Has anyone else had to use ABA and what did it entail?

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my nearly 6yo daughter was diagnosed as Aspergers/ADD and we have been told by both her diagnosing doctor and the autism specialist for the schoolboard that she needs Applied Behavior Analysis. I called my insurance provider but they have no one locally. I would have to drive her 45 minutes away. What I'm trying to find out is if this will be an ongoing treatment that I will just have to figure a way to do it on that basis, or if I can find a local therapist (obviously not certified for ABA) but with experience with Aspie children. Also, even though my insurance will work with ANYONE on a single case agreement for this, there just is NO ONE locally. Even the schoolboard guy could give me no answers! I'm attending a speech on Autism given at another elementary school tonight...perhaps another parent will have had this problem and found a way to overcome it. Any feedback would be greatly appreciated.

Disclaimer: NOT A PARENT, am a person the autism spectrum, and a pretty good guy
FAR FROM AN EXPERT

It is clunky. When it doesn't work, they just think they need to do more of it or do it in a more purist fashion. They are ideologues, to some extent. They are true believers, to a considerable extent. These are believed to be universal principles, capable of working with anyone, children, circus animals, etc. It is not at all respectful for the unique person your child is.

My advice, I have a bachelor's degree in psychology, and have seen two university lectures on ABA, is to light-touch it. If it works it some areas, great. Take it as one tool among many. But do not allow them to turn it into a religion. Do not allow them to convince you you're doing something wrong as a parent.

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Looking back on it, as a person with Asperger's, high functioning in some areas, not so much in others. The times that have helped, and what would have helped more, is to build my strong areas, roll with my good points (matter-of-factly shore up deficiencies but don't focus on these). For example, I've always been good at organizing other kids in activities and projects, for example, these cool tag games in high grass when I was in 2nd grade, backyard carnivals when I was in 5th grade, etc. As an adult, I've done political activism and have been a retail manager on three occasions (more if you count informally). So, I want to primarily focus on being a builder and positive leader. I don't want my primary focus to be on getting subpar at "hanging out," which I'm not particularly good at and not particularly interested in any case. I can accept that many people like unstructured "hanging out" where the conversation flows from loose connection to loose connection with good-natured teasing (sometimes blurring to not so good-natured). I can accept this as a social fact of life. I can let it be. I do not need to make it a major life project of mine , at expense of things I really want to do.


NOTE: After living by myself from 1985 to 2008, I have been living with my parents since Oct. 2008. And yes, it has been difficult at times. So, I certainly have my issues.

Last edited by AardvarkGoodSwimmer on 03 Feb 2011, 3:54 pm, edited 1 time in total.

I have found ABA works very well for my kids. (Both AS)

Yes it can be very intensive and expensive, depends on your own individual requirements. I know of some people who employ a therapist for 30 hours a week, it is very expensive, but the outcomes have been amazing for their child.

We however, meet with a therapist once a month and discuss the behaviours that are causing concern. We have, together with the school and therapist, devised behaviour charts and use a token economy system. Achieving desired behaviours are rewarded, positive reinforcement is the key to success. It isn't costing us much and the kids love having a chart and can't wait to show us at the end of the day how they have behaved. I can honestly say the ABA has made a HUGE difference in their behaviour - so much better.

You can do it yourself but you do need support from a certified therapist.

You will get further info including videos at the following link: http://www.simplestepsautism.com/

Good Luck

Be careful with ABA. Stimming and not making eye contact, for instance, aren't behavioural issues and if they are addressing such you should stop.

Yeah there was no-one around here, so we hired two of our friends one a qualified pre-school teacher and got them supervised as such by a proper ABA consultant from another city. She comes up pretty regularly and does training for them also we take videos of them teaching him and send them off for review. It really does work for my little guy (passive NV Autism) it seems. Expensive though just because of the hours involved, about 20 a week.
Interestingly I almost feel as much as the ABA, it's having someone constantly 'in his face' albeit in a nice way that has made him way more social in that it has shown him the value of interaction, and developed his eye contact to amazing levels even though in his case it was not really an objective. It also I feel has taught him that there are some things that you just have to do even though you may not really want to, life is like that.

