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

(116 Posts)

Anyone else going to be watching this?

bigTillyMint Tue 05-Nov-13 20:30:24

Ooh, thanks for the heads-up - yes, I will!

MyBigShoutingDay Tue 05-Nov-13 20:32:13

Thanks for the reminder.
Meant to set the sky box for this earlier in the week.

You're welcome!

Oooh, it's starting!

I'm watching.

mariomadmum Tue 05-Nov-13 21:37:14

I'm watching

GobbySadcase Tue 05-Nov-13 21:38:37

It's actually pretty balanced.

googlenut Tue 05-Nov-13 22:04:11

Think ABA came out on top which is what the research shows as well. The school which was being portrayed as the 'softly ' approach said the boy that wouldn't eat would be eventually tube fed whereas the ABA school got the lad eating sausages in 6 months.

NewBlueCoat Tue 05-Nov-13 22:04:44

It was a LOT more balanced than I thought it would be. I caught a bit on the lunchtime news about it, and my heart sank - most of the piece was about Skinner, with footage of pigeons pecking buttons and emphasis on the animal training/Pavlov's dog aspect.

But the programme was good overall (I missed the first 20 minutes).

Jack reminded me a lot of my own ds, physically - a real heartbreaking grin.

NewBlueCoat Tue 05-Nov-13 22:06:16

I was horrified, tbh, by the school's virtual shrugging of shoulders and talk of tube feeding as inevitable. That could so easily have been my child they were talking about, a total food refuser.

GobbySadcase Tue 05-Nov-13 22:14:02

I don't think either side came out 'on top'.
Shows how polarised the two schools of thought are and explained well why, too.

I don't want to change my kids, which does fit in with my personal view on ABA for my own family.

I do recognise many families do find it of yes, however.

I don't want to change my Ds either. But I want him to change his impulse to spit in peoples faces. I want him to change his eating habits of using his hands and smearing his food all over the table. I want him to change his way of requesting things with a scream to a sentence that will sound polite enough to get him what he wants.

When he has those skills in his repertoire he is then free to chose his new or his old behaviours.

Rentahoose Tue 05-Nov-13 22:18:42

Granted it was an interesting documentary though I did find lots of it distressing.

I have no experience of autistic spectrum personally but (fresh out of uni) once went for an interview in North London as an ABA teacher. Granted this was 20 years ago. I think it was for a unit somewhere.

It was the strangest interview I've ever been to in a house in a residential street. I had no teaching qualifications and no experience with children and yet they had invited me to an interview (because I would have no preconceptions). They weren't interested in what I had read about autism and spent most of the interview selling me/ telling me about their wonderful system but not really asking me any questions.

I seem to remember all the teachers had reward charts/point systems of their own so everyone staff and pupils were following a positive reinforcement system which I found a bit strange.

I did coming out feeling I'd been a bit brainwashed. Having said that I didn't get the job (just as well as I wouldn't have been very experienced/qualified).

It does seem to have brought about some amazing results though I'm not surprised the system is seen as controversial.

GobbySadcase Tue 05-Nov-13 22:22:25

I agree that undesirable/harmful behaviours need to be stopped. If ABA works then fantastic.

Didn't work with my three.

NewBlueCoat Tue 05-Nov-13 22:27:19

rentahoose, could you explain what you find controversial about a system of positive praise and reinforcement?

I find this stance odd. I have a dc at an ABA school. HIghly structured, although seems to spend a lot of her time playing board games at the moment grin

I also have dc at mainstream school.

the similarities between the two are greater than many would think.

in the ABA school, the system is more individualised, but the overall goals are the same (encouragement to behave in a socially aware and responisble manner, as befits being in school) as in mainstream. event he systems used are not that different - in the ABA school, the reinforcements come quicker (dc has to work through a set amount of 'tasks' before getting reinforcement - which is playing a board game. at mainstream, my dc have to work through a set amount of work, before being allowed 'golden time' - where they mostly choose to play board games grin)

obviously, the curriculum is differentiated at the ABA school, and the staff ratio is much higher. but overall? same system, different school.

Rentahoose Tue 05-Nov-13 22:39:02

Yes but you see I don't really like punishment reward systems myself. Although I accept they do probably need them in a school environment, I've tried to avoid star charts and time out etc at home. But that's my personal opinion.

