ABA TV documentary - 5 Nov, 9pm, BBC Four

(116 Posts)

Anyone else going to be watching this?

Gobby, if you want your child to behave in a certain way, then you do something to encourage that, and the child's behaviour moves in the direction you hoped for, then you have succeeded at ABA.

A rather clumsy version that you would find difficult to prove effective without recording, but next time the situation occurs you'd not only know what you can do but you may have an idea how to make it happen faster or better. That is also ABA.

It's highly likely that you are using ABA without realising it, if you are getting effective results.

Tethers, only very badly designed ABA programmes will ignore the need for a thorough assessment of the function of the child's various behaviour before any attempt is made to change them.

The trouble is that there is a lot of poor practice going on due to the ignorance and low-levels of training both in practice and in ethics of many who deliver ABA.

That is not a reason to dismiss ABA out of hand any more than thalidomide is a reason to dismiss medicine as out of hand.

bigTillyMint Wed 06-Nov-13 14:27:06

tethers, that sounds really interesting - I work with a wide range of children with all sorts of prior experiences, and would be really interested in any books/videos/training you have to recommend?

working9while5 Wed 06-Nov-13 14:43:25

I would agree with you tethersend about trauma.
On the other hand I see so much ineffective practice with this group I am generally worried about, there is such little understanding or positive approach to it.... I have had two kids who spring to mind.. one v compliant always in school but drowning not waving and basically suicidal& another whose deep-seated issues resulted in issues I was constantly called on to treat as 'social skills deficits' that were really much more about pain not having a safe outlet. In both cases there basically were no services. Just crappy termly chats for half an hour with a primary care mh worker hmm.

ABA as a skills based approach is very effective.... but itneeds to be situated within a range of aapproaches especially where psychological issues are at stake. Even the difference between CBT and trauma-focused CBT is intense. I like the new Mindfulness and Compassion based approaches for some of the kids I work with who are, say, traumatized by social anxiety and negative experiences though obviously proper therapy required.

tethersend Wed 06-Nov-13 14:45:37

The thing is Starlight, even the most thorough functional assessment of a non verbal child cannot take into account their prior experience if its not known. You cannot always know which child has experienced trauma, and which behaviours stem from that.

I agree that there is a lot of poor ABA practice, but that is not what I am referring to. Experts in the field still cannot always know a child's prior experience and have to make educated guesses, as do we all. The difference is, standard ABA techniques which are proven effective in the majority of cases can have a harmful effect in some. Also, little is known of trauma driven behaviour by most senior ABA practitioners, since the training they require is so specialist and intensive; they simply do not have time to specialise in all fields.

BigTilly, happy to recommend if you want to PM me some general issues/ where you are?

This book is useful if you have any children with attachment difficulties.

tethersend Wed 06-Nov-13 14:51:50

Working9while5, completely agree with you about the poor practice, and that ABA can sometimes be effective in some cases.

There also seems to be much difficulty in diagnosing children with disrupted early lives with ASD, as so many issues are attributed to attachment disorder or vice versa.

I have not seen Mindfulness and Compassion approached put into practice- it's interesting that you find them positive. I'd be interested to know more about this if you are able to say?

You can't know tethers, but you can't know WHATEVER therapy you use but at least with ABA you keep meticulous records of what you are doing when and why which means issues can be identified sooner and before they get worse.

I booked a mindfulness course recently but then couldn't go, so my DH went instead.

He's an engineers and totally non-woo and says it makes a lot of sense to him.

googlyeyes Wed 06-Nov-13 15:05:26

theconversation.com/behavioural-method-is-not-an-attempt-to-cure-autism-19782

This is an interesting response to the programme by Prof Richard Hastings

tethersend Wed 06-Nov-13 15:06:47

Meticulous records cannot tell you if something is emotionally harming a child if the target behaviour is increasing though, Starlight. They will only tell you that the programme has been successful, as defined by the mastery criteria.

I realise that I am talking about a minority of children here, and for the vast majority, ABA is a powerful and very effective methodology. I just want to refute the assertion that ABA will be effective with all children if used correctly, as I do not think it can be.

tethersend Wed 06-Nov-13 15:09:38

As an aside, I was also quite hmm at the extent to which children are medicated in the US, even in ABA schools.

Glad that it doesn't happen as much here.

working9while5 Wed 06-Nov-13 15:56:49

Tethers anxiety and panic most common among my group of kids and having had my own experiences with both I have a lot of interest in it. My personal interest is in Acceptance and Commitment Therapy which arose really out of behaviourism and is rooted in it but basically represents a but of a schism from ABA 'proper' and is redefining itself as 'applied contextual behavioural science'.

I'll have to be very basic here as my own understanding is developing, but my understanding of it is that we become conditioned within our verbal communities to respond in certain ways to the labels we or others put upon us. We become how we talk about ourselves, which is shaped by those around us and the broader verbal community.

In the context of trauma consider how child sexual abuse, alcoholism, domestic violence are treated in terms of the shared understanding of the victim in the media... you'll never get over it, you will have trust issues, you may be more likely to self-harm or do poorly academically Tec. These become internalized and drive behaviour. I have some limited experience of this being a 'child of a broken home' in Ireland in the 80's and how I worried about what this meant for me.

