I'm just not understanding ABA Therapy???

Miranda - posted on 12/28/2010 ( 21 moms have responded )

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Hi All - My son is 5 years old and has PDD-NOS. He just started in home ABA Therapy 2 weeks ago. So far he is actually enjoying it. I am curious to hear from people who may have any words of wisdom or words of caution. At this point his therapists are trying to start off a little easy on him to build repore and to get to know where a good starting point is. So far he has blown through all the programs that they have done with him. Is there a point to this therapy if he isn't being challenged? I know it's only been 2 weeks, but I just don't know how this is supposed to go??? Another Question - He dose a lot of "zoning out", flapping, and vocal stims (especially when he's tired). Are they supposed to address this during his therapy? Am I supposed to stop him from doing these things when we aren't at home? I don't think he can help it. How do you teach these kids when the right time and place is? At this point the therapists haven't addressed it at all that I'm aware of. To be fair I will admit I have not talked to the Senior Therapist about my concerns yet. I was hoping to get some feedback from you all first! I love my boy and I want to do whats best for him but I wish I knew what that was!

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Christi - posted on 01/05/2011

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Is this an ECI program, or a paid at home ABA therapist? My son is going through ECI and although they are not supposed to, his therapist is running ABA therapy with him since our insurance refuses to cover it and there is no means for us to pay for it. It might seem like he is blowing through the programs, but they have to figure out his weeknesses and there is an order they go in. I was given the order and everything involved when we first started, Are you keeping a binder with all the info and all his therapy sessions? I keep a binder so I can track how is doing in therapy and in the therapies I run myself at home. He gets two therapies a day for an hour each. They should address the zoning out and teach you how to handle the flapping and such as well. It's not about teaching him the right time and place, he is showing you he is stressed which is a good thing. If he needs to flap, let him. My son shakes his head and it helps calm him down. It has only been two weeks and I would certainly address any concerns with the therapists. I thought it wasn't going to help but we are four months in and my son is a different little boy :)

Jody - posted on 01/04/2011

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Hi there,
I have a 12 year old in the spectrum and I will say ABA is a broad term and can be generalized. It's important to know the specifics to what they are doing. We did ABA with our son when he was two but over the Years I have found better in my opinion than the traditional ABA approach. In particular is prt which is actually short for pivotal response technique and is modeled by the UC Santa Barbara 's autism research clinic. It's even better. And as far as the stimming, have you ever heard of the son-rise folks? Their center is in Mass and they have a lot of opinions on allowing our kids to stim. They call it ism's. They have a whole model but one of their big things is not only allowing your kid to stim, but to stim with him. They feel it helps the child feel more in control and brings you into their world so you can help them come into ours more. I like programs that focus on the social aspects and how to engage naturalistically mote so than ABA. I hope this helps. Much love and success to you. J

Sandra - posted on 12/28/2010

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From what I understand of ABA, it is teaching through quick repetitive trials of a skill or task. My son has been in ABA for a year and a half now and is 5 and a half years old. I wouldn't expect too much progress at the very start, because they do need to develop a baseline of his skills, and completely evaluate where he is at. Also, the ABA worker has to get through the "honeymoon" period with your son as well. ABA is a long, time consuming process. Also, with PDD-NOS, I would assume your son is high functioning. That being said, he will probably fly through some or many of the programs. My son has Asperger's Syndrome, and is very high functioning. His programs have to be evaluated at least monthly, because he masters tasks and skills quickly, especially since we started a good nutritional supplement and removed milk from his diet. As far as your sons "zoning out" and stuff, that is very typical of Autism Spectrum kids. When my son is having ABA, I never go into the room, unless the ABA worker comes and asks me for help. A good ABA worker can work through most of your child's behavior, continue to progress through the work that needs done, without needing mom to intervene. Also, if you do intervene for every behavior, your child learns that if they act out, mom will come in, thus making it harder for the worker to have a "teacher" type relationship with the child. And some of these behaviors your child can't help. It is something that has to be managed, some for life. It is very hard to teach a kid with ASD when the right time and place for certain behaviors is, because they think differently from other people, and don't make the social connections to what is ok in a given environment, that come naturally to non-ASD people. Just keep asking questions, and educating yourself. Best of Luck to You! I hope this was helpful!