I didn't feel comfortable with the teacher saying if it takes 3 hours to get the required result so be it and no one likes to see children so distressed when being given new foods to eat ( though granted they did back off when the child became too distressed). a lot of it seems like dog training to me.

RE controversial I'm also talking about what some people were saying on the programme (thought the autistic mother spoke very movingly about this) about autism being the way someone is wired and whether ABA denies the existence of something that makes them who they are. Granted for those on the milder end of the spectrum it is easier to accept this argument.

I think the blurb for the programme indicated that some people think the system is abusive ( I know they are largely talking about in the past when punishment was used, ie in some of the old footage)

But the whole of society is built on punishment/reward systems.

Why do you recycle your cardboard? What do you gain from going to work? Why do you have a wash in the morning?

You can't tell me that none of these behaviours aren't at least shaped by other peoples expectations of you.

Why did the child only eat liquid food?

Coukd it possibly be because the mother had been rewarding the behaviour that enabled the child to continue without moving on, from a very early age?

Btw, I'm not saying it is her fault, but that she should have been given a lot more support a lot earlier and that child's behaviour should never have developed that way making it harder to address.

banana87 Tue 05-Nov-13 22:47:22

I was really pleased with the documentary. I thought it was well balanced and ABA clearly came out the better intervention for children with autism.

I challenge anyone who states "ABA didn't work for my child". How do you know it was the ABA? ABA does not work if it's not consistent. If an individual is being reinforced intermittently for behaviors, those behaviors will continue. If you stop reinforcing unwanted behaviors, and replace them with more appropriate behaviors (and reinforce the occurrence of THOSE behaviors), you will ALWAYS be successful. ABA is used in everyday life. It's why we work, talk, clean, etc. There is no such thing as "ABA didn't work". Rather, the consequences were not effective, the function of the behavior was not considered, or the teacher was not effective in reducing behaviors. Not the "ABA wasn't effective".

I think everyone would find it really unacceptable if you went to the dr with a specific infection and were told "here, I'll give you something that covers it all...maybe...oh wait, the science hasn't proven this med to be effective but here, try it...it might work". So why is it acceptable to do that with children with autism?

googlenut Tue 05-Nov-13 22:47:44

What I found really interesting was the little boy who started eating - did you see how delighted he was when the sausages arrived. So the distress he was obviously feeling before - which was probably due to fearing the unknown food or to a bad experience of food he has had - was holding him back from the pleasure he then went on to experience.
I think this is where children with autism really diverge from other children. This really strong resistance to being made to do something they don't want to do. ABA tries to break that through finding a strong motivator and repetition.

NewBlueCoat Tue 05-Nov-13 22:48:11

I do see your point re: reward systems. I don't use star charts/time out either. and I do think that the mainstream school my dc attend have a very poor grasp of how to properly use a reward system, and that worries me.

I do think, however, that humans are wired up, generally, to seek social reward. it is how we have set up our society.

the argument as to whether ABA fundamentally changes a person is an interesting one. I'm not sure that it does. it may change some external habits and behaviours (especially if they are socially unacceptable ones), but I am not sure it changes the actual person. ABA can't and won't take away my dc's autism.

I didn't really like the 'if it takes 3 hours' bit either. to me, that says that the wrong demand has been placed (one that is too stressful at that point in time - the step is too great, maybe). I can honestly say my child has never been made to sit out 3 hours or more to complete a demand. but as to the dog training aspect - in the programme Jack was very distressed initially around food. yet 6 months later he was keen to eat, outside the home and school environment, and tucked in happily. if this end was achieved via glorified dog training, does this matter? he can now face a life where he can eat normally - something we all have to do, day in, day out - without fear and anxiety. I can't see how this is a bad thing.

Rentahoose Tue 05-Nov-13 22:49:56

I agree society is built on these systems. I still don't particularly like it that my DD will do anything in school for a sticker/some sweets.

I don't really want a child who will only tidy up/ contribute to the household, be nice to her sister if there's something material in it for her.

I don't think parents used star charts in the seventies, we just did what we were told surely.

