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Getting the Best for Your Child with Autism: An Experts Guide to Treatment.
Bryna Siegel , PhD. The Guildford Press, New York, 2008. 267. CA $16.95.
Bryna Siegal is the Director of the Autism Clinic and Co-Director of the Autism and Neurodevelopment Research Center at the University of California. Her educational background is diverse, including clinical and developmental psychology, early childhood education, and collaboration with psychiatrists. She also has extensive clinical experience. As such, she is well placed to pull together scientific information within the context of the social and emotional situation in which families with an autistic child find themselves.
Although the introduction suggests, “This is a book for parents who already know a thing or two about autism,” the level of background knowledge required is not extensive. The language used strikes a good balance between the needs of parents with different levels of education. It is informative and scientifically accurate, yet sensitive to the emotional turmoil that parents may face. The book claims it will help parents to target the treatments that best meet their child’s needs, evaluate their child’s strengths and weaknesses, form an effective relationship with teachers and therapists, and know their legal rights. So how well are these areas addressed?
After a brief introduction, paragraphs are grouped into four sections; the titles of which orient the reader to the part that they need. Chapter headings are also helpful, for example, ‘Setting a Course: Navigating the Diagnostic Process to Emerge with a Plan’. The flow of chapters mirrors the sequence of questions that parents may ask as they go through the process of diagnosis and treatment planning. One refreshing aspect of this book is that it does summarize all the main approaches, in contrast to those that encourage a specific course as if diagnosis is the only aspect of a child that is relevant. Children with autism are as diverse as typical children, and it is reassuring to see that this not only acknowledged, but incorporated throughout the text.
The first section is aimed at parents who are questioning or unsure about their child’s diagnosis. Dr. Siegal’s summary of the diagnostic process is extensive and inclusive, starting with a comprehensive exploration of screening, and then explaining how and why formal diagnoses are made. Much of the terminology that parents will hear during the assessment period is explained. Although information is tailored to individual health care plans, most of the discussion is equally relevant to our publicly funded system. Parents are gently guided to advocate for their child and ensure that diagnosis is made via evidence based approaches and best practice models, while acknowledging that they may not have every test or professional available to them. She provides a summary of the information which parents will want to have gathered by the end of the process, and why this is helpful. She also addresses the question of when enough assessment has been done, encouraging parents not to use it as a way of avoiding acceptance of diagnosis.
The second section emphasizes the importance of parents’ involvement. They are encouraged to maintain a normal household routine, as far as possible, to care for themselves and other children and to take simple and practical everyday steps that benefit all family members. She emphasizes that, “A child with autism is a child first, autistic second; he needs a life and home as well as treatment.” Parents are guided to determine not only how much, and what type of treatment is needed, but when enough is provided. The third area of the book examines formal treatment, examining the roles of various professionals. Unfortunately child psychiatrists are not seen as having an extensive role – there are too few of them available. Core treatment approaches are all covered. Ways in which treatment options affect different aspects of a child’s challenges and strengths are examined, allowing parents to choose the approach, or combination of approaches, that best meet their needs. Finally the legal rights of a child with autism are explained. This is not directly applicable to Canadians, but advice about the collaborative process with schools and other agencies is well thought through and could also be useful to parents of children with any challenge.
So, this book lives up to its claims. I will recommend it to parents of children with PDD. It would also be a useful text for General Practitioners who wish to better understand the diagnosis and treatment of their autistic patients or for Child Psychiatrists who do not have extensive experience in this field.