Sunday, May 3, 2015

What to Do after an Autism Diagnosis

"It doesn't feel real.
But I'm not gonna let it phase me."
~Samantha Greenbriar, Gone Home

A lot of people find it overwhelming when the diagnosis of autism becomes official. Some of us already knew and just needed it from a professional; others are completely blindsided and fall apart, with no idea what to do next.

Before I address that question of what to do after the diagnosis, I want to tell you something. An autism diagnosis does not change a person. Let me repeat that. An autism diagnosis does not change a person. You are the same person today with your diagnosis that you were yesterday without it. The only difference is that now you know what you have, so you can learn more about it, find other people with it, and understand more about how to help yourself. Diagnosis is a good thing.

Your environment - past or present - did not cause this. Nor did your parents' style of raising you. Babies show signs of autism as early as a few months old (source). If you're autistic, you have always been autistic. You just didn't know it yet.

What you do after the diagnosis depends on age. But before I get into this, let me just say one more thing: if you don't feel comfortable doing this right away, that's okay. Take a few days or a week, get used to the idea of having autism, and then go forward. A week is not going to make a difference in the grand scheme of things, but your attitude very well might. Services cannot really help you if you're not willing or ready to be helped.

If you're a parent of an autistic child, be aware that your kid will take their cues about autism from you. If you associate autism with stress, so will your child. The reason this is so critical is because you are capable of removing yourself from the autism (whether or not you choose to is a different story). They are not.

Toddlers and Preschoolers

Services for kids between 18 months and 4 years are pretty widely available. The professional who diagnosed your child may be able to tell you what would benefit them most, or you may have to look into additional assessments. If your child is younger than three and you're in the US, this is typically done through a child and family center, or independent programs. Three- and four-year-olds are given services through the school district, even if they aren't in preschool.

Some services are covered by insurance, others are not. Your options are likely to include:
  1. Specialized preschool. In some areas, your child may be eligible for free or reduced cost preschool.
  2. Feeding therapy is available for children age three and under who have difficulty in this area. With a slightly older child, a visit to a private therapist or children's hospital may be necessary.
  3. Speech therapy if there is a significant speech delay or other issues.
  4. Tools such as AAC devices are covered under most insurances if your child could benefit from one.
  5. Occupational therapy to help with fine motor skill development and very basic self-care skills, like feeding oneself.
  6. DIR or floortime therapy to assist your child in reaching developmental milestones.
  7. A designated session with a therapist or with other children to practice social skills. For example, the therapist may guide the children through the steps to a successful conversation. ("Matthew, that's great that you shared how you spent your weekend. What could you ask so that others have a chance to join in?" If he's unsure: "Can you ask Sarabeth how she spent her weekend?" And so on.)
  8. Your child may be eligible for a service dog. Resources are here, here, and here. You can also search for programs in your region here.
  9. Applied Behavioral Analysis (ABA). This is very controversial among the autistic community. Some children improve tremendously, while others have suffered abuse and come away worse off than they were before the therapy. If you feel ABA would benefit your child, please keep an eye out for warning signs. See my post here, and an analysis by a parent over here.
  10. Look for research studies in your area that may be able to further autism services, and help you and your child.
Pick up An Early Start for Your Child with Autism for yourself. The Survival Guide for Kids with Autism Spectrum Disorders (And Their Parents) may benefit you, but is not really accessible to your child at this point.

At this time, I have not been able to locate any resources geared to very young children that do not show autism in a wholly negative light. UPDATE 10/2015: The show Sesame Street now has an autistic character, and offers information on her disability. Resources available here; the storybook in particular is very accessible to young children.

Elementary School

Once your child enters kindergarten, you will need to be informed about your rights in regards to their education. There's a lot that can be done to help your child succeed, but you may have to request it specifically. Look through the district handbook, as these vary between states and districts.

If your child attends public school, the school is legally required to provide a free appropriate public education in the least restrictive environment. This means you cannot be charged for services given through the school. Although the district cannot force your child to attend special education classes until all other options have been exhausted, it may be recommended. Some kids are mainstreamed, others attend special education all day, and some spend part of the day with typical peers and part in special education.

Your options may include:
  1. A 504 Plan if your child can be mainstreamed but needs services to succeed, or an IEP (Individualized Education Plan) if your child would learn better in special education classes.
  2. Special education classes if necessary.
  3. A specialized summer camp or extended school year can be written into a child's IEP. This is different from summer school, and will vary depending on your child's abilities. Stay educated on your rights and options, particularly when the time comes to transition to middle school.
  4. Life skills classes to prepare your child for living independently one day. Your child might learn how to make a bed or load a dishwasher.
  5. Speech therapy if there is a significant speech delay, or related issues such as stuttering.
  6. Tools such as AAC devices are covered under most insurances if your child could benefit from one.
  7. Occupational therapy to help with fine motor skill development and basic self-care skills, like getting dressed independently.
  8. DIR or floortime therapy to assist your child in reaching developmental milestones. Note that this may not be an option in the later elementary school years.
  9. A designated session with a therapist or with other children to practice social skills. For example, the therapist may guide the children through the steps to a successful conversation. ("Matthew, that's great that you shared how you spent your weekend. What could you ask so that others have a chance to join in?" If he's unsure: "Can you ask Sarabeth how she spent her weekend?" And so on.)
  10. Your child may be eligible for a service dog. Resources are here, here, here, and here. You can also search for programs in your region here.
  11. Applied Behavioral Analysis (ABA). This is very controversial among the autistic community. Some children improve tremendously, while others have suffered abuse and come away worse off than they were before the therapy. If you feel ABA would benefit your child, please keep an eye out for warning signs. See my post here, and an analysis by a parent over here.
  12. Look for research studies in your area that may be able to further autism services, and help you and your child.