When I ask my DD why she is rude to me and wouldn't dare be rude to her teacher " You won't put me on time-out".

I don't want to have to use time-out.

googlenut Tue 05-Nov-13 22:51:36

Agree and the other school could only hope for tube feeding - I found that much more distressing than any of the melt downs during ABA.

NewBlueCoat Tue 05-Nov-13 22:52:31

the acceptance that tube feeding was inevitable chilled me.

NewBlueCoat Tue 05-Nov-13 22:53:55

how far does that go? resistance to reading and writing? ok then.

resistance to stopping spitting? ok then.

resistance to stopping biting? ok then

resistance to behaving in any socially acceptable way at all? ok then.

bloody awful.

I wouldn't accept it for an NT child, so why shoudl I be expected to accept it for a child with ASD?

Rentahoose Tue 05-Nov-13 22:53:57

Oh and I know a school where the teacher gives stars out to foundation children who arrive with a smile on their face. What message does that sound out. That to be sad is wrong.

And those who don't cling on to their parents get a star too. In the first two weeks of school. These systems can be used for good but some teachers seem to go way over the top.

banana87 Tue 05-Nov-13 22:54:34

The only time it would "take 3 hours" would be if you've presented the child with a demand and because in the past sitting/crying/screaming/hitting meant that demand was removed, the child tries everything he/she can to see if the demand will be removed. It's basic science. We do it when that soda machine doesn't deliver your drink like it's supposed to, or the washing machine doesn't start when you press the button. You initially try harder and harder to get that machine to make the response you expect and if it doesn't you stop trying. If you keep the demand on it may well take that 3 hours (known as an extinction burst), but as soon as the child works out that those behaviors no longer get him out of doing the task, he will stop and starting complying.

NewBlueCoat Tue 05-Nov-13 22:54:40

reward systems being used badly doesn't mean that all reward systems are bad, though.

So why do YOU tidy up and contribute to the household?

NewBlueCoat Tue 05-Nov-13 22:55:21

yes, banana. demand avoidance a huge issue.

Rentahouse, I do not doubt that due to the immense ignorance around ABA and reluctance to study the topic means that you have a substantial number of teachers badly using reward systems.

banana87 Tue 05-Nov-13 22:58:05

Demand avoidance isn't the issue. The reinforcement for displaying avoidant behaviors is.

Rentahoose Tue 05-Nov-13 22:58:38

Yes the eating example was a great outcome and it was handled relatively sensitively. I'm sure it would have taken weeks and weeks to get to that point.

I suppose I was just thinking just let him eat what he wants and keep putting new foods on the table/plate and eating with him and not putting him under any stress but that is what I would do for a NT child ( I have a fairly fussy eater). I accept that whereas an NT will eventually extend their repetoire, an autistic child may not.

NewBlueCoat Tue 05-Nov-13 22:59:43

yes, banana, agree.

banana87 Tue 05-Nov-13 23:00:05

What's more ethical? Allowing a child to beat you up, having everything done for him, doing whatever he wants because he can't be told 'no' or a temporary 3 hour extinction burst? Hmmmm....

banana87 Tue 05-Nov-13 23:02:02

I think it took 6 months to get to that point (with Jack eating) which shows how much shaping went into it. It's not a "fast fix" and doesn't claim to be.

NewBlueCoat Tue 05-Nov-13 23:02:55

but then what's ethical about treating a child so very differently (ie not shaping behaviours, which happens in all schools) just because they have autism? because that's what the argument of 'oh, but it's the way they are wired, and we can't change that' leads.

NewBlueCoat Tue 05-Nov-13 23:05:09

'fast fix' is exactly what it isn't.

we've been working for 7 years now to get my dc drinking again, following some spectacular mismanagement in a mainstream pre-school. and while fluids are now allowed, we're still not at the point where a drink can 'just' be given, or asked for when thirsty etc.

Rentahoose Tue 05-Nov-13 23:05:32

"So why do YOU tidy up and contribute to the household?"

I tidy up if I want a tidy room not because someone is paying me/rewarding me. It might be it's own reward. Sometimes I just don't tidy. Soon gets messy again with DC.

I contribute to the household because I love my DC and want the best for them. if they are happy I'm happy. I appreciate DC are great big egotists though!

