Parents of children with ASD, Is ABA the answer?

[Slinkysista]

Hi everyone

Doing some research work for university on the pros and cons of ABA in the treatment of ASD.

Was wondering what the general mood was towards ABA amongst parents of children with ASD on this site. Amongst the parents I know personally and from what I have read there seems to be two very distinct camps those who can't praise it highly enough and those who think it is overrated and have ethical concerns about implementing an ABA program ( as in ABA is trying to change their child and is totally unaccepting of what some parents feel are their child's little personality quirks as the Son Rise program, for example, would).

Where do you stand?

The most important thing is that you keep your child enthusiastic and motivated and so SO praised when they achieve the smallest of steps. The programme should be something they enjoy and WANT to do. If it is a battle of wills or the child is distressed then YOU are doing it wrong.

The huge amount of applause coupled with the giving of the desired reward should eventually just lead to the huge amount of applause itself being enough, and hopefully, the task itself should be rewarding enough, or one learning task that they have mastered and enjoyed being the reward for the one they are struggling with.

And why aren't we all working like this?

The resistance to the approach amazes me on some levels.. but then, on the other hand, as I have seen first-hand the "dark side" of (so-called) ABA, I suppose I understand why it can be misunderstood. If I had simply participated on the programmes I was on and not read about it/engaged with it academically elsewhere, I would probably believe that ABA involved a fair deal of punishment and restraint and crying/screaming/kicking. Which I could not endorse, for obvious reasons.

We need more people like Moondog to show that ABA is not incompatible with public sector ideals and values: that it is child-centred, ethical etc. Hopefully, one day I can be one of those people too, but right now am confined to prosletysing on boards like these as money and time are tight!

The other thing to note is that any good teaching is very-ABA like in practice. Small, individualised steps, high emphasis on motivating the individual, opportunities for practice and fluency, removing supports as fluency increases etc. I think a lot of the work I do is very "ABA" and I think I use a discrete trial training format without thinking about it. I fall down a bit when it comes to more complex avoidance behaviours etc as I don't have sufficient training to really deal with this appropriately, as the programmes I was involved in used punishment and aversives to overcome this which I can't and wouldn't want to use, and access to high quality reinforcers for avoidant kids in schools is often poor.

Moondog, how did it become so accepted in your area? What were the things that helped?

Working, I agree (are you me? I agree with everything you say, all the time. We should go into practice together!) .
Any good teaching does as you say, adhere to the principles of ABA. What I am interested in (and I suppose is my area of clinical expertise) is fluency based instruction. Learning how to learn well until what it is you are learning becomes almost an automatic response, as opposed to a tearful battle of wills.

What helped you ask 9-5?
Undoubtedly the fact that we are a few kilometres away from a superb university's 5* Psychology department which was the first in Europe to offer an MSc in ABA. This means that our ABA is state of the art, not some crappy thing cobbled together by a few charlatans with dubious qualifications.

I won't state explicitly where i am but it isn't hard to work out if people are interested and maybe want to find out more. Freedom of inofrmation requests to LEAs and PCTs regarding funding of individuals working for them to do an MSc in ABA are very useful things to know for people who want to.....encourage their own services to offer similar.

9to5 agree absolutely ABA is everywhere - its how you learn to swim and drive a car - break down the skills to small parts, demonstrate, teach one step at a time and chain them together - plus fade out the prompts, floats and instructor to independence!

Hi I started the original thread and for one reason or another was unable to get to read all the responses until today. Thanks everyone, Seriously I have learnt more from reading the responses here than I have reading books about ABA this last few days (assignment deadline looming) .

I have come across a lot of anti-ABA sentiment from both my tutor and other people in my class who have children who have children on the AS.
Am still quite confused as to why people with no axe to grind (not LA/teachers etc) are so against it when the evidence seems to back it up!!
Any ideas?

Hi Slinky - actually your thread was one of the things which made me put two articles up on the mumsnet blog about my experiences with ABA, and the huge prejudice I met against it. Go to sickofsocalledexperts blog - one is a general article, one is more about how useless the SALTs were in getting my boy to talk.The things I say in there show exactly why the LAs are prejudiced against ABA. Apparently , it all dates back to one particular anti-ABA report from years ago which was given to all LAs, possibly via the Birmingham university education bods, and since then no-one in an LA has bothered to read anything new on the topic!

Slinky, as someone withing the 'system' (an NHS SALT, although happily one from a place where the PCT and LEA work very hard and effectively together and where ABA based education and SALT are freely available) I acknowledge what you say.

