ABA Therapy??
breezy0629
member
I am in a part of the country where ABA is a total out of pocket expense. We found a fairly good group of professionals to help DS & I never pursued it. I keep getting this gut feeling that I should have looked into it more in the beginning, but I was still in denial and telling myself 'oh, he might lose his label in a year or two' [what was that about?! silly me]
Just curious from a parental/therapist point of view what about it is SO helpful? Are there a certain set of issues it addresses or would most any child of the spectrum benefit? I have a hard time thinking of putting my child in a program that is 25-40 hours a week - but then again - I think it's high time I at least find out some good resources and figure out what all the hype is about.
Re: ABA Therapy??
we've only had a diagnosis for a few months and been using ABA therapy (among other things) for even less time, but here's my limited perspective:
1) ABA is a proven therapy, shown to have marked success on ASD kids. That was a big deal for me.
2) DD's progress is tracked very closely with ABA, so you can see exactly what areas DC is improving on and where they're struggling. In my mind, this allows the therapist to be very targeted and focused with regard to the programs she's running with DD.
3) Like you, I too was terrified of the 25-40 hour/week recommendation, but I've quickly learned that while that's the recommendation, that doesn't have to be what you do. We've settled into about 10.5 hours of ABA per week, along with a few more hours of EI services, and that seems to be working well for Sylvie. If I see after a couple of months that she's handling the workload well and think she could benefit from add'l hours, then I'll add a session or two more. But for now, her team of therapists and I are very comfortable with her schedule. At the urging of my EI staff and even some of the ABA agencies I spoke with, I quickly got that 25-40 hour/week number out of my head, and just initially bit off what I thought we could chew, which was about 7-8 hours per week. The reality is, 25-40 hours just isn't feasible for many families- in our case, I just felt it would have a negative impact on my whole family's quality of life, so we opted for a schedule that was more meanageable for us. Keep in mind, many ABA agencies will obviously push you to pursue more hours, and the fact of the matter is, from a treatment standpoint, more hours is usually better. But my thinking regarding that is, what good is an add'l session (or 3!) going to do if Sylvie is so tired and cranky that she can't even participate, you know?
(I should also add, I was very willing to explore and consider ABA therapies b/c it's fully covered here in MA for ASD kids, and there are LOTS of providers in our area to choose from- so I didn't feel like it was a huge financial leap of faith in addition to everything else... I can imagine how nervewracking it must be to be considering a therapy option you know little about AND that costs you a lot of $$$ out of pocket.)
good luck, and please feel free to page me with any questions you might have... it was just a few weeks ago I was in your exact shoes!
It's so funny how one minute I'll be on here 'giving' my 2 cents and then the next asking for 2 cents. LOL This is such a great support to me
We will be moving to PA in the near future (we finally have an ETA of March) and the resources there are far better. I also already have contacts.
I won't STOP my research, but I think i'll let the school system work for a while and see how it goes.
I am a ABA behavioral therapist that does a great deal of work with behaviors as well as academics. I have seen alot of children on the spectrum that have made a significant amount of progress once they have started receiving ABA therapy. Each child is different and there are some children who do not do well with ABA therapy. I also am a strong believer that ABA does work with the right children but I also believe it has to do with the therapist and how they work with the individual child.
ABA has to to do with repeating trials over and over again and using different levels of prompting to teach the child different skills or information and the levels change as the child gains or looses the information. I am a big believer in at least giving it a shot if you can do it for financial reasons I see that you do not live where it is covered. I am not sure on how old your DC is but if you child has hit the school age of getting a IEP and everything than you might be able to fight the school district to help with the cost or the whole thing. As far as the 25 to 40 hours of it, I would work slowly up to that many hours to see how your child does with it and also so you dont over load them. When I did EI services before I got into the school district we started the child off with 2 or 3 2 hour sessions a week and gradually went up from there.
