new ABA programme - how much supervison per week?

[JoMaman]

I'm part way through organising ds1's ABA programme (he's 2.5). Have got the tutors, have decided on verbal behaviour approach, have met with various consultants and/or supervisors... but cannot decide on who to lead the programme.

One of my concerns is availability of the supervisor. How often should we expect to see them? I've spoken to families who have quite hands on supervisors, who come for a session every week, but supervisors I have spoken to seem to all expect to come for only 5 hours every 4-6 weeks.

In your experience, is this really enough contact for them to know your dc, the tutors and the programme well enough to add value? Is it ok so long as they are available on the phone/email for questions?

Feel like everything else is nearly in place and my indecision about which consultant/supervisor is holding things up for my ds... any advice gratefully received x

Hi - we don't use a supervisor, I deal directly with our consultant (phone calls/emails every couple of weeks on average). We have monthly team meetings that feed back to consultant. My tutors work together which other families too & know each other pretty well so I think that's helped it run smoothly. We email a lot, everyone gets a short update of any issues the most recent session may have brought to light.

My lead tutor does supervisory work for other families & usually does 1 session a month/6 weeks with them. TBH we've managed fine with just the consultant (he comes up for a day every 2-3 months) - he is highly accessible though (only charges for whole day visits & will drop in for free if he's local to us). I do the paperwork & organising resources etc.

I don't know what's typical really - we're doing a VB/NET programme - but it isn't typical ABA filling in lots of data sheets etc

thanks phlebas. We're also doing VB but I didn't realise that there was less data collection involved, I will ask about that when i speak to both possible consultants.

I think it's just us wrt data collection rather than a VB thing!

I think generally there's less when you do a NET programme but I'm sure ABA-purists would be horrified by our programme. Perhaps I should call it ABA based-intensive play and language therapy - we are always aware of the ABA principles & techniques underlying what we're doing but form filling & box ticking would interrupt our teaching - we always try to keep it naturalistic & generalise new skills immediately. There have only been 3 occasions in 9 months that we've needed to collect data on particular behaviours (& it has been obvious that we've needed to), I can't think of any other times when it would have been helpful. DS is atypical as far as ASD goes (has a strong element of PDA) - when we were recruiting tutors our consultant told them to try & forget everything they had previously learnt about ABA - most of it wouldn't be relevant. The tutors have found it challenging, they've needed a lot of support from the consultant.

We're not & won't be going to try to get LA funding which means we don't need to build a case to show it works.

We're at a similar stage to you - just going through the interview process to find tutors, and hopefully starting the programme in late August. We're using ABA/VB too. Our consultant has advised that a standard programme would have quarterly visits from the consultant and monthly visits from the supervisor.

However ds hasn't had a dx yet, and hasn't met our consultant so until we do a proper assessment we're not sure of the exact programme. Also we're trying to reduce costs as much as possible (to help avoid bankcruptcy!) so we may try and reduce the input from either consultant or supervisor, as long as the effectiveness isn't compromised.

How are you finding the process so far? I have to admit I am exhausted, bewildered and stressed by it, and feel quite alone. Along with the usual feelings of guttedness (for want of a better word!), despair, fear, anger, hurt etc that go with having to face the fact your child is autistic

Hi - yes all the above feelings on a daily basis too I'm afraid...And the ABA programme stuff is all a bit nerve wracking. I didn't follow a very organised interview process when I met tutors, they just came to the house and after a short chat I made a sort of gut decision based on how they were interacting with ds1 (and ds2). I'm sure if I was not reeling from the dx whilst doing this I would be more rigorous or scientific, although I suppose nothing is set in stone and you can change tutors and consultants if it isn't working out. I've found talking to other mums further down the track helps, although when deciding to VB or not VB I found myself changing opinion based on whatever the last person I spoke to said - very confusing. Good luck!

Phlebas - sorry, I just saw your post. its interesting what you say about NET. I'm keen that a lot of our programme happens away from the table too. Ds1 loves working at the table and is really able to 'tune in' to instructions there, but its a different story when he is elsewhere. I've been going back and forth in my head as to whether its better to a) stay mostly at table, since he likes it, and try to get really far with new skills, in the knowledge that he prob won't be able to generalise them yet, or b) do a more NET approach but perhaps gain the skills less quickly but in a more generalised way. I decided to try NET and see how it goes...