I do some work for money but luckily enjoy my job and that is what gives me a lot of satisfaction.

I'm not saying people don't work for rewards but I want my toddler to wee in the potty because she needs to go not because she's going to get a chocolate button. You can't force someone to wee on demand.

I don't think all reward systems are bad (although Alfie Kohn would disagree) and some children definately need them. I just wanted to see if I could appeal to reason but accept children are not reasonable beings.

GobbySadcase Tue 05-Nov-13 23:08:16

Now you see I find that really offensive.
Autism is a massive spectrum. What works for some doesn't work for all.

I've said ABA doesn't work for my family but I accept it works girl some.

How DARE you say my way is wrong? Path at because I don't follow a system that isn't right for my family that I am allowing undesirable and dangerous behaviours to continue?

You have NO right to do that. None whatsoever. It's not your way or the highway.

How disrespectful.

Is having a tidy room not rewarding to you then?

NewBlueCoat Tue 05-Nov-13 23:09:24

you dont have to use food rewards, though. it's up to you to get inventive and creative with your rewards.

one of my dc potty trained using a dvd as a reward. it helped shaped the behaviour - she knew when she needed to go, but sometimes wanted to hold out too long (if playing etc) and helpfully was desperate to watch a particular DVD. combine the two for a short while, and job done.

another one potty trained using me singing a silly song as a reward - another new verse each time there was a success. made for lots of laughter and shared time while we made upt he new verse. I preferred that reward, but you have to work with what motivates the child.

I don't think anyone has said your way is wrong Gobby.

banana87 Tue 05-Nov-13 23:10:40

Socially mediated reinforcement will come for NT children. But you have to start somewhere and fade...it's exactly how you would have been shaped to find a clean room reinforcing.

My goodness, what would become of my NT dd if I simply let her be herself with no behaviour shaping.

googlyeyes Tue 05-Nov-13 23:11:30

Oh yes, the acceptance of the near-inevitability of tube feeding was utterly chilling. And the anti ABAers would doubtless think that denying the child the chance to ever EAT FOOD was less cruel than teaching him to try new foods, which involves some short-term discomfort, yes, but leads to a life positively transformed forever.

As someone said earlier, Jack certainly looked happy when the sausages and chips arrived.

The proponents of the 'ah, bless' school of thought never seem to give a thought to the fact that the cute kiddies they work with will be adults one day...childhood is a v small proportion of their lives and when they reach adulthood unable to make any sense of the world, or to cope with changes to routine, or unable to even communicate basic needs/ wants...what then? Someone else's problem I guess!

Rentahoose Tue 05-Nov-13 23:15:00

Yes but it is its own reward. I want my DC to do things because they are intrinsicly motivated. They want to do it because it makes them feel good about them selves. I do use praise but I prefer giving a lot of choices, hoping that DD will choose to help me tidy up. If she doesn't ok she's made a choice. If she does I'll tell her that was a great help to me.

Now I'm not saying I don't have a quite difficult time parenting because of this. As my DH says without consequences I frequently render myself powerless.

I can see how these systems are helpful to other children/parents though.

Please don't see any of this as a criticism of those who use these systems. I was interested because I come from a different perspective.

GobbySadcase Tue 05-Nov-13 23:15:27

Oh there's plenty of snarkiness here clearly showing that any way other than ABA is 'wrong'. Loads of it.

If my son wants to hand flap to calm himself down who is that actually hurting (to give a direct example from the programme itself). Gunnar stated parents wanted that kind of behaviour trained out because they found it embarrassing, which I find appalling.

'I contribute to the household because I love my DC and want the best for them. if they are happy I'm happy.'

Then your reward is that you are happy because your Dc are happy.

'I do some work for money but luckily enjoy my job and that is what gives me a lot of satisfaction.'

Then your rewards are both money and satisfaction.

Rewards are not stickers. They are not money and they are not food. They are whatever it is that motivates you to do something.

If you are thirsty, you are rewarded for getting off the sofa and getting yourself a drink.

GobbySadcase Tue 05-Nov-13 23:16:17

I shape behaviour. I don't out my children through several hours of distress to do so.

So Rentahouse how would you teach an NT child that things have their own intrinsic rewards?

