This week developmentally-based Speech and Language Pathologist (SLP), and DIR Expert Training Leader, Melanie Feller returns to discuss the importance of parent choice in therapeutic approaches for children with developmental differences. She is the founder of Alphabet Soup Speech Consultants, has taken Brazelton Touchpoints training, and is also the first speech pathologist in the United States who is Self-Reg™ certified, a method to support self-regulation in individuals of all ages.
Promoting Parent Choice with Melanie Feller
Four Components of Parent Choice
There is a growing move towards Developmental Approaches when it comes to supporting children with developmental differences. But it is overwhelming for parents new to autism to navigate the many options available to them. Even many physicians are unaware of interventions and approaches other than ABA. Still, we want caregivers to have evidence-based options rather than a prescriptive therapy. What families choose will depend on their beliefs, values, and lifestyle. A good practitioner will help families navigate their options.
In Melanie’s practice, she often comes across parents who never knew there was a choice in the approach they take when supporting their children with developmental differences. They say they had ABA (Applied Behaviour Analysis) but that they didn’t find it helpful. As her clients came to her with these stories, she thought more and more about parent choice and has come to think of it in terms of four main areas: Empowerment, Education, Support, and Respect.
Melanie believes we need to empower both the parent and the child as well. It’s important that parents aren’t pushed aside with therapy behind a closed door for 45 minutes. Parents need to feel capable and that they’re their child’s best teacher as they know them best and feel they can accomplish something by being an active participant in their child’s life rather than therapists coming in taking over while they stand aside. The practitioner doesn’t know all. We need to change that mindset that something’s broken and needs to be fixed by therapists.
Recently in our podcast with Dr. Robert Naseef, we discussed how there is a learning curve for caregivers to accept the child as they are, how to best support the child, and get to the place where the parent feels empowered. I shared with Melanie how I questioned a lot of things professionals said to me early on after my son’s diagnosis. If it doesn’t sound right, listen to your gut as a parent. It can be challenging because we carry the guilt of wondering if we did the right thing–especially when therapists try to steer us in other directions. But beware of fear-based talk and think: would you teach a neurotypical child in this fashion?
As parents, we always face the question, “If I don’t listen to this expert, what’s going to happen to my kid?” but as developmental psychologist Dr. Gordon Neufeld says, we always need to gain that perspective that we are our child’s best choice. There is no prescription. Every child is different. It’s a process because the child is always changing and growing. Dr. Neufeld calls it the ‘dance’ to find what works. And as things change, we do the dance again, confident that we are the ones best equipped to support our children.
Part of how you get empowered is with education, which is about learning about the options out there. Many might start with ABA and realize that once children learn numbers, letters, and say their name, the social skills are still lacking and they come to developmental approaches. Melanie and I discussed how she delivers speech and language therapy as a developmental approach in our last podcast. While Melanie and I both believe the developmental approaches are the best options–and namely the Developmental, Individual differences, Relationship-based (DIR) model, we don’t assume to know what’s best for your child. Educating yourself is essential.
Melanie emphasizes that support is about ongoing support. You just can’t be told to go read a book or look at a website. It is a hard balance to find practitioners who are willing to learn about the Developmental profile, the Individual differences and form a solid Relationship with your family. When the therapist does this, the parent will automatically feel supported. And when parents realize how happy their kids are and that they are enjoying the sessions, they feel supported. Therapists should offer coaching and education for parents, and there should be support for both the child and the parents.
I asked Melanie what she does to get parents actively involved because sometimes parents are resistant to taking an active role in their child’s therapy. Melanie says that some parents may be unaware they should be involved and some might be unwilling. If the therapist senses this, they can bring the parent in slowly: maybe invite them in for the last 15 minutes of the session, or invite them to come watch anytime. She has an open door policy: she keeps the door open so parents can hear and see in her therapy room. Sometimes this is just enough.
She says that sometimes it’s doing DIR with the parent too. You ask things like, “Did you notice when your son did this, you responded in this way?” When you reflect on the process it’s a learning process. She checks in periodically with her families and keeps an ongoing relationship, making sure everyone’s on board. She also checks in each session to know what the child went through even that morning before they arrived. Realizing that someone cares, professionally, is listening, and really understands what the family needs are is important.
Respect is having the trust with whom you work with, Melanie says. You can relax. And it includes respect for the child and the parent. Even if we don’t agree with what the parent is doing, you need to respect their opinion, Melanie says. Respect involves advocating for the child. People may have assumptions about your child, so you need to tell them what your child needs. Parents should always feel they can say “This is working for me” and “I don’t like this“. Melanie adds that parents should always ask why a practitioner is doing what they are doing and share where you hope to go next. A good professional will always be happy to explain why.
Melanie says she is always moving towards the child being their own self-advocate. We need to instill in our children to recognize when they become dysregulated and figure out what they need, or advocate for it when they can’t themselves. Therapy is not about compliance drills and crying. Melanie says that maybe one day you get to therapy and your child just won’t have any of it. Even though you paid for the session, you need to respect if they are having a bad day and just can’t do it. We always want to be client-centered.
Thank you to Melanie Feller for sharing her thoughts about parent choice with us. It is important for parents to have choice, to feel empowered, educated, supported and respected, and to want the same for our children. Please consider sharing this podcast on Facebook and Twitter, and if you have any related questions, comments or experiences to share, please type them in the Comments section below.
Until next time… here’s to affecting autism through playful interactions!