I'm still operating in the vague hope that our LEA might fund it if I take them to tribunal, although they have a bad track record as far as I can tell and there is an ASD school (non ABA) in our borough, which I gather gives them carte blanche to say that adequate provision already exists.

Our interviews have been based a lot on gut feeling too - as you say, the way they interact even for a short time. (We saw one girl who was very sweet, but as she was telling us how good she was at interacting with children, ds actually was by her side trying to get her attention to play and she didn't even acknowledge it!)

Can I ask, how old is your ds1 and when was he diagnosed?

And why did you finally decide on VB?

Sorry for the bombardment of questions. I would love to be able to talk to other mums in a similar position but sadly don't know any! I was introduced to ABA through someone I got friends with, whose ds was at the same nursery as mine, but they have sadly now moved, so I do feel very alone.

"there is an ASD school (non ABA) in our borough, which I gather gives them carte blanche to say that adequate provision already exists"

That's the situation here too, it came to down whether we'd be willing to put ds in an inadequate/damaging provision in order to prove the ABA was better. I couldn't do that.

My hiring was based on a mixture of personal recommendation & gut feeling too

I think non table/VB is slower to start - ours was painful at the beginning, it took months to get compliance & there was a long pairing process. Now though ds is age appropriately compliant (not one of those ABA robots that critics go on about ) with pretty much everyone in all environments. He's picking up academic stuff but we don't teach academics - it's really a developmental programme & we do lots of RDI too.

We tend to do two long (5-6 hour) days where ds goes out - bus, train, park, zoo, shopping, cinema etc etc - all of which are highly motivating environments for him & get loads of language & social stuff covered. Then two short days (3-4 hrs) which are home based & focus on skills - play, gross & fine motor etc. DS does enjoy DTTs on the computer so he often gets those as a reinforcer lol

Hi bialy, ds1 is 2.5yrs old, i also have ds2 of 9 months...i've always known something up with him and since Jan I've thought ASD, but it wasn't confirmed until a month ago.
I don't honestly know why we're going with VB, hence feeling a bit unsure of my decision, but mainly its because ds1's biggest obstacle is lack of communication skills, so i wanted to prioritise that, and I've heard good recommendations about the method. Also, I initially met a mixture of practitioners and just found the VB ones a bit more on my wavelength - again, no scientific analysis involved and a bit of reading around the subject but with 2 dc under 3 it is quite hard to find time to educate myself at the mo!

phlebas - one of my tutors has an RDI background, at some point I will investigate if any of the techniques are applicable to ds1. I'm sure ds1 would also love DTTs on computer but don't know how to find/buy the right programmes- any tips on where to look? TIA x

Very sorry, I haven't read this apart from the first 2 lines of the first post! As far as I am concerned ABA is about Supervision Supervision Supervision. If its a cost issue you can cut down later, get as much as you can now, hands on with child, parents and team. I will read it all over the w/e

Your situation really does sound similar to mine, my ds is 3.2, and also have dd of just 9 months. Your dx seems to have been quick though - we were first referred in March but so far have only had one meeting with paed - been referred to social communication clinic/salt but don't even know when the next appts are. We just feel we have to do something to help.

My ds's biggest deficit seems to be social communication/interaction (with most people other than dh and me), so we're hoping that the VB method will suit him better than table-based.

I'll keep an eye out for you on this board, would be good to swap tips etc about starting out on this journey

Davros that's useful to know, reassuring that the cost may not be so huge forever!

there are quite a few www.mousetrial.com/ is a good cheap one to start with.