I have heard very interesting talk about, say, the conflict experienced by abused kids because of their feelings of love for abusers or even worse where they have had physical responses to sexual acts or 'complied' or even looked forward to sessions with their abuser because of the conditioning of the abuse. This is simply a product of their learning history with their abuser: they have been groomed to these responses and part of the destruction of the abuse is that it makes the abnormal typical and even reinforcing. This is why vulnerable neglected kids are more likely to be abused of course: they are targeted because their compliance can be moulded through a mixture of love and fear and over time deeply disturbing things can become reinforcing because of how the brain associates things. Many abused kids are confused and frightened by the complex and varied responses they have to their abuse and not so many initially realise abuse is abnormal. Then when this becomes apparent and they need it to stop, this puts them outside the verbal community e.g. they can't disclose or admit to these experiences because there is an agreed understanding they will be weepy and hate the abuser and not enjoy sexual activity and be relieved it is all over etc when. In reality things are often more complex..So there is a battle as suddenly there is this realisation that they can't trust what they thought was trustworthy as it is damaging and destructive and not love as they thought it was and yet there's limited scope to really explore this, admit to it or discuss it in any detail with non-abused people so they are left on shaky ground. This then increases the likelihood of negative outcomes as they may not feel they can trust anyone or may seek out experiences like the abuse to return to 'normality' as they learned it but then increasingly hate themselves and feel more isolated and damaged for doing so.

Ultimately the 'answer' is to try and see through the limited ways language can convey experience and to reduce the tendency to need to be in a box to feel okay e.g. 'damaged victim' or 'innocent Angel' or 'wanted it really' or whatever label or phrase that person comes to use internally to label experience. There's a lot of complicated stuff behind this in terms of how language works etc and how we treat words as real through our conditioning.

In real terms the practicality is about letting thoughts and feelings come and go without needing to interpret them or make them into a massive story and realise no thought is dangerous. For abuse victims this might be around fears they will abuse or that they wanted or asked for the abuse etc. A lot of it is understanding the brain tries to trap us into these evaluations and that a simple word like love or abuse or whatever is loaded with all our millions of personal experiences and can act as a trigger to feelings. Typically we chase these thoughts and then react in the ways we've been conditioned to. Mindfulness and compassion are about just recognising those triggers, being friendly to yourself about them and letting them go. Feeling the discomfort, looking at the painful memories, allowing ambiguity etc without worrying what this means. Setting then your own course following what you care about without being bogged down by labels or the past.

This is stupidly oversimplified... there are many more layers. I guess ultimately it's about understanding how experience conditions the language we use and how we understand it, how this feeds into how we interpret experience and how this complex learning history drives forward our behaviour as we grow and learn. These approaches are about trying to help people step outside that cycle and learn to recognise when language and thoughts are trapping them into unworkable destructive behaviours.

tethersend Wed 06-Nov-13 16:16:32

Sounds interesting, working- will PM you.

Homsa Wed 06-Nov-13 22:06:50

ABA worked wonders for our son, but I don't think it's the be-all and end-all. There ARE some skills which are very difficult to teach through "traditional" ABA, and much as I hate the word "eclectic" when it's used to mean "however little the LA can get away with", I think you do need a mixture of approaches.
RDI (Relationship Development Intervention) is one to watch I think - I hate the way it is all commercialised and copyrighted, but it's still an interesting take on autism teaching. I tried an RDI strategy with DS once to encourage him to reference faces more (note I wasn't trying to teach him "eye contact"!). In order to get DS to realise by himself the intrinsic rewards of looking at faces - that you find out important information - I used facial expressions and head movements whenever he really wanted information from me (e.g. looking for a favourite toy). It worked amazingly well. Yes, it's just another form of operand conditioning, but I didn't see very much of that in our ABA programme.

CrabbySmallerBottom Thu 07-Nov-13 23:28:10

Fascinating post Working. Gave me a bit of a lightbulb moment.

finefatmama Sat 09-Nov-13 12:01:06

What if this was a chat about good old penicillin and a poster came on to say that it didn't work because her kids went into anaphylactic shock and another poster came on to explain that her child's symptoms though similar turned out to be viral or penicillin resistant...

ABA school v other schools, grammar v comp, religious school v non-religious, private v state - we'll always be damned if we do and damned if we don't when it comes to parenting and schools for out NT or special needs kids. I chose to move to get ds1 into treetops 5 years ago and I'm glad I did as ds1 went from 75 tantrums a day to 1 every other day in the first 2 weeks. Distressing as that was at first, life is so much better now and my house is no longer smelling of shite as poo smearing was the most reinforcing activity for ds1 followed by lining up everything useful daily object we have in the house but could not use.

At Treetops, if he doesn't make progress in a week the program is reviewed. I have seen aba home programs remain unchanged for months despite lack of progress which can be frustrating for all parties and unfair on the child. I also like that treetops focus on pairing and getting the kids to like the therapist.

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