ABA Therapy? What Works Best?

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Who has experience with this? It was recommended by the therapist who diagnosed our daughter. I don't know where to even begin to find a place that offers this. I've contacted my school district for an independent evaluation - they haven't called me back. I've heard ABA is great, and I've heard it is horrible. ??? The therapist said we've already been doing ABA types of things, and it's working. We've improved her eye contact, some of the stimming and a few social behaviors. I'd like to learn to do all I can at home, before school, so I can hopefully keep her in mainstream classes. My goal might be out of the park, but I'm hoping. Right now she is doing very well in a mainstream preschool.

Also, what has been most beneficial to those of you with children on the spectrum?

We've never done ABA therapy. We don't believe it's in our son's best interest to get rid of stress relievers such as stimming, forcing eye contact. Having talked to enough autistic adults that find eye contact abhorent (including myself), I just don't see it being good for him.
The latest studies comparing results from ABA vs other therapies show no major difference in the outcomes among the groups.
The closest we came to trademark therapies was his inclusion in Integrated Play Groups, which is a formal way of saying "play dates" supervised by a teacher with peer friends (NT). At home, I write cartons that explain social situations. There is a copyrighted program called Social Stories but I made my own based on familiar characters and situations. I started with popular characters, progressed to caricatures of ourselves. Now I stick to written schedules with just words on them.
PECs is apparently an ABA-based therapy but used outside of that context. PECs is a system of communication with very simple pictures and words. You reinforce speech or substitute speech with these cards and reinforces routine and transition. You'll see PECs in almost any special ed class. The high cost of PECs in 2002 is what motivated me to create my own pictures. I'm sure it's a lot easier these days to get the software to print them out.

My son received ABA through EI and he is in preschool now and gets it in school and 6 hours at home a week. I believe for my son a little of everything is the best, I have heard some people say that 40 hours of ABA makes some kids amazing but sort of robotic, I don't want to offend anyone this is what I have heard! I think each parent needs to do what they feel is the right thing for their child. I like a little of everything ABA, floortime, music therapy etc. I think no therapy is universal to everychild. I would say research everything. Good luck with everything, this forum is great and I am sure you will get valuable information here.

Expensive!! ! 10k-30k and up per year. (some report over 100k)

There is a strong push by the applied behavioral analysis people to try to get government assistance. Strong enough that they want to try to make it the mandatory therapy for all autistics. Autism is bordering on "epidemic" status when defined by the amount of money spent on it. A large chunk goes to ABA.

Do some research!! ! Take a look at what its critics say. My wife can tell horror stories about the things she learned when figuring out if it was an answer for our daughter. It is brainwashing. They try to reprogram the child with appropriate responses. We decided against it because of the potential harm was too great (the line between therapy and abuse is too gray and there are many cases where it gets crossed) and our daughter isn't that non-functional. I would call it last resort. My wife will tell you to run far away and not even consider it. In my opinion it is a money making venture first, and might help someone second.

I can't site sources (perhaps my wife can). She tells me the guy that came up with this program tried to cure gay men in the '70s with similar principals. Half of them committed suicide.

In theory, ABA is not really any different than spanking your toddler when they try to dash into traffic. It's just rewards and punishments - on the surface. Go a little deeper and you're opening a 55 gallon drum of worms.

There are some who think of ABA as The One True Cure for Autism, and that if a kid is started in ABA at age 3 or 4, they will be functionally non-autistic after several years. So there is a definite cult following, with groups trying to get governments to adopt and fund ABA as the holy grail of special ed. Ivor Lovaas, who (inspired by B.F. Skinner) came up with ABA as we know it, doesn't believe in autism as a condition, but rather as something that we just need to be trained out of, in the same way that we'd housebreak a pet.

The critics point out that ABA ignores causes, and seeks to treat observable symptoms. If you give an autistic kid an electric shock every time they flap their hands, they may not stim afterwards, but does that make them better in any meaningful way, or even leave them unharmed? And, even when it comes to doing away with outward symptoms, ABA does not seem to have a big edge over competing therapies.

