Who’s Involved in Your Child’s Autistic / Speech Delay Journey?

So let's talk about who's involved and what kinds of therapy you should get when your child is deemed speech delay. So we have talked about, and you must have stumbled across a lot of articles online and videos about milestones and whatnot. So I'm not going to get into the details of that. You're not here for that. It's just if you're already concerned, then you know, who are the parties, who are the professionals who are going to help you? The first person, obviously, who's going to be in touch with is your pediatrician, right? That person, depending where you're from in the world, is going to give you some recommendations or they're going to run some tests. Some pediatricians in the world, in the United States, they're able to perform some screening or diagnosis. Most of the time they will screen for autism and some doctors will actually even do an assessment. So for us in Asia, pediatrician cannot do this. So what they do is they refer to developmental or clinical psychologists for further assessment. So if I'm wrong here, do let me know. Because every country is different. I don't know. I come from Hong Kong, so our system is pretty similar to that of the UK because we were colonized. But at this point in time, I just want you to know that will be your first contact. It's either a doctor or a psychiatrist. Right after that, usually speaking, if it's a language delay, you're going to see someone like me, a speech therapist. So a speech therapist is going to perform an assessment to see if it's a speech and. Or a language problem. So a speech problem is the sounds that are coming out of my mouth right now, those are. That's speech, right? And speech sounds are like the pronunciations of those sounds. So if I'm saying certain sounds wrong or I'm not saying it in a particular correct way or manner, and that would be a speech problem. But language is. You can hear the sounds and coming out from my mouth and you understand my message. The message itself is language. So I might supplement with some gestures, right? And if I'm telling you some concepts like big and small, my hands here, doing the gestures are also part of language. So speech therapists for myself or speech language pathologists in the, in the United States, our job is to see these things and recommend you a course of action. You have pediatricians and psychologists who are in the camp of assessment, right, assessing your child. And they do not necessarily give you the treatment because they're at the front end where they screen and assess your child, and then they throw your child towards the therapists who are interventionists like myself. So you have speech therapists, you have occupational therapists, you have physical therapists, you have other therapies like ABA therapy, you have music therapy. There are loads. Right now, let's get into it slowly. We have play therapy. So let's get into it slowly. Let's talk about the parts that I know first, which is speech therapy. After the assessment, what we're going to do is they're going to tell you the intensity and the severity of your child's diagnosis. So we're going to say, oh, look, we're going to give you a prognosis. Prognosis just means basically how well on a, on a professional standpoint, how this case is going to go. Right. And don't mind me using these words because I'm not trying to be inhumane. I'm just using the words that a professional would use in this particular time, this case or client, their prognosis means how well will they fare with time. That's what we're thinking, right? How well is the therapy going to treat? Prognosis is going to be either good, fair, or not looking good. And other than that, we have a diagnosis which is it goes from mild to moderate and then the moderate to severe, severe and then profound. So going through all these, and this should go across all types of therapy, diagnosis, including occupational and, and physiotherapy, because I also read the reports for that, so I know they kind of use the same scales. If you're talking about mild, a mild delay or disorder, it means that not that far off. If we're talking about delay, a mild delay would be around that of a six month to a year delay. We would say it's mild. That's cool. Mild to moderate is a little more than that, maybe a year plus. And then moderate would be like two, like one and a half to two years. And then severe would be like three years or two. Two to three years of delay. Right. And it's not only just calculated with months or years. Right. It's calculated by how your child is able to function in the world. If we're talking about a severe case, it means that they're unable to communicate, they're unable to do a lot of social functions, and they're unable to understand a lot of language. Right. And in speech therapy, we look at a few things. The big camps are speech sounds that I just talked about just now. And then we have receptive language and then we have expressive Language receptive. Language means how much you can understand. Expressive means how much the child can actually talk. All right, so that's a speech therapy camp, the occupational therapy. I'm not an expert. Go find someone, go on YouTube and check it out. But the big difference is occupational therapy. What they do is that they deal with anything head down. All right? So OT and PT is head down, ST is neck up. Right? That's how they talk about it in the hospital. That's the easiest way to talk about. So OT is all about fine motor, right? Why is it called occupation? It's because we're thinking about how to rehabilitate or habilitate. Those are long words. Just means how can I get you to do your job? So your job as a kid is that you're becoming a student. So therefore, there are some skills that you need as a student, like concentrating, right? Cognitive skills, being able to grasp things and hold pencils, to write and reading. And reading as well. Sometimes, you know, being able to climb things up and down using, like, some muscles, getting the sensory intact. Because if they don't have the sensory intact, they're going to run around. They can't do their job as a student, right? So occupational means that and why it's called occupational? Because in the beginning it was only for adults. So if someone had a traumatic injury with a hand, boom, like that. Have you seen Dr. Strange? Right. When their hands are messed up and they have to rehabilitate to learn the muscles there, then you would find an occupational therapist. But occupational therapist also works for children who are on the spectrum or like any child who was born with a deficit or disorder. So in occupational therapy, at the very least, from my perspective, don't give me some, hey, man, you don't know anything about ot. Shut up. Right? I'm just giving you a brief overview. Fine motor skills, sensory profile, right? Those are the big camps. And then the third big one is cognition, which I don't know what's going on over there and, and how they treat it. Also, sometimes OT also goes into any life skills. For instance, what overlaps with ST and OT is that they do sometimes feeding, eating stuff, and also some oral motor stuff. I know we said neck up and neck down, but, you know, sometimes that just happens