Autism Therapy Fatigue

The relative of an autistic girl asks if there's such a thing as "therapy fatigue" in a letter published in the Manila Bulletin Publishing Corporation:

.....I noticed that the child is always tired of attending one therapy after another. She becomes cranky and would be moody at the end of the day. Sometimes, she even refuses to go out as if she doesn’t want any therapies anymore. Is there such thing as “therapy fatigue”? If yes, should I tell her parents to stop or lessen giving the child therapy session? If none, can you tell me until when should a child with autism continue to attend therapies?

Responds Dr. Myra V. Altonaga, a neurodevelopmental pediatrician based in Cebu:

...herapy fatigue often occurs in children who are subjected to daily therapies (not just one therapy). In other words, their daily routine would include going from one therapy to another.
In my clinical practice, I’ve encountered parents who would not be contented with the therapy in the center alone but would also get home service therapy within the day either just to fill up the schedule of their children, or to maximize the intervention.

But we have to remember that they are also children who want to play and do things that they enjoy. We have to give them enough time for these also.

Lessening the therapy sessions would be helpful. Anyway, the big factor for the success in the intervention would be the follow through and the active participation of the family members and not the frequency of the therapy sessions.

It's not hard for a parent to go into autism-therapy-overdrive with so many therapies and treatments, educational, biomedical, medical, etc.. When my son was younger, we tried many things; sometimes it felt (felt) that there was an unconscious feeling among parents that "the more we're doing, the more it shows how hard we're trying. Gradually---after seeing what helped Charlie and what not---we let go of the alternative biomedical treatments and focused on his education. The only doctors we visit now are the pediatrician (inevitable colds and minor ailments), the neurologist, the dentist. (And I think we all felt a sense of relief at not driving him every which way to yet another therapy appointment.)

When do you know when enough is enough?