ABA therapy? ASD toddler with poor receptive language

[2boysandadog9]

Hi everyone, I have posted here before and have read through lots of posts and found some great advice!

My son just turned 2 and is beginning the assessment process for ASD.
He doesn't respond to his name or point (he has started pointing a little bit!), his eye contact is sometimes good but only on his terms. He is very active and hit all his physical milestones on time or early.
He doesn't have any obvious sensory problems or repetitive behaviours (yet!)
My biggest concern is his lack or understanding - receptive language as well as expressive language. He has improved over he past few months and understands a few basic things such as stand-up, sit-down, upstairs. But he doesn't understand instructions such as get your shoes.

I am looking into the possibility of starting an ABA program part time for him. Does anyone have experience or advice about setting this up?

I'm worried that because of his lack of understanding language it will not be worthwhile?

I am based in west London, any advice about finding tutors would be appreciated as well!

We are doing a lot of floortime and repeating simple words with him, I have the hanen more than words book and try to encorporate it into our days.

Does anyone have a child with severe receptive delays at 2? Did they improve?

Sorry for the long post! My little man is sweet and cuddly, I adore him and just want to help him. I'm not sure ABA is right for him at the moment, but I have read a lot of positive stories and I am willing to try things out and see what if anything he responds to.

[sickofsocalledexperts]

Yes ABA helped my boy a lot. He talks in little sentences now, not fluent but given he is at the v severe end of the spectrum it is great. Try this website and ask for tutors on the ABA-UK yahoo group

//Www.abaa4all.com

[2boysandadog9]

Thank you sickofsocalledexperts!

I have actually read some old threads that you were part of and have learned loads from them. It great to hear your boy is talking in sentences, did he have receptive issues when he was younger?

I have joined the ABA-UK yahoo group and checked out the website you recommended, both of which I hadn't come across in my crazed internet searches!

Thank you so much!

[MaterofDragons]

Both my twins had very severe receptive language delays. They really had no clue what was going on around them and as a result were v frustrated and unhappy.

We've started a home ABA programme for them and they have both made progress - so much more than we expected. Still a way to go BUT nothing else was close to working. Good luck!

[Tortoisecharlie]

Yes my child has severe delay in receptive and speech too. I have used a kind of combination of ABA, floor time and Hanen more than words for the last year and it has helped MASSIVELY.

I also read the Verbal Behaviour Approach book. They kind of all are doing similar things, so I wouldn't be too purist even with ABA. It doesn't necessarily have to be sitting down at a table at all, it doesn't have to be long drills. In fact it should build up very gradually, be fun, and have no or very minimal upset. It's getting down to your child's level and reining in your own language so that it is really, really, really clear and simple for the child.

I found the start quite hard, I didn't know how to pitch it, my child was very resistant. So do choose your therapist very carefully. Or just start yourself at just below your child's level.

I'd say if you can get them to understand sit down, stand up etc then you are already on the right track completely. Get your shoes comes a little later, but it will come. I myself did loads, and loads of 'fun' stand up, sit down, then 'wiggle' or whatever my child found particularly hilarious for at least a couple of months, if not more before introducing 'get your shoes'.

I started with 'Give me' with my hand outstretched. If my child didn't give me the object I just placed his hand on it and modelled the action and then hugely made a fuss of him. If he didn't like it I did it only when he was in a good mood, and only once, and very quickly and then gave him something great afterwards like a tickle, which he loves.

Only after a couple more months did I move on.

When I did, I placed the shoes next to me and then paired 'Give me' with 'Shoes'. And did the same thing. Gradually I placed the shoes further away.

A year later, from my child not understanding one single instruction, no verbs at all, only some nouns, he under stands several two step instructions and is beginning to piece words together and really, is just taking off. I'd say if anything slow down and don't push too hard. Keep over and over and only move on to more complicated instructions when you are really sure they understand it in several different contexts. Sounds like your child is learning anyway!

