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“Is OT Too much? 

Recently I had a client who wanted to get a discharge from the OT services by saying the child is going to school and then, has 4 hrs of Behavior therapy and so, we feel that adding OT -which is NOT every-day-but, only once a week-NOT for 4-5 hrs a day, but  for 1 hr only – will be “too much”. 

Disclaimer: This Blog is NOT about STOPPING YOU FROM GETTING BEHVAIOR THERAPY, BUT, creating an awareness on how to stop yourself from being trapped by those “salesy hours” in oppose to 1 hour of quality services. 

Really? IS OT REALLY TOO MUCH?

Choosing between Occupational Therapy (OT) and Behavior Technician therapy is a significant decision for individuals and families navigating therapeutic options.

Both approaches are fundamental in rehabilitation but differ in their philosophies, methods, and target populations.

It is always a big deal when we have to choose between two. If we can cut-off school timing, if we can cut-off family gathering, we can definitely cut off 40 hrs long therapy just to get 1 hr of quality evidence-based professional Occupational Therapy services.

Here are some details to understand both professional services:

Occupational Therapy (OT)

Occupational therapy focuses on helping individuals of all ages engage in meaningful activities to enhance their independence and quality of life. OT addresses physical, cognitive, and emotional challenges, aiming to improve daily functioning in self-care, work, and leisure.

It employs a client-centered approach, tailoring interventions to meet the specific needs and goals of each person. OT is beneficial for a wide range of conditions, including developmental delays, physical disabilities, mental health issues, and neurodevelopmental disorders.

Behavior Therapy

Behavior Therapy which is provided by BT/Behavior Therapist or by using Applied  Behavior Approach –  is the ONLY behavior-focused approach primarily used to address behavioral challenges, especially in individuals with autism spectrum disorder (ASD). Rooted in behaviorism, it aims to modify behaviors by analyzing and altering the relationship between actions and the environment.

It uses systematic, data-driven techniques to reinforce positive behaviors and reduce undesirable ones. While commonly associated with autism, this therapy also addresses behavioral issues in other conditions like ADHD and conduct disorders.

Comparison and Integration

Philosophies: 

  • OT takes a holistic, client-centered approach, focusing on the overall well-being of the individual. 
  • BT  is grounded in behaviorism, emphasizing observable behaviors and systematic modification through reinforcement.
  • Target Populations: OT serves a broad spectrum of individuals across all ages and conditions. 
  • Behavior Therapy primarily targets individuals with ASD, though it can be applied to other behavioral challenges.

Methods: 

  • OT uses hands-on activities, adaptive equipment, and therapeutic exercises to enhance functional skills. 
  • Behavior Technician relies on behavior modification techniques, reinforcement strategies, and rigorous data collection to track progress.

OT Can provide services to enhance behaviors using effective and harmless Evidence based therapeutic approaches and a couple examples of such evidence based scientific approaches that OTs are, ALERT Program or Zones of Regulation. 

On the other hand- Behavioral Technician CANNOT work as OT. 

Education:

  • Occupational Therapists go for extensive Masters or Doctorate degrees after completing 3-4 years of bachelors in medical science based subjects. The intensive Masters and doctorate are scientific evidence based education degree programs which prepare them to understand and provide treatment to their expertise area of client care effectively. After completing degree- they have to PASS national board certification to prove their capabilities and then, only OT can treat clients. 
  • BCBA/RBT etc. are “certification” courses that can be accomplished by any one within 40 hrs of “in person” or “online” training. 

MY QUESTION IS: would you TRUST your Child’s therapy FOR 40 HRS with someone WITH ABOVE MENTIONED education or TO SOMEONE WHO IS WELL TRAINED, AND KNOWS DIAGNOSIS AND PLANNINGS INSIDE AND OUT, WITH EVIDENCE BASED PRACTICES? 

Why would you leave your child in the hands of someone for 40 hrs and say NO to someone qualified for just 1 hr !!

Choosing Between OT and Behavior Technician Therapy

For those with challenging behaviors, especially related to ASD, Behavior Technician therapy may be more suitable due to its focus on behavior modification. This therapy is effective for developing communication, socialization, and daily living skills through structured teaching methods. OT, however, is more versatile, addressing a wider range of conditions and focusing on holistic improvement in daily functioning.

Ask yourself and write YES and NO next to each:

  • Do I want to raise my “Autistic” child as an individual who is confident the way he/she “sees” and “understands” the world? ________
  • Do I want to raise my child as “FIXED” just to please societal norms? _________
  • Do I want to raise my child who “has to follow adult lead instructions” to FIT into the BOX OF Well BEHAVED CHILD? ________
  • Do I not want to teach my child to be independent the way he/she wants to “do” the tasks by making decisions by themselves, and finding solutions to potential problems arising in completing the tasks by themselves? __________
  • Do I want my child to FEEL TRAUMATIZED in the future when they grow up like other Autistic kids are feeling who are grown-ups right now, who went for more than 30-40 hrs of therapy and were constantly “corrected”? ________

[1 hr per week – OT is really  too much for your child if you answered “yes” to all questions above] 

Now Ask yourself these questions:

  • Do I LIKE SOMEONE CORRECTING ME all the time 5 hrs / day whatever I do in the comfort of my own home? ______
  • Do I get irritated when someone is always “judging” me and ready to ‘fix’ my way of eating, biting, sitting, playing, and bathing? ______
  • Do I love someone “new” or “not so familiar” or “professional” always come to my home 5 days a week for 4-5 hrs to teach my child how to behave – even after I HAVE COMPLETED 5-6 hrs of school already and followed school-rules already in the day – to “FIX” my “home-based behavior”? ______
  • Do I not like to just be myself in my own home? ____
  • After my long workday DO I NOT NEED MYSELF BEING MYSELF? _____
  • Do I get irritated when SOMEONE, even my husband/wife, tells me “how to make my bed” or “how to put laundry” or “how to put dishes into the dishwasher” correctly all the time? _____
  • Do I NOT throw tantrums because I AM OVERWHELMED WITH CONSTANT “DO THIS” AND “DO THAT” from others? In the workplace and now at home too? ____
  • Can I work with 100% focus if you are overwhelmed? ____