How would you then teach a child with ASD who is unmotivated by social acceptance or praise?

Rentahoose Tue 05-Nov-13 23:18:18

"My goodness, what would become of my NT dd if I simply let her be herself with no behaviour shaping"

I'm not criticising your parenting though. Just saying you can shape a lot of good behaviour/politeness simply by modelling it.

NewBlueCoat Tue 05-Nov-13 23:20:13

rentahoose, you are right that in the 60s/70s there wasn't so much use of star charts, and reward stickers etc.

but there also weren't many children being given a choice as to whether they would like to help tidy up/whatever chore.

I can't say I recall ever having a sticker chart. but I also had no choice in helping tidy up the living room/my bedroom/doing the washing up/etc.

'If my son wants to hand flap to calm himself down who is that actually hurting'

Well I really don't know about your Ds. But if my Ds was hand flapping at the edge of the kerb whilst I was trying to teach him a basic road safety lesson I'd want him to stop and pay attention.

'I'm not criticising your parenting though. Just saying you can shape a lot of good behaviour/politeness simply by modelling it.'

I don't disagree with that. Only I'd add that for a child to then copy and internalise that behaviour or model they'd have to see something in it for them. That might be parental approval or validation or perhaps feeling more grown up, who knows.

But children with ASD are rarely socially motivated, at least at the beginning until they have been taught explicitly the value of social reward.

GobbySadcase Tue 05-Nov-13 23:24:19

Well good for you.
You clearly feel your way is the only way and nobody is allowed to disagree.

And people wonder why I don't go near the SN boards.

Rentahoose Tue 05-Nov-13 23:24:24

"So Rentahouse how would you teach an NT child that things have their own intrinsic rewards?"

I don't know. My DD seems to be proud of the pictures she draws, the writing she does. She was proud of riding her bike without stabilisers and told everyone.
I give her a lot of attention (which is positive reinforcement I suppose) but this is not particularly conditional.

"How would you then teach a child with ASD who is unmotivated by social acceptance or praise?"

No idea but I never said reward systems were wrong in the contexts of school. But would probably do more verbal affirmation and would hold back on the raisins/sweets

googlyeyes Tue 05-Nov-13 23:24:51

I have to say I would take a few hours of distress over not being able to eat solid food for life. Or being in nappies for life, or being unable to communicate.

There may be short term pain (figuratively speaking) but it's for a v v long term gain.

Being tube fed can hardly be a barrel of laughs

Gobby, the SN Boards are full of people who don't and never have done ABA.

What happens if he refuses the tube feed?

Rentahoose Tue 05-Nov-13 23:27:50

This is a great discussion but I'm afraid I have to get to bed. Now if you could get a toddler to stop waking at night with postive reinforcement, I might just give it a go.

What if verbal affirmations never had any affect?

That was what was so sad about Patience's son. He would clearly do anything for her. SO much potential.

Well some might suggest controlled crying for that as a behaviourist intervention, but me, I'm an attachment parent and would never do it. Good luck!

GobbySadcase Tue 05-Nov-13 23:30:58

So you're assuming that because I don't practise ABA my kids are non verbal nappy wearing food refusers?

No they're not.

The Autism Spectrum is too huge for one approach to suit all.

Rentahoose Tue 05-Nov-13 23:31:26

I guess if I was in her/your situation, I would try anything- of course I would.

Did Patience refuse ABA? I think I missed part of her story.

No. I guess it was never clear how expensive it is to get the LA to fund ABA. It isn't obtainable for the average person. Most sell their houses and get into huge amounts of debt.

Rentahoose Tue 05-Nov-13 23:34:20

Ah you see I'm an AP parent too! so we do have something in common.

Breastfeed for years too (so that hardly fits in with societal expectations).

Good night all

Homsa Tue 05-Nov-13 23:34:49

I guess it makes good TV if you oversimply things by making it look as if ABA was "harsh but effective" and other options "soft but ineffective".
It was deliberately polarising - they could have shown was what a special school was like in the 1960s, for starters!
ABA is an incredibly effective teaching method, and it transformed our son's life. ABA expanded his horizons and allowed him to experience things that had been closed to him, and to eventually discover their intrinsic rewards.
We don't run a programme anymore, because he doesn't need it. He is learning well in a mainstream school, and he is an outgoing and happy child. He is also autistic, and that's a part of who he is, and a part of the person we love. We never wanted to "fix" him, we wanted to open up the world to him. That's your job as a parent, surely?