Middle and High School

Services outside of school are fewer once you reach middle school, but there's still plenty through the school system. A lot of it will depend on your area and schooling situation.

If you attend public school, the school is legally required to provide a free appropriate public education in the least restrictive environment. This means your parents cannot be charged for services given through the school. Although the district cannot force you to attend special education classes until all other options have been exhausted, it may be recommended. Some students are mainstreamed, others attend special education all day, and some spend part of the day with typical peers and part in special education.

Your options may include:
  1. If you are at least 14 (16 in some areas), you may attend basic job training. Work experience is also offered at some schools, either at the school or at an outside location.
  2. A 504 Plan if you can be mainstreamed but need services to succeed, or an IEP (Individualized Education Plan) if you would learn better in special education classes.
  3. Special education classes if necessary.
  4. A specialized summer camp or extended school year can be written into your IEP. This is different from summer school, and will vary depending on your abilities. You and your parents need to stay educated on your rights and options, particularly when the time comes to transition to high school, post-secondary education, or college.
  5. Life skills classes to prepare you for living independently. You might learn how to do laundry or make easy meals.
  6. Speech therapy if you have a significant speech delay, or related issues such as stuttering.
  7. Tools such as AAC devices are covered under most insurances if you could benefit from one.
  8. Occupational therapy to help with fine motor skills and self-care skills, like performing basic household chores.
  9. A designated session with a therapist or with other students to practice social skills. For example, the therapist may guide you through appropriate dialogue. ("Caroline asks if you want to go to the movies this weekend. How could you tell her politely that you don't want to go? What if you do want to go, but on Friday, your parents ground you for something you did? How could you tell her?")
  10. You may be eligible for a service dog. Resources are here, here, and here. You can also search for programs in your region here.
  11. Applied Behavioral Analysis (ABA) is not generally started at this age, but may be continued if you were receiving it when you were younger.
  12. Look for research studies in your area that may be able to further autism services, and help you and your family.
Past the age of 18, some adults attend a post-secondary school to help them further their life skills. Services will still be available to you through the school district until you reach age 22.

Good books for yourself include Different Like Me, Middle School - The Stuff Nobody Tells You Aboutand Preparing for Life.

Good books for your parents include How to Teach Life Skills to Kids with Autism or Asperger's, Girls Growing Up on the Autism Spectrum, and Adolescents on the Autism Spectrum.

You can also share the information in the book The Survival Guide for Kids with Autism Spectrum Disorders (And Their Parents).

Adults

Unfortunately, once you graduate from high school or post-secondary education, there are not as many services available to you. This is one of the flaws of the system today, but that doesn't mean there's nothing you can do.

Some services are covered by insurance, others are not. Your options may include:
  1. Job placement, or a spot at a workshop where you will be able to start your career and get paid fairly.
  2. If you live in the US and are unable to work due to autism, you can apply for disability payments. A thorough guide to doing this is here (don't be fooled by the design of the site; the information is still applicable to anyone applying for disability). Sorry, I'm not familiar with resources from other countries in this respect.
  3. If you are in college, your 504 Plan or IEP from high school can follow you. Contact your disability office and find out how they can help.
  4. Tools such as AAC devices are covered under most insurances if you could benefit from one.
  5. You may be eligible for a service dog. Resources are here and here.
  6. Live-in caregivers if you are able to move out but need help with your day-to-day life.
  7. Group homes if you need more intensive help with your day-to-day life but are not able to live with your parents.
  8. Look for research studies in your area that may be able to further autism services and help you.

I'll be updating this post in the future if and when I learn more. If you know of any resources not included here, please feel free to leave them in the comments to help others.

4 comments:

  1. This comment has been removed by a blog administrator.

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    Replies
    1. Firstly: you don't "recover" from autism. Autism is lifelong and not a disease.

      Secondly: we don't suffer from autism. We suffer from the way you treat us.

      Thirdly, and most importantly: what in the HELL makes you think it's okay to come onto a blog written by an autistic and start spreading information on how to abuse autistic people?

      Delete
    2. You don't actually have autism. This is proven by the fact you type.

      Delete
    3. I really hope this is sarcasm. Please show me where "inability to type" is listed in the DSM-V criteria for autism, thanks.

      Delete