Coming to this thread late as last week spent on interim review ensuring we held onto aba won at tribunal last year.
To answer the original post yes ABA has been life changing for us and DS. My experience has been that there are lots of cross over between ABA and other approaches and approaches are not as opposed as people might think. It does depend on the type of ABA and there is lots of variation. Many of those who started under Lovaas went on in the field and adapted it and blended it with other approaches and what we use is discrete trial teaching aba but with a lot of emphasis on social and play. DS is 4. Our ABA team definitely use techniques from Floortime and RDI for eg, not because they buy into the idea behind RDI / floortime that if you recreate the typical developmental steps you can rewire / change the brain; but because those practitioners have come up with some nice fun activities which can be used within ABA to promote social interaction. Also many speech therapists do use PECS and token systems which are very ABA based. However other approaches eg PRT, Early Denver etc all have ABA base. So the idea that ABA is this rigid approach is completely misleading. The ABA staff we work with are constantly trying new things and their ABA model is constantly evolving. For eg with teens they would use group counselling / support groups. They will borrow any other approach that works.
What I like about ABA is that it keeps its integrity. I do not doubt if I went to see Teacch in its purest form that it would have something worthwhile to it; but what happens is TEACCH allows itself to be diluted into eclectic approaches and used by people who have been on a 5 day course and used in mainstream not teacch classrooms and it becomes so diluted to be worthless. I also think it sets very low expectations for children and sort of encourages dependency on routines and structure which some (not all) autistic children can actually be taught to manage without. I feel like it expects children to remain disabled and dependent on others forever. eg we were being told to use symbols on a keyring to communicate with DS long after he had gained speech and could follow verbal instructions.
ABA is about using motivation and rewards and setting a clear expectation the child will do what is asked (and it is a single trial to start with eg a 1 second task) before getting the reward. For DS when we started we had to do this hand over hand eg give me the green brick - now you get that reward. Once DS understood this contingency it opened up a window in which he could engage and learn whereas he lacked any motivation to do so for the sake of learning. He would have done repetitive stuff all day. Now he can sit for about 15 mins and do tasks before getting a break which is about typical for a 4 year old.
As I understand it children who were deemed to be at all parts of the spectrum and with and without LD have been shown to benefit from ABA but those who have language skills, are young when they start and learn quickly in the first few months have the best chance of a good outcome. So I think many HF children actually gain massively from ABA.
I know some children deemed to have SLD have had good outcomes but the % is lower; some of these parents whose children made very slow progress can be negative about ABA, but I suspect their disappointment would be the same with any approach.
There is also some bad ABA out there and some people do have bad experiences just like some of us had some lousy teachers.
Historically the anti ABA movement refer back to the fact that ABA was initially used for eg to try and 'cure' homosexuality and I have been to a conference where Richard Mills the head of research autism made a great deal out of Lovaas's involvement in such research (I have no idea whether he led it or was just a research assistant at the time) as a reason why ABA should be shunned - even though his website shows positive evidence for ABA. The conference was at an NAS school and obviously most of the NAS top brass are very wedded to the TEACCH approach they use at their schools. They also make much of the fact that early ABA used 'aversives' eg a slap on the hand or a loud 'no!' when the child got the answer wrong. This is where the idea ABA is cruel comes from. A few weeks ago i went to a talk where an autism campaigner was talking about a book he has written on the history of autism and in a room full of autism 'experts' including Uta Frith he said it would have been better if Lovaas had not been born. The author just happens to be best mates with Schopler (TEACCH). A laugh went around the room as though badmouthing Lovaas was a common theme at such talks. I think the history of ABA is used to cast a shadow and stop impartial assessment of the merits of modern ABA.
So ABA does have a murky past BUT it was the 1960s when actually being homosexual was illegal in many places; when many schools used corporal punishment and when children with autism were thought unteachable and locked up in institutions. This is often missed. ABA has moved with the times and just as we don't cane children in mainstream school anymore, ABA does not use aversives.
However you will find alot of autism 'experts' very anti ABA will hark on about its origins as though that makes it an approach that should never be used. Just because we used to transport slaves on boats, doesn't mean we should not ever go on a boat.
The other thing which people seem to hate about ABA is the idea of cure or recovery. People are obsessed with the Lovaas study about whether 50% of children 'recovered'. the author I mentioned said he had interviewed some of the 'recovered' people and they were still autistic. But Lovaas never as I understand it said these children were cured, what he said was that they could function in a typical classroom without any additional support. I think use of terminology like cure or recovery has been unfortunate as ABA is always judged against that bar - do children recover - rather than being judged in the same way as other approaches - do these children make good progress / speak / become independent.
In the best ABA clinics in USA nearly 100% of children gain speech. Its like the difference in UK and USA cancer rates 10 years ago. We don't even collect the data on % who speak but it is much lower perhaps 50%
Because there is this idea of recovery (eg Maurice book Let me hear your voice' whose children no longer met the diagnostic criteria) then people judge ABA much more harshly and always refer to flaws in the research and literature yet then fail to apply the same degree of scrutiny to other approaches whose research and literature also have flaws.
Then of course as Star says there is the expense.
DS package of fulltime ABA costs £50k pa.
But the idea is that is a short term programme of 2-4 years and will then fade out - assuming he has a good outcome and will save money later in life if he can live and work independently.
I do know children who had ABA and do now manage without any support in school but I doubt their parents would say their children had no trace of autism what they would say is that the autism is no longer disabling.
We had to fund ABA ourselves for 18 months, plus reports and legal fees. I would think that cost about £12000. But we also had to give up work and be the ABA tutors and that has cost us about £15k-20k a year in lost income. Now even though we have won ABA I cannot go back to work as there is a recruitment freeze. So my income is staying much lower than it would have been had my son got decent provision 2 years earlier.
My view of Sunrise is that it sounds like a cult. I also don't agree with the idea that parents should do most of the therapy. Now DS has a fulltime programme with tutors who come in he makes more progress than when I was his tutor and was a tired out, stressed out Mum trying to juggle work, ABA and three kids. Yes parents need to know how to work with their kids but the idea that parents have to do all or most of the work (which most UK research eg PACT is looking at) is wrong in my opinion and is being used as a cheap way of delivering intervention. I love the fact that people come in and work with DS and I get a break. Also he benefits massively from working with lots of different people, in different environments including mainstream nursery.
The attitude to ABA has to change at a national level - by govt review of research and NICE type guidance for education interventions. No LA can really embrace ABA fully as everyone would then move there. We also have to get much better at measuring outcomes eg can the child speak, dress, how many friends do they have rather than just academic outcomes and then we can properly see which approaches add value and which don't.
I do know SENDIST turned down a Sunrise case - the LA had agreed some sunrise but not as much as parent wanted - because SENDIST were not convinced it had any evidence behind it. So evidence of effectiveness is important. The evidence behind ABA is now not controversial and people borrow from ABA all the time. The myths remain to stop parents looking into ABA and then asking for it to be paid for.