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ABA Programme? What is it? Anyone tried this?

(17 Posts)
dietstartstmoz Fri 07-Jan-11 20:19:28

Hi,
We have our first paed appt on Weds but we are expecting a dx of ASD at some point, and i'm really struggling with it all to be honest.
Anyhow, he should be starting school in Sept 2011, and I did my mainsteam spplication before we were aware of the severity of concerns from pre-school/nursery etc. Not sure what will happen over the next few months, if he will be ready for school, mainstream or something else.
Have been swotting up on MN, and just wondering what an ABA programme is? Just wondering if there is anything I can do to help DS with his development in anyway and help to prepare him for school?
Any advice, as always, gratefully received.

Marne Fri 07-Jan-11 20:29:30

Hi, we don't use ABA with dd2 but i think its more to do with behaviour (i'm sure someone who knows will be along with more info).

My dd2 (ASD) started school in september 2010, she goes to MS (not through choice), we tried for a sn school but we were turned down.

Dd2's main problem areas are speech/language and sensory problems, her speech has come a long alot in a year but her sensory problems seem to have got worse.

I would say 'you deffently need to get a statement for him before starting school', this will put in place any help/support he will need at school (this can take up to 6 months).

I think its hard to prepare any child for school but its even harder to prepare a child with ASD.

Toppy Fri 07-Jan-11 20:55:39

Hi Diet - I remember you from a post back in Nov where you hinted on a newly diagnosed ASD thread that you might be in this boat soon yourself. We got a diagnosis in Nov and my DS is just 3. Its been rough.

ABA is something I really need to find out more about too so I will be watching your thread with great interest. Our immediate reaction after diagnosis was to get DS into a special nursery for a couple of sessions a week which we are paying for whilst we go through the Statementing process. I spoke to a friend of a friend who now lives in the US and her son aged 4 has just had his diagnosis 'lifted' in the US (does not happen in the UK) after 2 years of ABA. She seemed to have a team of tutors that she got together who came to her house and worked 8 hours a day for 5 days a week with her son in a designated room free of all distraction. She said they sort of 'trained him' to learn behaviours using Smarties as a reward. It obviously has amazing results to have 'cured' her son but I felt really overwhelmed at the thought of putting that in place myself and it seemed to be very expensive too. However I am going to do some more research into it as I have been feeling really guilty that I have not lept on the one technique that seems to have proven results.

I think PEACH are meant to be a good organisation for finding out more about ABA and also look at Wikipedia on The Lovaas Technique (Dr Ivar Lovaas was the developer of ABA)

StartingAfresh Fri 07-Jan-11 20:57:41

You might like to read 'Let Me Hear Your Voice' by Catherine Maurice, first.

A lot of the techniques are similar to those advocated by supernanny, but basically you use the motivation of the child teach them skills by rewarding them the instant they change their behaviour and act minutely in the way that you would like them to. Once they understand what they have to do to get the desired feedback you up the stakes a bit etc etc.

The most important aspect arguably is that you keep detailed data on what is working and what isn't and break down tasks into the smallest parts and then build them up again a tiny bit at a time as fast as you can so the child doesn't get bored.

StartingAfresh Fri 07-Jan-11 21:01:01

Your child 'should' be motivated, and therefore engaged and happy during the programme. You are not trying to break them, you are trying to find out what they love most in the world and give it to them over and over for putting up with a few seconds of work at a time.

You are also aiming to make the few seconds of work rewarding and motivating in itself so that ideally, he is asking to do it and you can use the work itself as the reward iyswim.

StartingAfresh Fri 07-Jan-11 21:06:01

Why don't you join the ABA UK yahoo group and ask if anyone in your area is running a programme. Almost all families running programmes are so used to people coming into their home they are happy to have people come and observe and see what it is all about. They will also have knowledge about the local 'scene' and politics with the LA.

hth

Agnesdipesto Fri 07-Jan-11 21:53:50

Am sure you will have lots of replies by time I finish typing this!

We use ABA, we started at 2.10 and my son is now 4.

