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Anyone got any experience of psychotherapy for an ASD child?

(29 Posts)
pannetone Fri 17-May-13 12:21:50

Because that is what CAMHS are now offering for my 8 year old DD who has just been diagnosed with ASD (HFA for what the term is worth). She already has a diagnosis of selective mutism. I am pretty clueless at how psychotherapy will work as it is very unlikely that DD will speak at all... On the other hand I was not at all keen to do 'family therapy' which was offered last year when older DS got his ASD diagnosis. Managed to turn that into CBT for DS, which obviously wouldn't work for DD.

DD is very anxious and I don't know whether it is a risk that psychotherapy would just increase her anxiety - although I realize that's not 'meant' to happen!

pannetone Mon 20-May-13 13:09:52

Thank you for all your posts - and the experiences of psychotherapy.

paperpickle your DS's experience sounds awful for both of you. You say that it is now clear that your DS's anxieties and behaviours stem from his AS and that there is no need to consider any additional factors. This is what I am confused about. If the psychotherapist accepts that DD is how she is because of her ASD and selective mutism, is there a place for psychotherapy? DD does have issues with anxiety and separating from me because of her ASD and SM. My worry is that the therapy will look for other explanations of her behaviour, for example, the relationship between me and DD WITHOUT reference to her ASD, and that they won't take enough account of her ASD in her ability to 'change' and 'move on', or in advising me how to 'parent'.

OTOH I am aware that I might be being hyper-sensitive to any 'criticism' of my parenting and anything that I am doing to 'reinforce' the behaviour. We were repeatedly told that the therapy had been successful for both children with ASD and those with SM. DH is more focussed on that. We agreed at the meeting for DD to be put on the waiting list - nothing will happen before September.

I agree with all those who say that it is the ASD and SM that are 'controlling' DD. As she gets older she is more self- aware and wants to be able to speak because she says that is 'normal'. When she had art therapy she was sad that she didn't manage to speak to the therapist although she wanted to. She didn't know why she couldn't. No control there...

Another huge issue is what Mareeeya says about the point of getting an ASD diagnosis is to put strategies in place to support DD at school. We pushed for a year to get them to assess DD for ASD (the diagnostic service wanted to wait until her selective mutism improved...) and now we have it, the diagnosis should be used to understand why the usual SM strategies don't seem to be working as yet for DD. We are waiting for the ed psych report and I think that we should be putting into place its recommendations before even considering psychotherapy. Your comment zzzzz that the most likely cause of DD's anxiety is 'not having the quite profound needs of HFA met adequately' and I think this hits the nail on the head on what is happening at school, whereas I think that we do pretty well at home - with DS now 18 I have had a fair few years of ASD parenting!

MareeeyaDoloures Mon 20-May-13 19:52:32

TBH, I would imagine you are the therapist most likely to succeed with your unique experience of the combination of ASD and SM and of what makes your own dd tick. Like ASD, there are probably subgroups in SM.

Presume you know the principles of behavioural interventions already. Video modelling shows promise too. There doesn't seem to be much evidence for psychotherapy type stuff.

MareeeyaDoloures Mon 20-May-13 19:57:34

TBH, I would imagine you are the therapist most likely to succeed with your unique experience of the combination of ASD and SM and of what makes your own dd tick. Like ASD, there are probably subgroups in SM.

Presume you know the principles of behavioural interventions already. Video modelling shows promise too. There doesn't seem to be much evidence for psychotherapy type stuff.

DD also had about 10 sessions of art therapy organised by her school which she liked going to. It probably took her the 10 sessions to get settled. Perhaps school might consider some more mini-sessions, now that they can be adjusted to take account of the ASD?

Phone calls? emails? writing a word down? Speaking at home, then playing it back on Talking Tom during the session? Sorry if teaching granny to suck eggs blush

pannetone Mon 20-May-13 20:32:50

Thank you Mareeeya - some familiar stuff there and some to explore. I have got to get up to speed on all these psychology terms - I hadn't thought of the 'sliding in' work that has been done with DD as a behavioural intervention. But that is certainly what I favour as being most likely to produce results - rather than the psychotherapy/psychodynamic(?) stuff.

And i've just re-read that small steps intervention plan for SM by Maggie Johnson and Alison Witgens (I have the manual)that you linked to - and it seems glaringly obvious that it hasn't been followed properly with DD. I don't think DD's 'keyworker' was ever properly 'slid in' - I was never asked into school to do this. And there hasn't been anywhere near the time commitment to several sessions a week which there needed to be at the beginning. The school now seem to complain about the amount of time/SALT intervention invested in DD with little progress but I don't think it's been done properly. Now I feel a bit that my eye has been off the ball... Though with DS3 also being being assessed for ASD and fighting (and winning) a disability discrimination claim against ASD DS2's school life has been a bit hectic...

Off to do CBT 'homework' with DS3 but I am going to print out that Maggie Johnson link, highlight where the programme hasn't been followed, and arrange a meeting at school once the ed psych report is also in. I am not going down the psychotherapy route when the school hasn't followed an established SM behavioural intervention.

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