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How to prioritize autism services for your child: Answers from Dr. Melanie Hsu

How to prioritize autism services: Q&A with Dr. Melanie Hsu

Updated: August 11, 2023 · 5 Minute Read

Melanie Hsu, Ph.D.

Reviewed by:

Melanie Hsu, Ph.D.

Highlights

  • Comprehensive assessments conducted by a diverse team of specialists can help you understand what services your child needs.
  • Work on regulating your child's nervous system first with a service like occupational therapy. From there you can focus on therapies like speech and then social skills.
  • Services at school are mostly focused on helping children succeed at school. Seeking services outside of school may help children learn skills necessary for common day-to-day tasks.

Beaming Health’s co-founder Marissa Pittard sat down with autism expert Melanie Hsu, Ph.D. to talk about the science behind autism and the therapies that can help children thrive. They answered common questions about autism and chatted live with parents. In this clip, Dr. Hsu answers parents' questions about the different services available to children on the autism spectrum. She explains how parents can decide which services their child needs, and how to prioritize those services.

 

 

This transcript has been edited for length and clarity. You can find the full video conversation in the Beaming community. 

 

How do you know which services a child needs? Will a pediatrician know? 

It starts with comprehensive assessments to understand where the barriers are and how to address them. 

 

Pediatricians are amazing and I respect what they do, but that isn't necessarily how they're trained to think about these things. They look at symptoms and they say, ‘Okay. Let's do this,’ or ‘let's do that.’ 

 

I often work in an interdisciplinary team where I am lucky to have access to a speech language pathologist and an occupational therapist. And we all work in conjunction to say, ‘These are the things that are getting in the child's way and this is how we think those barriers can be removed.’ Psychologists, we’re trained to do that. We're trained to look at all the pieces and then put them all together. 

 

Working with a team and working with a psychologist can be really helpful to operationalize the problem. To say, ‘Okay, this is the impact of functional communication, which would be speech. This is the impact of sensory-motor issues or regulation which would be OT. This is the impact of emotions…’ and then from there develop a comprehensive plan.

 

How do I prioritize services? Which services are the most important? 

It can be very overwhelming to try to prioritize everything. 

 

We always say regulation is at the base. You need to be well-regulated in order to be able to learn things. So what we often suggest is looking at whether or not an individual is more dysregulated. 

 

OT (occupational therapy) can help with making more sense of sensory information, so your body is more efficient and accessible. 

 

Functional communication is often a really big part of dysregulation. If we feel like we can't talk about what's going on for us, and we don't have the words to put our experiences into a way that other people can understand, that often causes a lot of frustration. And so often we talk clinically about making sure that the regulatory systems are working correctly and that the individual has a way of communicating functionally and prioritize it this way. 

 

And then social skills are on top of that. 

 

Who should I work with to help my child improve their ability to regulate their nervous systems?

Working with a skilled occupational therapist is really helpful. Specifically, sensory processing is something that some occupational therapists are trained in, because everyone has different specialties.  

 

Mindful movement and yoga are those kinds of things that help a person become more attuned to what's going on for them inside and how that links to their behaviors is a key part of that. And this can be done through an occupational therapist. 

 

Mindfulness type of therapies could also be done through a clinical psychologist or a mental health clinician. But if it's a significant area of concern, if there's a lot of dysregulation, we often suggest consulting with an occupational therapist first. 

 

What is the difference between services provided at school and services provided outside of school?

Schools focus on helping a child access the curriculum. The services that are offered through school are much more narrow and specific in scope. And so a lot of times parents are like,  ‘But they're not always at school.’ We want to be able to expand these skills outside of just what we would use in the classroom, even though those things are very important. 


People usually seek services outside of school to help with the many different environments that individuals find themselves in, even though again, a lot of things that you learn in school are applicable outside as well. But the school is bound to their first consideration, ‘How is it going to help the child be successful at school?’ and so their focus on OT, for example, may be specifically on handwriting versus something that a parent may be more concerned about, like activities of daily living. So outside of school, you can get a wider range of services and a broader scope.

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