This post is the sixth in a series based on a transcript from a recent Q&A with Dr. Barry Prizant as part of his webinar, “Family Collaboration: An Essential Element for SPED Success.” Questions came directly from audience participants — special education directors, special educators, speech-language pathologists, and parents, and answers are from Dr. Prizant. Click here to see additional questions from the Q&A.
How can we help parents to understand that more services are not necessarily better services?
This can be a tough situation, especially when parents are hearing from other parents or from outside professionals that “You need to get more hours of therapy to your child. What you are getting is not enough hours.” It just so happens that the philosophy in working with many kids with autism and many kids with related disabilities, communication disabilities, developmental disabilities, is that coordination of services is a better marker of intensity of services than simply the number of hours.
Let me say that again, coordination of services is a better marker of intensity of services rather than the numbers of hours, especially the numbers of hours of pull-out therapy. Now why is that the case? Isn’t it logical that if a parent feels that their child gets five hours of speech and language therapy a week, that is better than maybe getting three half-hour sessions, but having the SLP consult with staff and having all the staff trained in strategies that they could use to support a child’s communication development? So think of the other way. If more time and more effort is put in to coordinating where you have a very talented classroom teacher who makes communication opportunities throughout the day, who knows how to use non-speech communication systems and speech-generating devices for kids who need them, where the staff also puts the time into providing informational or training sessions to parents, then that child is getting that support throughout the day across partners and across settings.
This is in contrast to a child who may be getting individual pull-out speech and language therapy where, by the nature of the caseload of the SLP, she or he is just not available to monitor programs, to do in classroom co-teaching, to do consulting. This also goes for OTs, PTs, psych services, and so many other kinds of services. This is something I believe falls into the category of educational support to parents and to families, the educational support being that if we can be as consistent as possible across all the child’s partners, across all the child’s settings, that is providing a more intensive learning experience. To use a word that everybody knows, your child is more likely to generalize what he or she is learning because those are opportunities and those supports were in place across all settings.
I have found that it’s typically parents of younger kids who hear from a variety of sources — from some professionals, from something they’ve read, from other parents — they hear that, “You need to really build up those hours because hours of therapy equals quality of program.” I will tell you in my 40 years of experience working in all kinds of settings and in hundreds of school districts, by far the best programs I have seen is when there is that careful coordination and parents are educated about the importance of careful coordination rather than just counting hours like chips if you will. Now you still could count hours, but you could count hours in terms of educational sessions for all of the staff, in terms of monitoring by specialists in classrooms, maybe not providing direct services. but in terms of actually consulting to educators who are likely to see the child much more often.
And by the way let me not leave out paraprofessionals and aides as well. I consult some programs where paraprofessionals get wonderful support from teachers and therapists and they are very skilled throughout the whole day in providing support to a child that they are working with, and I consult to other programs where the SLP and the OT comes in, pulls the child out, and the para takes a break and goes off and gets a snack, and there’s not that coordination at all. It’s not focus of what is going on.
Dr. Barry Prizant is a clinical scholar, consultant, researcher and expert on childhood communication disorders. His new book, “Uniquely Human: Seeing Autism Through a Different Lens” is scheduled to be released in August, 2015 by Simon and Schuster. To contact Dr. Prizant for a consultation or workshop in your district, visit https://www.barryprizant.com/.