I am not sure if I have helped you at all I hope I have and if you want to talk anymore or have anymore question feel free to contact me at katie7897 at hotmail dot come
take care
katie
I teach special education, specifically kids with autism. I am also trained in ABA.
The beauty of ABA is that it can address just about any issue your child is having. Behavioral, academic, social, pretty much anything. It is comprised of trials and filled with loads and loads of positive reinforcement. I have personally witnessed it ?do wonders for a variety of kids with a variety of issues.?
It's expensive but with the right therapists it can make a huge difference. Best of luck. ?
Sorry I am late to the conversation here! Been busy week at work. We do ABA with ds and have been for almost 3 months now. Ditto to what a lot of the other posters have said . . .only evidence based intervention for ASD children, and his goals are measurable and you can see results and places where there is a need for improvement. The 40 hrs thing really overwhelmed us at first too. Right now, I supplement some of his hours on the weekends, so with that and his three therapists that he has, he gets about 12-14 hours a week. Financially that is all we can handle right now until we get a handle on our insurance issues. We live in a state that does have excellent laws for ASD children and insurance (Indiana), at last resort, we may do a private insurance policy for him, which will cover all of his therapies, which would be about $190 per month, which beats the $2500 out of pocket we are paying right now. And if this private policy or insurance goes through, we may address upping his hours at that time too. Then it will be a matter of finding someone, as therapists are few and far between here. . .already starting to look again now.
It is working for ds. He has mastered over half of his IEP goals set by the school already, and wasn't even expected to meet them until April 2010 when he turns 4 years old. His behavior has improved tremendously. He follows one and two step directions now. He responds to his name and comes. He will stop when we tell him to stop. Doing the therapy myself some has helped learn more effective ways to teach and interact with ds, plus it also helps with his natural environment learning.
I hope that helps some. Good luck!
I just want to add a few things.
I am not completely certain about the claim, "ABA is the only evidence based therapy for kids with autism." Stanley Greenspan has taken data and shown progress. ST, OT and PTs all over the nation can show they make progress with children on the spectrum. I think that claim is over used. My opinion.
By nature, ABA is all about collecting data and developing skills that can be measured, through reinforcing desired behaviors and extinguishing undesired behaviors. Thus, ABA has a lot of data and "proof" that ABA is effective. And I believe that the "40 hour week" recommendation is in place because most of the evidence is based off of that amount of intervention. Let's be completely honest. Any child receiving 40 hours of direct teaching at a developmentally appropriate level, by some kind of professional who has some knowledge of development and behavior modification, WILL make progress. So to me, the claim that 40 hours a week of ABA will help your child isn't really that impressive.
I used to be an ABA therapist, I recommend ABA often, and I also see big down falls when ABA is used alone as the sole intervention technique for many ASD children.
Many children with autism are blessed and cursed with amazing memories. Thus, they can often make some serious "progress" with ABA. They meet goals left and right and move on to more programs and gain more skills. But lets say the goal is identifying objects by their function. They have learned that when someone asks, "what flies?" they answer "a bird." Pretty awesome....until you realized it is a trained response. The child hasn't learned that a bird can fly because it has wings...thus immediately able to generalize that bees, butterflies, planes, etc. can all fly as well. NOR would the child then have the creative problem solving to say "a book with wings" or something else silly (and developmentally appropriate) in response to the question, "what can fly?" So in this example, does it matter that the child can answer the question if he is only doing so because he was taught that specific example? I suppose I could argue either side.
