Frequently Asked Questions: Therapy

Who are the best candidates for your therapeutic services?

Any child or teen with an autism diagnosis. Parents and caregivers can also benefit from our available support resources. We will teach you the power of positive interactions and how to use our practices at home so your child can benefit 24/7, not just during therapy sessions.

Is an ASD diagnosis required before an evaluation?

 

In most instances, insurance companies will require an autism diagnosis prior to having an evaluation with Positive Development. Your Intake Coordinator can help to determine if your insurance company requires it.

Positive Development does provide virtual diagnostics (18 months to 9 years) in the DMV area.  Learn more Autism Diagnosis in the DMV area here.

What is the evaluation process like? How will you relate to my child if they do not speak or do not like strangers?

Once intake documents are completed, you will meet with a clinician in a Parent/Caregiver Interview. Our clinician will discuss your child's developmental history and create appropriate goals. The second visit is conducted in-person with your child, with the goal of slowly building trust in a safe space. Our therapists are skilled in assessing your child’s development through play-based observations and parent interview.

Why is there so much emphasis on early intervention?

 

Early intervention is backed by strong evidence and endorsed by leading U.S. medical societies. We encourage you to consult with a provider in regards to early services to support your child's long-term growth and development. Research shows that early intervention can lead to physiological improvements, such as changes in brain wave tests (EEG).

Autistic symptoms can be identified in toddlers as young as 18 months. Read more about identifying the first signs of autism here:  Signs of Autism in Toddlers.

 

Can you help my child or teen who has multiple diagnoses (e.g., autism and ADHD, autism and learning disabilities)?

Absolutely! We are here to help regardless of number of diagnoses.

 

How long is treatment?

Treatment length varies based on diagnosis, however, your child may show significant growth in as little as six months when engaged with 6-10 hours of weekly therapy.

 

How am I updated on my child’s progress?

Treatment plans and goals are continuously updated as therapy is conducted. You will meet with your child’s dedicated team once a quarter to review progress towards those goals. Every six months, we will reassess your child’s progress. You will be updated on your child’s progress through parent support sessions and/or by the clinical lead. Treatment plan and progress towards meeting goals is monitored on a weekly basis.

 

How is developmental therapy different from ABA?

In short, Traditional Applied Behavioral Analysis (ABA) focuses on specific behaviors, while Developmental Relationship-Based Intervention (DRBI) focuses on the whole child. Traditional ABA has historically been the primary therapy offered for people on the autism spectrum, which teaches skills to gain desired behaviors through reinforcement and discipline, often led by an adult. This approach focuses on observable behaviors and is measured by meeting predetermined developmental goals vs. individualistic goals.

Developmental therapy includes DRBI and is part of the broader DIR® care model, which takes a somewhat different approach.DRBI looks beyond specific (and often stereotyped) behaviors like aggression, rigidity, and withdrawal to understand and address the neurodevelopmental challenges beneath the surface. These challenges may include motor planning, emotional self-regulation, sensory sensitivity, learning disabilities, and speech delays. DRBI is child led, without a pre-determined schedule of events or tasks to complete.

Read more about the core differences between ABA and developmental therapy here: ABA and the Developmental Model: A Slight Controversy in Autism Therapy

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Is developmental therapy clinically proven to be as good or better than ABA?

In 2020, the American Psychological Association’s Psychological Bulletin recognized developmental and naturalistic developmental behavioral interventions (NDBI) in its highest tier of efficacy and supported research among autism treatments. 
There is a growing body of evidence with multiple academic research papers that cover key components of DRBI such as relationship-based and parent-mediated interventions, as well as whole program research and meta-analyses (examination of past studies to look at overall trends). Here is a representative selection that demonstrates the depth and  breadth of this research: 

1. Three independent reviews by the California Health Benefits Review Program (CHBRP) at the University of California Berkeley (2018, 2019, 2021) conducted to advise the California Legislature found DRBI to be evidence based for treating children with autism.
2. DRBI and NDBI have a moderate effect size on social communication in children with autism, while ABA research is  inadequate to calculate an effect size. Sandbank 2020. This research won a 2021 award from the International Society for Autism Research (INSAR).
3. Gerald Mahoney (with F. Perales) demonstrated that relationship-focused interventions are effective for children  with autism in several papers, including Using Relationship-Focused Intervention to Enhance the Social-Emotional  Functioning of Young Children with Autism Spectrum Disorders (2003), Relationship-Focused Early Intervention  With Children With Pervasive Developmental Disorders and Other Disabilities: A Comparative Study (2005),  and Relationship-Focused Intervention (RFI): Enhancing the Role of Parents in Children’s Developmental  Intervention (2009).
4. Parent-mediated communication-focused treatment in children with autism (PacT): a randomized controlled trial, and parent-mediated social communication therapy for young children with autism (PACT): long-term follow-up of a randomized controlled trials. Pickles, Green, et al, 2010, 2016.

5. DRBI reduces ADOS scores dramatically in children with autism. Solomon (PLAY Project), 2014. 6. DRBI helps social communication in children with autism. Casenhiser (MEHRIT), 2011, 2014. 7. DRBI parent coaching improves parent responsiveness in children with autism. Siller (FPI), 2013, 2014. 8. DRBIs help a range of functional goals in children with autism (meta-analysis). Binns, 2019. 9. Developmental and Parent Implemented Interventions yield statistically significant outcomes. Steinbrenner, 2020.

What is my role (as a parent/caregiver) in my child’s developmental therapy?

You are a vital component of your child’s success and the rate in which it occurs.  We know this can sound overwhelming, but at Positive Development we support and empower you so you can further support your child. Our support sessions help you understand the “why” behind your child's behavior so that you no longer feel a disconnect. We help you build a stronger bond while at home, incorporating therapy goals to be practiced daily in fun, simple ways.

We see rapid growth when you and our team work together on your child’s progress. This oftentimes leads to “generalization,”; this is when your child transitions to exhibiting a certain developed behavior or action outside of therapy, such as at meal time, bath time or the park.

Is this for kids with 'behavioral' problems?

Yes, we treat children with an autism diagnosis, which can be described as including “problematic behavior”. We do this by addressing the core underlining challenges causing the behaviors.

What is the time commitment?

This is solely determined by the assessing clinician and the needs of your child. We suggest a minimum of 6 hours of developmental therapy per week and 2 hours of parent support per month, for at least 6 months.

Do you offer virtual or at-home appointments?

We offer a hybrid model of telehealth with both in-center and in-home visits. Most speech and occupational therapy appointments will occur in our centers. Parent training and coaching are often delivered via telehealth. Our developmental client coaches typically conduct their sessions in your home. Coverage is based on individual insurance plans, which is discussed prior to scheduling.

 

Can my child receive services at daycare, preschool, or another school setting?

Delivering services outside of our centers and/or at home are considered on a case-by-case basis and may require insurance approval.