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HisMom
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05 Jan 2013, 2:17 pm

Please help me, fellow ASD parents.

I have been researching my options for an in-home ABA program. There are so many "flavors" of ABA out there - Lovaas, DIR / Floortime, ESDM, TEEACH, VB etc

Since my son is pre-verbal, my top priority is getting him to TALK / communicate ! I am unsure of the ESDM or Floortime approach, as these seem to be very child directed and he has limited focus, interests and skills. Of course, these are my beliefs based on my limited research on these methodologies so far, so please feel free to correct me if I have misunderstood these approaches.

I am currently doing flash cards with him (based on the advise of one of the members here) and he is just barely beginning to respond to it.

Given this, what approach would you most recommend for a pre-verbal child with LIMITED skills across domains ? And how many hours a week at a MINIMUM would be considered "best practices" ?

Thanks in advance for any advise / feedback you can give me.



lady_katie
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05 Jan 2013, 3:02 pm

I don't have any advice, as I'm about to start heading down the ABA road myself. I was just wondering, what is the difference between "pre-verbal" and "non-verbal". Thanks!



McAnulty
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05 Jan 2013, 4:48 pm

I'm personally not a huge fan of aba, but most of the things you mentioned aren't aba anyways. I did my own blend with my son. I bought books on all the therapies you mentioned, and kept the parts I liked and discarded the rest. Most of the way I do things with my son is most similar to floor time, following his interests. Also a lot of physical help, when he was younger I could show him something until I was blue in the face and he never got it, but put my hands over his to help him go through the motions and he'd pick things up fast. My favorite approach was The Hanen program. This book focuses on communication and starts from the very beginning, at a level where no communication exists and progresses in well defined stages. It helped my son go from no communication other than crying about a year ago, to using one sign 8 months ago, to using three signs, hundreds of pictures, and some vocalizing and joint attention today. His communication has improved drastically as well as his desire to socialize and share his emotions with others. He is much happier now that he can get his point across most of the time. Any approach that uses a child's interest is good in my opinion. I'm wary of aba because it's quite rigid and doesn't teach a child to be flexible or to learn in a meaningful way.
Good luck! Once communication is unlocked it's like the floodgates open and life just seems to get a hundred times better.



McAnulty
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05 Jan 2013, 4:53 pm

Oh, I forgot to mention how much time we spent doing things. I didn't exactly time it, I didn't really think of it as therapy so much as a different way of being with him 24 hours a day, but we spent most of our days working on one skill or another, as long as he was receptive and not getting frustrated. Aba is much more strict, with well defined periods of instruction and very specific methods and observations, and I think usually 40 hours a week is considered the norm. I think the minimum I usually see is 30-35 hours.



HisMom
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05 Jan 2013, 4:55 pm

McAnulty wrote:
I'm personally not a huge fan of aba, but most of the things you mentioned aren't aba anyways. I did my own blend with my son. I bought books on all the therapies you mentioned, and kept the parts I liked and discarded the rest. Most of the way I do things with my son is most similar to floor time, following his interests. Also a lot of physical help, when he was younger I could show him something until I was blue in the face and he never got it, but put my hands over his to help him go through the motions and he'd pick things up fast. My favorite approach was The Hanen program. This book focuses on communication and starts from the very beginning, at a level where no communication exists and progresses in well defined stages. It helped my son go from no communication other than crying about a year ago, to using one sign 8 months ago, to using three signs, hundreds of pictures, and some vocalizing and joint attention today. His communication has improved drastically as well as his desire to socialize and share his emotions with others. He is much happier now that he can get his point across most of the time. Any approach that uses a child's interest is good in my opinion. I'm wary of aba because it's quite rigid and doesn't teach a child to be flexible or to learn in a meaningful way.
Good luck! Once communication is unlocked it's like the floodgates open and life just seems to get a hundred times better.


Yes, yes, yes.. Communication is key !

Thank you for the heads - up on the Hanen Method. I will look into it at once.

How old is your son ? Mine is 3.5 years old now, and very, very vocal, although he stims on the same sounds over & over again, while never emitting other phenomes, but he has a come long from where he was even back in September.

When you say he uses pictures, do you mean PECS ? We tried it with our boy, but his attention span is so short, and his focus so very limited that it didn't work for us and we had to abandon it. I label everything to him and the flash cards are barely beginning to work, so maybe it is time to give PECS another shot.

BTW, I was told VB is a form of ABA that focusses on language. Is this incorrect (the part about it being "ABA", I mean) ? Also, could you share what books you used ?

Thanks !



zette
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05 Jan 2013, 5:03 pm

How old is your child? I have no direct experience with the choice you're facing (my DS had a very minor speech delay and was always communicative even when he had few words) but I read quite a bit about DIR/Floortime when he was first diagnosed. If I had a pre-verbal child who was "in his own world" and not communicative, I would look very closely at this program, because it is centered around fostering the DESIRE to interact and communicate.

I've heard that Denver Early Start has had a lot of research showing positive progress in comparison with other programs.



HisMom
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05 Jan 2013, 5:54 pm

Zette, my son is 3.5 years old.

We have been doing our version of Floortime / ESDM for the last few months. We recently did our own assessments on him using the assessment charts on the Floortime website and discovered that he has been stuck at a very early Level 4 for MONTHS NOW. This pretty much agrees with our informal observational analysis of him and we are frustrated.

The program recommends that we go back and continuing working on the earlier stages, as they believe that progress to the next level only comes when all the earlier levels have been mastered. We don't know better than Dr. Greenspan, of course, but time is of the essence, as he is already 3.5 years old and still pre-verbal !

So, we are wondering if we should continue doing Floortime & ESDM, working on his current skills more intensely, OR, if we should migrate to a stricter / more intensive ABA program, such as Lovaas or VB, that would help him overcome whatever roadblock it is that prevents him from advancing to more sophisticated Level 4 skills, and, then, eventually on to Level 5.

My head spins and I need guidance thinking this through. Help !



McAnulty
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05 Jan 2013, 6:51 pm

Technically we didn't use pecs, but yes, they were pictos. We had tried them when he was younger with no response. Then when he was 22 months I tried again. I made one picture (he understands real pictures better than the drawings) of his absolute favorite food. Then we approached it like pecs, one person had the banana, and the other one put the picture in his hand and helped him exchange it for the food. After only 6 tries this time he understood and started doing it himself when it was the only way he could get his favorite food. So I would try again every month or so, because you never know when he'll ready. Once he understood the banana card, he understood any picture of a tangible item, and slowly we added harder ones like "eat" or "dance". But I had tried this many times before and he just wasn't ready until then. He is now 2 & 1/2. He took off with the pictos at 22 months. He does not produce a wide variety of sounds either, and does a lot of vocal stimming as well. But once in awhile lately there is some inflection and I can tell he's expressing something with his sounds sometimes and not just stimming.
Verbal behaviour is like aba. With my son, it was just too much for him. He found it frustrating, couldn't focus, and it just felt like drills of torture. Neither of us had any fun and I felt like it was ruining our relationship and counterproduction. And he didn't learn because it wasn't something he wanted to be doing. Some families swear by aba, and I know every child is different, so it might work for you but it wasn't right for us.
Does your son use any communication at all? My son started with pulling or pushing my hand to get me to do something. It wasn't long after this that he was ready for pictos.
For the books, I'll have to get back to you. I think I bought one on ABA, on on verbal behaviour, one on floor time, one on RDI and the one on the Hanen program, which was called "More than Words".



McAnulty
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05 Jan 2013, 6:53 pm

Oh, and pivotal response