Okay, okay. This picture is a little on the gross side. But it's relevant to the theme of this post, so bear with me.
You can divide most autism therapies into two camps: those that are done mostly by parents, and those that are not. Some therapies lend themselves to either direction and indeed some research has been done in the ABA camp to see how allowing parents to run ABA affects outcomes.
In the "do it yourself" camp there is Floortime/PLAY, RDI, More Than Words, and biomedical options. ABA can be done this way as well and many people do it.
In the "leave it to the therapists" camp there is ABA, standard speech therapy and occupational therapy.
Most of the "do it yourself" therapies involve therapists setting up programs, monitoring it and providing feedback to the parents. But the parents do the bulk of the work, because after all, the parents are the ones with the children the most - at least, that is generally the way this approach is marketed.
There are definite positives to this approach:
1. Training and supporting parents is much cheaper to governments who are expected to provide intervention for autism.
2. Involving parents to this degree encourages them to accept accountability on how the intervention is working.
3. Parents who are well trained are better suited to continue to teach their children long after the early intervention period.
But there are problems with it too:
1. While we'd like to think most parents are the best teachers for their kids, some parents just aren't. They are not going to do as good a job as a trained therapist. They may lack the intelligence, or lack the time or energy to do a good job. Full disclaimer: I have done ABA with Alanna and after two hours with her my brain is fried. I do not think a parent could realistically do this intensively and properly without help but that is just my opinion.
2. Some parents need to work. Many parents work but do not need to do so (I'm not talking about your neighbours who work to pay for the SUVs they got last month), but some, including single parents, do not have a choice. In this case, the child is not going to properly receive intervention from a program training the parent because the parent may only see them in the evenings and on weekends.
3. As a parent it is very easy to be lazy. Add to that the pressure of turning every activity into something therapeutic and you have a stressed out parent. I do try to incorporate all the principles of ABA and More Than Words into my interactions with Alanna, but it's nice that the "pressure it off" me because I know her intensive teaching time is taken care of.
4. Some parents have multiple children. It is difficult to provide the intensity of interaction with an autistic child when you have another, let alone three or more children! Any time your child is spending off in their own world is wasted, and sometimes you have to let them do that if you have more than one child.
By the way, I should also note I'm not partial to the idea of universal government-funding for daycare (I am okay providing it for those who really need it). Some people believe parents are idiots and the state should raise children. I am not suggesting that at all. We strongly believe in having a parent at home for kids and neither of ours go to child care. However, I do think there is a case to be made for a balanced approach - one where therapists and parents are heavily involved in their child's intervention.
What's your take?