What kind of therapy would you expect for ASD (nearly 2)?

[catski]

I've got my knickers in a twist about this again this afternoon.

My son (22 months) was diagnosed with mild autism a few weeks ago and we are due to have a meeting with his diagnositc team and the disability service at the end of this month.

We're in sweden so services will not be the same as in the UK, but I was hoping you could give me some indication of what would be reasonable to expect in terms of therapy.

At the meeting where we got his diagnosis they said he should be put into nursery. When I asked about SALT, they said he was too young. They haven't given us any other advice on how best to help him.

On the recommendation of some of you (thank you!), I got a copy of the Hanen More Than Words DVD, which I think is great and although I haven't got through it all yet I've been putting some of their approach into practice and he already seems to have picked up a couple of new words (albeit very badly pronounced), so I think I disagree that he is too young for SALT.

I will mention this to them and ask again for some help from them with SALT, but what else do you think is reasonable for a toddler?

I would think about PECS not therapy a such but can really help your child communicate. Another thing to think about is Makaton.

What therapy really depends on your childs issues- occupational therapy can be useful if issues with fine motor skills. Intensive interaction/play for developing skills.

I think so much depends on the child - even although the dx is the same. I think the good thing about Hanen is that it covers all the bases, PECS might work, Makaton/Signing might work, speech alone might work. It is up to the parent to decide what works best so you have to assess your child's learning style - but not easy at 2 years I agree so it may be more a case of trying and experimenting.

Hi, dd2(3) gets no real therapy, she goes to a special needs nursery which provide SALT and music therapy she also uses PECS and Makaton thanks to the nursery but we get no NHS therapy at the momment. She was sent to see a SALT but we were told they could not do a lot for her as she is non-verbal. We are waiting for refferal to a occupational therapist and another SALT but we have been waiting almost 6 months .

I would recomend using PECS, dd picked it up very fast at the age of 2.5.

if i was in the uk, i'd be looking at makaton alongside speech, and also would be expecting a portage worker to come along once a week. but i'd be looking for a part time nursery place as well. so not therapy really, but just helping along with developmental stages and see where you are going, really... adjust as necessary!

(i say this as you don't mention any issues with gross or fine motor, but am assuming some social/ interactional, but not necessarily sensory) if sensory etc then ask for OT referral as well, although lots of NT toddlers have all sorts of odd sensory things going on at this stage, so you would be aware of anything considered out of this 'normal' realm lol. bit little for trad OT anyway, but sensory ideas might help prevent any future issues.

I don't see why a SALT should refuse to work with a child who is non-verbal. DD is 2.7 and is only now saying her first words (hello, biscuit) but she has been working with a SALT since she was 6 months.
Little kids in our area go to a group SALT and portage session.

Arabica- i think it depends on the SALT, we are waiting for an appointment with another SALT but the first said she could not help as dd was non-verbal and did not respond well whilst out of our house, the SALT refered us to the SN nursery and now dd gets group therapy.

We also get help from portage, portage will be helping dd2 when she starts main stream nursery next month by visiting and giving advice to the nursery staff once a week.

Altogether i am happy with all the help we have had for dd2 as she hasn't got a dx yet.

Ds2 had his first appointment with the SALT about a month or so after his 2nd birthday.

He also had sessions in the sensory room with an OT.

He had play therapy from the portage service too.

Marne,I'm concerned about some of the things you say,so will comment on them.(I'm a SALT infield of SN with 15 years experience btw.)

'Hi, dd2(3) gets no real therapy, she goes to a special needs nursery which provide SALT and music therapy she also uses PECS and Makaton thanks to the nursery but we get no NHS therapy at the momment. She was sent to see a SALT but we were told they could not do a lot for her as she is non-verbal. We are waiting for refferal to a occupational therapist and another SALT but we have been waiting almost 6 months .'

You said:

It sounds like your dd is in a really great place.Chances are all those things like PECS and Makaton have been instigated by the SALT, so they are therapy. A SALT's job is to promote optimal communicative environments and to ensure that the people in a child's life have the best possible skills to do that. 1:1 sessions with a SALT are of little to no use unless the everyday way of communication is fine tuned to the child's needs.

Having said that, using the argument that a child cannot be ssen because s/he is non-verbal is the biggest pile of horse shit ever (most people I see are non-verbal) and I would challenge it with vigour and demand to see the policy that states this is so.

I would also start muttering about discrimination (which it is) and go to see SNAP/Parent Partnership about it and ask them to take it up on your behalf with Chief. Exec. of Health Trust.

And Stary, use of PECS is a therapy.
Unclear as to why you think it isn't.