It's rather odd. I think part of it is down to a rather pompous assumption that what is on offer is what is best. Parents who reject it are seen as 'difficult' and unrealistic. In many cases, parents are unrealistic about what is on offer and how effective a patchy eclectic (aka 'bloody shambles') multi disciplinary service can be. It's public sector stuff, not flashy private input.

Additionally, most public sector workers in this field have their noses to the grindstone, trying desperately to wade through hundreds of children, all with hugely differing communication needs and all with parents, some of whom are more engaged than others. That's before you factor in all the other people you need to deal with-the 1:1 assistants, the teachers, the social workers, the OTs, the physios. Honestly, if you could see my caseload and what it is I am meant to do in an academic year, you would be amazed and question whether any of it can be done properly.

So, there is no timer, energy or inclination to find out about more up to date effective practiices, and even if you were willing, the NHS hasn't got the money to spend on training of any significance for most people.

I have an MSC in ABA. Paid for by ME and studied for in the evenings and weekends and holidays.Ii hadf no more than a handful of days off in the 3 years it took me, to attend lectures. If b I read an academic paper or a book or attend a conference, it's ME who pays for it.

Without flattering myself, most people don't have that level of energy, comitment or discipline.

In many ways, all i have done is make my job harder as I know know that so much of what SALTs offer is ineffective and pointless, partic. to children with salt. It's not their fault. They genuinely don;t know another way of thinking.

A real commitment to ABA based education and salt requires seismic systemic change. Not more money or staff really as there are more than enough people 'working' in special educational settings (devoting hours to lolling about in bloody 'sensory' rooms or messing about with sand.) They need to be put to work, real work and to see what is really possible.

That's true. but I very much doubt that most people actually know what an ABA based education involves. We all avoid arduous tasks-it's how we operate.

However, once people get into the swing of data collection and analysis they love it.I have so many staff telling me it has given them a new lease of life. They can see the difference they make and it makes them feel professionalised and valued, partic. assistants.It is so great to watch them blossom in confidence and make data driven decisions. Things that don't work get discarded, with no recriminations or hurt feelings, things that do work get pursued with more vigour.

Following something like ABLLS or VB Mapp is a piece of piss frankly-colouring by numbers. Far less draining than plucking vague trgets out of the blue and 'working' on them sporadically until everyone gets bored.

I attended a meeting yesterday just like that - what was strange was that there really nothing for me to argue with because it is all just so so vague and directionless, and no one is able to explain in any detail why they do what they do - the best they could come up with was variants of 'well we tend to do it because that's the way we do it'

god the thing I hate most is sitting in a meeting opposite a professional who says "trust us, it just works" when challenged on their method/views/opinion.

Especially when I have just reported that it isn't working, and have asked for an alternative view/intervention.

To then be faced with "but we have worked with hundreds of children, and belive me, overall it does work" is infuriating because:

1. the implication is that I have not tried, committed fully, or devoted enough energy to it,

2. they know my dd better than I do (mostly with minimal actual hands on experience of her - but hey, she has ASD, she must be just like all other ASD children ), and

3. if neither of the above are true, then it must be the fact that dd is unable to learn that is at fault. not the method, or intervention (even when I can demonstrate that I can teach her whatever they are trying to do... - then it is a fluke, over-reporting by a delusional parent, or "robotic learning, not generalised" - even when demonstrated in a setting other than the one she learned it in, or when shown using different stimulis, different language - you name it really!)

the whole SN system is rotten to the core - lots of people professign to care, whilst ignoring what parents say, and ignoring what the actual studies demonstrate. much better to carry on with the lovely sensory rooms, and the low expectations - wouldn't want ot have to actually teach the children, now, would we? (mind you, that is vaguely reminiscent of education as a whole in this country right now - lots of nice fluffly interventions, and not much output as a result)

I really wish we could get more publicity for this dreadful situation - I often find that family/friends are surprised when I criticise the SN system. They are not stupid by any means but they just have not come across the arguments we are presenting and are very very accepting and trusting that the professionals know best - probably a bit like me before I found out otherwise !

Another thing that came up in yesterday's meeting was when the NHS SALT was telling me how other families use visual schedules etc, she let it slip that none of the children's problems had been solved and that, er they were just trundling on with the same old problems, the only difference being a series of pictures on the wall. I think you are right Lenin, it is seen as old fashioned to have concrete expectations and to do anything concrete to get them realised.