Applied behaviour analysis is a very structured way of teaching children. It breaks down tasks into their smallest components and teaches them one step at a time. So if you think about learning to swim you might sit on the side and put your legs in, then learn to put your face in the water and blow bubbles, then you might learn how to move your legs and then arms using floats and then gradually work up to actually swimming. ABA does this with everything but into its most tiny steps

So as an eg when we started DS could not copy a simple instruction he would not look or respond when we spoke, so ABA staff found what he liked (they watched what he went for in a room) and then gathered up those things. They then put 2 bricks on a table and said 'give me red brick'- of course he ignored them - so they did it again but this time they put their hand over his and made him give them the brick and then immediately gave him a favourite toy. This way he quickly learnt if I do what they want, I get things I like so he was motivated. We then figured out what he already knew eg colours and what he didn't know.

There is a focus on rewarding behaviour you want to see more of eg speech and ignoring behaviour you don't want eg aggression. So if DS kicks etc he has anything he is playing with taken away and is ignored but if he asks for something spontaneously we give him loads of praise (he no longer needs actual toys) or tokens on a reward board where he earns time to go and do freeplay. They reward behaviour which children with autism find hard eg just looking at the toys (DS would try and build bricks while looking out the side of his eye and using one hand so they would reward him if he looked at the brick and for using 2 hands) and now he builds towers like any other child - although his concentration span is shorter (but improving). Much of it is taught using prompts eg physically prompting and then fading out prompts asap so the child really learns the skill independently and is not reliant on someone to tell them to do it.

Its very systematic so we would teach DS to copy or follow instruction eg clap hands - then we would ask him to do 2 things eg clap hands and sit down and build up. Then do it in different settings and with different people. Then use imitation / instruction for more typical play eg crashing 2 cars together - then adding sound eg he would copy crashing two cars and saying 'crash' - then getting him to copy another child doing it - then starting with 2 step instructions etc So there are heirarchies of teaching skills with it getting harder very gradually. So at the start DS could not copy 1 step, used only 2 words functionally (although he knew 100s) or follow a 1 step instruction but within 6 weeks he was using words to request things, using 2-3 word sentences to request, following long chains of imitations and following longer instructions. It is hard painstaking work for DS (some children make quicker progress some slower) - some things take months to teach others he gets in a day. Its not a cure. But for us its been very effective where other approaches have failed.

ABA staff also take data and evaluate it - so it is a science - so the staff would do the imitation programme say with the cars and score how often he got it right at 1 step then if he got 80% success 4 days in a row they would say he had mastered that skill and then move onto the next mini step. And there are programmes for everything - language, play, brushing teeth, not hitting, sharing etc etc every aspect of life is worked on very systematically.

You can watch some video on youtube and look at websites like Treehouse, PEACH, Autism Partnership.

I actually find it hard to explain ABA really you need to go and see some (we often have other families come and watch DS who are thinking about ABA) and then the penny drops.

Its also supposed to be intensive - anything up to 40 hours a week. We did 15-20 ourselves (with a supervisor training us) for a year until we got to tribunal - and then we won 35 hours a week funded by local authority. LAs hate ABA as its so expensive. It has had a reputation of being harsh (which dates back to when it started when instead of rewards they used punishments) but modern ABA is not it should be very fun and playful but there is an insistence the child do what its asked to get rewards - so this is the behavioural bit as you are very firm and consistent - but actually children with ASD like this clarity. You will still come across very negative views about ABA because of this history (although to be fair all children in those days were subject to corporal punishment). Because its expensive the negatives are perpetuated as a reason for families to be denied ABA eg its very cruel, you drill a child for hours etc etc

DS has his ABA at home and in nursery - so we employ staff who go to mainstream nursery with DS. We hope to keep it into reception and beyond. Before tribunal we had just a mainstream 1:1 and that was hopeless as while they were well meaning they did not have the knowledge of how to teach a child with autism. It was just babysitting. We were denied a place at special school (we would have tried this as really we could not afford ABA for a year we are broke now)

Many children with autism need to be taught things in a structured 1:1 way as they do not learn from watching other children / their environment. However the aim is to teach the 'learning to learn' skills eg paying attention, being in control of their behaviour, being able to imitate etc in the hope that children will become more tuned into their environment and will be able to learn more typically. Some children who do learn how to learn in a more typical way do exceptionally well and can become indistinguishable from their peers. Thats not to say its a cure - more they have learnt enough strategies to be able to adjust.

Many special schools and ASD units will use elements of ABA and there are some ABA schools around the country - but if you want the LA to pay expect a battle - really you have to do it yourself for a while to prove it works for your child - and ideally have tried the LA offering to prove it did not work.

