Boston Children's at Waltham

The goal of speech therapy is to help your child communicate effectively with other people across all environments. This may take the form of using gestures, simple signs, verbal speech, and Augmentative and Alternative Communication (AAC).

Some other common things speech therapists can help with:

• Nonverbal skills, such as signs or gestures
• Forming speech in a clearer way
• Communicating thoughts and feelings clearly
• Understanding and responding to questions
• Discerning facial expressions and their corresponding emotions
• Noticing and understanding body language
• Feeding and swallowing
• Stuttering

When you visit a neurologist, they’ll assess your child’s needs, run some tests (think imaging or EEG), and diagnose. From there, they’ll create a customized treatment plan. Medication, lifestyle tweaks, or maybe even a referral to another specialist could be on the table.

There unfortunately isn’t one test for all neurodevelopmental conditions. Most likely you will go into a visit to test one or two medical conditions. If you are looking for a comprehensive autism evaluation, developmental pediatricians, psychologists, or neuropsychologists are the preferred specialists who can diagnose autism.

No, neurologists focus mainly on non-surgical interventions. If your child needs surgery, neurologists might point you in the direction of a pediatric neurosurgeon.

The occupational therapy process includes an OT evaluation before care starts. Here are the four steps your family can expect when starting occupational therapy:

1. Complete OT evaluation. An occupational therapist first identifies your strengths and needs through a thorough OT evaluation, also known as an OT assessment or screening. You’ll answer questions about you your skills, and you will most likely demonstrate these skills via hands-on activities with the therapist. Evaluations can last 30 minutes to a couple hours.
2. Approve OT plan. The therapist develops a care plan with individualized goals and customized interventions based on your needs. You can also share any specific goals or concerns before approving the OT plan.
3. Start therapy sessions. The therapist works directly with you, using various strategies and exercises to systematically improve areas of limitations and to build upon your strengths. If there are others part of your care team, the therapist may teach strategies for supporting your individualized needs at home and may recommend tools and techniques to use at home, in the community, or in the classroom to help you thrive.
4. Monitor your progress. You can expect ongoing progress monitoring and communication to ensure you're achieving your short and long-term goals.

Once you find a quality physical therapist you want to work with, here are a few things you need to know:

• There will be an evaluation. First, you can expect an assessment to identify your child’s areas of strength and needs. A physical therapy evaluation usually lasts 30 minutes.
• You’ll review and approve the care plan. The physical therapist will create a care plan, also known as a plan of care (POC), outlining the goals and strategies. They will review this with you and your care team before moving forward with therapy sessions.
• Physical therapy sessions will be fun. PT with children is designed to be enjoyable. The therapist will use strategies and exercises based on your child’s needs. Exercises might involve playing on large stability balls, obstacle courses, movement equipment, stretches, and other hands-on activities.
• Expect home exercises. Physical therapists commonly assign exercises to work on at home. Doing these exercises with your child outside therapy sessions can improve your child’s overall progress.

Yes! Most providers offer physical therapy in their offices or a clinical setting, but many are offering at-home options. Virtual options have become more popular in recent years. You might facilitate care with the guidance of the physical therapist.

Pediatric physical therapy is considered safe and should not hurt. Autistic children spend their time in PT moving and exploring their environment. If you are concerned about your child experiencing pain during certain exercises, especially if they may struggle to communicate and advocate for modifications, speak with their physical therapist about your concerns.

Yes, picky and selective eating is actually a quite common concern for children with autism. If you rolled your eyes looking at the steps above because your child with autism has never had a full day's serving of vegetables in their life, you are definitely not alone. As if getting kids to eat their veggies isn’t challenging enough, research shows children with autism have significantly more eating challenges than their peers who are not autistic.

In addition to sensory difficulties that can lead to a lot of anxiety with food, autistic children are 4x more likely to have gastrointestinal issues such as stomach pain and discomfort. This creates the perfect storm for extra extra picky eaters - and a lot of added obstacles and concerns for parents. 

The difficulties associated with autistic children and food can cause a wide range of concerns from children being underweight to overweight (overweight children can still be at risk for nutritional deficiencies!).  This can lead to slower than normal growth and nutritional deficiencies like low vitamin D and calcium levels. Even when given multivitamins, many children with autism are still found to have some of these nutritional deficiencies.