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

(116 Posts)

Anyone else going to be watching this?

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.

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

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

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.

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

Sounds interesting, working- will PM you.

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 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.

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.

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

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.

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.

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?

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.

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.

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?

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.

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.

tethersend Wed 06-Nov-13 14:16:56

I used to teach at an ABA school, so watched the documentary with interest.

I have seen it work miracles for some children, and fail spectacularly (for whatever reason) with others.

I now work with trauma experienced children and would have grave reservations about using ABA with children who have experienced trauma, abuse and neglect. It may well be appropriate in some cases, but problems can occur when the function of a behaviour is not fully understood, and the child's prior experiences mean that they are unable to link positive reinforcement with desired behaviour in a tangible way. Standard ABA techniques such as ignoring unwanted behaviours can be very harmful to a neglected child, and most ABA practice I have seen in the UK and the US takes little account of this.

I think ABA can work and can work brilliantly- but not for every single child.

Gobby I don't think (but excuse me if I've missed it) that anyone has said directly that what you do with your children is "wrong". Surely there is no right or wrong, just what works for the individuals and their families....?

Most stories here seem to be from those who have had a good response to ABA, probably inevitable because of the title, but I for one would never assume that what works for one works for all. Each child is individual and therefore must be treated accordingly. For those of us without SN we are all different and respond differently to things, so why would those with SN be expected to be any different (too many "differents" there); probably clumsily worded, but what I'm trying to say is that in my limited knowledge is that there is no "one size fits all", and you should carry on doing whatever works for you and your family, without feeling pressured.

GobbySadcase Wed 06-Nov-13 13:29:34

More snarky remarks.
Where do you get off telling me my way is inferior when it works for us?

No, I don't sit there watching my kids stimulating all day. Just because I don't do the sainted fucking ABA doesn't mean a prescribed route of x, y and z will happen.

What is it with you lot? Are you that closed minded that anyone who dares yo do things differently must be sniped at, derided and inferred as a bad parent?

NewBlueCoat Wed 06-Nov-13 12:10:47

ouryve - snap. dd doesn't always like it if we praise her, and certainly gushing, over-the-top praise has always unnerved her. she spent a lot of our recent holiday saying 'don't say 'well done, dd' ' as it made her uncomfortable.

ouryve Wed 06-Nov-13 12:01:19

But would probably do more verbal affirmation and would hold back on the raisins/sweets

I've always avoided food rewards with DS1, since he has an over-emotional relationship with food, already, but, quite often, gushing praise makes him really quite angry. He's only just beginning to understand, at almost 10, that someone being pleased with you is quite a nice feeling. Sometimes. There are still many times when he doesn't care if someone is pleased.

He is so extremely demand avoidant that he'd often refuse to do something he enjoyed if he knew it met someone else's approval.

Without a complex chart, with specific, motivating rewards for tiny steps in the whole process, I suspect he would still be in nappies.

NewBlueCoat Wed 06-Nov-13 11:38:22

Howling, as a sample day (my dd is at an ABA school), dd will do:

arrive, and have registration (circle time: greet everyone, complete the register and talk through the day)

she has, on any single day, various groups (could be SALT group, OT group, handskills, topic work, etc). today she has topic work (they are working on nationality and identity. she will be making a flag as well as examining various object of cultural significance to each class member) and SALT group (she will be reading through her group book, and working on some of her SALT targets - to answer questions about the text and find points in the story to illustrate her answer). these groups can be from 3 children up to whole class (6 children), or may be mixed in the case of OT for eg, and made up of children from across classes, according to ability and activity.

in between, she will also work at her desk, with her tutor 1:1. she will work on literacy (at the moment concentrating on spelling in a variety of ways - handwriting, typing), numeracy (beginning column addition using 2 digit numbers, and working on monetary values), and may also practise things like a new board game to share at social skills group. she will also work on creating mind maps, to help with her SALT targets of widening vocabulary and increasing conversational ability.

as part of her conversation targets, she goes with her tutor to talk to less familiar tutors (dd finds conversation difficult, yet enjoys talking to people; increasing her repertoire of conversations means she can share with a greater variety of people; exposing her to less familiar tutors means she has to work at getting her meaning across in a better way, as these tutors will not 'know' dd and won't be able to compensate at all. naturally, she practises with her tutor first until she is comfortable, and the unfamiliar tutors have been primed so that the interaction can be a success)

she also has daily living skills to work on - she is 9, and so school are beginning to prepare for body changes and puberty. so she is learning about bodies, and about her own body. she also helps to clear up at lunch and snack times, and there is a rota to help with things like loading the dishwasher, or putting items away/wiping tables etc.

in OT group, she is working on motor skills via cutting, bike riding, and yoga!

her playskills targets include learning new tunes on the piano (she has mastered several so far, from nursery rhymes to show tunes), and playing a game of a peer's choosing (they take it in turns to choose the game, and play nicely)

and all that is just an overview! her day is as varied (and possibly more so given the utter flexibility of having your own curriculum and tutor) as dd2's (in Yr2). each target on her comprehensive IEP can be taught in a variety of ways and situations, and is done so. each target is flexible across the day - so while working on her motor skills via yoga, she is also working on her listening skills and imitation skills. while working on her conversation via mind maps, she is also reading, matching, writing etc (just like any child at any school).

the absolute last thing she is doing is sitting at a desk all day long doing trials.

HowlingTrap Wed 06-Nov-13 11:32:19

Basic behaviour training isn't always if ever, going to work on a severe case where elements of brain damage/stunted brain growth is at play. My sister is essentially stuck at a toddlers level, a young toddler at that,

ABA will work with some kids but not all, I think perhaps the older ways frighten people, the footage from the 60's was horrible , but teachers in general were more cruel to children so more telling of the times than the technique.

HowlingTrap Wed 06-Nov-13 11:15:31

I watched this ,my sister went to a special school and she started talking , writing although her speech is incredibly limited its better than none.

However she started a residential day centre at 18 + and my DM does have concerns about how well the staff are trained, too easy for poorly educated,ignorant people to get jobs in these places and some of my sisters obsessive behaviours have gotten worse.

I would have like to have seen more about what else ABA schools did, or is it just constant drilling?
That Gunner became a bit of a childcatcher/caricature didn't he? my and the hubby were in hysterics most of his screen time, "I don't appreciate autism!" I don't think anyone does confused

bialystockandbloom Wed 06-Nov-13 10:37:04

working that's really interesting - perfectly illustrates how all of us, every single minute of every day, are having our behaviour and responses shaped by the behaviour of others towards us.
ABA is just that really - an intensive, tailored analysis of behaviour, and then adapting how we respond as parents/teachers to that behaviour.

buskersdog I have absolutely no doubt that if my ds had not had ABA he would not be where he is today, and that if we had waited till 7 he would not have naturally grown out of it. There was no question of misdiagnosis.

He was 3.5 when he was dx, and when we started ABA, and there was no doubt about the diagnosis then, he was showing clear impairments in the core triad (communication, interaction, imagination), though he didn't have many of the traits commonly associated with autism (no sensory issues, no need for routine, no stims). I know that if we had not been shown a way to motivate him to learn and engage, he would have retreated further into an increasingly narrow, rigid world (it was happening before our eyes between the age of 2-3.5). Tbh I think it's shocking that there could be a blanket policy of not dx before 7yo. I cannot see how children with a different developmental path could just naturally grow out of it without meaningful intervention.

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