ABA Therapy. Does it work?

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Why couldn't one just say 'could I have that.'...'could I have one of those.' see there is some flexibility depending on the context of the situation.....if its obvious you'd be asking for the apple its not 'wrong' not to use the word apple. However if its very un-obvious it's the apple you'd be referring to then its probably better to refer to it as an apple or at least point at it.

I am not sure what better ways the poster your responding to would have in mind.......and I am not sure exactly what therapy would help people with autism communicate better as I am not an expert but. "that's not EXACTLY right, no reward for you...only more endless work." is probably not the best way to go about it and that is the impression I have of ABA therapy. Its designed to make someone communicate and behave exactly the way the therapist or parents want rather then what might be the best way for that individual child.

And as I mentioned before there can be more than one correct way to ask for something, so that just proves my point there is no reason someone should be forced into un-natural behavior.

CARD didn't specify that the 40 hours was in addition to school. I assumed that this WAS school, or somehow in lieu of school. I should hope it's not in addition.

Isn't ABA essentially what NTs kids get from their parents all the time?
"No running through the house. Walk."
"Stop playing under the table. Get your bottom in the seat and sit still."
"Quit playing with your food and eat."
"Stop being so loud; we're in a restaurant."
"Turn that TV off, and do your homework."
Behavioral observation followed by corrective action, possibly with a threat of punishment or a reward for good behavior? Seems like it's 24/7 for most kids and parents, not just kids on the autistic spectrum.



Any mis-use of any therapy by anyone is always bad. I just don't think ABA deserves the blanket negative response that it receives. I see some good coming from it when applied appropriately, however I also don't believe that ABA is the only solution, and I don't encourage someone to use it exclusively. It assumes that the child will learn WHY they are doing something as a result of doing it repetitively. It should ultimately be paired with some cognitive instruction, but that can be said for all kids and adults. Most people don't know why they do half the things they do, because they aren't taught to think about it.

Its deja vu because we've been here before in another thread about a year ago. I believe it was a specific example of toilet training and I pointed out the various reasons why your suggestions would not work.

Yes I have considered:

-The child actually wasn't feeling significant pain
-The child was in shock
-The child just didn't know what they should do
-The child didn't want anyone to come and touch him

The truth is I cannot know as it was a friends son with AS, its my assumption the pain from a broken radius and ulna would over-ride anything else and cause someone to cry out. Well it had been up to that point and I was amazed.
I can tell you though with more certainty, that with my son when he was injured or in distress, he would weep, i.e. tears but silently, this was consistent. Now he cries normally, i.e. audibly I think this is because he himself has learnt that he gets comforting as a result of his audible crying i.e. learnt to communicate - because he really likes the comforting and seeks it out, I know that much. We can't yet ask him.

I am not discrediting your opinion, I was qualifying it by saying I have experience that you appear not to have, and in my opinion that gives me insites and understanding that you don't. OTOH kettle meets pot; you earlier implicitly disqualified the validity of my opinions by saying only Autistic people know whats best for other Autistics.

Well, I agree with what you say there.

From my understanding ABA aims to treat autism as a behavioral problem......rather then a mental condition with symptoms that an individual person with their own wants and needs has to live with. That is the main problem I see.

I think a lot of methods used in ABA sound pretty nightmarish. I don't know how many are still used, although the first time I read Michelle Dawson's writing on the topic it had a big impact on me.

Most of the horror stories I've read don't match up with what Nostromo's saying, however. Admittedly, my research is not as deep as others' has been, but the lack of 40-hour weeks, the focus on finding ways for Nostromo's child to communicate, etc. strike me as quite different from the use of aversives and rigid teaching that characterizes what I recall reading about a few years ago.

One problem is that ABA refers to a wide variety of techniques, but that the acronym itself has a fairly negative and unethical history. I don't think that one needs to have actually parented or cared for an autistic child to point that out (as Michelle Dawson and others did, as linked earlier in this thread). Such as Dawson's reference to research that NTs found it more satisfying to use more aversives on autistic children, or research that focused on the use of aversives for behavioral modification. One element is the focus on the need to eradicate autistic behavior as the problem, even though a lot of autistic behavior is adaptive to the environment, to overload, etc.

I don't know, I'm super ambivalent. The child I referred to previously didn't did not - to my knowledge - have ABA (parents couldn't afford it) but even though he would be described as "lower functioning" I never had a problem with his behavior when I was watching him, but his parents also said he behaved unusually around me, and reacted to me in a way he didn't react to other people (I think of what anbuend wrote about autistic people being able to read some other autistic people's body language).

I found the example about sitting in the corner and not asking for help to be interesting. When I was in early grade school, a student stabbed me in the leg with a pencil and broke off the point in my leg. I didn't tell anyone about it, but it became fairly obvious when I developed an abscess (I could not easily walk, although I tried). My recollection is just that I didn't think of telling anyone, as asking for help was (always has been, really) fairly difficult for me even when I realize it's a possibility. It was pretty necessary for me to get that help, and not knowing how to ask or not realizing I could and should ask for help has been a long-term frustration for me.

Don't be. It's actually quite natural for an autistic person in pain not to cry out. We're not particularly brave or anything, and not all of us have diminished experience of pain.