While it is very often used on those who are at the moderate to severe range of the autism spectrum, it is not used very often on aspies. Now that AS is starting to be considered a subset of autism, there seem to be those who think that if it's good for one kind of autistic, it will be good for all of them. If you're interested, you should plan on some in-depth research. Just be sure to listen to what both sides say, because it's a messy and complicated subject, and questionable statements are made in the most vehement of ways.

I've been seeing a lot of negative information regarding ABA. It bothers me how into it the therapist seemed. I watched a couple of YouTube videos on it, and I found it quite abrasive. I can see how it could help train kids out of some of the behaviors, but I wasn't really seeing how it helped on more than a surface level. Being on the spectrum myself, it seemed like just more stress mentally - but then that's only me personal opinion and I didn't know. I'm very new to all of this, so I really value the input from parents who have been where I am and done the research and had their own experiences. It's one thing to hear something from a professional who has studied something, and something else entirely to gain insight from actual parents who have been down this road and seen what works and what doesn't.

I'm learning quickly that this isn't an easy road.

I didn't have ABA forced onto me, and I've turned out, just fine.

ABA is stick and carrot behavior modification. Period. I'm not saying it is necessarily a bad thing. However when my husband and I were first looking into options for our daughter (six years ago) this therapy still used physical punishment such as slapping, spanking, general hitting and other methods up to and including cattle prods. It seems that things have changed in at least so far as the extremes used for consequences for negatively desired behavior. At that time you had to pay for an expert or two (or three) to enter your house, evaluate your child, begin the ABA process and then teach you how to apply it. There was alot of focus on discouraging "undesirable behavior" such as stimming behaviors or lack of eye contact. The research is based on Skinner, and Lovaas (the latter using the therapy on homosexuals; subjects who later in life did reportedly have a significant suicide rate, although I am having a difficult time verifying the percentage.) It was extraordinarily expensive and when you read the books put out by the people that offered it and spoke to them you got a series of gushing anecdotes without alot of data to back it. Also I (and this is just my opinion mind you) had a vague sense of "If you aren't doing this you aren't doing enough for your child. Don't you want to cure them?" Which only reinforced my sense that this was an opportunistic money motivated "therapy", and suspect. There is certainly a sort of "cult following" of this form of therapy, it can indeed induce "mechanized" or "robotic" responses and behavior, and if taken to it's extreme is abusive (the latter is my opinion).
Having said that there are certainly good points within the method.

"Chaining"- Breaking down into small steps basically. You take a task you want them to learn and break it down into little pieces that you teach one at a time. If you want them to brush their teeth you may have to begin by teaching them how to unscrew the toothpaste first for example. My daughter is learning to ride a bike. She was having a hard time learning how to swing her balance and the bike from one foot to the other with the other foot on the peddle. So we learned that first. It seems a simple enough concept, but it can be hard to separate the whole (ride the bike) from the steps and sequences (get your balance on the ground first.)

"prompting"-verbal, hand over hand, modeling the behavior.

"Fading" your prompts so that they are eventually doing the task or behavior on their own.

"generalization"- You take the skills or behavior they have learned in the structured environment and teach them how to apply them in a more generalized or socially applicable setting.

This is good stuff, and in a very real way common sense (to a point), and you probably are already doing alot of these things. I think you are right to be concerned that your sons therapist is pushing this so hard. It can be horrific, and there is a certain "this is the answer" mentality involved with ABA. I don't know if I would count her out yet though. I would talk to her and see how far she wants to take this. Use your own judgement and (please understand that I am not trying to be patronizing here) go into this knowing that you know your son the best and you are the one who knows what he needs. Get the info from the professionals and make your own judgements. There are alot of approaches and countless combinations of them. There are some professionals who will try to intimidate you into thinking they know what is best. They will preach what their training and (sometimes) what the current or most popular research says is the best course. I would be leery of those who talk of "cures", or tout a primary therapy. And in my personal opinion, I would think very critically about a therapist who seems to be pushing any one method very hard, especially ABA. I'm not sure what kind of therapist your son is seeing now; psychologist ?, psychiatrist?, OT?, (you prob. said and I missed it.) Seeking another opinion might not be a bad idea. Have you considered a pediatric neurologist? They may be able to define things a bit more for you and your son and give you some leads on more options for therapies and therapists. Rapport with the professionals you and your son are working with is important, use your instincts; if your gut is uneasy about someone or something trust it. I'm sorry this is so long, and I'm sorry if I'm repeating what you already know, but there is alot of info out there and it is easy to get overwhelmed. Good luck.