in different countries. Okay, so how about physical therapy? Physical therapy is when anything big movements, right? Physio or physical therapy, wherever, like, depending where we're living. Everything to do with big movements and using muscles are and should be with the physiotherapy. So it's Pretty simple and pretty easy to understand. Because a layman like us, we also use physiotherapy, right? Whenever we sprain an ankle, we're not able to do have a big enough range of motion, we find a physiotherapy, right? So it's the same with children. So why would children need it? Some children have brain injuries when they're born, right? Some children have low muscle tone when they're born. Some of them have high muscle tone, some of them are spastic, some of them are flaccid. There's loads of different things that are going on. Some of them, they don't have good coordination. They may be ataxic, apraxic. Those are huge words. You don't need to know it if you don't know it. Okay. Anyways, these things are what you're going to see. The three T's, as we say, S, T O T, P T. Who else is going to be involved in your child's habilitation journey? Well, there's a lot more. Okay, so other than the therapy stuff, I want to go into the other stuff like social workers, right. Social workers and counselors. So these two are more important as your child is becoming at school age. Right. So once your child is going into primary school, there will be social workers looking after a child. Right. And there will be counselors looking after a child. Why? Because after sex or something, children start to have. Or us in general, we have emotional needs. And that emotional need comes from. Stems from their need to be understood, Their need to be the environmental factors that like in the family, they don't. They're not able to speak their mind. There might be stuff going on at home and social workers are always there to help out. And social workers are like the key part because they know a lot of the theory and master of probably none. I would say don't get angry here, but they are jacks of all trade. They know most of the things. So when you're finding a leader of a center, a leader of a special needs program, it's most of the time it's going to be a social worker. Right? Whereas a counselor is more towards like after primary school, towards secondary school, middle school, whatever you call it, then a counselor is going to work a lot more intensely to counsel the child's emotional and academic needs at that point. Because St otpt we're not going to help you with, with academic stuff at that point in time. We can try, but that's not our focus. Our focus is to habilitate your child good enough to go to school, but how your child does in school, it really depends on how they feel about it. Are they able to assimilate, are they able to make friends and stuff? And that in the end is going to be with social workers and counselors. Okay, so let's talk about the big elephant in the room, which is ABA therapy. And we've done like multiple videos about ABA therapy. I'm not going to go into the exact details of which, but basically AB therapy is a way, a behavioral. Like everything that we do is on a behavioral level because there are different levels of intervention. All right? There's behavioral, there's behavioral, cognitive and then medical and biological intervention and stuff. So a lot of stuff that we do. For instance, I'm talking to you, that's on a behavioral level. I'm trying to change a behavior through my explanation. So at that point in time, you will see a lot of the. In terms of aba, you will see that they use behavioral techniques to teach everything. And we're talking about speech and language. We're talking about desensitizing a child from a situation which is a notice job, right? Teaching them some gross motor things, such as riding a bicycle, which I've done before as an ABA therapist when I started. We also do some stuff like academics, math, all these things we teach with a behavioral system. And the key word here, here is to build a behavioral system to keep their behavior in check so that they can learn. All right? So ABA therapy is much more effective with children who are on a spectrum, all right? And the key word is being contingent. Because children who are on the spectrum or people, they are very rule based. So if you give them a behavior behavioral system that is very rule based, you have to be contingent, meaning you have to be working within that rule and meaning what you say. And it's going to make it a lot easier for them to understand what you want for them to do the world. Okay, what about the other therapies? Before we go there, let's talk about educational psychologist. Before. I remember when we were talking about academic stuff. Educational psychologist deals more with dyslexia, deals more with academic stuff, deal deals a lot more with reading and writing in general, is what I know. Okay? So it differs from country to country from where I'm from. That's what educational psychologists do. All right? Other stuff like play therapy, music therapy, other whatever therapies there are. I'm not downplaying them. They have their part in the world. I do not know enough to tell you, but Let me tell you this. Play therapy usually is from 2 to 6 years old. Preschool children benefit the most from play therapy. I believe play therapy is basically pretty similar to what we do as speech therapists, because I've seen them in real life doing it, and it's basically going the very naturalistic route, meaning, oh, can I see what they're doing? Is there a function to a child's play? Can I follow the lead and provide more over there? Obviously, I'm simplifying a lot of what they do. Their play therapy theory is a lot better than what I can understand. I mean, I don't do a lot of free play stuff, right? They're always on the mat. They're playing with them, they're observing, they're using like, it's very unstructured, so to speak. Music therapy, on the other hand, music therapy is so huge, right? You see, one music therapist do something is very different from another because of the instruments that they play, number one and number two is that like different children, they like different things. You really need to think about if your child has. Has a tendency to like music or not. And all I can say here is that if you have the resources to do so, go try it. All right. I really don't know because for my education, it was more traditional. I went to speech therapy. I worked as an ABA therapist, and I got my skills that way. So if you're asking about play therapy or music therapy, I'm not the best guy to ask about. But that pretty much covers up everyone who would be involved in your child's journey if they are speech and language delayed or on the spectrum. All right. And if I missed anything, let me know. And if you're looking to teach a child at home yourself, going from no words to sentences, you can go to www.agentsofspeech.com course we've made all the courses for free. And we've made a very vibrant parents community there with over 3,000 parents over there right now as of this recording. And I think you'll learn a lot over there. So that's it for now. Thank you so much for tuning in, and I'll see you in the next one. Bye.