CHOOSING PROFESSIONALS & Coordinating Services
Because ASD and related disabilities are difficult to diagnose, a child may be evaluated by a variety of professionals before a final diagnosis is determined. Unless specifically trained in the area of developmental disabilities, physicians and psychologists may have little experience with autism spectrum disorders. Many have never seen a child with autism or a related disability when a parent brings their child in with the first signs of the disability emerging. The following are brief descriptions of the specialists most commonly associated with diagnosis, intervention, and treatment of autism spectrum disorder and suggestions about how to select professionals to work with you and your child.
Developmental-Behavioral Pediatrician: A physician specializing in diagnosing and treating children with developmental disabilities from birth to adolescence, who will follow the child's development and sometimes supervise medication management.
Psychiatrist: A physician who focuses on diagnosing and treating mental illnesses from a biological and psychological perspective and may prescribe various medications for treatment.
Psychologist: A licensed practitioner specializing in diagnosing and treating a person’s behavior, emotions, and cognitive skills. They may recommend strategies to aid growth and development or help with challenging behaviors.
Neurologist/Pediatric Neurologist: A physician specializing in diagnosing and treating disorders of the nervous system, including seizures. They may run neurological tests to rule out seizures and other brain abnormalities.
Geneticist: A physician specializing in the study of disorders associated with heredity.
Occupational Therapist: A licensed practitioner specializing in enhancing participation in the performance of activities of daily living (e.g., feeding, dressing), instrumental activities of daily living (education, work) and social participation. Some non-school based OTs address hyper- and hypo-sensitivities associated with ASD.
Speech Language Pathologist: A licensed and certified practitioner specializing in diagnosing and treating disorders of communication, including speech articulation, voice, and prosody, and language, including semantics, syntax, pragmatics. They may also specialize in disorders of reading and writing, or swallowing and feeding.
Audiologist: A practicioner specializing in the diagnosis and evaluation of hearing problems.
Behavior Analyst: A practitioner specializing in the use of principles of Applied Behavior Analysis to developing desirable behaviors and replacing behaviors that are problematic. There are several levels of certification for behavior analysts, and more detail can be found by clicking on the link.
The Selection Process
Choosing a professional is not always easy. When choosing a professional to work with you and your child, it’s important to look for someone who shows respect for the parents and regards parents as experts on their children. The professional should convey a sense of hope and have a philosophy similar to your own. Look for a professional who takes an individualized approach to treatment and intervention — one who does not say that all people with autism exhibit the same characteristics.
Based on your child’s needs, it will take various professionals working together with you to develop a treatment and intervention plan. The most effective treatment of people with autism almost always involves a long term team approach. Visits to the classroom, home, and community usually provide the most useful information about the child. Since frequent visits may not be possible, the professional may collect information through interviews and questionnaires.
Just as professionals ask many questions, so should you. Remember, no questions you have regarding your child are trivial or unimportant. You may want to ask some of the following questions of the physicians and therapists:
What are my child’s strengths? How can they be maximized?
What specific activities or interventions should I do at home?
What kind of testing and evaluations should my child have?
Why should my child have these tests and evaluations?
How is each test or evaluation performed?
How will the results influence my child’s intervention or treatment?
Can you put me in touch with another family you are currently working with?
Do you have any articles or resources on autism or autism spectrum disorders?
Can I have a copy of your report? How soon will it be until I receive it?
Obtaining and reviewing all reports is very helpful in understanding your child’s needs, progress, and how recommendations can maximize your child’s potential.
Sometimes evaluations and recommendations may be different or conflicting. This can be confusing and exhausting. A case manager or service coordinator can help when questions, problems, or concerns arise. A case manager keeps current records and, when appropriate, shares information about a child with professionals involved in that child’s care. It’s one very effective way to make sure a child’s needs are being met. Case managers may also help by making sure all appointments are scheduled, tests are performed, evaluations conducted, and that appropriate and effective follow-up care is being provided.
If an evaluation has been performed at a Child Development and Evaluation Center or if the child is receiving services through a state funded program, chances are that one person has been designated as a service coordinator or case manager. If this is not the case, you can ask for help from your pediatrician or family physician, local Autism Society of America chapter, your local school district special education department, or CARD. Some parents elect to perform this role themselves.
Parents and professionals communicating effectively and respectfully as partners is an important factor in achieving progress and success for any person with ASD or a related disability. Working as a team by sharing information and responsibility can be the most effective approach when developing a treatment plan. Parents often have the best understanding of their children’s behavior, communication, preferences, and motivations. Professionals may suggest various ways to help a child but parents know what activities are practical for their family life. Parental perspective is integral when developing an intervention plan. Professionals specializing in ASD have specific knowledge and training with regard to evaluation and development of education and treatment plans. By working together and respecting each other as equally important partners in a child’s care, parents and professionals can optimize the potential for a child’s development.