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ABA report - help

(45 Posts)
inappropriatelyemployed Thu 31-Jan-13 20:14:28

I was really annoyed today. I got the ABA report through that I am paying for but it was emailed at the same time it was sent to school, OT and SLT giving me no time to comment or discuss inaccuracies/concerns with the therapist. I don't find this acceptable do you?

The therapist came in fora second visit last week on a day that DS did not want to go into class. He does this every so often. He gets into a panic about everyone looking at him. He wanted to work outside and arrangements are made for this. He always go back into class the next day. I think part of this is that there are no arrangements to support him in class when he is there, e.g. by allowing breaks.

On the day the therapist came in, his TA was not around - we found out half an hour after drop off that she had a hospital appointment. She had told the receptionist last week but not thought to tell DS. I basically TA'd for him for most of the morning and he was fine. Then the ABA guy decided he wanted to see him in class. I knew this would distress him but I didn't want to look like the indulgent mum so I let everyone try and persuade him without success. I intervened and got him as far as the end of the corridor. He got really distressed about working outside the class as he didn't want people to see him. He wanted to work at another table a few feet away. His teacher said no and he got more distressed than I have ever seen him and although he sat at the table he refused to work. The ABA guy was telling him to do as he was told and do as his teacher asked. He said to me 'I see what the teacher/TA mean about non-compliance' which I got a bit annoyed about as this was a pointlessly engineered confrontation.

I withdrew from the situation with DS in tears. I just thought people would blame me for the upset because I was there. I let him down. Big mistake. He ended up massively distressed and doing a half day. He ended up out of class for two days. Why did I not just tell them all to stop and move him myself?

His TA has been whinging about how he'll never go back if he is indulged. I told her to have faith and today he did. Good as gold. The head agreed with me entirely. He said ask the ABA guy to deal with him rather than teacher and TA.

Instead, the report is circulated to one and all before it is even circulated to me.

The report mentions all the behaviour he saw but gives it no context at all. It was as if DS was just sitting there for a regular lesson outside class and that he decided to throw a wobbly.

It talks of not using the term 'anxiety' and how he will need to do a functional analysis to decide if the bahvioour is anxiety - how can you do that?? and why would it make any difference if it was behaviour you needed to change?

Despite not wanting to use labels, he then talks of tantrums and non-compliance and then all the petty problems teacher and TA have with his issues about sitting on chairs in assembly etc. Stuff that was agreed with the EP and SENCO months ago. It's like teacher and TA just used this as an excuse for a good old moan and he just listened to them.

I feel really let down. There's no bloody way I am paying for an intervention to get him to line up or sit on a chair. This is a child who was out of school last year and who didn't speak to anyone. He has come a long way. I wanted the intervention to skill him with social skills and help him deal with change not criticise him and make him sit on a chair.

I was going to email the multi-disciplinary group with a response but I don't want to be too angry. All the therapists involved are therapists we are paying for so it is not gone to the LA.

Would anyone read it for me? Star, Agnes, sickof, Moonie?

Dev9aug Thu 31-Jan-13 20:26:36

I don't find this acceptable do you? not at all, I would be pretty pissed at him and he would know about it.

On top of that, I agree that it is piss poor to label the behaviours you mentioned as 'tantrums', 'non-compliance', it just gives ammo/excuse to idiots who can't get through to children, something I have struggled with in our programme as well in the past.

inappropriatelyemployed Thu 31-Jan-13 20:31:38

Thanks Dev. I was really surprised by this. It seemed really slanted. It was all about insightful comments by staff. No mention of lengthy discussions with me.

Even the head thinks the staff are out of their depth and need more training!

The destructive confrontation he witnessed should have demonstrated their lack of ability to handle it. Yet, instead, he seemed just to blame DS for not doing as he was told.

He has some really good suggestions but I feel undermined, especially by his circulation to all and sundry. He even told me last week he would send a report to me first.

babiki Thu 31-Jan-13 21:34:16

I would be fuming too, from the same reasons - sending the report to other people first and also the language he is using, our tutor would not use those terms. It does not sound as if he 'clicked' with your child much and I do think that is important. There are other tutors around - maybe he is good with other kids in other situations, but it looks as it's not working out for you and your ds..

inappropriatelyemployed Thu 31-Jan-13 21:48:28

Oh God. It is just money down the drain.

