Determining priorities in treatment can be a hard thing to determine as a family. There are a lot of things to consider when thinking about what to treat, when to treat something, and how to treat something. Thinking about the needs of your child and family and making sure there is a good balance is a good check to keep in mind when prioritizing needs and treatment.
I recently had a parent refer to the many needs of her daughter in this way: “It’s like there are three floors of the house burning! Where do we start and which level do we fight the fire on first?” This provides an excellent visual metaphor for determining priorities in treatment.
When a child has autism, or another neurodevelopmental disorder, there are many areas of need to consider. The pervasive nature of the diagnosis leaves little unscathed in terms of development and functioning. The extent to which each area of functioning is impacted varies, but it’s safe to say that all children on the spectrum are affected by their autism in numerous areas. There are communication problems, social interaction problems, restricted behaviors, rigid thinking, and other issues that come from having the core deficits of autism. Then, for many kids on the spectrum, there are the co-occurring problems to address such as impulsivity, feeding problems, sensory processing problems, motor deficits, academic problems, and more. The list can go on and on depending on the child and it can, indeed, feel like all three floors of the house are burning.
Once you have carefully and thoroughly identified the conditions and areas of functioning that require treatment, the question becomes what to treat, when to treat it, and how to treat it. The pervasive nature of these disorders is the equivalent of a house that burning from a fire that started in the foundation. There are a few options to consider when making these decisions:
As parents and professionals we have to recognize that there is only so much “water” to go around – only so many hours in the day, energy to expend, knowledge that can be absorbed, money that can be spent; the list goes on. We need to consider the idea that it is not necessarily about getting more water, it is about how that water is used. It is about:
Think about how you are prioritizing the needs of your child. Are you able to rest assured that you are targeting what needs to be targeted for now, and that everything else needs to be left for later? Do you have a strategy that is allowing you to put out the fire from the source instead of blindly aiming water at the obvious flames? Do you have a good balance in your family where autism is one part of what you focus on as a family, and not the thing that takes up everyone’s time, energy, and finances? These issues are critical to consider when initially making treatment decisions, and must be revisited frequently along the journey of providing for the needs of your child and family.
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