FOCUS Therapy in Fort Myers conducts a range of in-depth evaluations for children who have been referred for speech, occupational, physical, or ABA therapies as well as ADOS testing. During our evaluations and therapy sessions, we rarely allow families to directly participate – but we have evidence-based reasons for our position.
During evaluations, we want to ensure every child receives an assessment that is as accurate as possible because that is what is going to allow us to:
- Determine whether the child needs therapy.
- Calculate the frequency/level of therapy that might be recommended.
- Make a strong case to the relevant insurer(s) about the medical necessity of the therapy.
Parents, when present in the room during FOCUS evaluations, can unwittingly stand in the way of those goals. Why? Mainly because children rely on their caregivers when things get tough – to help them, to comfort them, to make it better. When a child is struggling in a certain area, such as communication or independence with self-care skills, our clinicians need to independently observe the particulars.
Parent input is a key aspect of our evaluations, but we need to see for ourselves, too. Jennifer Voltz-Ronco, MS-CCC/SLP and FOCUS Therapy Owner/Founder, explained that when a child is accompanied by a parent during the direct observation portion of the assessment, parents often interfere without intending to do so or even realizing it.
“For example, in speech evaluations, parents might talk to the child or give clues to help their child ‘get the right answer’,” Voltz-Ronco explained. “We might ask the child to point to an object out of an array of 3-4 items by saying, ‘Show me the cup.’ Standardized testing requires that we be very specific in how we present these items – and with the requirement that we wait. And while we wait, we’re looking to see how long it takes them to process the directive and what they do. Will they look at us to see if we’re looking at the object? Will they point to it or make a face if they’re unsure? They might associate a cup to mealtime and instead point to a cookie. If the child looks to our face to get a clue, that would indicate social awareness and joint attention – key pre-linguistic communication skills. If there is a delay in their response, there may be an auditory processing issue. If they grab the first thing in reach, they may have impulsivity issues. Watching a child while they’re thinking tells us so much. But parents in the room might think the evaluator presumes the child doesn’t know the answer, so they interject. They say to the child, ‘You know what a cup is, like the blue sippie cup you have at home.’ Unfortunately, what that does is give the child numerous opportunities to hear the word, ‘cup,’ and in many standardized tests, we aren’t allowed to repeat the word or give a description or synonym. So with that, we lose the opportunity to see what we needed to see, and must in turn score the response incorrectly – which impacts the overall results.”
She went on to explain that often the key responses FOCUS therapists are looking for aren’t necessarily what an untrained observer may presume.
What’s more, some children can become what we call “prompt dependent.” That means the child looks to the parent to prompt them (to take an action, answer a question, etc.) – even if they don’t necessarily need the prompt. Many of our team members are parents ourselves, so we wholeheartedly understand how difficult it is to wait for your child to “do it themselves.” It is actually instinctual to intervene when we see or sense our child needs help. But during these evaluations, this intervention – however slight – can actually prove more of a hindrance when what we’re seeking are accurate results.
We DO Want Parents Involved in Their Child’s Therapy Journey
Although it is important for parents to remain outside the room during evaluations, this does not mean we lack transparency or that we don’t want parents involved at all in the therapy process. In fact, we get the best results from therapy when parents are fully engaged!
But we discourage direct engagement during the evaluation process and therapy sessions because we want to ensure our findings are accurate and that your child gets the true level of support they need.
While we want parents to be involved in consultation, goal-setting, education, and carryover, we strongly advise parents against sitting in during therapy sessions for the following reasons:
ADOS testing, also known as the Autism Diagnostic Observation Schedule, was found in a recent, large study to measure severity of autism traits equally well in both girls and boys. This is good news because research has shown doctors may misdiagnose or overlook autism in girls, because it can sometimes look a little different than it does in boys. Boys are four times more likely to have a diagnosis than girls.
FOCUS offers ADOS testing in Fort Myers at our pediatric therapy clinic. Early diagnosis is important for both girls and boys to be able to access early intervention support and therapy, so it’s important that the testing effectively recognizes the symptoms in all kids. The U.S. Centers for Disease Control and Prevention estimates about 1 in 59 kids have an autism diagnosis.
As our Florida ABA therapy team can explain, autism spectrum disorder (ASD) is a developmental condition impacting one’s ability to communicate and socialize with others. However, it’s necessary to recognize that symptoms of autism can very significantly from person-to-person. (Hence the phrase, “If you’ve met one person with autism… you’ve met one person with autism.) Still, girls may not always fit the “traditional” understanding of a person who has autism. In some cases, they may also be better at hiding it.