ABA v traditional speech therapy-what do you think?

[tiredmummyoftwo]

DS (4.2) has been having ABA since January and he has been improved a lot behaviourally and to certain extent communication wise. He was verbal before starting the therapy and had a lot of language, but what he only used one or two words to communicate his needs and now he can do 4-6 words sentences. We have been reviewing his progress over the last few weeks and it seems that he has now hit a brick wall. He is not behaviourally challenged anymore, he never had any sensory issues so that's still alright. But his speech seemed to have stopped at his need level ( I mean he only talks when he needs something or when he wants to share something with us, but he is not doing any conversation or social communication). DH and I are wondering whether it's time to try some traditional speech therapy as he has not progressed much over the last few months speech wise. What can a traditional SALT offer that an ABA therapist can not? Moondog or any other SALT around?

Any advice on this will be greatly appreciated.

[Davros]

Ime, these days, many "traditional" speech therapists will use behavioural methods, e.g. schedule board, token system, reinforcement etc. I think it depends more on which SLT you choose and how they work but they certainly can offer more than a standard ABA therapist who can carry out SLT's recommendations outside 1:1 sessions. A professional SLT understands how sounds are formed, joined, work on retrieval etc.

[sickofsocalledexperts]

I think what you are talking about is the trickiest thing of all with autism - fostering in the child the DESIRE to communicate, rather than just the tools to do it, eg speech. My boy too sees very little point in communicating unless he has a need he wants met. I still think ABA has the best chance, but I think they have to start teaching him to have a conversation in a very automatic way at first - eg "how are you? he says "fine". What did you do at the park, I went on the swings etc. It's exactly this kind of social chit chat that some autistic kids can't see the point of as they have no particular need to share information. But I do think it can be taught from the ground up, by trial and error, and I think the ABA folk know more about how to motivate an autistic child to learn new things (or at least most ABAers, and the SALTs I ahve come across just don't know enough about autism, but try and impose their nf methods on the asd children)

[cyberseraphim]

Same situation here. DS1 has basic communicative language and can comment on his interests and insist that others share them but conversation is not present. My expectations might be lower though. My brother has full use of language and has normal cognitive ability but I can't really say that I've ever had a conversation with him as the desire for such exchanges is not there. I am more concerned about expanding functional language at the moment

[huffyhuffystompstomprahrahrah]

I concur with Sickof - ABA therapists/supervisors will know lots about encouraging social communication - especially those with a VB emphasis which is all about how language works and the connections and understanding that is needed in order to communicate successfully and socially. ABA also works with motivation to show kids just how reinforcing communicating can be.
The majority of therapists that I know will also have a wealth of experience in working on sounds, word retreival etc. but a SALT may have more knowledge about oral motor side of things and why particular sounds are harder than others.
But, it would depend on who you are working with, as Davros says.

[tiredmummyoftwo]

Thank you all for replying. We have two supervisors working with him at the moment who seem to be at a loss as to why DS can do certain things on one day and can't do it next day at all. They both have over 12 years experience so I trust them, but bottom line is DS is stuck and they can't figure out how to unblock it. He shows some desires to do social conversation as he will approach somebody with a hello and ask them to play with him, but then if it is his peers, he does not know what else to say and if it is an adult, he waits for them to ask questions. His cognitive ability seems very good, but he does not want to learn from us or his therapist. He does not remember what they are trying to teach him concept wise, but he seems to be able to remember things I have said to him couple of years back. What we have noticed is that he pays attention to things when he does not realise that he is being taught something, so for example, he has learnt all the letter sounds from DVDs as my daughter likes to watch them. Although he never sat down long enough to watch it fully, he has picked up everything on those DVDs. He shuts down completely when he sees us trying to teach him something, so with the ABA therapist he will just say whatever comes to his head at the time of question (his compliance is 100%, so he knows he needs to give an answer), but another time during play he can answer that question correctly. If the professionals can't figure out why this is, I don't know what we can do. This is why I was wondering whether a traditional SALT is more effective when it comes to teaching speech than an ABA therapist.

From all of your replies, it sounds like if we can figure out why this is, then we can cure his autism.

[sickofsocalledexperts]

My son is like this - he will say any old thing just to shut the therapists up sometimes. I think it's a bit like sometimes he deliberately switches his brain "on" and sometimes he can't be bothered, and switches it "off". Myself I don't believe ABA can cure autism, but I do think it can ameliorate it greatly. Some people say autism is in fact "extreme maleness" and if you look at how differently a male converses to how a woman does ("did you see the match? "yes"), it's not that surprising that autistic boys don't "get" chit-chat. But I do believe ABA can teach conversation in an artificial way, till one day it becomes more natural to the kid. Your boy sounds like he picks things up very quickly so t hat's a good sign. Good luck!

[tiredmummyoftwo]

Sickof, you are so right about extreme maleness as DH is quite quiet type of person and it does not help that DS has inherited this. Sometimes I point out these similarities to DH and he says he was not like that as a child, now coming home from work he likes his space. Wouldn't it be wonderful if DS starts doing what your friend's DS did smallwhitecat? I guess we can only hope.

I think for the time being we are going to introduce an hour a week of SALT and continue with the ABA. Our ABA therapist seems more concern with making him independent than speech at present.