[1 hr per week – OT is really  too much for your child if you – well, I am leaving this decision up to YOU to decide for every question above] 

I am not sure about YOU, but, as 12 years in practice, and a mom, I would definitely love my “me time” at home after a long day at work. I need some sensory strategies to calm myself down such as a work-out (for my vestibular and proprioception needs) and candles for my emotional regulation as good smells make me feel ‘happy’, a warm water bath to relax, and before work or during the work sipping strong coffee or crunchy foods.

It's time for YOU to speak up for yourself and your community. This is about uplifting the ASD community and supporting raising ABUSED AND TRAUMATIC AUTISTIC ADULTS.

We all have sensory needs and so do OUR KIDS. They don’t need to be fixed. We don’t fix our behaviors of sensory needs, we REGULATE them using strategies such as going out for a run, going on a hike, taking showers, cooking favorite food, eating pistachios or pretzels, or just watching TV or reading books.

We don’t put ‘data’ next to it such as “how many times I refused to sit today or put my finger in my mouth out of anxiety as I had a big presentation at work”. WHY OUR KIDS?

ONLY a LICENSED OT, who are professionals to understand children in such a better way, can use strategies to help you understand the child to “regulate” their needs and explain how they see the world and make sure to support them the way they love to grasp the information.

It is important to advocate for our one child and choose what is best. 40 hrs of the same routines, or 1 hour of quality time with professional guidance.

It is sad when parents just think “more therapy more results” mindset or just because the child is “taken care of” and we are off duty.

It is sad when we just trust individuals who “see” observable behaviors only but do not find any depth behind those behaviors. Any human being does not LOVE to act out or LOVE to throw tantrums or LOVE to run on the streets. THERE ARE PURPOSES AND BODY NEEDS AND LACK OF REGULATION. WHICH ONLY trained and licensed OT can GUIDE YOU WELL and NOT Behavior Technician.

It is also sad that you cannot see how much a child can get overwhelmed with 40 hrs BUT, DOING 1 HR OF OT makes them overwhelmed where they are actually having fun and function.

It’s upsetting that denying services for OT is EASY for the majority of parents but, requesting REDUCED HOURS FOR Behavior Technician therapy is not.

It is sad that even if you recognize 40 hrs are a lot, you cannot advocate for your child’s needs and understand the value of OT services and end up deciding ‘not doing OT’ just cuz it’s too much!!

The question is – IS Occupational Therapy – REALLY TOO MUCH?

Or are you misguided?

I read this somewhere and I am sure you believe that too, “I don’t want to” is an Extremely VALID reason to NOT do any task.” and I would add – no one should be counting as “child says no” to do the task and label it as “bad behavior”. PERIOD.

MOST IMP References PLEASE READ THEM: (DO NOT AVOID READING THESE ARTICLES)

ARTICLES 

Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis | Emerald Insight

https://stopabasupportautistics.home.blog/2019/08/11/the-great-big-aba-opposition-resource-list/?fbclid=IwZXh0bgNhZW0CMTAAAR3HefjCTbpl3xPT3KMrTtjOsa9iTM-EDiIMWcpZS96WD7wK9z_MTqMAR0U_aem_ATXtBgsouH8HFXqfYqmcc4LD6K83TWj3a0rIUkBpTYtr01O-dAW9pFXkpip-SxOz2IxdslE3A4ioK5TCuhuctEAz

https://therapistndc.org/aba-is-not-effective-so-says-the-latest-report-from-the-department-of-defense/?fbclid=IwZXh0bgNhZW0CMTAAAR1pXx6GJov2kD2-j714SvgLsiMTIUWC2ocyJp-nyh5PzNr9F576v51h85g_aem_ATXh3CWxl4TKxERJeA6DV7hD6TQm_YxNrsuxlDJuy32nHSfJnVhWiHlnwQ4SLwl6nXozRA8be3zkj83XtUKsm7FD

https://www.sciencedirect.com/science/article/abs/pii/S0883941716300061?fbclid=IwZXh0bgNhZW0CMTAAAR2RulKxh5oDuag7UmsgPQiVm2CtZhbOZQFHk5cq7zuzIEOvlYEUEpFi_qw_aem_ATUr5bViewWFIT0VHMYYHqh_Hj2leb3VA3Iw6U6N6Y6RoMasrtulKlCiVIqEbFu9TvKXTOgONocjXtX1Zfp8mggn

NOTE:

THE DECISION TO CONTINUE/DISCONTINUE ANY THERAPY OT/ABA IS SOLE DECISION OF PARENTS/CAREGIVERS OF CHILDREN who are OT Park client or potential clients. ABOVE INFORMATION IS ONLY CREATED TO CREATE AWARENESS ABOUT HOW PROFESSIONAL SERVICES WORK. It does NOT guarantee any success of therapy one over another. THE REFERENCES ARE ATTACHED FOR PARENTS/CAREGIVERS TO LOOK, READ, AND SUPPORT THEIR DECISION MAKING JOURNEY. We aim to advocate for getting services in an appropriate manner, and NOT choosing between two. WE support balance between all and not AVOID ONE OVER OTHER. THANK YOU. 

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