Here's our experience:

Our son was five when we received ABA therapy through the state in California. There was NO slapping, hitting, any kind of physical punishment AT ALL. I think that is something that used to be done YEARS ago -- if it is still be done in corners of the world, it should be stopped. "Motivators" were used, i.e. candy, toys, hugs, praise, whatever would motivate the child. We had a rough time trying to figure this out, since our son wasn't motivated much by food. I think he liked praise better than anything.

What skills they worked on:

1. learning how to give and take in play situations
2. paying attention to others
3. learning how to STOP when asked
4. joining in play situations appropriately
5. Basically enjoying the company of others
6. Playing an activity that is not of his choosing

I'm sure they worked on other things (this was six years ago). The therapists were GREAT, very kind young women, who entered our home and became part of the family. They would come for three hours a day, five days a week. This was back when our son was in kindergarten, so he would attend morning kindergarten, come home, have lunch, and then have ABA for three hours.

We only did this for maybe eight months. We decided that this would be too much combined with first grade, so we stopped ABA therapy.

My opinion is that, in our situation, it was very low key, and a lot of what is done is just common sense. Much of what is done could be easily done by parents, and probably IS being done by parents, they just don't label it as ABA. I do think it is effective for people other than parents to come into the home and work with the child. What I felt that it did for our son was that it helped pull him out of himself and into the world of other people. He would say as much now -- he has just recently talked about "when he didn't like people" and "when he didn't like doing stuff that other people liked to do" and how he now has friends and enjoys activities with other.

ABA isn't magic, and the way it was done with our son, it was just more common sense. I feel it is good to do at a young age, and can help with some children.

Kris

I didn't use ABA, but I can say that it doesn't sound good. Stick and Carrot style behavioral modification doesn't seem like it would work, at least it would have made me misirable. I think that the best method is to try to understand the student and guide him or her into doing the right thing for the right reason. Find out what the kid best responds to and use that to try and get them to open up and function. Just trying to force them to do the right thing wouldn't work.

I agree, siuan, that these are things all kids deal with. In my son's case, he was more ADAMANT about these things, only wanting to play what he wanted to play, wouldn't listen to others when asked to stop doing an activity, etc. He wasn't super bad, just bad enough at these skills so that other's didn't want to play with him so much.

I also totally agree that with some books, you could implement your own program. I don't think ABA is a big enough deal to pay for 50,000 a year services from multiple therapists. At least it wasn't in our case. If our son had been lower on the spectrum, I suppose I would have paid for any services that would have improved his life. ABA is, in essence, just common sense parenting skills, taken to the MAX. I am sure that a person could implement this type of program themselves.

Kris

In terms of 'goals outside the park' I'm absolutely right with you. For too long people have been told 'there is no solution to Asperger', just like centuries ago they were told the world was flat.
I believe I have found my way out of Asperger - following Baron-Cohen's 2006 breakthrough that Asperger is hyper-systemising, I have just turned my systemising off - http://unlearningasperger.blogspot.com/ - it's wonderful, and I hope other people can find this or other ways out.
very best wishes
JC

Kris: I know what you mean. My son gets focused on something, like playing with the DVD player, and of course we tell him to stop. He can't stop, however, until he has finished what he was in the middle of (like closing the DVD tray) then removing himself from the cabinet carefully and closing the door to the cabinet when done. We see that he's moving in the right direction and we let him finish at his pace...but I tell you it's frustrating. Most kids would just get out. He has to do it methodically.

JC: thank you, I'll check it out.