WilsonFrickett Thu 31-Jan-13 21:55:00

Inappropriately, I don't want to send you over the edge ((pats hair in soothing fashion)) but did you find this ABA person or the LA? Are you comfortable with their credentials? Because even the language they're using sounds off to me. And circulating the report sounds like they have an agenda. Sorry if I'm way off beam but this just feels all wrong. For eg my ABA tutor only sees us occasionally at home and I once asked about engineering a situation where she could see some of DS more challenging behaviours and she put me right back in my box. I just can't see someone like her standing by when I child was put in a distressing situation.

Again sorry if I'm off beam x

inappropriatelyemployed Thu 31-Jan-13 21:58:25

Now we found them. Excellent credentials but let the screaming happen right in front of him.

AgnesDiPesto Thu 31-Jan-13 22:00:05

Yes email me I'll read it

Dev9aug Thu 31-Jan-13 22:08:47

I don't know how you feel about your ABA guy say if he hadnt sent this report, but it is not uncommon for consultants to push children beyond their limits to see what they are dealing with and come up with a program.

inappropriatelyemployed Thu 31-Jan-13 22:17:17

That's the problem Dev. People say different things about what is appropriate for consultants.

If he was going to do that, he should have said so but he didn't engineer it so much as let it all go wrong. Then judge him for it.

bialystockandbloom Thu 31-Jan-13 22:19:44

Where did you find him, and is he qualified to be sole supervisor/consultant?

I'd be bloody pissed off too about sending the report to everyone too.

Re the 'functional analysis' - tbf you do have to undertand the function of a behaviour in order to successfully approach and change it. I guess he just needs to work out if ds's behaviour was based in anxiety about change, or demand avoidance, or attention-seeking, or sensory etc. You would do this by taking ABC data.

And, to play devil's advocate, the fundamentals of ABA teaching are that the first thing to do is to gain 'instructional control' with a child - ie that before any teaching of social skills, language, play, whatever, the child has to want to engage and start the process. And that's done through the pairing process - the ideal outcome being pretty quickly that the tutor has paired himself with such positive things (attention, fun, rewards, etc) that the child wants to be with them rather than not be with them. Until you have this, you're basically bribing or forcing them to do what you want.

I am hesitant to say this, as obviously much of what you describe is pretty poor, but it wouldn't be a negative thing to me that he saw him at his most "non-compliant".

I sometimes wish, actually, that ds would have a 'worse' day when we have our ABA workshops, but our consultant and supervisor are so good and are so much fun for ds, he behaves impeccably and I'm always left wishing they could see him on an 'off' day hmm

But anyway the point is that if you think this tutor/supervisor (whatever he is) is not working for you, not recognising or addressing the real difficulties, look elsewhere. There are lots of us who can recommend others I'm sure smile

There might be an underlying difficulty with all this though if the TA is not on board with all this (which irrc she's not?) - she's the one who has to act as day-to-day tutor for ds and the ABA supervisor should be giving her proper training and she must be willing to learn if she's not just going to see this as a license to discipline him.

inappropriatelyemployed Thu 31-Jan-13 22:29:08

Thanks that is really helpful. I understand what you mean but I still don't understand how you can actually distinguish between anxiety and routines based on anxiety. This occurred when DS was simply asking to sit on a table so people couldn't see him. It's not like he got off with work or got a great for it.

He has worked as a consultant in an well known organisation.

But DS wouldn't even speak to him as he left. And the licence to discipline is exactly what I am worried about.

Dev9aug Thu 31-Jan-13 22:48:10

* I understand what you mean but I still don't understand how you can actually distinguish between anxiety and routines based on anxiety. *

You know IA I need to write this down as the points you make are very useful, this is exactly what I would like to know, hopefully I will get some answers soon.

bialystockandbloom Thu 31-Jan-13 22:56:01

Well I suppose routines are always built up as a way to deal with anxiety, so either way, it's a case of a) working out what is causing the anxiety/routine, then b) taking positive steps to address it.

You'd have to take data over the course of weeks to get to the bottom of it. So whether it's because he finds the work too abstract (eg is it during specific lessons? I have realised with ds in Y1 that much of literacy is taught using abstract concepts dependant on chidlren's innate skills of inference - so hard for ds!) or is it the noise of the classroom? Or has he learnt that if he behaves like this he gets lots of 1-1 attention? (sounds harsh but hopefully ykwim).