I would also point out that a dx is often of little or no use.

1. It is estimated that up tp 80% of SN is of unknown aetiology.

1. A diagnosis often brings little to the table in terms of the best intervention. Witness another poster on MN having been told that her child with DS cannot acquire two languages which is a patent lie and an example of how people with the same diagnosis are lumped together by stupid prejudiced 'professionals'.

1. A diagnosis is often no more than a rewording of what you already know.

'Global developmental delay'. What the hell does that tell anyone who has a brain and sees their child is taking longer than others to reach milestones. PDD NOS (Pervasive Developmental Disorder Not Otherwise Specified). Absolutely pathetic.

Thank you moondog for your advice- i was very upset after seeing the SALT as they said there wasn't anything they could do, she did say that she may be able to send someone to the house to work with dd but this never came off. She made mew feel as though they were too busy and short staffed to spend time with dd2 and that it would be a waist of time as dd's comunication skills were nil. I am very happy with the help she gets at the sn group as she has SALT once a week and music therapy most weeks, her comunicatoin skills have come along in leaps and bounds since using the PECS. Do you think i should be pushing for her SALT through the NHS or is what she gets enough?
She has an apointment next week at the hospital for part of her asessment so i could chase up SALT then.

You could, but if i were seeing your dd, I wouldn't be needing to see her IYKWIM, because i would be confident that she was getting the support and specialist intervention she needs.

I work in classrooms like this where the set up is so great and runs so well, all I need to do is monitor and trouble shoot.

As I said,a proper communicative environment tailored to your child's needs is vastly superior to an artificial set-up in a clinic where a salt works 1:1 with a child.It's a waste of time, appart from for assessment or to show others how to use a specific technique properly.

Thank you all for your replies. Sorry for not replying sooner - I got waylaid this afternoon.

I think the PECS/Makaton/Intensive interaction/play based therapy ideas sounds good for us. There are no motor or sensory issues that I'm aware of, and no stimming (yet) that poses a problem - he does sometimes run round in circles looking sideways at the floor, but he's easily distracted from it and it doesn't interfere in day to day life. He has in the past done a little spinning of himself and wheels on cars, but he seems to have stopped that now so maybe this one is just a phase too.

His problems are with expressive speech (receptive seems fine), social interaction and imaginative play. I wouldn't say his communication skills are zero though. His pointing, eye contact and sounds have really come on since using the Hanen approach. He has a few words which he will use spontaneously, and a few others he will use when asked to, although his pronunciation is pretty bad. Is that non verbal?

Do PECS and Makaton come under SALT? What?s occupational therapy? And music therapy? And what do portage workers do?

Sorry for all the questions!

When he was diagnosed they made a big point of saying that we should continue with the bilingual approach (he's half swedish/english) so I'm glad they will be supportive of that.

Yes PECS and Makcome under auspices of SALT. Google OT and Music Therapy.I'm a big fan of the latter (I run a signing business with a MT) but be wary of expecting it to be anything much more than a lovely addition to an educational schedule that has at its core the aim of teaching child to sit, concentrate, listen and learn.

I think the salt you get varies greatly our first one offered nothing in wayof signing or pecs and said same thing that caan not helpas ds was non verbal and not even babbling.I had to find sgning course of my own back,trying find next stage but thats whole another story .

But our latest salt took time to listern to me,5 mins to see where my son was at,then started to help me put things in place.we dialed right back on trying to get him useing spoken laungage and hav econcertrated on giving him a voice in other forms and for us it has worked cue one less frustrated ds and mum
.Not given up on him speaking with voice but is now not our sole focus

we can not get portage here or sn nursery but we see salt every 6-8 weeks an she gives me things to work on

As for labels ds has dx of GDD with asd traits,SLI,MLD biggest problem I have is not with the labels,ut there what gives you acces to courses here and sadly the GDD label stops us accesing here as lot courses put on are only for those parnets with dc .dx of asd. But that is down to our health service locally and currently arguing the toss with them

oh and ds is 3.8

Phoenix, that horrifies and astounds me.Most of the people (adults and kids) I work with are non-verbal.
Tonnes can be done.
A blatant case of discrimination.

Moondog, if only we all had access to SALT within school...
That's but a distant dream here!!
Aside from anything else, the idea of NOT having to drive DD to 3 or 4 appointments a week. It would be bliss

yep hence why we have new salt ,I wrote tons and tons of letters to bosses,mp and anyone else could find.took your advice from earlier posts so thank you Moondog

fingers crossed along as panel agree ,ds gets in the sn school,they have actually employed their own therapist in school af/t hence was big plus for me