance (and local) clients would depend on the profile of the client
We also review video footage from long distance clients and feedback is provided by video according to the needs and concerns stated

Phase 4:

This phase is only as needed. Sometimes we need more work on these areas noted, though goals in this area is targeted throughout the first three phases.
Development of a sense of self, autonomy and self-esteem
Social skills with peer interaction
Sibling and family relationships

Are you ready to learn more about our unique and specialized approach Schedule A Free Phone Consultation today!

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Testimonial

Images used are stock images to protect the privacy of clients

Ken, Corinda, Drew, Max and Emily Crowther (July 2006)

A Total Approach has been part of our family’s journey to help Max for over four years. Max, now six years old, has autism, apraxia, hypotonia, nocturnal epilepsy, and severe motor planning deficits.

N.S. – May, 2010. Mason, Ohio

My name is N.S., and my son H.S. received Tomatis therapy with your team back in 2004. We think of you frequently but this afternoon my wife and I spoke of you again. H., now 9, is in third grade and participates in an accelerated academic program in our public school.

Images used are stock images to protect the privacy of clients

Grateful Mom (September 2017)

Dear Maude and Angela,

I wanted to reach out to both of you and let you know how my boy is doing. I have been thinking of you all a lot lately as I reflect on the last 3 years.

B. mom of team of ASD

Hi Everyone!

Last night (Monday) I took John for a guitar lesson at the music place where I work. I also set one up for Saturday with a different teacher, and then he will decide which teacher he thinks will be better for him.

Images used are stock images to protect the privacy of clients

A Total Approach has been part of our family’s journey to help Max for over four years. Max, now six years old, has autism, apraxia, hypotonia, nocturnal epilepsy, and severe motor planning deficits. A Total Approach has always enthusiastically encouraged and supported us, although Max was, at times, slow to progress, and many other professionals weren’t sure how to help. The therapists at A Total Approach are the best we have seen, and they have dedicated themselves to constantly updating Max’s program to meet his changing needs. They also will share new ideas based on the latest research to assist him in achieving his goals. These ideas, based on the Individual Difference Relationship Based Approach to therapy as well as intensive Occupational, Physical, and Speech therapies, include Therapeutic Listening, Tomatis, pressure vests, brushing programs, and a whistle blowing protocol to help with sound production. They have coached us as parents, consulted with his teachers, and attended countless team meetings, all with Max’s needs being their focus. There aren’t words to describe how important Maude Le Roux, Angela Johnson, Mary Beth Crawford, Ayesha Ganges, Janice Buckwalter, Teresa Scully and the entire A Total Approach team have been to our family. They truly have gone above and beyond for us and remain a crucial part of Max’s treatment plan.

Thank you

Ken, Corinda, Drew, Max and Emily Crowther (July 2006)

Images used are stock images to protect the privacy of clients

“He has a terrifically-bright future”

My name is N.S., and my son H.S. received Tomatis therapy with your team back in 2004. We think of you frequently but this afternoon my wife and I spoke of you again. H., now 9, is in third grade and participates in an accelerated academic program in our public school.

Today my wife and I attended a PowerPoint presentation, about jellyfish, that he gave to his classmates, all of whom also tested into this accelerated program. We were so proud of him that we almost both cried during his presentation. When he was initially diagnosed with an autism-spectrum disorder, we were terrified about his future.

Today, he is in gifted programs at school, he is one of the best ballplayers on his baseball team, he plays piano, has lots of friends, and has a terrifically-bright future.

We recognize how lucky we are, but particularly lucky to have had you in his life.

Thank you.

N.S. – May, 2010. Mason, Ohio

Images used are stock images to protect the privacy of clients

Dear Maude and Angela,

I wanted to reach out to both of you and let you know how my boy is doing. I have been thinking of you all a lot lately as I reflect on the last 3 years.

Currently, He is attending a private school in the Bethesda, MD area called “The Harbor School”. We couldn’t have found a better fit for him. He has 2 teachers and 11 kids in his classroom. They follow an almost “floortime-like”approach to learning. He loves school and has fit in perfectly! We are still doing OT, speech, some visual therapy, and also feeding therapy at The Floortime Center. I have developed a lovely relationship with the staff there and my boy enjoys it!

I was on the A Total Approach website the other day, looking up some things about Tomatis to tell another Mom. I came across my testimonial after our first 3 intensives together, and I cried. It brought me right back to how I had felt first walking through your doors. You saved us. I was told by the developmental pediatrician right after his 3rd birthday that he would probably never be in a typical classroom, doing typical things, with the other typical children.

I pitied myself and cried for a few weeks. I then got to work, and after speaking with Angela after the new year, I immediately knew there was hope. Angela, you truly gave me hope! Maude, I still will occasionally look at the videos from our intensives to remember how far we have come. It has been nothing but up from there. Your entire staff over the years were nothing but loving and supportive.

I just can’t thank you enough for helping us to get to this point. A side note, He found a pair of head phones and occasionally wears them and pretends he is playing in the “big gym”.

Sorry for the long note. I just felt so compelled to write to you both, and send you all my love and gratitude!

All my best, Grateful Mom (September 2017)

Images used are stock images to protect the privacy of clients

Hi Everyone!

Last night (Monday) I took John for a guitar lesson at the music place where I work. I also set one up for Saturday with a different teacher, and then he will decide which teacher he thinks will be better for him. I was able to go in with him last night because I wasn’t working, but on Saturday, he’ll go in with the other teacher on his own because I’ll actually be on the clock. He met both teachers last night and whoever he chooses will be a great fit for him. They’re both great guys and I think he’ll do well either way.

Driving home last night, it happened.

John said, “Mom, I thought I was going to be really nervous. I thought I would be so nervous that I wouldn’t be able to do anything. But Mr. Ben was very calm and welcoming, and I felt really good while working with him. I was able to hold the guitar and play it because he helped me just be calm.”

He FELT nervous! He felt NERVOUS! And he SAID so! He talked about his emotions!

He wasn’t worried about being too perfectionistic, he wasn’t even hesitant in talking about it. It was as though we’d *always* talked about these things.

I’m SO impressed!

Meanwhile, in addition to piano, John now plays the electric guitar. Oh yeah – we stopped and bought a starter guitar kit on our way home because if you’re going to take guitar lessons, you’re going to need a guitar.

I told my co-worker that he’s earned a permanent position in our family’s hearts because of this. I told him that while he probably thinks he was just teaching guitar, he was really giving us keys to open a door to a whole new experience for John, and all the goodness that comes with that!

That’s good news for a Thanksgiving, right? We have lots to be thankful for!

Thank you to all of you for investing your time and energy into our boy – our tween, as he refers to himself. We couldn’t do it without you, and it turns out that John is a REALLY cool kid! I never doubted that, but it’s so fun to see who he’s becoming! Thank you for the large part you play in that! We are so blessed to have you all in our lives!

Much love and wishes for a very happy Thanksgiving!