Jennifer - posted on 01/07/2011

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Hi I know its sooo hard. I have a 14 year old son who is also PDD-NOS we did ABA therapy for 2 years of his life from 3 to 5. People in our house 40 hours a week teaching my son everything.. It realy did help alot! Building a repor is very important. In my my sons case I wanted him to have everything he needed to know and then some before kindergarden so that way the only thing he had to worry about when he got in a school setting was being attentive. From our experiance they would spend 5 mins on what ever we were trying to master. Then give him a break at witch time he was allowed to stem or what ever but during actual therapy learning time he needed to be (zoned in). Unfortunatly the steming as never gone away in my sons case. Now that he is 14 he knows there are certain times when he can stem and certain times that it is unapropriate. I use a stress ball for him it helps with steming. hang in there I hope I was somewhat helpful. I would discuss the steming during therapy with the therapists. Remember mothere intuition is a very stong thing : )

Laurie - posted on 01/04/2011

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They could just be doing skills assessments right now, it's easier to determine where the child needs help if they can get them to do what's comfortable for them. The theory behind ABA is that positive behaviors are reinforced so they reappear, negative behavior (as long as it's not harmful) is ignored so it disappears over time. These kids can't help the stims and the therapist can address it or give you suggestions to help it if it's causing a problem. You should be sure to tell the therapist the behaviors that bother you and the ones that you can live with. They can sometimes accidentally reinforce behaviors you're trying to get rid of without even realizing it. The fact that he doesn't have tantrums during the therapy is good, when my little girl started she didn't get any work done b/c the majority of the time was spent getting the tantrums to cease. She still has some stims but it's getting easier to find the causes. Just pick your battles. the therapy helps with reasoning, social skills, and helps to get them to age appropriate tasks and beyond. Just hang in there, consistency and following through are the most important things to see results. I wouldn't worry about the stims when your out. When people stare I just tell my little girl "look they left without their manners" The kids don't really care if people stare. The zoning out, high fives work to bring my little girl back sometimes, so do hugs, and just getting directly in her face.

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Kathy - posted on 01/04/2011

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Hi Miranda
I also wanted to give you some comparison from my friend and fellow consultant who also has a masters in ABA. I will put that at the end of the post-
The problem comes in with behaviorism in general is they are focused on behaviors and not developmental milestones. In essence they are building static skills without the function of the skills. My older son responded to skill training ( ABA) but it left him with No theory of mind/perspective taking skills. He was able to talk but he could not really *communicate* which means that non verbal communication and co regulation that a typical child can do. Once I backed up, and addressed those basic milestones, he was able to capture the ability to share perspective and experience share. He wanted to share his life with me and have a relationship. I wanted my kids to talk so much…but once he did, it was all instrumental language for his needs. RDI changed that to true communication! My younger son, I was told he would never talk. He did not respond to ABA skill training ( he was in it for about 6 months) and so when we switched over to RDI it was incredible.
I am now an RDI consultant and tell people if I had to do it over again, I would start with RDI and use some ABA strategies if needed but the milestones are the most important thing for our kids. Once they were in place my younger son learned typically !! That meant I did not need to teach in a rote way, but instead in a mindful way! Here is a chart to describe the differences with mindful vs static
http://mysite.verizon.net/vze3ww4z/id8.h...
Kathy
www.autismremediationforourchildren.com
Static vs. Dynamic Thinking
ABA
Just by the way ABA is structured promotes static thinking which you could also think of as black and white thinking.
There are correct answers and there are incorrect answers just as there are appropriate behaviors and inappropriate
behaviors. This type of teaching actually works quite well for individuals with ASD in teaching static skills as
the ASD brain is extremely good at learning Black & White rules, scripts, and answers. However, this is actually reinforcing
static neurological pathways in the brain and therefore, individuals on the spectrum become rigid and inflexible
in their thinking and they do not develop the ability to think dynamically or understand that in real life problems
for the majority of the time do not have black and white answers and tend to fall into more of what is commonly
referred to as “grey areas.”
ABA attempts to “generalize” black + white answers to more grey areas but this is often difficult as they static pathways
they are creating are difficult to change. A child taught to answer “I’m ok” to being asked “How are you?” who
is then asked to used generalized versions of this answer such as “Good” or “Fine” can do so but often replaces he
answer “I’m ok” with one of the other options thinking “good” is the new “correct” answer instead of using “I’m
ok”, “Good” and “Fine” interchangeably as hoped.
RDI
Because RDI is not a skill based program, it does not place the same emphasis
on “correct” answers. Its focus is more about developing the dynamic function of the brain & the individual with
ASD’s ability to think like their guides. So for example, if you think about the question “where is the right place for a
box of cereal to go in the cabinet?” The person with ASD learns with the aide of their guide that there are many “correct”
places, although some may be better or worse than others, for the cereal to go. It is in many such experiences
with a guide that the individual with ASD will discover how to make “good enough” choices to “grey area” problems.
Lacking Skills vs. Developmental Gaps
ABA
ABA would access a child to determine what skills they lack and then teach to fill in these skill areas. For example, if
a child was not pointing and labeling objects, a “labels” program would be implemented. Likewise, if a child could
not cut on a line, a “cutting” program would be implemented. Whatever skill deficit there is, a program would be
created to address this skill.
RDI
RDI is not against skills as everyone needs to learn what objects in their environment are called as well as how to cut.
However, RDI follows typical development to determine developmentally appropriate objectives for each individual
on the spectrum. If a person is able to re-do missed developmental milestones, catching up on skills will not take
long, however the reverse is not true. Being able to cut does not guarantee you will be able to understand the perspective
of another person.


