Should My Autistic Child Go to Preschool?

If you have the option of keeping an autistic child at home until they're old enough for kindergarten, should you do it? The answer will depend on a number of factors including:

• Your child's needs, challenges, and preferences
• Your community's offerings and openness to an autistic toddler
• The availability of an appropriate preschool or preschool program
• Your personal ability and willingness to work with your child on building social communication skills
• The availability of in-school or out-of-school therapists at a cost you can afford

Pros. A home setting can be ideal for autistic preschoolers. It provides a safe and secure setting that is personalized to your child's needs, and it can be a convenient setting for the intensive therapy that's so often recommended. Sensory input can be controlled, and expectations remain consistent throughout the day. Some therapists feel that the familiarity of home is conducive to learning and that parents are the best therapists. Still, others feel that there are no better options.

Developmental and play therapies, such as RDI, Floortime, and Sonrise are generally given by parents in a natural setting. Specialized preschools and clinics may not even offer these programs. If you are providing a developmental therapy, then home may be your best or only option.

In most communities the stay-at-home parent need not go it alone; school districts and/or regional autism agencies offer a good deal of support as well as itinerant therapists, and autism support groups are great sources for playdates and other community opportunities. A great way to start accessing these options is to contact your local autism agency for early intervention services and to connect with local support groups to meet other parents or caregivers like you.

Cons. On the other hand, the choice of at-home care means that someone, usually a parent,  must be willing and able to stay at home with an autistic youngster. The stay-at-home parent is unlikely to have the time and energy for a regular job in addition to all the work involved in caring for an autistic toddler. What's more, most children with autism do best in a very routinized, predictable setting. If you have other young children or are working from home, a home setting can become unpredictable, loud, and even chaotic.

Beyond the obvious and critical issue of finances, the role of stay-at-home parent to a child with autism is not for everyone. The role usually entails acting as a therapist during at least part of the day, managing your child's behaviors outside of the home while shopping and going to playgrounds and other settings, and acting as a case manager for the many therapists and doctors you may now have in your life. While some parents find this type of challenge interesting and even stimulating, others find it depressing, difficult and exhausting.

Pros. In many communities, partial or full-day preschool is available free of charge to all families. Children with autism not only receive academic instruction but also (in most cases) receive at least some in-school therapy. Many areas also have at least a few private preschool programs that are specifically geared to children with special needs. Depending on your child's needs and their offerings (and, of course, your finances) a private preschool could be a great match.

Preschools for children on the spectrum are often (though not always) staffed by people who are specifically trained to support your child's needs. They are structured, consistent, and have all the tools at hand to work on skills ranging from social interaction to fine motor coordination. Preschools also offer the very significant benefit of a community of peers and their parents, something that is very tough to create from the ground up if you have an autistic child.

In some cases (especially when you've chosen parent-centered therapies such as floortime or RDI)  it's positive and beneficial for parents to provide therapy. But if your child is receiving applied behavioral analysis (ABA), there's no particular reason why your child should be at home: ABA is generally provided by non-parents for many hours a week.

Cons.  While the ideal preschool setting can be terrific, the fact is that many preschools are far from ideal. You may find that your child is getting little out of the experience, or is even having a negative experience. You may discover that the so-called "trained" personnel are actually teacher's aides who once went to a lecture on autism. You may learn that the other children in your child's group are far more or less disabled than your child, making socialization and learning difficult.

If your child is at a typical preschool, even with early intervention services, you may find that typically developing children (or more likely their parents) may be less than willing to reach out and include your child (and you)  in their social groups and out-of-school activities.

Whether you choose home or preschool, it's important to remember that you can always change your mind, or even mix and match. There is no absolute right or wrong; the answer you reach will relate very specifically to your family, your location and, of course, your child. As you consider your decision, ask yourself these questions:

• Can we afford to have one parent stay at home?
• How does the potential stay-at-home parent feel about an at-home role with an autistic child? Will he or she feel resentful, exhausted, or overwhelmed? Or, alternatively, would he or she feel engaged, excited, and energized?
• What does your child want or need? If your child is relatively social and engaged, and/or fits well into an existing preschool program, it may make sense to give preschool a try. If your child seems to need a lot of 1:1 therapy (and you can and want to provide it), a home could be a great option.
• What do your other children need? Will keeping an autistic toddler at home cut deeply into the time and energy you have for your other children?