Anyone who has worked in an early intervention centre is familiar with the scene of a parent standing in the waiting room trying to schedule a therapy session. “How is 4pm on Tuesday”, the secretary might say. “Sorry, he goes to OT on Tuesday afternoon”, says the Mother, “how about 4pm on Wednesday”. “Sorry, there isn’t anything available on Wednesday but what about Friday”, the secretary counters. “No, he has speech pathology on Friday, we could do sometime late on a Monday”…. This typically stretches on for a while and highlights the enormous demands placed on parents when they have a child going through early intervention.
These demands are not ill-conceived. Contemporary research tells us that intensive intervention delivered early in life is associated with superior outcomes as compared to less intensive therapies conducted later in life (e.g., Rogers et al., 2012). Some research even suggests that there is no point at which increasing early intervention hours does not lead to further improvements in children’s therapy outcomes (Granpeesheh et al., 2009). Based on these findings, the answer to the often-asked question “should we do more therapy” ought to always be yes. However, it is important to consider that other factors, such as parenting stress, have been found to impact on the effectiveness of early intervention (Osbourne, McHugh, Saunders, & Reed, 2008). Optimising therapy outcomes is therefore not simply a matter of perpetually increasing intervention hours, parents must also take their own wellbeing into account.
To this end, I encourage parents (perhaps not as often as I should) to sit up and take note of the fact that they are actually doing a great job. It might sound strange, but this can come as a surprise to some parents who seem to have acclimated to the exceptional demands of supporting their child’s development and are focused solely on achieving improvements into the future. For these people, I would like to point out five of the things I see parents do in the clinic that are truly impressive.
- Showing up – as someone who does not have children and is familiar with the traffic situation in Sydney, I am amazed by parents’ ability to get their children to their various therapy appointments. They do so much work even before they enter the clinic doors and should take the time to acknowledge it.
- Being invested – every week I have parents come into the clinic and tell me about something new that they have noticed about their child. The excitement that a new word or a newly established friendship can elicit from a parent is something to behold.
- Being curious – parents often have questions about therapies and/or advances in research they have read about in the media. The fact that they are able to come up with these questions in the absence of any apparent free time demonstrates the tenacity with which parents pursue an understanding of their child’s difficulties.
- Going without – not only in financial terms but also in terms of time, it is impressive to see how much parents put into their child’s intervention relative to how much they give themselves. Parents should be careful here not to go overboard, but also be proud of the fact that they go without in order to better support their child.
- Being involved – whether it’s taking turns pretending to be dinosaurs or jumping across the room on make-believe Lilly pads, it’s always encouraging to have parents actively participate in therapy activities. This is relatively easy for therapists because they are often able to take a few minutes after each session to recuperate. For parents, on the other hand, the show continues as they transition to the car and on to the rest of their day (sometimes with a very excited/energetic child alongside). Once more, I’m not sure how parents manage it but they really ought to remember that they are doing a great job.
Granpeesheh, D., Dixon, D. R., Tarbox, J., Kaplan, A. M., & Wilke, A. E. (2009). The effects of age and treatment intensity on behavioral intervention outcomes for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(4), 1014-1022.
Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). Parenting stress reduces the effectiveness of early teaching interventions for autistic spectrum disorders. Journal of autism and developmental disorders, 38(6), 1092.
Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., … & Dawson, G. (2012). Effects of a brief Early Start Denver Model (ESDM)–based parent intervention on toddlers at risk for autism spectrum disorders: A randomised controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51(10), 1052-1065.