NewBlueCoat Tue 05-Nov-13 23:35:41

um, positive reinforcement (coupled with a sleep/wake clock and moving her in with her sister) stopped my dc2's extreme early rising. she was about 2.5 at the time, so you never know.

good luck! interrupted sleep is a killer.

bialystockandbloom Tue 05-Nov-13 23:40:55

I feel really, really uncomfortable with this notion that ABA is somehow 'denying' peoples' autism, which kept being brought up in the programme (by the anti-ABAers of course). Ime it is absolutely not about this. It is not a 'cure' for autism. It is a method, tailored to the exact needs and difficulties of each individual child, which teaches skills based on a really really simple principle (which starlight has explained clearly).

It doesn't take anything away. It adds to a child's skill base, their ability to communicate effectively, to interact, and to engage.

No of course stimming doesn't do any 'harm'. But it can interfere with a child accessing experiences. And when a stim causes harm to another person (eg headbanging/hitting someone) then what do you do? Accept it as part of a person's 'condition'? God. There is still such a low expectation from people with autism, that somehow by teaching skills it denies them to be the person they are.

I have no judgement whatsoever about how other people bring up, or teach, their children, but this thoughtless, ignorant stance against a method of expanding an autistic person's life experiences and skills drives me mad.

We have done 3 years of relatively intensive ABA (verbal behaviour method, exclusively done in the natural environment) with my ds. I have seen pretty much all of the sessions he has had. Not once was there cruelty or punishment. (Unless you would consider punishment to be him not being allowed to get sweets by hitting me.) The 'distress' he went through was no more than my NT dd goes through if she demands cake and I say no.

The endless clips of extreme 60s/70s methods (which I expect weren't even that representative at the time) were so damaging. I wonder what clips of 'special schools' of the same period would have looked like by comparison? hmm

TheBuskersDog Tue 05-Nov-13 23:45:38

I have to say I would take a few hours of distress over not being able to eat solid food for life. Or being in nappies for life, or being unable to communicate.

I don't think anyone claims any of these things can be sorted in a few hours though.

I think ABA is among many methods that can help to a certain degree, depending on many factors. Some things would happen anyway because of the child's development or using different methods.

I don't believe it will make a child with autism NT, and in cases like the boy in Sweden I think he was probably misdiagnosed at 3.

bialystockandbloom Tue 05-Nov-13 23:46:25

Oh blimey, tons of x-posts blush

gobby I don't mean to come across that ABA is the only way, and hope that you aren't put off the SN board from fear of that. I only know that it worked so successfully for my ds, and I would just like it to be more widely and properly understood - at the moment it is presented as so extreme and controversial, when in reality it just isn't.

homsa puts it very well.

GobbySadcase Tue 05-Nov-13 23:47:15

Of course I don't accept behaviours that cause harm. But I also don't use ABA.

Why do people not accept that there is more than one way?

bialystockandbloom Tue 05-Nov-13 23:50:31

Gobby, I do accept there is more than one way. Just what I said before, I just wish ABA was better understood, and not constantly presented as something extreme, harsh, controversial and somehow 'alternative'.

googlyeyes Tue 05-Nov-13 23:50:38

I didn't assume anything at all about your children Gobby.

For those at the severe end of the spectrum things like potty training, eating normally and communication are things that may never come without painstaking work. Acceptance and modelling behaviour will rarely cut it.

But if these things are achieved, the lives if these children are utterly transformed. And no child is going to be less happy because they have learned to communicate.

At other points on the spectrum issues are quite possibly very different.

bialystockandbloom Tue 05-Nov-13 23:56:50

I don't believe it will make a child with autism NT, and in cases like the boy in Sweden I think he was probably misdiagnosed at 3.

People have said similar about my ds, who is now 6.5 - the difference in him is astonishing. Npt because he's 'cured' but because at 3 he coudn't communicate, didn't really engage except on his narrow, rigid terms, didn't play, and left to himself would have spent all day on the same repetitive non-functional actitivy.