Below is a list of critical developmental milestones from birth to five. What I hope you will see are not of these are
“skills” that ABA teaches or that can be taught in a skill acquisition approach. These are developmental milestones
and no amount of skills can replace or compensate for these developmental foundations. These are the foundations
upon which meaningful cognitive, communication, social and behavioral development is built.
1. Learns that actions can be coordinated with others, but not controlled by them; and that coordinating actions
with others is better than acting alone.
2. Repairs breakdowns in coordination with partners
3. Interprets and uses non verbal communication to have meaningful exchanges with partners, including facial
expression, gestures, and voice
4. Communicates with partners mainly for sharing experiences and learning about how others interpret the world
5. Monitors interactions to ensure partners have understood what has been communicated
6. Enjoys being with partners that change their actions and routines; does not like doing the same thing over and
over again
7. Takes turns appropriately and at the correct time in a wide variety of interactions
8. Understand that perception is dependent on position and person’s unique experiences
9. Recognizes that everyone can have different perceptions of the same item or event, and that all perceptions are
equally important
10. Pretends on his/her own with a partner, and can coordinate his/her imagination with partner’s imagination
11. Understands that friendship is consensual, acknowledges others’ similarities and differences and desires to be
liked and accepted
12. Develops more than one solution to a problem, and more than one way to approach tasks
13. Thinks about actions before taking them, and can determine what actions are appropriate for the current setting
14. Understands teasing, offers of support, and degrees of agreement
15. Accurately interprets when others are upset, as well as regulates the degree of emotion tied to different experiences
16. Transitions with little preparation
17. Carries out familiar routines and tasks from memory
18. Uses the knowledge of negative consequences to adjust behavior
19. Takes pride in accomplishing challenging task
20. Understand and regulates own emotions based on the current situations, and recognizes that others may have
similar or different reactions to an event based on their personal experiences