Only by observing and taking data over time can you really see what's going on.
And the bottom line remains: whatever is the cause of the anxiety is the thing to be dealt with.

inappropriatelyemployed Thu 31-Jan-13 23:05:38

Thanks. 1:1 attention is a possibility but then the need for the 1:1 could be because the pace in the class is too difficult or he s just tired of it. But it happens so occasionally and the next day he bounces back.

I always think - why not ask him? Is this not possible in ABA? DS is generally dead straight and will say.

inappropriatelyemployed Thu 31-Jan-13 23:07:07

Taking data over works with this TA is not going to happen really is it? It will hardly be objective.

This is what moondog meant the other day isn't it.

Dev9aug Thu 31-Jan-13 23:12:11

Yes, it will be the TA implementing the program.

inappropriatelyemployed Thu 31-Jan-13 23:16:37

He has sent data collecting sheets too before programme is drawn up. There is no way TA can do that.

bialystockandbloom Thu 31-Jan-13 23:22:36

Why can't the TA do that? Our TA does. What's the arrangement/statement you have? If the school are agreeing to follow the strategic programme of support and intervention from your ABA supervisor, why can't the TA do that?

Don't see why you couldn't ask ds straight out tbh! Though it might not be totally helpful - I know my ds would say soemthing truthful and factual but not that illuminating! But yes, good idea - why not ask your tutor what he thinks of that?

inappropriatelyemployed Thu 31-Jan-13 23:26:41

Supervisor was supposed to speak to him but then it went pear shaped.

Our TA is the one who thinks he is naughty anyway and her idea of compliance is based on those of a Victorian with high standards of courtesy.

inappropriatelyemployed Fri 01-Feb-13 04:44:25

My concern is also - what are the strategies to be used to work on something.

All I saw on Monday was 'do as you are told'.

inappropriatelyemployed Fri 01-Feb-13 07:55:27

Also, how does deciding if the behaviour is motivated by anxiety or anything else change how you address this.

My real worry, from Monday is, that his perception seemed to be 'he needs to do what he is told' and that will just lead to forced confrontation

PipinJo Fri 01-Feb-13 08:41:36

Hi I think by knowing what the trigger is will determine the response...so if it is anxiety...anxiety type responses will be put in place....for my ds it was withdrawl and breathing exercises or hand massage with breath lying down.

If avoidance then ignore and continue to place demand.

He has to learn that doing X will result in Y or Z, these rules are really important.
However if it is social skills you want ds to learn I strongly recommend getting a private SALT into sch to do social skills with your ds and later a peer when improved or will ABA 1:1 take on this role if taught by SALT?

inappropriatelyemployed Fri 01-Feb-13 09:35:43

'If avoidance, then ignore and repeat demand.'

This is what I am concerned about. DS shows little emotion and is high functioning. He uses the term anxiety to describe the odd day when he can't go into class. It is the odd day. He uses it sparingly and I trust what he says.

He still has to do his work. He don't upset anyone and he goes in to class again when settled without an issue.

The therapist who doesn't know him saw all this in action as he came on one of the rare days he is out of the class. Yet the implication seemed to be that DS was just picking and choosing what he wanted to do. Based on what? Not observable behaviour but teacher./TA comments.

He didn't know what to do to change the situation after DS was just forced into a corner which created confrontation. So it was all pointless.

I just don't feel confident that a therapist can unpick whether this genuine anxiety, demand avoidance or routine and the wrong decision could have catastrophic effects.

IE, I honestly haven't a clue what is going on here. However, I do know quite a bit about the context and culture of ABA, so with that in mind could the following be happening?

The Consultant is used to parents treating him like some kind of saviour, and having blind faith, not due to his ability necessarily, but due to their desperation and there really being little in the way of alternative. So, he is used to not having to prove himself to parents.

The Consultant is used to schools/LAs having a negative view of ABA and going on the defensive, digging their heals in and generally refusing to cooperate or confide.

He has judged the situation to be as above and therefore written a report as a sop to the school, rather than to you to ensure his 'way in' for your ds, and possibly also his future employment?

I'm not saying this is what happened, but it does seem to be all a bit of a muddle somehow.