My last devil's advocate point is that ABA therapists are trained in behavior modification (most graduate programs I THINK AND HOPE have some specific courses on typical human development as well as issues related specifically to autism. But lets remember that the title ABA therapist doesn't require any type of degree/formal education. A Board Certified Behavior Analyst (BCBA) has a masters degree in behavior analysis and has completed a certain number of supervised one on one hours by a BCBA. If not a BCBA, they could be an out of field college student with 10 hours of training, for example). Anyway, If you break human development into it's many parts, including fine motor, gross motor, oral motor, language, cognition, social-emotional, and i assume I am forgetting some, you quickly realize that an ABA therapist is not possibly specialized in all of these areas. And remember, by definition, an ABA therapist is working on changing "behavior" - rather it is asking who questions, saying ssss, jumping, using the toilet, writing letters, sustaining eye contact, what have you. But we all know that there is a lot more to a human than what we can observe - feelings, emotions, intentions, relationships, thoughts, impulses, etc. These IMPORTANT components that make us human are often over looked by behaviorists....and I don't really think we can afford to over looks these parts of people.
A final example - I can't imagine anyone is really still reading this novel - but in case... Joe goes to therapy and is unable to climb stairs. (I am not a PT so I am making this example up - any PTs, excuse my errors) A physical therapist will identify it is a result of poor hip flexion, weak quad muscles, and poor balance. Therefore, the PT will address these three issues via exercises, other activities, etc. Then Joe is not only able to climb stairs, but he can do a host of other more challenging activities because the PT has remediated the underlying problems. Maybe it took a little longer, but now subsequent "milestones" do not have to be addressed individually. And, future development can happen naturally as a result of a solid foundation. An ABA therapist isn't specialized in the anatomy and physiology of stair climbing and other motor developments. So, they work on stair climbing. Initially they may reinforce lifting the foot a tiny bit, then when it is a little higher, then they reinforce one step being taken, and continue in this manner until the actual behavior - climbing stairs - has been mastered. But is the underlying problem taken care of? quite possibly not.
Bottom line - which is probably all you wanted, OP - ABA can be an effective tool to help teach certain skills. However, as with all therapies, make certain you are aware of it's shortcomings and can anticipate where issues may arise. Also in the case of an oral motor, language, executive functions, fine motor, gross motor, balance, coordination, strength issues, I highly recommend finding the specialist (SLP, OT, PT) who has the most specific training in that particular area.
Lastly (i don't think it is the 1st time I have said this- oops), the actual person working with your child is perhaps the most important. If you aren't feeling "it" with a particular ABA therapist or SLP, don't dismiss the entire field. Find a person who works well with you, your child, and your family. We are out there.
I am truly sorry this is so ridiculously long. I wasn't going to respond, but couldn't hold back any longer. I am very passionate about this topic. Excuse typos, I am not proofreading!
**susanmosley** - THANKS for that. I did read it all [it's ok, Im a long response person too
]
That was actually exactly what I needed to hear. A good explaination of not only HOW it is done but some background as well.
What you were saying about memorizing things such as 'a bird flies' and not having the ability to generalize is one reason I remained ok with the therapies we were involved in (OT, DT, SLP, TEACCH) during EI. That is certainly a good picture of the way my son learns. It also explains why when I sit in on testing and he's answering questions (that have been taught to him in rote) I'm sitting there going, yep - taught him that, taught him that, etc.. And I know he doesn't have the general knowledge on that subject, but THEY don't. He also is very easily stuck into doing things only one way... so variety is KEY for him. We even go in and out as many different doors as possible going to/from school these days. For some reason, He thinks he needs to go IN one door and go OUT another. So, it's time for change.
Thanks for ALL the responses!! I think once we are in PA we may seek out an ABA therapist to see how that would work with his needs and his team of services, but for now I'm not going to get into all that with only a few months left before our move.
You got some great responses, that's great! I totally agree that you must not rely totally on ABA. There needs to be specialist as well working with your child. My ds has a private ST and OT as well. Our ST happens to be a former ABA therapist (got lucky with that!), so she compliments our team very well!
Ds does have an aide too in his classroom, that does a mixture of assisting him in the classroom and one-on-one ABA. We felt that we needed someone familiar with his program that could help him transfer his skills and also work on his social skills.
So, you have to look at your specific needs for your child and go from there.
*jrosie*
might as well email. I dont mind hearing different points of view.
scottandbriana at hotmail dot com