Angie - posted on 01/04/2011

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Personally, I am not a fan of ABA. From what I've seen, it basically teaches them to react a certain way, but it doesn't address WHY they are acting that way, or why they need to change. In my opinion, that makes them robots. I did my own therapy with my kids, focusing on sensory integration, since that's usually the root of WHY they do what they do. Then, I focused on teaching them why things are inappropriate, giving them tools to cope in other ways and teaching them self-control. I did not allow stims or zoning out, because it's a way of escaping reality, and that's not good. They have to learn to deal with life, and through teaching them that, they learned that life wasn't so scary that they needed to escape. It was basically reprogramming what their brains were telling them, and that's that the world is scary and they have no control. Now, when my kids were excessively tired and couldn't go to bed for some reason, or they were in a really stressful environment like Disneyland and I knew it was too much sensory stimulation, I allowed them to do whatever they had to in order to cope. As they progressed in other areas, they learned to cope and now I can take them anywhere without problems. It is a process. It took about three years with my oldest to really start seeing him take control without my having to coach him, but he did it.

Angel - posted on 01/04/2011

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I want to say that ABA has been the best thing that my children have recieved (I have 3 on the spectrum). Seeing there are 3 of them, the ABA first started with their socialization as brothers then little by little he would work with each on their problems. Now after about a yr, we are to the point where he has grouped them with other boys of their respective ages so that they can know they are not alone in their struggles and to have them deal with other children with the same type of issues. He takes them out to the movies, for pizza or just to the arcade so that they can learn social skills for the real world. There are times that he will take 2 of my boys (the 2 that have the hardest time getting along) so that they can work on their own social issues as well as brotherly issues.
If it had not been for finding this wonderful ABA that we have, I would not be where I am and my boys would definately not be where they are.

For you, just let it flow and if you don't see anything you like, then get a different ABA because you should be seeing a difference as well as the ABA should be working with you to help you deal with all the issues as well. Good luck but it is definately a great asset!

Shelly - posted on 01/04/2011

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Although I do not have much to contribute to your post, Im a so very glad you posted it!! I havent been on here in a couple weeks and my son 5 yrs old with PDD-NOS just started ABA also 2 weeks ago!! I am in the same boat as you!! We are still trying to figure out where in our house it is best for them to work with him. Also having therapy 5 days a week is a bit much to get used to, but Im taking it all one day at a time. I too am concerned all what the therapist are doing with my son. I know they are working a lot on fine motor and academics, but I also hope they are addressing the behavioral concerns as well!! Good luck with your journey and thanks for sharing. I sometime feel alone in this, alothough I know there are several families going through this, however no one I know personally has a child with special needs!! It's nice to come on here and see something that I can relate too!! Happy New Year!!

Kathy - posted on 01/04/2011

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Hi I have 2 children who were Dx with Autism 10 and 6 years ago. We did ABA with my oldest until he graduated out b ut he was still lacking the social understanding...and with my younger son he made no progress with ABA. We switched to RDI and my oldest is now fully recovered and my youngest is just about there...
Here is an explanation between ABA and RDI is you are interested-
http://mysite.verizon.net/vze3ww4z/id13....
Kathy

Kim - posted on 01/04/2011

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Best advice I can give you is get a parent advocate....they are free. They will explain everything in english to you and fight for your son's best interest... good luck to you.

Julie - posted on 01/04/2011

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ABA has changed our quality of life with our son....we've seen AMAZING strides in him since beginning ABA. We started when he was three and now he's six. He's in a regular class at school among typical peers and at the top of his class. Communication with the lead therapist and the consultant are KEY. Learn as much as you can about ABA so you can have worthwhile conversations with them showing them you also know what you're talking about. Raise all the concerns you have and challenge them to address them. We've had ABA in the school system where we live and also have a home program. I'm so thankful for it!!!

Diane - posted on 01/04/2011

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My son did ABA for five years. My favorite analogy is the 3-legged stool approach: Choosing a balanced approach: Some form of dietary intervention to meet the child's specific needs (typically the GF/CF - gluten free, casein/dairy-free, while many opt to remove other common allergens to which their child tests sensitive/reactive), biomedical intervention under the care of a DAN doctor based on testing results that will guide the doctor as to the child's specific needs, and an educational component (for us, it was ABA until our son was able to mainstream into typical school, then shadow aide at school with afternoon ABA to fine-tune deficits. His ABA program ended when we moved to TN in 2006 - he was in the advanced stages of Theory of Mind (higher level thinking skills), and while he did not finish it, he did no qualify for funding in TN due to his high level of functioning. Yet in the past four years since moving here, he is still a very strong student academically, learning with typical peers in Middle School.