ABA has changed my life. I am hoping to study it. I am a huge advocate. But my motivation is not JUST really about being interested in it. It is because there is such crap out there in the name of ABA. And still, often, (and probably because there is little alternative) it is better than what is on offer. It's like these flippin legal firms. They're crap because they can be, and it is hard to fight a case that you'll still probably lose due to their failure, without them.

I want to scream for you. Not many people take things to the end of each road like you do. When you do, all you seem to be finding are more and more potholes. I'm truly sorry.

'He has sent data collecting sheets too before programme is drawn up. There is no way TA can do that.'

Why?

'He needs to do as he's told'

Yes. Of course he does. But the success of ABA is in the fact that he WANTS to do as he's told, like my NT dd WANTS to do what she is told in school, broadly, - it makes her feel happy. No-one beats her into miserable submission/compliance. I would not expect anyone to feel that was appropriate for my ds either, just because he isn't motivated by the same things.

inappropriatelyemployed Fri 01-Feb-13 10:17:01

Star that is very insightful as his response to me seems to suggest that is exactly the case. He said that many schools don't want ABA so he was trying to keep them onside.

This stands or falls with the right judgments being made about behaviour and with the TA. His visits have at least highlighted that agreements I thought we had reached are unwillingly abided by and that the teacher and TA resent being made to abide by them.

This cannot be delivered by this TA.

inappropriatelyemployed Fri 01-Feb-13 12:06:54

Didn' t see your second post. That is what I am worried about Star that it just becomes about 'putting your foot down'.

I wish I had had a chance to discuss all this before it was circulated.

I am seeing head today. What is the most important thing to raise to ensure that school can guarantee that the TA would be able to do this?

Broadly, the TA has to reflecton her actions to ensure that she 'wins' ds' cooperation. That you and the ABA tutor can help her do this. That you trust her to keep this at the forefront of her mind and to call on you regularly to support her.

????

inappropriatelyemployed Fri 01-Feb-13 12:22:24

Thanks. And that she sticks to a programme I suppose and doesn't go off message!

LOL yes, but tbh, would a week or so of her 'simply' trying to win your ds' cooperation and that is all all? Practise and practise,

You know. Get her to tick something every time he does as she asks, and write down the details every time he doesn't, with her incentive being that every time he doesn't she and you have to sit down and talk through the scenario and make suggestions how she could have changed what she did to get him better to WANT to comply. Idea is to increase the number of ticks daily.

Explain that 'complying' can become a habbit. So if you ask the child to do something 10 times and all 10 times those things are fantastic and rewarding for them, then the 11th time you ask them to do something and it is more neutral or a bit worrying, the trust is there and they are so used to doing as they are told that they brave it and get on with it.

Her reward is when there is no challenging or non-complience behaviour and she doesn't have to see you - yay!!!!!!

or that might be going too far!?

Though it is how you start off early behaviour programmes for little ones. Once they are used to doing as they are told, they stop resisting, or resenting and then hopefully the learning becomes rewarding enough to keep them on task.

inappropriatelyemployed Fri 01-Feb-13 12:51:31

Great idea. Not sure she would go for that ABA programme for the TA! Your idea of a trial and maybe some understanding of what ABA is about to see if it would be workable is important.

ABAtherapist Fri 01-Feb-13 17:01:18

I think it is worth ringing your ABA guy and asking him some questions.

You are paying him, have you agreed that he could share the report with others? He should have had this permission before he circulated the report; if not, you have a legitimate complaint about confidentiality.

Trained behaviour analysts don't even think in words like "tantrum" and "anxiety". We think about specific behaviours, and the possible functions of those behaviours. However, the language of ABA is awkward and it can create a barrier to acceptance from schools, SALTS, etc. We might use those words in an attempt to be understood by others. Anxiety is a really tricky one. Often schools will use this as a way to avoid dealing with behaviours: "there isn't anything we can do, he is anxious." This places the problem on the child rather than the environment. Often we see challenging behaviours because the child wants to escape a situation or seeks a different kind of attention. When a functional analysis shows that the behaviour happens more often in one circumstance than another, it suggests that changing the circumstances can change the behaviour. This places the responsibility with the school staff. In my practice, I always defer to the FA when staff want to place the blame for the behaviour on a trait of the child. Conducting an FA and showing the data is much more convincing than saying to the staff "you are wrong, it is not anxiety".

