An evaluation treatment matrix for parents of children with developmental disabilities, mental health and/or behavioral issues.
How do you tell what is good quality therapy for a child with a disability, mental illness, and/or behavior problems? This system is not perfect; however, it is based on extensive research and can be used as a GUIDE for evaluating treatment options as well as evaluating the quality of treatment being provided.The program will be strength based. While this does not mean that the program ignores deficits or problems, the primary focus will be strengths. Safety should always come first; however, is the long term and clear emphasis on increasing appropriate behavior?
Providing a best practice, research documented and peer verified approach that matches the disability, disorder, issue, and individual situation for your child i.e. PLAY, Lovaas, ABA. Does the provider provide a well researched, developmentally appropriate, and best practice intervention that is known to provide best outcomes for a child of (age of your child) and (disability, condition, or diagnosis of your child)? They should be able to tell you exactly what intervention they are providing and provide you with the research to back it up. If they can not, they should have a very good explanation of why they can not.
When therapy is integrated into yours and the child's typical routines, more really is better. Are you an integral part of the therapy, are you being taught things that you can do to support therapy and is there follow-up to see how well you are doing and what you might do differently to adjust for better results for your child? Are you listened to as a partner and an expert on your child? Does therapy support and promote inclusion in typical healthy productive routines that your child's peers are involved with i.e. 4-H, scouting, school activities, church activities etc.?
I.E. Speech, Physical Therapy, Occupational Therapy, or other type of specialist. Is there a global approach to your child? This does not mean that the other therapists have to be providing direct therapy. Sometimes this can be only for consultation and evaluation. This is not essential for every child but the need should be explored through the Functional Analysis or Behavior. Is this occurring or has it been thoroughly explored?
Is there both communication and an integration or support of services being provided by other professionals. Does the therapist working with your child, collaborate with and integrate suggestions provided by other therapists?
Evidence that the child is making significant progress with the existing therapies. (May include maintenance for certain degenerative syndromes.) Can you easily recognize significant achievements made by your child, that were written as specific goals or objectives on your child's plan.
Quality and appropriate (including developmentally) Measurable Behavioral Objectives. Does your child's plan contain objectives that are so clear and concise that you know exactly what your child is to do and when your child is to do it? Do you also clearly understand when your child will have achieved this objective?
Quality and appropriate (including developmentally) Functional Outcomes.
Are the outcomes and goals on your child's plan something that s/he will be able to use as a part of his or her normal routine? Is this a skill that you would teach a typically developing child? Is s/he learning something that s/he could possibly use if s/he were living on his or her own?
For some interventions and disabilities this would include the first three years of life; however if Best Practice is provided can extend through age 8 or 9. (This does not mean that treatment is not important for older children, it is. It does mean that early intervention is crucial if at all possible. This is partially because of what we know about brain development.
Some other crucial times can be times of transition, including between schools, moving, family transitions, puberty etc.
Is therapy being provided at a crucial time period and if not, does the therapist acknowledge and understand the importance of these periods and is s/he prepared with a transition plan for these periods?
Medication is not needed for most children. If it is being used, has it been prescribed by an expert. A children’s psychiatrist is recommenced if at all possible. If there is medication is there close collaboration between the therapist and the physician?
Existence of a functional behavioral analysis. (Also called a functional analysis of behavior.) (Must include, environment, setting events, sleep, diet, medical, communication etc.) Was a functional analysis of behavior conducted, especially for a child three years or older?
Does your child have a positive caring relationship with the therapist or do you believe that they will be able to develop one. (Knowing that the therapist personally cares about the individual is important for any therapy.)
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