[Tortoisecharlie]

P.s. Your child is just 2? Then they are doing well. If they are progressing with your input then understanding is emerging. My son understood less than yours at age 3, yet I am very positive that he will get almost full understanding in time.

[2boysandadog9]

Thanks materofdragons, great to hear that you are seeing good progress.
I definitely feel like the SALT sessions DS had were not making any difference so hopefully ABA will be better! Can I ask how long you have been doing ABA with your twins?

Tortoisecharlie - what great progress over a year!
Thank you so much for the tips, I have been modelling 'give me' with his cup and other items and he now sometimes does (although often he just chucks what I am asking for on the floor!)
I have heard about VB and will look more into their techniques and the book. I am hoping to do 10-15 hours ABA with a tutor (2/3 hours in the morning) but in a naturalistic way. It that too much for a 24 month old?? Can I ask how old your child was when you started

As you said you did, I think a combination of floortime and hanen along with ABA/VB will work well for my DS. I am guessing he will be resistant at first as he is very self-directed - unless I am roughhousing tickleing or chasing him which he loves the most, and keeps me busy!!
In terms of tutors, I imagine I should be looking for someone DS bonds with and is energetic and keen??

Thank you!!!
I honestly appreciate everyone's feedback. It's great to be able to talk to people who 'get it' iykwim!!

[2boysandadog9]

Sorry Tortoisecharlie, I didn't see your second post until after I wrote mine!

My son turned 2 last week. 3 months ago I realised he understood practically nothing unless I was gesturing. So for example at bath time I would say upstairs for bath - but was guiding him towards the stairs and thought he knew what I was saying. I tried without the gestures and he looked at me blankly.... the same with stand up and sit down, in the buggy etc
He now understands when I say these things without gesturing so that's progress!
I know I am a naturally impatient person and realise that this is something that will take time and patience. Sometimes I think he will never fully understand, but from what I have read a lot of kids really progress in this area by 4-5... seems like a long way off but I am determined to stay positive and work at his pace.
Thanks for the amazing advice x

[WellTidy]

At 2, my DS didn't have any sensory issues or repetitive behaviours. He wasn't super keen on strangers, but he was pretty much in track developmentally save for his language, which simply didn't come. He didn't point either, he would take me to things he wanted. And I basically anticipated all of his needs. He was very happy and placid.

At 2.4 we started an intensive course of private speech and language therapy, which had no impact. I did a lot of play therapy and music type therapy. It had no impact. In the meantime, DS basically stayed stagnant in his development.

At 3.3, we started ABA. It was amazing from the outset. It showed us that DS was capable of learning and he formed wonderful relationships with his tutors.

He was diagnosed at 3.6 as having ASD and scored significantly across the triad. He is now 4.4 and we are still doing ABA. DS is now talking, albeit a lot of echolalia, but there is some expressive and functional language too. He sings songs. He does puzzles. He sorts and matches. His receptive language understanding is hugely proved. He makes excellent eye contact and plays interactively. ABA has been amazing for us and i couldn't be happier. I do not regret it at all, and I am so glad we started early.

DS still has a lot of difficulties, but now we have strategies in place to deal with things as they arise, and we are supported in that hour consultant and tutors. I feel that we are doing everything we can.

Please PM me if you think I can help. It took us about six months to decide to do ABA and then recruit tutors etc. I had reservations about the commitment it would require and how the number of ABA hours would limit us as a family. But it's been the best thing ever for my DS, and I know for sure that he would not be where he is now without it. Don't get me wrong, he is still about 12-18 months delayed developmentally on average. And there are things that he really struggles with as he has not control issues.

[WellTidy]

That last sentence should read 'he has huge control issues'.

[2boysandadog9]

Thanks for your post WellTidy.

It sounds like your son has made amazing progress! I know my son will probably have new challenges and behaviours as he grows but after my initial panic I am now feeling ok about the future, whatever it may hold I know we will be fine .