I think its very important to have a therapist that is interested in the child and observant (the analysis word in the ABA acronym) instead of just mechanically going through the tasks.
We initially taught him ABA ourselves using guidance from a site called rethink autism, it actually worked pretty well, and I feel probably if we could keep it up we would be the most effective teachers he could have, its just so damn hard trying to work and have a life and do that too.

As a non-parent certified 'Ervaringsdeskundige' ('Hands-on Expert') with AS, I'm worried about ABA sometimes.

Specifically, ABA was based originally on the work of the famous Doctor Ivan Pavlov. The dog guy.

And was developed to 'cure' homosexuality, among other things.

Now, modern ABA has developed a bit since those days, but the inherent danger of the philosophy behind it still remains:

ABA treats behaviour, not the causes for behaviour. And this can be confusing for young children.

What this ultimately means is that while ABA is very good at teaching 'correct' behaviour, but not the reason for that behaviour. It doesn't teach a child when it's right to be polite and when your child needs to stand up for themselves even if it might be considered rude. It teaches a child that it's polite to shake hands when meeting a new person, but it doesn't teach them that you shouldn't shake hands with the homeless man who asks you for money on the street. It teaches a child that they shouldn't yell at people, but forgets to teach them that it's ok to yell for help if using one's 'inside voice' would mean they wouldn't be heard.

Ultimately, ABA programmes responses, not thought.

I can't tell you whether or not ABA therapy is a good idea because there is no firm definition for what it involves.

The Food and Drug Administration (FDA) keeps a pretty close watch on the pharmaceutical industry. As such, when you pick up a bottle of aspirin you know what exactly is in that bottle, and you know that it has been verified. By comparison, there is no FDA when it comes to autism therapies. You can go to a hundred different therapists who each claim to use ‘ABA treatment techniques’ and you will get a hundred different therapies. Even treatment centers, which have multiple people on staff, will vary how they treat your child based on which therapist your child works with. Some therapist will just do whatever they want and put a label ABA on it so that parents are more likely to trust that it is a good therapy. As it is, terms like ‘ABA therapy’ have become nothing more than marketing terms like JUMBO or SALE. They really don’t reflect what the actual treatment is like, any more than seeing the word sale guarantees a good price.

It is always possible that your child may get some help, but that depends solely on the person they are dealing with, what they are trying to accomplish, and what methods they use. Just because they put the letters 'ABA' on it doesn't mean anything.

Actually, did you mean Dr. O. Ivar Lovaas?

But yeah, there is some dark history there.


I don't know a lot about ABA, so all I'm going say is, like anything it can be used in good and bad ways, so try to only use it for good. Back just 10-15 years ago the goal of "Lovaas" (which is historically where ABA comes from) was to make a child's behavior "indistinguishable from his/her peers." So, stims were to be "extinguished" because they were "purposeless behavior." And the same for anything else that was strange looking from an NT viewpoint. This was done with "aversives," which were punishment (ammonia capsules under the nose, grabbing the head and shouting "no!" at close range (imagine that while having hyper-acute senses and someone doing that) and so on).

Aversives have (mostly) fallen out of favor, but there is still a danger that ABA can be used to unknowingly extinguish behavior that is important and adaptive. I.e. stims, or if, say, eye contact is a major stressor, or reactions to clothing texture, and so forth. So, I'd say, try to be aware of that kind of thing (which you probably already are trying to do, being on this forum).

I'm glad that I didn't have to go through ABA. I'm glad that I was born into a working class family at a time when a kid could be a kid, whether or not, they were on the spectrum. However, I wish the best for you and your daughter.

ABA is basically good teaching principles, and it involves human/animal nature. All people- NTs, those on the spectrum, geniuses, intellectually disabled, doggies, kitties, etc etc... behave in a way that is reinforcing. Every action has a function- you eat to alleviate hunger, you go to the movies to have fun... but on a developmental level, a lot of things NTs do instinctively, like imitating, paying attention to others, making requests, those on the spectrum may find hard to see the point. ABA pairs a very tangible, desirable reinforcer with these developmental milestones.

