Choosing early interventions for disability

Choosing early interventions for disability

First steps towards early intervention: diagnosis and treatment plans

The type of early intervention you choose will depend on your child's disability.

Getting your child's disability diagnosed will you help you chose the right early intervention. If your child's disability or developmental delay showed up at birth or soon after, you might already be well along this path. But if you don't have a diagnosis and you're concerned about your child, you can ask your GP for a referral to a paediatrician.

The paediatrician might do a formal assessment of your child. This can mean several visits and tests. Information and reports from these assessments can help to work out what services and support will help your child now and in the future. These reports might also be useful when you're applying for services.

Treatment plans
The assessment or diagnosis should give you an understanding of your child's current skills, as well as possible gaps in skills or development. It should also include a treatment plan designed to work on these gaps.

As part of the treatment plan, the paediatrician might say your child needs a particular type of intervention or therapy and give you a referral for these services.

You can get a good understanding of what the intervention can do for your child by asking questions and writing things down when you're with the paediatrician. It's also OK to speak to the doctor on the phone afterwards if you want more information.

Once your child has finished a course of intervention or therapy, you might need to go back to your paediatrician for a review. Depending on your child's progress, the paediatrician might send your child for more of the same type of intervention or for something new.

Choosing evidence-based early interventions

When you're looking at any early intervention or therapy for your child - even one your paediatrician recommends - it's best to get some reliable information about it. This is even more important when you're doing your own research into interventions and therapies.

After all, you wouldn't give your child a medicine if you thought it wouldn't work - if it hadn't been tested as effective and safe to use. It's the same with therapies and interventions. You need to check there's good evidence to say they work.

Interventions that are based on scientifically validated and reliable evidence are the ones most likely to:

  • work
  • be worth the time, money and energy you have to invest
  • be safe for your child.

Here are some tips for choosing wisely and thinking carefully about individual interventions.

Think about the claims
Sometimes it's hard to know whether an intervention for a particular disability really works. Often this is because it isn't clear what people are saying the intervention can do for your child, or what the end result is supposed to be.

For example, you might want your child to 'behave better', 'act normal' or 'be more social'.

To get clearer information about the claims being made for the intervention, you might ask questions like these:

  • How will I know whether the intervention has worked?
  • What does 'better', 'improvement' or 'cure' really mean? That is, what changes in my child should I expect to see?
  • How will the changes be measured?
  • Could the changes be measured by anyone (objectively)?
  • Is there a risk of bias, or 'seeing what I want to see'?

Ask about the evidence
As a parent learning about a therapy, you might be finding it difficult to look at things objectively. It's easy to feel overloaded with information, or to think straight away that the treatment works - after all, you just want to help your child. You might also get different advice from different people, including professionals, about what will work.

And to make things even harder, many interventions haven't been properly tested.

In this situation, it's worth asking what evidence there is that the therapy does what it says. The information you find about an intervention won't always be clear and conclusive, but it's always best to make an informed choice.

Some questions to ask about testing the therapy
The following questions can help you work out whether the therapy has been properly tested:

  • Has the therapy been tested?
  • Was the test reliable or fair?
  • Did the test use unbiased research methods that couldn't be influenced by the person running the tests?
  • During the test, could other factors (such as parent or therapist expectations) have influenced the results? What about the placebo effect?
  • Was a control group (or 'comparison group') used in the test, and did participants have an equal chance of being in the control group or therapy group?

Some questions to ask about the science behind the therapy
The following questions can help you work out whether the therapy is backed up by reliable science:

  • Have other people tested this therapy and come up with the same results? This also helps to ensure that the results one researcher got weren't because of other factors, and were in fact because of the therapy.
  • Were the results published in a scientific journal? Or by an organisation or association with a good reputation, like a university or hospital?
  • Were the results published more than once, or as part of a bigger study, like a systematic review?
  • Can I get copies of what has been published?

These questions about evidence and the science behind it are based on what we know about how interventions are tested.

Choosing an intervention that suits your child and family

On top of the evidence, practical and personal questions are also important to think about. The following questions might help you decide whether an intervention is a real option for your family.

  • Cost: is the intervention affordable? If not, are there subsidies, rebates or funding that can help you afford it?
  • Time and involvement: some interventions take a lot of time and need you to do a lot as a parent. Can your family commit to this? What would you need to do to make it work?
  • Availability: is this intervention available in your area? If it isn't, is there a way you can use it? Are there places available in the program?
  • Child fit: does the intervention meet the current needs of your child?
  • Family fit: does the intervention meet the goals and needs of your family? Does the intervention fit with your family's beliefs and values? Or can adjustments be made to accommodate these?

It might also help to read more about choosing disability service providers and what to expect from disability professionals.

Warning signs about early interventions

There are some warning signs that an intervention isn't all it claims to be.

For example, beware of any claims that an intervention will cure or fix your child, or make your child 'normal'.

Beware of jargon too. Lots of scientific-sounding language doesn't necessarily mean that the approach is scientific.

Is the cost excessive? Watch out for interventions that might be trying to sell you something or whose costs seem out of proportion to what's being offered. Talk to people you trust to find out more.

Some interventions might seem harmless. But if they're not right for your child, they can waste time and energy that you could be spending on interventions that might get better results.

Lots of testimonials or anecdotes about an intervention's effectiveness can also be a warning sign. This is especially so if the only evidence in support of the intervention is testimonials and anecdotes. Testimonials don't replace quality research. Families might give testimonials for many reasons, and there might be other explanations of why an intervention seems to have worked. The family might have been doing something else that helped, the improvement might simply have been consistent with the child's expected development, or it might be the placebo effect.