I think the whole education system has got really confused between the words - "discipline" and "punishment". Kids need discipline, particularly autistic kids imho, but the minute you use that word, people have terrible associations with corporal punishment etc. That's why they are only ever talking about rewarding good behaviour, never getting rid of bad behaviour. Hence large numbers of kids feeling able to tell teachers to f.... off, as they know there are zero consequences. I would NEVER hit a child, but I would make very sure that they know that mum is the boss and that certain behaviours are completely unacceptable. But we are so desperate nowadays not to go back to the bad old command and control structure of education, that we have forgotten to be the adults! A lot of it is hypocrisy too - very many people who I tell about ABA end up "confessing" to me that they smack their kids occasionally, and get confused when I say I don't approve of that at all.

I agree with everything you all say.
It's a real case of Emporer's New Clothes.Everyone knows it's shite but noone knows what to do about it, so they all nod and pretend it works when it doesn't-and that goes for all aspects of education. Luckier kids will learn anyway, but if you have educational needs, you are stuffed in the genereic special and m/s section.

Katherine Birbalsingh is a very interesting and inspiring teacher who dares to say it like it is-she got sacked for her troubles. Check out her book,blog and weekly column in the Telegraph.

I actually don't believe most of the people involved expect change. They subscribe (albeit unknowingly) to one of Parkinson's Laws. An organisation is started to effect change but ultimately its purpose is to perpetuate its own existence.

The whole SEN industry (and it is an industry) fills me with utter utter revulsion. Professionals drunk on their own smug sense of purpose and pereception that they know best.

I have quoted him before many times on MN but as my hero Michale Maloney (look him up) says 'If the teacher hasn't taught, the child hasn't learnt'.

If the kid isn't getting it, you are doing something wrong, NOT the kid.

Whatever your political bent, there is more chance of righting this absolute fucking farce under the Conservatives then there is under anyone else, least of all Labour who have ruined the educational chances of so many children with thier pathetic equality for all message. better to all be useless together eh?

Sickof, how did you get on yesterday?
Let me know!

Yes, easier to hide behind a smokescreen of guff like awareness or support or self esteem. heaven forbid one should ask for anything concrete!

I don't write about them here much but as a parent have experienced all of this bullshit and, being on the other side of the fence (ie as a parent and not a professional) it made the scales fall from my eyes so damned quickly.

I cringe only to think of all the flannel I have talked and got sucked into actually beleiving myself before starting to learn about ABA and having it exposed for the meaningless bullshit it is.

Very depressing actually. I burn with rage a great deal of the time.

Small, I didn't see that (am abroad) but I read an inteview with her a couple of weeks ago and thought she sounded bloody marvellous. We need more people like this and far fewer of the kind you so accurately describe.

I don't think it is as cynical as some people suspect. I certainly don't think it's because of a fear of hard work. It is soul destroying to churn out the same old stuff day in and day out and see it NOT WORKING. There will always be lazy folk, but the majority work hard at what they do (even if it is ineffective).

I personally suspect that the reason a lot of SALT doesn't work is purely down to time/frequency. I have always used behavioural techniques in my work (communication temptations etc) but what you can achieve in a one-off meeting with parents for 45 minutes that isn't followed up for six months is, well, minimal. I could get a child who wasn't talking to request within the hour in clinic, but the families struggled to replicate. I used to give beautiful recording sheets etc but the families I work with.. well, many of them aren't even literate.

This relates to the fluency issues moondog discusses. If you have very minimal time to train/advise, then even if your strategy works, it is unlikely to become "embedded" in the way in which that person communicates (whether at school/home) with the child/young person with a difficulty. They try for a few days, but it doesn't really take off and it is abandoned.

I do believe it's how you teach BUT you also need time. Face to face time to model/shape/chain - do all that stuff. SALT used to be very behavioural but the demand outstripped supply and it became dilute. In intensive settings, SALT techniques often work quite well because they are more embedded and prompts are naturally faded etc. SALT should be about isolating targets (task analysis) and practising the smallest target to fluency, then chaining it with other targets and reducing prompts.. but how in God's earth can you do this with a child you meet once every term for 45 minutes? Short answer: you CAN'T.

Yeah am researching this assignment and am finding it hard to find anything of substance that is critical of ABA.
It's just the usual old guff, the terminology, training the children as you would a pet and a new thing, apparently ABA infringes on the child's civil liberties and human rights!!

Seriously I just find the whole thing a total injustice to families who have children on the AS, just horrendous when you see what is offered to some children.