Within my private practice with the Autism population, I have discovered that the parent-child dyad can be a wonderful way to work if the circumstances are right. It enables me to model for the parent and offer creative strategies and techniques for their child. But even beyond that it is an enriching experience for me as the therapist as well. I learn how parent and child relate and communicate with each other; helping me work better for the child.
I have been working with a young client for over a year where I am fortunate to have this situation. Mom is very open to working with her son (around 9 years old with moderate ASD) and helping him to discover his inner creativity. Having her part of the session is also a great asset because she can comfort and “regulate” him when over stimulation occurs. She then becomes a model for me as well!
So how does this dyad really work? Besides having mom there for a comfort to the child, she is able to tap into her own process. In addition, I can sense the energy and synergy between mother and child; bringing them back to the beginning stages of attachment. This helps the child explore the creative modalities that I present to the both of them. The trust is there and the child and mom play off each other with my direction.
However, the session must still have a structure. This child (like most ASD children) thrives on having a schedule and knowing what comes next; behavorial strategies are still incorporated maintaining focus and engagement. I have adapted a child-centered approach by combining it with behavorial techniques-not easy, but possible. There is a lot of mirroring, but also redirecting. There are limits set and he responds well to this. However, within the limits, I always include choice making.
The mom and I set the stage together. We create a “schedule” (see diagram below) for her son to visually see and have him make choices (he is verbal) about what activities he would like to include.
Throughout the course of the session, we refer back to the schedule and cross off the activities that we have already completed. This feels comforting for the child as he maintains awareness and control by actively knowing what is next.
I also allow for breaks when needed. This allows him to regulate his sensory needs. He gets up and jumps, stretches, goes to the bathroom, has a snack, or just relaxes. Sensory issues and/or basic needs can sometimes come up during the session and all that is needed is a “mini” break. For example, he has oral needs and will eat a chewy fruit snack and be fine. I may have not known this if mom was not available.
Would this approach work for all children? I think it depends on the needs, age and their issues of attachment. With this particular client, I do know that at the end of the session, it appears that both the mom and her child are satisfied and have enjoyed the creative process and the activities presented. At times, she becomes so overwhelmed by his accomplishments it is quite emotional to witness. The artwork lines the kitchen counter and both mom and her son gaze together very proud; feeling good about the time spent together.