I don't think I knew what his personality was when he was dx at 3. He is now a sweet and lovely boy (stroppy and all that too, of course) and definitely ASD, but his skills now enable him to engage with the world to the extent that you can describe his personality. Many people who know him now have difficulty believing he has autism, and actually I think I'd struggle to get him a dx if he was assessed now - not because he was misdiagnosed, or 'masks' his autism, but because he has been taught so much which many people (paediatricians included) believe not possible for someone with autism.

GobbySadcase Wed 06-Nov-13 00:02:39

It certainly took a hell of a lot of painstaking work by us too - times 3, and yes DD still isn't quite there.

But it's happening gradually. Just because it wasn't achieved by ABA doesn't make it wrong.

I've already said if ABA works for you go for it - only to be tokd it didn't work for me cos I did it wrong - how rude!

NewBlueCoat Wed 06-Nov-13 00:04:38

bialystock, similar could be said for my dd.

several parents at her (ABA) school initially wondered why she was there. she is so far removed from the toddler who was diagnosed at 2 that it is incredibly difficult to even remember what she was like back then.

She has a severe language disorder as well as ASD, and I think if she were to be dx'd today, it would be the language element that would be seen, as she also displays so many behaviours which are 'not possible' for someone with autism.

we have just been on holiday. there were at least 4 occasions where the surprise shown when autism was mentioned was genuine grin. at the airport on the way home, I was chatting to another family for a good 30 minutes (while also chatting to dd) before I had to explain her behaviour. And when I mentioned autism they were shocked, because it was not a possibility that had entered their heads. never thought that would be possible

sparklysilversequins Wed 06-Nov-13 00:14:27

Just want to join this thread as am currently studying Behaviourism and in turn ABA. Also have two dc with ASD. I have learned more from this discussion than reading my text book!

ABA can't not work. That wouldn't make any sense scientifically.

Poor application of ABA would still work, though just not with the outcome you wanted.

GobbySadcase Wed 06-Nov-13 00:21:47

Really? Even if you have a child entirely unmotivated by reward?

I think there is a lot of misconception about what rewards are.

If a child does something, anything, then they were motivated to do it by the reward it brings them above all other possible alternative actions.

TheBuskersDog Wed 06-Nov-13 00:25:27

bialystockandbloom, it's interesting you say he is definitely ASD but you think you'd struggle to get a dx now, I think this is why in lots of areas they don't like to diagnose before 7 because some children can develop a lot in that time. Not saying your son would have got to where he is without intervention, rather it is difficult to know how a child will develop either with or without intervention, or, for example, if they also have a learning disability. It's great that your son has come on so well by the way.

I think in the case of the boy in Sweden they were claiming he didn't have any features of autism now, although I may have missed them saying he did.

And if they just sit still unmoving, then THAT is what they are currently most motivated to do.

But starting intervention at age 7 misses all of the early years opportunities when the brain is at it's most receptive to learning skills.

And you don't reward behaviour, you reinforce it. Which is why it can't not work.

You identify the behaviour you want to see more of, and those you want to see less of and change YOUR behaviour to get the child to want to do more of one and less of the other. You keep changing your behaviour until it happens, and then you keep changing your behaviour to get it to happen faster.

banana87 Wed 06-Nov-13 08:50:16

the bottom line is that ABA is used everywhere, everyday without even realizing that's what's happening. It shapes our everyday behaviours. It is the only intervention with years and years of peer reviewed research to back up its effectiveness. If parents and professionals would rather close their eyes to that and go with the eclectic intervention that isn't shown to work then that's their prerogative. If they would rather watch their child stim all day rather than do something about it, fine. I just hope parents who don't use ABA or are resistant to its methods ask themselves where their child will be when they are 18 and how will their behaviours be managed then.

working9while5 Wed 06-Nov-13 09:16:23

I just want to say that as a speech therapist working intensively with language disordered kids I use mainlt ABA teaching methods with no external reinforcement.

I work at secondary and the kids are motivated primarily by the fact that in their sessions they get to work at a level and in a way where they see progress and where it's tailored to their unique learning profile at that point in time. In their mainstream classes frequently vocab is well above their comprehension and tasks are so incredibly demanding that opportunities for independent learning are limited.