It's just that crying out in pain is a sort of communication. When a person's mind is overwhelmed by pain, the NT reflex is to try to get someone to pay attention to them. For an autistic person, that's not the first thing you think of. When I'm in pain, my reaction is to get very quiet and still and try to gather my thoughts and deal with it. Or, if I am noisy, it's not directed at anyone--not meant to get attention. In extreme pain, I tend not to vocalize much, but just to squirm slightly, trying to get more comfortable. As a youngster, I would scream at the slightest provocation--mild frustration would have gotten the same reaction as being burned by a hot stove (in fact, it did; my mom didn't realize how badly hurt I was because she was so used to me screaming; only when she looked did she take me to the emergency room--where the doctor rightly told her she had been overreacting, because the burn was no more than a couple of inches across and responded nicely to home treatment--at the time, I was about four).

Asking for help when in pain is actually quite an advanced communication skill. The pain itself is taking up a lot of resources and you simply cannot marshal your most precariously-held skills when you are under that sort of stress. And that's assuming you know you are in pain in the first place.

I think the best approach for teachers and parents of kids who haven't learned this skill is to learn to read how the child reacts to pain and watch them. If you were to see me curled on the floor, very quiet, breathing slowly, holding quite still, you wouldn't think "pain" immediately; but someone who knows me well might. That's how I react to it.

Parents and teachers need to communicate. The parents, who know how their child reacts to pain (and how the child looks when in overload, and how the child looks when frustrated or mentally stuck), need to explain to the teachers and therapists what to look for when their child needs help. Asking for help when in distress is one of the later communication skills that a child will learn, in many cases; teaching it first would probably be difficult to do. More basic skills should be taught first--for example, how to show someone what you are looking at; how to point to something to bring someone's attention to it; how to answer questions; how to make requests.

Almost every autistic child starts out with a basic knowledge of cause-and-effect. If we didn't, we wouldn't know that rocking makes us feel good or that turning a shiny object over in your hands makes it interesting to look at. And, luckily, cause-and-effect is the only thing that's necessary for experimentation, and experimentation is the only thing necessary for learning. In an environment where experimentation is encouraged and failure is not penalized, where exploration is possible and the child feels safe, learning can take place. Communication starts in NT children when a child notices that babbling toward the mother gets results. Autistic children can learn in a similar way: When I do this, you do that. We've seen it, or done it, ourselves--asking questions over and over just to check that the reply will be the same, laughing with delight that we can predict what the other person will say. Or we quote things we've heard, to see how other people reply. That kind of experimentation is what leads to learning communication. Cause-and-effect should be used as a way to explore things, not as a way to curtail "inappropriate" behavior.

Regarding the child with the broken arm, the simplest explanation of a lack of instinctive pain ---> communication response is the most likely. I understand this intuitively, because I never communicated any kind of pain either, and it was definitely because the idea of communication did not occur to me, no matter how much anything hurt. I did not understand that speech and gestures were mind-to-mind communication at all. For most of my childhood before the age of ten, I did not communicate due to a lack of instinct to communicate and a lack of understanding of the concept of communication. I did not identify with what Temple Grandin wrote in her books about wanting to communicate, but not being able to speak the words. I was not struggling to communicate, because I did not know what communication was, and I think that a lot of autistic children do not know eggsacly this, but this can be explicitly taught at an earlier age than ten. It can take a lot of repetition to teach an autistic child, a young one, one of these extremely non-intuitive skills, and maybe that is why these therapies take so many hours a week. The alternative is to wait until the child is older, like around age ten or pre-puberty, until the child gains enough cognitive abilities, as I did, to work out the rules themselves, but this alternative is too dangerous, because it is not guaranteed that the child will be able to do this, figure out what communication means and how to communicate on their own. If there is also intellectual disability, then this is not an alternative at all. Once a certain time point during development has passed, it may not be possible for an autistic child to develop a certain skill, such as speaking. I can understand why parents would want their children to get early intervention, but early intervention does seem quite rigid, as it is done by people who do not intuitively understand autistic children and must rely on rules without context, as many autistic adults do in social interactions.

Well that is why its important the therapy recognizes a child with autism might have to do things a bit differently in order to function comfortably. Rather then trying to brand any expression of 'autistic behavior' as 'bad' or 'wrong' to try and force them to act in a way that does not make sense for them via punishment/reward. Many hours of that is probably not a good idea......I think therapeutic intervention for is fine but it needs to be in the interest of the child.....not just what everyone else wants from the child.

I myself was more one of the types who knew what communication was, but just did not get it like other people...and as a result wanted to socialize/communicate but had difficulties with it. So the feeling of wanting to say something but being unable was present often. But either way it's not a behavioral thing its a mental processing thing.

Regarding the child in pain, here's a very interesting thread that popped up recently: http://www.wrongplanet.net/postt188449.html

I believe that the vast majority of neurotypical people are completely unable to understand why someone could instinctively keep quiet when they're hurt badly. I think that most people would dismiss this fact out of hand, even when told otherwise. Nevertheless, it is very true. So therefore, (functioning) autistic people need to be involved in research and therapies.

ABA is very intensive therapy that may help to meet specific goals. However, the ability for the child to generalize a what is drilled in ABA therapy to other context and environments may be difficult depending on the individuals cognitive level.

Why do we exist? The same reason some people are born with birth defects and spina bifida and cerebral palsy.

Don't glorify differences that make living more difficult.