Completely on a different note - many parents recommend Hanen More Than Words book when you get a new dx which has strategies eg especially use of visual supports etc as a good place to start if you want to teach yourself some things to help.

moondog Fri 07-Jan-11 22:21:27

That's a terrific post, Agnes.

StartingAfresh Fri 07-Jan-11 23:04:07

Another 'negative' of ABA that LA's and others like to bring up is that an intense programme is unfair on a small child. It is cruel to subject them to a learning programme when they should just be being children.

This argument is fundamentally flawed because children without ASD are subjected to learning programmes from the second they wake up until they go to bed. Everything they do is about exploring and learning, testing, engaging with people etc etc. Okay, they don't have anyone directing it, but it is happening nonetheless.

ABA means that for as many hours in the day you can manage (ideally ABA becomes a parenting stratey too) the child is engaged in OUR world, learning and enjoying learning. The difference is that children with ASD don't have a natural ability to direct this themselves so need some 1:1 to do so.

IMO you are levelling the playing field, not imposing something unnatural onto them.

moondog Fri 07-Jan-11 23:06:09

Yes, as some wit posted on a Yotube clip of some fantastic Direct instruction in response to comments about how 'regimented and cruel' it was

'Yeah, look at those poor bastards, sitting there, learning and listening and joining in. inhuman isn't it?'

Toppy Sat 08-Jan-11 00:12:12

Wow Agnes - that is an AMAZING post !

How did you ABA-ers go from newly diagnosed to full ABA programme and did you do it fairly quickly ?
We are 2 months into diagnosis and still feel we are in an info vacuum. Had a speech therapy session today with a new SALT and she spent an hour working out what would motivate DS so she could introduce PECS at our next session. That is all that has happened since diagnosis other then me find a special nursery place independently. Nothing has been offered in the way of advice or support about how to go forward with ASD. Naively I sort of thought we might get some guidance from the professionals. Instead I have been flailing a bit trying to read about all the different types of intervention. I figured once I had DS in a place where they are experienced with ASD for a few hours a week I could take a bit more time to investigate ABA, bio-med, SonRise etc. I am hoping the new nursery will be able to advise me too but obv if they are not an ABA nursery they are probably biased.
I'd love to know how others decided to go ABA - its one of those routes that feels like something that 'other people do' and I am a bit perplexed with myself that I have not pursued it yet - I guess it feels a bit foreign and I would not know where to start !

Agnesdipesto Sat 08-Jan-11 00:19:52

Yes Star we had this argument let him be a child - from autism outreach of course - to which I said but he isn't being a child he is sitting on a computer all day wearing a nappy, not eating normal food and not engaging with anyone and he could still be doing that when he was 30. Even the LA EP agreed saying and how long does he need to be a child - all children need to be taught but some children need to be taught more than others - you want him to be independent and capable and happy and that isn't going to happen by leaving him to his own devices. Of course he said this is the privacy of our sitting room not unfortunately in any meeting or the tribunal room!

StartingAfresh Sat 08-Jan-11 00:35:46

Toppy Are you able to say where you are in the country?

I got a dx in September, tried the LA provision for all of 2 months and luckily realised fast that it was a load of well-meaning tosh and got an ABA programme up and running by November.

Having said that I started first investigating ABA in June but thought I should see what the LA was offering post-dx. Like you, I thought it would all flood in.

As soon as I realised it wasn't going to, I made alternative arrangements.

In many ways I didn't go down the ABA route then for the reasons I would go down it now.

At that point I was fairly convinced that ANY intervention that was intensive and focussed would be a damn sight better than the LA offering, so I simply chose the method that had the most research backing it so (I thought) I would have credibility with the professionals and they would understand why I was opting out of theirs. Ha Ha

It's a daunting thing to start and unfortnately it is also unregulated so there are 'some' cowboys about which only serves to fuel the LA fire of doom, so you do have to be a little bit careful.

An excellent introduction to ABA is the 2 day introduction to PECS course run by Pyramid Education (they invented PECS). It is the best ABA training for beginners I have come across. You can justify the expense as your SLT is recommending PECS anyway, but if it is a struggle they do have some funding to help parents.

FrostyPhlebas Sat 08-Jan-11 00:51:35

We started ABA before diagnosis - some providers require a diagnosis, others don't. It isn't a teaching method specific to ASD, it's helpful with any developmental delay (& NT children) - we started primarily to focus on ds' language delay.