Although he hasn't been diagnosed yet I'm certain he will be, at first I wasn't sure but over the past 4 months it is becoming clearer and clearer that he is different from his peers. I don't think he is on the severe end of the spectrum, but I don't think he is mild either - mostly because of his communication problems.

I have definitely anticipated his needs and I'm trying to slowly encourage him to point at things to request them which is working (sometimes!) I have read so much and think just speech therapy is maybe not targeted enough for ASD kids. It seems that people who say ABA is not great tend to not have actually done it. Everyone who has done it say how great it has been!
I have the same worries about how full on it will be and how it will impact my family, especially my 6yr old DS (who is NT). But I think that if I see good progress it will be worth the upheaval and financial strain for a few years!!

I will definitely PM you over the weekend, thank you so much.

[WellTidy]

I have an older NT DS too, so we are in a similar position. DS2's language has only come over the last two months. Until then, he only had the b and d consonant sounds and a few vowels.

We used PECS from about two months into ABA and he got it pretty much straightaway. I took photos of anything and everything and he just ran with it. It was a godsend.

I think many of the people who aren't positive about ABA have children who function at the higher end of the spectrum, for want of better phrasing. For some children, there may be other techniques that would also work. For my DS, I know that nothing else was having an impact, so I am very much in favour of it.

[Tortoisecharlie]

Welltidy your child sounds very similar to mine! Very similar age too. I also tried occupational therapy and speech therapy but he just wouldn't engage with anyone. He didn't pay attention at all and would scream anyway if anyone tried to talk to him from age 2 until 3.5

So pleased that your child has made progress! That is great to hear.

2boys you are so great to have recognized your child's difficulties so early, a full year before I got started with mine. The only thing I would add to some great other suggestions from posters, is that my child was very sensitive and very resistant. So when I began a more 'ABA' type approach, I didn't do anything like 10 or more hours at first. In fact I started with only a few minutes, on his level, on the ground, getting him used to just paying attention and 'letting go some of his control' to me by letting me direct a little - playing only very fun short playful games at first.

So just saying that everyone is different, and my child responded to a very, very gradual approach.

Also just to echo 'Welltidy' - my son presented with mostly severe language delay, and like you I was super keen on getting his language up and running. Within a year I now have adjusted a lot so that I am more realistic about his pace. I don't push him, more a lot of 'nudges'. And his repetitive behaviour and need for control and now emerging as the main sticking points in daily life, rather than his language, which is coming along fine.

[Mumoftwinsandanother]

also did ABA with my DS aged 3. He's now 4 it has worked amazingly well. Went from limited language to age appropriate skills in about 9 months. He still has huge issues with communication (talks loads but about what he wants to talk about only and only to whom he wishes e.g. not school teachers or peers much). It does impact your life (financially and socially) but I take a lot of control of the programme and tailor it to fit all of us. Like a PP I had to start small (30hrs a week would not have been acceptable initially although think DS would happily accept that now as loves it and doesn't much like being left alone without a "tutor" anymore as not as much fun). Good luck and 2yrs is excellently early to have discovered problems and gives you loads of opportunity to find the right therapies etc to promote life chances/happiness.

[2boysandadog9]

Thanks guys, I really appreciate everything you have all said!
I do feel lucky to have noticed his problems so early, although that does make me worry that as he is presenting early he may be more severely affected... but I guess the earlier you can teach him skills the better!!

I am naturally impatient and know I need to slow down and let him develop at his own pace. I can see how he has improved his understanding over the past few months and I need to just encourage him continue.
Lots of fun activities that have learning without being pushy, hopefully I can find a tutor that bonds well with him.

I feel much more positive now. I know every child is different, but hopefully ABA will teach me how to help his communication and development. He is still so little and it's hard not knowing what will happen in the next few years... but I am staying positive and fingers crossed he will come on leaps and bounds!