Also, do note that I have talked to many parents who wanted to focus only on one or two of the above approaches, rather than a balance of all three, and I rarely have heard success stories when the focus is on education without complementing the efforts with diet and medical support with a DAN doctor. The reason is that diet helps set the stage for success. Can help improve sleep, gut issues, and overall health. Biomed helps address deficits and toxic levels that may be contributing to autistic symptoms, and once addressed, may help promote learning. More here: http://www.talkaboutcuringautism.org/aut...

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@Miranda, if you are noticing improvements, your son is heading in the right direction. Methods such as ABA and VBA tend to discourage stimming. Your therapist can help you teach your son trigger phrases that will remind him not to perform certain behaviors.

@Sarah, I wasn't sure if you were aware, but on the social skills ladder, ABA is lower than DIR, so if he was advancing with the DIR, you might try a lateral shift to NET or move up to RDI. We actually moved down from DIR to VBA (the method my son's preK teachers happen to be trained in) and it was fine overall. He actually benefitted from some of the aspects, such as picture schedules. One of the things that *really* irked me was their no stimming policy, which --as you already know-- is not similar to DIR. Have you considered the SonRise program? It might be a better fit than ABA if yourt goal is social functioning. If your goal is language aquisition, go for VBA. HTH

Sarah - posted on 12/31/2010

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Miranda, thank you for asking this question! My son is almost 3 years old and will be losing his current therapy provided by First Steps an early intervention program for children up to 3 years old. I had tossed around the idea of starting him in ABA (previous therapy has been DIR Floortime), but I wasn't sure if it would work for a high functioning child. The only ABA I had ever seen was drilling and seemed like "rote response" from the kids. My son is PDD-NPS and learns quickly but regresses just as fast.

Jan - posted on 12/31/2010

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I did ABA for 5 years and all your sons behaviours will be addressed such as flapping the say "hands down" which teaches them to control the flapping and they keep records of the amount of times from begginning to end of therapy which helps and make a big difference it changes my daughters behaviours even though i was skeptical it changed our lives and she got so much better went from spinning naked on the couch to sitting at a table and doing therapy at the end was actually writing her name but we ran out of funding which was sooo sad. you are so lucky to have this therapy it is a gift. I became a therapist from watching and learning from them relax and let them help your child its the best therapy ever.

Barbie - posted on 12/30/2010

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Hi,

My daughter receives 20 hours of ABA and just like you i was a little concerned, for the first 2 weeks they call it play time, so the child can get comfortable with them and get to know them, after that they see what the child knows and then they works from there! ABA is an excellent therapy, remember they do a little bit of everything Speech, Occupational, Physical & Special Instruction so take advantage mom ;)

Im also not in the room when shes receiving her ABA classes because for some reason she seem to pay more attention when im not around...lol However, Yesss i think you should definitely ask question... I asked so many question the ABA teachers probably got sick of me...lol

but its ur right!...so happy new year & Good luck!!

Miranda - posted on 12/29/2010

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Thanks Katherine. I will be patient and keep my fingers crossed. So far he seems to like his therapists. There are 3 main ones and I've heard them giving him lots of praise. I appreciate your input!

Katherine - posted on 12/28/2010

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I did ABA for 5 years on and off. It is a long hard road but once he gets the hang of it you will see a massive improvement. I shouldn't say long, it's not that long. It's trial and error. We try to do play therapy and structure so it's fun. You also have to make sure the therapist is a good fit for your son. You will know by the way he reacts to him/her. If she isn't giving a lot of praise or isn't seasoned enough you may want to switch.
Of course that's just my opinion.
You have to be really patient and you will see a difference.

Miranda - posted on 12/28/2010

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Thank you Sandra! I have heard that it's baby steps with everything. Just good to get some confirmation that things are going "normal." I appreciate your feedback! I don't know any other families using ABA Therapy so I feel like I'm a little alone out here. Thanks Agian!!!!

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