In our sessions we just pinpoint exactly where they are at, exactly the next steps they need and we set up tge learning so they can practice the skills they need independently and see their progress. A good example is a little girl who came to us from primary having had SIX years working on answering how and why questions. These are pretty critical foundation skills for learning in secondary. At baseline assessment she was only getting about 20% right. After a term of working intensively on the same standard materials most professionals use to teach these but doing so intensively and behaviourally, she got 90% on an assessment of new 'how/why' questions she hadn't been asked before. She also started answering in class.

She never got a sticker, star, sweet or even a 'good girl' as we don't talk like that at secondary. She did get our unwavering belief she could do better. It was and is her own motivation that spurs her on.

Students with autism don't always have that social drive to do better for themselves or others in a clear cut way where they see that if they practice x it will lead to y gain in their life. So tangible and extrinsic reinforcement is more common with this client group as a STEP towards making those links so that hopefully one day the reinforcement comes from within.

The whole educational system in the UK in special ed isbased on isolating specific behaviours and practising them to mastery. It IS the IEP system. All targets need to be smart eg specific, measurable, attainable, realistic and timed. It is based on applied analysis of behaviour. Why not use the scientific lliterature to do that well vs shooting in the dark?

Make no mistake. I'm a speech therapist. I do speech therapy things, not some sort of ABA 'program'. I just use what I know of task analysis and a variety of behavioral techniques that are common to special ed settings in the UK like social skills groups, precision teaching, direct instruction etc with better knowledge of those things than most of my peers. All this means in real terms is I get results because I am not spending most of my time endlessly cutting and pasting 'strategies' and puzzling over how to make these smart when they're sort of... waffle.

ABA is really much misunderstood!

working9while5 Wed 06-Nov-13 09:22:49

Oh and incidentally I have seen SHOCKING ABA practice. SHOCKING special school practice too... there are a lot of crappy providers out there.

I am not tied to any one school of thought or practice, I do what works for the kids I work with.

Bottom line for me is, after one session of working with a child on something can you prove that they know or can do something differently to before that session began? If not, teaching isn't effective. I don't much carehow that comes about as long as it is ethicak and effective.

working9while5 Wed 06-Nov-13 09:51:58

Last night my nearly-four year old NT kiddo went to the bonfire with us. Like many young kids he's a bit scared of fireworks. When we got to the park, the first ones went off and he started screaming HYSTERICALLY and begging to go home.

This is a great example of a very common situation where a bit of common sense behavioural thinking was needed.

If we left, we would have reinforced his idea that fireworks are dangerous and terrifying and also the reso of us would have been crabby and disappointed.

If we just ignored his screaming and/or shouted at him (as many do) we would have potentially made fireworkseven more aversive in future.

So we made a game of it. He is massively into superheroes right now so we labelled the green ones hulk, the red ones spiderman, blue/white/red captain america etc. For five mins we held him and just modelled excitement and kept the momentum high. We'd bought a light sword on the way in and we demonstrated bashing the ones he was scared of. Five minutes in he asked to be popped down and watched the rest of it shouting out superhero names.

It's basic ABA. Paired reinforcement (superheroes and cuddles linked to fireworks), preventing escape behaviour/avoidance, modelling, reducing support (all singing/dancing at start, fading this out as his distress reduced etc so he took it over).

With NT kids this stuff just works instantly in many cases. It is sort of intuitive for most parents too as they have a prior learning history of what approach works for their individual child, what will motivate and reinforce them in any given moment, when to keep it high, when to reduce support or praise and let them just get on with it. No one would even consider they were 'doing' anything let alone analysing and responding to behaviour. Yet we all do this stuff... it just requires different and more intense approaches sometimes for some kids. Yet the golden rule is you do the least necessary to get the result you want. A hardcore Supernanny approach is also ABA and might have had my son stick out the bonfire. ... but it would be against my morals and values so a softer approach that got desired result was what I needed.

It is all behaviour. If what you do works, it could almost certainly be analysed from an ABA framework just because it doesn't involve massed trials or tangibles etc. Modelling and shaping are behavioural techniques too!

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.

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

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.

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.

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 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.

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?

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.

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, 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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