Is There More We Can Do? When To Consider Private Therapy

As the parent of a child on the autism spectrum, you likely want to do everything you can to help your child. You may have worked diligently with your child's school to ensure that your child's Individualized Education Program (IEP) is as complete and thorough as possible. You are implementing strategies at home, based on the approaches your child's therapists are using. But could you be doing more? That is a question that nags many parents.

More is not always better. But certainly there are times when supplemental instruction or therapy could benefit your child. How do you know when private therapy is the right choice for your child and your family?

• Can you afford it? Private therapy isn't cheap, and not all therapists accept insurance. Carefully look at your family's financial situation and determine how much money per month your family can afford to spend out of pocket. If you can only realistically afford one treatment session per month and the private therapist recommends one per week, private therapy may not be worth pursuing at this time. Many families are tempted to get a second mortgage or rack up credit card debt to pay for therapies. Losing your house or having to significantly alter your family's lifestyle may be more damaging to your child than not receiving private services.
• Consider what you hope to gain from the therapy. If you are tempted to go all in with the idea that if you just do this one thing, your child will have a dramatic improvement, you may be acting on emotion and your expectations may not be realistic ones.
• Are you prepared to continue the private therapy for as long as the therapist thinks is needed to achieve the therapy goals? Even if the therapist can estimate how long it might take to see progress, be prepared if it takes longer (or never works).
• Is the therapy evidence based? Evidence based treatments have been proven to work in samples of individuals on the autism spectrum. Spending money on evidence based treatments may be less risky than pursuing other, unproven ones.
• Is the therapy something that isn't available through "free" avenues (the education or behavioral health systems)? Examples of treatments which might meet this criterion (depending on where you live) are Cognitive Behavior Therapy, family counseling, Applied Behavior Analysis, or psychiatric services. Your health insurance may pay for some of these services, but there may be a limit to the number of times covered each year.
• If your child is eligible to receive the therapy at school, would he or she have to give up something else that you feel is indispensable? For example, if taking part in one-on-one speech therapy would necessitate that your child miss math class each week, perhaps using a private speech therapist is a way to ensure that your child misses less class time and gets the individual attention from a speech pathologist that he or she needs.
• Is the therapy something you think your child needs but the IEP team doesn't agree? Some parents choose to pay for therapies on their own (for example, social skills groups or speech therapy) and then utilize dispute resolution to attempt to get the IEP team's decision reversed. Be prepared that this strategy doesn't always work, and it is better to work out a solution before paying out of pocket as there is no guarantee that a mediator or hearing officer will agree with you.
• Is your child behind academically but motivated to catch up? Maybe a private tutor could help.
• Is your child going through an especially difficult situation, like bullying, depression, or anxiety? If so, private therapy may provide critical extra support to help your child as quickly as possible, particularly if the difficulty is inhibiting your child from benefiting from therapies at school.
• Are you tempted to pursue private therapy because you don't like the school or behavioral health therapists working with your child or because you don't think they know what they are doing or understand ASD? Talk to the team and express your concerns. You may be able to switch therapists within the school or get a new TSS.
• Have you spoken with both the school therapist and the private one to make sure they will be working to complement each other's work? If the therapists are using different approaches, this may serve to confuse your child and delay progress in both settings.
• Would a private therapist be able to teach you better how to implement strategies at home? Being able to reinforce what your child is learning is important. While the school and behavioral health therapists should help you, if you need or want more information, private therapy may be a good option.
• How much free time does your child and family have? Private therapy is done on your own time. Are you able to take your child to afterschool appointments? Will going to afterschool appointments preclude your child from taking part in other activities, like afterschool clubs or sports? How will it impact your other children, who may have to tag along or be left home alone or with a babysitter?
• How will your child feel about receiving private therapy? Adding more therapy and instruction to your child's day may prove overwhelming. Take into account your child's age and tolerance level. Also, if your child sees private therapy as a punishment, it will be difficult for him or her to benefit from it. Work with your child and the therapist to make sure that your child understands that the point of private therapy is to help make your child's life easier — not to be an added burden.