We were referred last sept by our gp, met the community paed in oct, autism panel in june. In between we had 6 half hour SALT sessions (was verging on comical as he was paired with a similar age child whose parents only spoke spanish and had no intention of introducing english at home, yet the session took place in English with her parents behind her, translating what the SALT said, this included songs. It introduced a time lag in what were already quite stilted circumstances...Ds1 and spanish child both quite confused! Don't think it helped anyone! Oh and we had 2 physio sessions, still waiting for OT initial assessment. Doesn't feel like it has been quick! Still, I'm very grateful that we weren't fobbed off by the autism panel, as the dx has given us the impetus to get proper help in place

I am with Davros 100%. My son (3.5) has been doing VB for 18 months now, and for the first year we thought we could economise by prioritising one to one therapy time at the expense of supervision/ consultancy. And that is a decision I bitterly regret. Because it's all about quality not quantity, and I have now come to see that the absolutely most crucial part of an ABA programme is the consistency, ie making sure that the tutors are working completely in sync with each other. Otherwise you waste a lot of time and money as 'the drift factor' eats away at the effectiveness of your programme. If I could have my time again I would actually reduce therapy hours in favour of regular double-ups with supervisors and individual tutors and make sure that, as now, there is a team meeting (with consultant in attendance) monthly. Anything less and the programme is not tight enough to be effective, in my experience. The consultant should also be in close contact with your supervisor, so that he/ she is always involved in your child's progress and able to tweak the programme as progress dictates, rather than swanning in every 3 months and spending half the allotted time getting up to speed on how the previous months have gone.

I'm just glad that we corrected things before it was too late. The progress our DS has made in the last 6 months has been astounding.

We find the supervision invaluable
We do lots of therapy hours ourselves (all at the start and then when we were wiped out hired a tutor and snaffled a volunteer)
At the start we saw the supervisor weekly and then fortnightly
It had to be weekly at start as we were tapping lots of knowledge DS had already and once he "got" the method he whizzed through the early programmes
Now we are more into a steady slog - still progress but less dramatic than the early few months as the programmes and skills are harder
It is easy to drift even from fortnight to fortnight and let bad habits (usually lots of prompts) creep in.
It is very useful to be able to know the programmes yourself so you can do them at mealtimes, bathtimes etc - you soon find you can use ABA anywhere
So I would keep the supervisor hours up and cut back on tutor time and train yourselves up as tutors
My DH is the main tutor at the moment but it used to be me
Its great if your DH/DP (if you have one) can come to supervision sessions
We also have a Mum (ex teacher) who volunteers for us
If you live near a Uni then you can sometimes get students as volunteers
We only see a consultant quarterly but that is fine as the supervisors are very experienced and get lots of training and oversight from the same consultants on other families programmes (our tutor, supervisor and consultant are all part same company). In actual fact due to overlapping for training etc we get alot more oversight than that

To be honest, I think we could have managed without a Consultant at all, we needed his input when it came to dealing with LA and showing the programme was "serious" iyswim. I think a lot of people feel better about being away from the table, less data collection etc but, for us, it would have been a mistake. DS learned better at the table, we needed data collection or the next person on rotation couldn't do anything sensible or bodging soon started. Our program was still lots of fun, lots of play and time away from the table with trips and visits coming in later once DS had some skills and I had the skills and confidence to do it. I never understood the objection to the table, where do most of us work? Our Supervisor needed data to review the file at the start of her visits (once a week) but data collection needs to be quick and consistent. I was the Supervisor in that I managed everything, but I could not have done it from the ABA angle, I didn't have the experience. Beware of tutors and supervisors who tell you X isn't necessary or Y is better, what is the evidence and who is carefully looking at everything from a technical perspective to make those judgments? Our Supervisor was the only person allowed to change, move on or put a program on hold, you can't have everyone doing it, it would become chaotic, even though you may not realise it.

thanks - that has all been very useful. We've chosen the consultant and supervisor and are now nervously awaiting our next instructions. I am discovering how much of a control freak I am, and feeling very much at the mercy of others right now! I'm hoping that once it gets going, I'll get a clearer picture of what works best for ds, and will push for the programme to adapt around that [deep breaths]

I'll get a clearer picture of what works best for ds, and will push for the programme to adapt around that [deep breaths]

Exactly .. you'll do fine

[have just come out of 2 hour teaming meeting with three (!) targets we're going to probe & collect data over the next couple of weeks - that's radical for us ]