Our time line went like this:
Christmas when ds was 2 - started having concerns about development, went to HV
April - finally NHS SALT (completely out of her depth)
June - saw private SALT in & started Makaton/Hanen & portage, asked GP for paed referral
August - BIBIC for developmental assessment
September - started ABA (limited programme ~6 hours a week) had portage removed because we were funding our own 'programme'
October - saw paed & got diagnosis (no MDA, diagnosis was made from BIBIC report), started nursery
February - increased ABA hours in (we now do about 21 a week)

We started because it's the only intervention that has any evidence to suggest it actually works and because we were offered nothing except PECS (at the time when ds was signing 4+ word sentences) and the 'promise' of a place at a SLD special school (totally unsuitable). He has a great 1:1 at nursery who has been willing to have some ABA training & that has made a massive difference to his learning there.

It isn't without it's downsides (cost!) - tutors are quite frankly a complete PITA, I would love to be able to do it all myself - and hasn't been a magic bullet for us either. DS is still demand avoidant (light years improved from a year ago), he still resists direct instruction, he still operates on his own agenda. But he is in the normal range for receptive language, almost there with expressive (when we started he was untestable - he said nothing & understood nothing), highly sociable with adults (improving with children), and is 'ahead' academically (seems a bit silly to say that when you're talking about a 4yo).

We do a VB programme (use VB-MAPP as the assessment) but even for VB we're pretty lax. We've only ever taken first/last data (were never going to use data to prove anything re tribunal etc, do a huge number of cross-overs and since we're pretty much NET it just interrupts the flow too much). We've never done much table top stuff (for ds with his demand avoidance it would have been a disaster - we did spend a good 6 weeks probing & assessing before we came to that conclusion). DS has never stimmed or had that many behavioural issues so the programme focuses on (1) speech & language (2) Social skill (3) life skills - though again we've taken a developmental approach, he's making progress with potty training/dresssing now but we haven't pushed it hard. Most of our sessions take place outside the home (NET) - soft play, swimming pool, riding, museums, shops, punblic transport, cafes etc. When we are at home it just looks like play tbh.

You tailor the programme to the learner - ds has really good generalisation, learns loads incidentally and hates direct instruction so we work to his strengths while adapting for his weaknesses. I still hanker after a traditional Lovaas programme though - seems neat compared to what we do!

Toppy Sat 08-Jan-11 00:58:12

Hi Star - I am in London. In an LEA with a maintained specialist ASD school which is excellent but a bit daunting and which we are not likely to be offered but the fact it exists means we are not going to be offered anything else whatsoever.

I'm really impressed that you moved so quickly - this friend of a friend did something very similar but had a lot of US influence in her life (they'd just moved from there back to the UK). I just feel overawed by it but the more I 'chat' about it here the more 'think about-able' and maybe even do-able it seems. I will follow up your leads so thank you.

Diet - I did not mean to hijack your thread but thank you for starting it !

StartingAfresh Sat 08-Jan-11 01:07:16

Toppy It didn't feel quick at the time I assure you. I was panicking every day that passed that I was 'winging' it without proper guidance and my own made up programme.

When upon dx my saviours came from the LA and demonstrated they had much less of a clue than me, I knew what I had to do!

And that was to get something formal in place with a properly measured baseline so that I could see on an ongoing basis, progress or lack of progress in skill areas.

What is lovely about ABA is that you are no longer stabbing in the dark. Every day you can simply open up the book and see where your ds is up to and work on it. The fact that you see progress all the time gives you so much hope for the future and removes some of the fear associated with not knowing where your ds is on the spectrum, and what that means for the prognosis.

I live with the reality. It isn't always my preferred reality and tbh the reality changes as ds learns new skills or struggles with others, but I can safely say that right now in time, I KNOW my ds and what he is capable of, and where this is compared to his NT peers. The peace of mind that that brings is immense.

dietstartstmoz Sat 08-Jan-11 07:51:02

Wow, thanks everyone that's brilliant. To be honest my head is just everywhere at the moment, and i'm going to spend the next couple of days preparing for the paed appt, then after the paed appt, if they think it is ASD I will look into everything else. I know if it is that I can't change it, but I want to do as much as I can to help DS develop in preparation for starting school in 8 months time, as he's got a massive way to go yet. ABA sounds interesting, thanks Agnes that was fantastic information. We will see what this week brings, but i'll start to look into my options. Thanks, just love MN smile

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