Opponents of it often bring up the character of those involved with conditioning (such as those who tried to cure homosexuality during a time when heterosexual, patriarchal, family relationships were considered basically required) or the fact that it is anti-ASD- that it does not allow for stimming, punishes those whose only crime is being neurologically atypical, and puts too much stress on eye contact for no good reason, without realizing how deeply uncomfortable making eye contact can be for those on the spectrum. The first issue is completely irrelevant, the second is no longer the case with most ABA programs, and the last sort of refutes itself by revealing a bit of a deficit- those who deny there is any importance in learning eye contact are, frankly, missing something. (Both my husband and I have serious eye contact issues, and frankly, I've been conditioned naturally through natural ABA principles to address my aversion to eye contact. I have worked in retail/customer service jobs all my life and they require an ability to at least "fake it." I do not want to make light of the fact that eye contact can affect those on the spectrum in a way that NTs cannot understand- I just think it is worthy enough to merit encouragement through ABA techniques. I would never yank a child's chin up and yell at him to look at me.)

I have to say, I take my child to a center run by a bunch of grad students, 30 minutes away, and pay fully out of pocket. There are people who fly in. ABA therapy is usually long term, like a couple years, and often times it is difficult to get insurance to pay fully for the full amount of time necessary. I still say it is worth it. There is enough straightforward evidence that many individuals on the spectrum gain skills and lose problematic behaviors, even if you find Lovaas's own studies (a man who pioneered the technique being used for ASD treatment who found that about 50% of his clients receiving about 40 hours of therapy a week were mainstreamed and indistinguishable among peers) too good to be true. I will also say that it is not the hardest thing to learn/train other people in ABA techniques, and a home program may be something you want to look into, as well.

I see this post is a month old so you may have resolved your issue, but I hope others searching for information on ABA can take away from my input that ABA is not inhumane- it merely uses the natural principle that behavior that creates a desired effect is more likely to be repeated. Kids can "still be kids" so to speak, stims are not dismissed as "without purpose," merely redirected into more efficient ways to achieve those purposes, ABA is not a brand name but a pretty easily and concretely defined principle, making character attacks about proponents or assuming because these same principles can be used on dogs is an emotional reaction, not a logical one, etc etc.

It depends on who is providing therapy. I've had awful people as well as awesome people. Interview the company and ask questions that will give you insight into their philosophies. ABA is effective if it is well balanced and implemented in a fun and creative way.

I'm glad you said that. I was raised the same as you and now that I'm starting to have to make decisions about my daughter I can't help but be uncomfortable with the thought of ABA. I wonder what alternatives are out there and what is available in my area. Yahoo, here I come......

My son was recently diagnosed with ASD and he's 4. As a parent I'm looking at treatment options, and ABA is top of my list.

I have read the passionate discussions on this site re: the good and evil of ABA. I understand the hours (and yes, it is long, like a 40 hour work week). But here's why I'm considering it:

ABA-type of intervention has been proven scientifically through research methods (including randomized controlled trials) to produce positive outcomes for children with autism.

I've grown sick of the "industry" of quackery that preys on parents' desperation when they learned their child has ASD. I was one of those parents, and yes, I went out and bought hundreds of dollars worth of "special foods" based on claims of miraculous results (some even claim "cure").

Parents have talked about their gut not being comfortable with ABA -- mine is uncomfortable with dietary interventions that have not been scientifically proven (and in one research, has been disproven). ABA on the other hand, consistently delivers the outcomes I'm looking for, and that is reduction of maladaptive behaviors.

(As a background: I am a PhD trained biological scientist, and getting into research is a familiar course of action when investigating treatments and especially claims of "cures". I also will look at the way the research is "designed" to see if the results really show what the authors claim to show. "Wait, didn't you just say you spent tons of money on quackery?" yes indeed -- because I was also a parent who was desperate for "anything that works" when I first received the diagnosis about my child and I was intensely fearful.)

Here's where I as a parent can choose: ABA can be based on punishment or reward.

Koegel's work is based on positive reinforcement. I believe that method works infinitely better and is more long lasting in terms of results than using punishment. Even in our society we have examples of "ruling by fear" and why this method may look to "work" but in fact is built on shaky premises. In corporations, managers are trained to use positive reinforcement -- the bad managers are the ones who use punishment and fear as motivators.

As a parent, I intend to choose ABA techniques based on reward and not punishment.