You are paying for ABA, have you worked with the ABA guy to set targets? He should have known that you are not worried about him sitting in chairs (sitting with a group can be a very reasonable expectation of a child in mainstream school). It sounds as if you haven't really spoken to him about what you want from an ABA program. This is more likely to be his fault rather than yours, because you can't be expected to imagine all these potential scenarios and he should be able to anticipate these issues. I never sign a contract with families until we have agreed on goals and a method of working together. Is he very inexperienced? You might want someone with a bit more experience who can help anticipate these kind of problems.

inappropriatelyemployed Fri 01-Feb-13 17:21:12

Thanks that is really helpful.

I was very clear about what I wanted and what I didn't want but the whole process appears to have been diverted by staff concerns which the head doesn't share himself and has told staff not to bother about, e.g. sitting on a chair.

cansu Fri 01-Feb-13 19:32:06

Ok I agree he shouldn't have shared the report until you had seen it and discussed. However, I think also that you need to consider his advice and maybe accept that it reflects his prof opinion that day in that particular circumstance. to me it seems you have two choices dismiss his report because you no longer agree with his opinion or consider it. That will sound harsh and I understand your anger because I have also paid for many independent reports. I completely agree you should have seen it first and have had the opportunity to veto it being sent to the school. You then can decide to no longer use this person as you disagree with their opinion. FWIW I have used a consultant who has sometimes told me things I disliked and disagreed with but I have continued to use her because I let she had integrity and a willingness to say it how she saw it. I would however expect to have the final say about whether this view was shared with outsiders.

inappropriatelyemployed Fri 01-Feb-13 19:45:40

Thanks. I understand what you mean but his advice is not really saying anything but it is entertaining the possibility of re-opening accomodations which have previously been agreed.

It has demonstrated that teacher and TA (rather than ABA therapist) have a particular position on compliance at all costs which is not shared by the head.

I have spoken to the head and he would strongly reject any attempt to apply a 'compliance model' to DS as he believes DS is compliant, he only exhibits difficult behaviour when stressed and this needs accommodation and the development of skills. He thinks we can agree this internally without paying for therapist.

This is not the therapists fault. I had instructed him to look at one thing, but it has become clear that teacher and TA just think he needs to be the same as everyone else at all costs. This meant the discussion, and the therapist's attitude became diverted. But this is not the view shared by the head who knows him well and understands ASD.

cansu Fri 01-Feb-13 19:55:44

Could the report help you to get these people back on side? the other advantage to the consultant I mentioned was her ability to get the teachers on side in what was crucial. Because they felt she was listening to them as well as me they reacted very well to her and tried to show that they were taking her advice on board. For me this opened doors to new ways of approaching problems. Might also be worth considering if your head is moving on?

inappropriatelyemployed Fri 01-Feb-13 20:07:55

That is a good idea but I suppose the problem is cost. Do I want to pay an ABA therapist to change hearts and minds? Head's view is we could achieve same with Ed Psych who is very helpful

cansu Fri 01-Feb-13 20:18:43

I hear what you are saying. I stopped using the consultant for moment as school senco was so obviously on side that it was no longer necessary. In many ways having these people on side and willing to make that extra effort is the most important aspect in my experience. from reading your posts over past few months what stands out is your frustration with TA in particular. If she became your ds biggest advocate that old be incredibly powerful. It may well be impossible there are some who can and won't see but it might be worth considering. I agree head is important but if he moves on you have no guarantee about the position or priorities of who will replace him.

MareeyaDolores Fri 01-Feb-13 20:26:06

Head helpful, ed psych helpful, aba man not helpful...
This sounds most unusual behaviour
I think it helps to do an ABC analysis of the participants' behaviour wink

LOL, Incidently, I'm having my own spat with an ABA Consultant who isn't even hired yet. Give me strength! Some of them think they are Gods!

inappropriatelyemployed Fri 01-Feb-13 21:01:39

Head is trying to get a plan agreed via EPs recs before he goes.

I honestly think you can lead a horse to water but you can't make it drink sums up the TA and no matter how much effort you put in she will remain steadfast in her view.

Head said, unprompted, he is going to organise recruiting someone else to TA for DS for half the week to break this dynamic.

Oh that's good. If new person starts to get results, perhaps old person will model herself.

inappropriatelyemployed Sat 02-Feb-13 07:52:10

Well I think there is no chance of her changing her ways. She just as she wants based on her world view that you just need to put your foot down. It's probably because her techniques work so well!

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