Autism Therapy Fatigue
Published June 29, 2009 @ 02:57PM PT
The relative of an autistic girl asks if there's such a thing as "therapy fatigue" in a letter published in the Manila Bulletin Publishing Corporation:
.....I noticed that the child is always tired of attending one therapy after another. She becomes cranky and would be moody at the end of the day. Sometimes, she even refuses to go out as if she doesn’t want any therapies anymore. Is there such thing as “therapy fatigue”? If yes, should I tell her parents to stop or lessen giving the child therapy session? If none, can you tell me until when should a child with autism continue to attend therapies?
Responds Dr. Myra V. Altonaga, a neurodevelopmental pediatrician based in Cebu:
...herapy fatigue often occurs in children who are subjected to daily therapies (not just one therapy). In other words, their daily routine would include going from one therapy to another.
In my clinical practice, I’ve encountered parents who would not be contented with the therapy in the center alone but would also get home service therapy within the day either just to fill up the schedule of their children, or to maximize the intervention.But we have to remember that they are also children who want to play and do things that they enjoy. We have to give them enough time for these also.
Lessening the therapy sessions would be helpful. Anyway, the big factor for the success in the intervention would be the follow through and the active participation of the family members and not the frequency of the therapy sessions.
It's not hard for a parent to go into autism-therapy-overdrive with so many therapies and treatments, educational, biomedical, medical, etc.. When my son was younger, we tried many things; sometimes it felt (felt) that there was an unconscious feeling among parents that "the more we're doing, the more it shows how hard we're trying. Gradually---after seeing what helped Charlie and what not---we let go of the alternative biomedical treatments and focused on his education. The only doctors we visit now are the pediatrician (inevitable colds and minor ailments), the neurologist, the dentist. (And I think we all felt a sense of relief at not driving him every which way to yet another therapy appointment.)
When do you know when enough is enough?
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Comments (6)
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Kristina is a Classics professor in Jersey City, New Jersey, a blogger (formerly at AutismVox), a translator (of Virgil), and an advocate every day for her son, Charlie.
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That's a good question! I guess it varies from one child to another. It's hard because some resistence is inevitable, and certainly many kids with autism have benefited from undergoing long hours of ABA and/or Floor Time, RDI, speech and OT. But there is a balance between the pushing/pulling and the letting be. All kids need play time, leisure, rest -- time that the child controls, when the child chooses what to do. In other words, I don't know the answer, but it's another instance of both yin and yang being important!
Posted by Twyla Ramos on 06/29/2009 @ 03:48PM PT
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Hello, Kristina. I sometimes think our son needs a break...from me. For example, after a period of torturing him with flash cards and phonics workbooks I concluded, Hey, this kid ain't ready for this. He didn't like letters or spelling so I let it go. Fast forward a couple of months to this morning and here he is labeling everything in the house with blue painter's tape (the stuff is miraculous, peels right off). He labeled his crayon drawer "crayons", his superhero drawer "superheroes." And beside each word he drew a picture, in case a friend came over "who couldn't read." I helped with spelling and letter identification, pointing to a sound/letter card I brought from school. But my biggest contribution was staying out of his way.
Posted by California Father on 06/29/2009 @ 06:48PM PT
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Of course all kids need to learn to do some things that aren't necessarily what they'd most prefer to do at a given time but seriously, learning to manage downtime onesself is a skill that often gets neglected. This isn't a scientific statement on my part but a speculation: that is, that sometimes when someone appears to be having severe prolonged difficulties, it is because they really NEED downtime but don't know how to manage it when they have it, which makes the people around them respond by "over-structuting" their days.
This can lead to a vicious circle in which the person is totally exhausted but keeps "going" anyway and ends up eventually crashing or melting down.
(And I do speak somewhat from experience here, as I am *still* learning to take breaks as a 30 year old adult)
Posted by Anne Corwin on 06/29/2009 @ 07:37PM PT
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Anne- I agree with you that too many times we don't provide opportunities for our kids to learn how to manage downtime, and that is a real shame. I've always tried to treat my children as children first and autistic children second, but it's not always easy to do. I think that there's a lot of pressure (from outside and self-inflicted) on parents to make every moment "count", and I don't think that's always helpful to anyone. Sometimes people just need to be.
Posted by Jen Niebler on 06/30/2009 @ 03:42AM PT
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As someone on the spectrum (but not diagnosed until late in life), I didn't have any therapy sessions ... just made my way through life as best I could (which wasn't too bad btw).
A reminder that these kids have minds of their own and are not such that they need to be "trained". I think that parents sometimes forget that they can talk to their children in a two way conversation and explain things intelligently. The children will probably respond. The perception problems of people on the spectrum sometimes leads to people ignoring them as thinking and intelligent beings.
To some extent, you need to let kids be kids. You will be surprised at what they can do on their own. People (kids) adapt and develop coping skills on their own. Now it may help to give them some assistance in getting those skills ... but you cannot force it on them.
-- Bob S.
Posted by Robert Suvak on 07/03/2009 @ 07:37PM PT
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Anytime someone is pushing against their physical or mental limits, it can lead to exhaustion. Therapy is exactly that, it pushes against someone's limits (physical, emotional or mental) to strengthen a weakness. Overdoing a therapy can lead to exacerbating a problem, exhaustion and can actually set back the desired improvement.
Moderation in all things would probably apply.
Posted by William Brown on 07/04/2009 @ 10:23PM PT
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