[MaterofDragons]

We have been doing ABA for approx 8/9 months but with gaps as unfortunately we've had some bad luck with tutors (going off sick, car accidents, poor performance!)

In fact I would say finding good tutors is like finding treasure buried in your back garden. We will still continue with ABA despite any difficulties as it works so well for the dc

[sickofsocalledexperts]

Yes my boy understood very little at that age and now understands a great deal - you still have to keep the language simple but it is not a huge issue

[WellTidy]

Yes, I agree that there is a shortage of tutors, and then a shortage of good tutors. one of our tutors was unreliable (sickness, accepting conflicting timing jobs etc) but the others have been superb. That is despite not all of them having any ABA background, we gave training and then they trained in the job and in catch up teams workshops.

[Gabri1974]

Hello,
We have done pivotal response training. Its a type of ABA but more child-led and focused on motivation. It has been created by lynn and robert koegel in california. You dont need any tutors you have a consultant who assess the child and trains the parent. Its very tough ( and tiring) but it can work and its much more financially affordable that traditional ABA. There is no magic bullet thiugh. You have to find what works best for your child. All these methods Aba, floortime, son rise etc are all based on the child engagement. You know your child best, you know what interests him. Stsrt from that and when you have his attention, start to teach him. Emotion and word are closely related and i believe the best teacher for our special needs children are indeed us, the parents.
I noticed you are based in west london, so do i! Let me know if you want to meet for a chat or for a coffee.

[Rainbow14]

My DD had severe language delay at 3.5 years, we did Aba (VB style so lots of play based work) for ,18 months and she tests just right for her age.

Best thing and best money I have ever spent, choose a good consultant as I've come across lazy and inadequate ones, this goes for tutors as well.

My dd used to love her tutors, they gave her 1:1 attention and brought toys at every visit.

Go for it!

[mscongeniality]

2boysandadog9 - I came across your post while searching here as I am in a similar position. My son is just 20 months and his receptive language is lagging far behind. He hasn't been diagnosed with anything yet as it is too early to say but the Paed has recommended early intervention Speech Therapy.

Can I ask how you're getting on? I have read about ABA a lot in the past few days and wondering is it too early to start that now? How do I go about finding a good tutor?

Thanks

[2boysandadog9]

Hi mscongeniality, so we are a month into ABA. We have been doing between 6-15 hours a week (mostly around 12)
I haven't had a workshop with the consultant yet and so the tutors are just playing and bonding with ds, but I can already see some changes.
He is much more focused when playing and doesn't just run from thing to thing anymore. He is much more able than I realised, doing puzzles, matching colours and images.
In terms of language, his receptive has improved a little, although that may just be down to time. I feel like once he realises the power of language and starts listening more he will progress faster. I used to think he may never talk but I am now fairly sure he will. We have had a few odd words like crocodile and play-doh, so not the simplest ones. The potential is there, and I am hopeful ABA will help in bringing it out.

I don't think it is too early at 20 months, I have found that my tutors are surprised by some of his abilities and have worked with other children that began at an older age, whose behaviour issues were more entrenched.
When I say behaviour, I am not wanting to get rid of any stims or characteristics of who he is, but to help redirect him in a way that allows him to learn without being so easily distracted. Increase his attention span and help him communicate better.

I would recommend child autism uk as a starting point and I found tutors on vbcommunity.co.uk
If you have any more questions you can PM me
Xx

[2boysandadog9]

Rainbow, could you recommend a good consultant? I haven't actually had the workshop with mine yet, I'm not sure what I should be looking for in a good one!!

My tutors are great, and also more VB based, high energy and fun. I feel lucky to have found them!!

[2boysandadog9]

Gabri, it would be lovely to meet with someone in the area! I am in Ravenscourt Park/Shepherd's Bush area?

[user1497782510]

Hi my DS is 27 month and has no receptive language (except No which he seems to understand). We have just started ABA and I am hoping it works for him. I was wondering how your DS's were progressing with their language? Thanks