I know parents who have neurotypical children perform ABA-like techniques to get their children to produce certain behaviors, and they too, can choose between using punishment or reward as the motivator. Obviously the level of reward can differ when it comes to working with a child with ASD, but the principles are the same.

Therefore, neurotypical kids can sometimes hit each other and be aggressive when they are angry -- I don't buy into that "let kids be kids" approach whether I had a NT child (as I used to think I did, before realizing over time that I don't) -- or a child with ASD. My philosophy is looking to balance my child's strengths and personality with behaviors that will allow him to integrate and function productively and fully in society. It doesn't mean that he can't have down time and 'stim' if he has a need, it means he can choose the appropriate place and time to do that. In fact, Koegel's book (Overcoming Autism) talks about using stims as a reward in some cases.

It also makes sense to me that it requires "a full adult intensity work week" to carry out ABA treatment in children with ASD; we are essentially guiding their brains to reinforce certain neuronal connections while weakening others. Children are also exceptional at catching inconsistency in behaviors from adults, which means after the therapists have gone the parents have to continue the work.

Last edited by jstriding on 27 Oct 2011, 1:24 pm, edited 1 time in total.

I have used the services of an uncertified ABA therapist with both of my kids. (She is certified to teach special ed, has a B.A. and M.A. in psychology, and experience with working at different autism clinics under the supervision of certified ABA therapists. Apparently, at some of the clinics, they have one certified ABA therapist and several other therapists with M.A.s in psychology or education actually doing a lot of the hands-on work.)

They are also both on Prozac for anxiety and Clonidine at night for sleep and anxiety.

My oldest, with classic autism, has also had extensive speech and occupational therapy.

I'm currently doing pretty heavy speech work with my younger son also, but not as much with my older son.

The anti-anxiety meds helped with both my sons' anxiety and behaviors directly caused by that, including anxiety attacks, selective mutism (the older son) and repetitive OCD behaviors (the younger son).

I also work on reading comprehension and tutor in all academic areas with my older son, using computer programs, picture books, games, and educational videos.

For behavior, at home I use picture books about manners, video modeling, Joy Berry "Help Me Be Good" picture book series, The Social Stories Picture Book by Jed Baker, computer software from Social Skill Builder (I think that is the name; see "friends" on my free youtube Autistic Kids Channel), manners flashcards, do a little ABA myself, etc.

Teaching the correct behavior is not always enough, though, if the child desires to do the incorrect behavior. And I admit to not always following through on the punishments (too tired).

I have a therapist do ABA for a few different reasons: 1) We could not medicate away all behavior issues; putting my older son on several different meds during the day at the same time just resulted in over medication, excessive side effects, and drug interaction issues; 2) I get tired, and having someone else helping is good for me psychologically; 3) She is better at working on highly challenging behaviors and OT exercises; 4) Progress gets made faster if I have help. 4) She and I use different approaches, and the kids get less bored when there is variety. (I think that I'm better at creating creative lessons and lesson materials, and she is better at motivating with whatever materials are available.)

Anyway, good luck!

Last edited by blondeambition on 27 Oct 2011, 4:30 pm, edited 2 times in total.

THIS
I add that I use ABA mainly to teach language to my 4 yo Autie son , and it works.
Once he learned to imitate sounds I found speech therapy very useful also. I mean, it works for very basic teaching. The only behaviour I taught was toilet training, and it works also.
I don't think it can work for stimming

This is a timely thread revival. I was just taking some time yesterday to reflect on the fact I had asked my (non verbal, classic Autism) son to pick up a piece of pear that he had dropped on the ground and put it on the table. And I pointed to where on the table to put it and he followed my distal point. Both of these things seem (to me) to be near miraculous, taught to him through the ABA programme. My son will be 5 next month and we have been doing it since he was about 3 yrs 4 months. He does about 12-15 hours a week.

But it was only in the last few months that I have seen a direct correlation between the money, time and effort spent and practical skills developed. All that time spent doing what we refer to as his 'Homework' appeared to me to bring little or no obvious practical benefits although I knew he was achieving things in the programme.

But I guess he was developing a foundation to build on, learning to be accessible..for learning at first. Participating with the teacher..sitting through sessions..doing what is requested of him. Learning to 'look', learning to have joint attention. Learning to match objects and all the many little tasks they do.