Alternative opinions of ABA?

[kpjigsaw]

We are strongly considering starting an ABA programme for our son, and it's been very useful looking at some of the posts on here about it. It seems that a lot if parents have found it to be very valuable which is why we are considering it. I was just wondering whether anyone has had a bad experience of it - I don't mean an individual poor tutor or whatever, I mean does anyone feel it didn't work or was even detrimental? Just trying to get a balanced view as it seems all the negative opinions are held by the 'professionals' rather than people who have actually experienced it.

Any thoughts?

I don't think negative opinions are held by all professionals, but the trouble is the way ABA is delievered in EIBI home programmes is expensive for LA's to fund and they kind of hold on to the idea that they will do the best they can with what they have for as many people as they can and so jealously guard their budgets to fund their own salaries and the jobs which generally they enjoy.

They see an unfairness in 'some' children getting something and they judge for themselves that the children of the parents that have the resources to ensure it happens are by default, the children that possibly then need it the least.

It's a complex scenario. Not one single professional came to evaluate or even watch my ds on his home programme despite my hundreds of invitations in the early days when I thought I could convince them with common sense. I'm guessing now that the reason for it is that they might not be able to deal with the challenge to their rationale that helps them sleep well at night.

But, that isn't what I came on here to say actually.

What I wanted to say was that I promise I won't jump down anyone's throat for an alternative opinion. Some of us ABAers have a strong voice on here and by the nature of what we believe in it would be hypocritical to prevent challenge.

I am genuinely interested to see what replies you get too.

I have always been told baout "lots"of families who are dissatisfied with ABA - told by LEA, dd1's last school etc.

I have never met any in RL, and trying to think about it, the closest I have come to negative views on here have been posters who think it is not for them, as a family - which is not quite the same thing, really.

So, will watch with interest.

I only know about ABA from what I've read on here. And I think it sounds very impressive.

However i have had huge success with curing the underlying physical problem rather than changing behaviours.

For example my DS used to walk out of class up to 5 times a day. As I understand it ABA would have reinforced his staying in class behaviour and encouraged him to stay in class all the time. Now I didn't realise he walked out of class because he had hypersensitive hearing and class was actually painful to him. So if we would have used behaviour techniques we would have been teaching him to ignore his pain and instead do what adults tell him - not something I want to teach him.

Instead we did AIT and cured his hypersensitive hearing. Then he stopped walking out of class.

So my only comment about ABA would to be make sure you also try to find and cure underlying physical problems.

(but my child is probably older and more 'mild' than yours)

Most of the anti aba feeling I have come across has been from folks whose views are based on hearsay, not personal experience. For instance local authority bod or salts. No-one who has actually used it has ever complained, ime.

I can see why that would be a worry Indigo. Good ABA has the 'behaviour' at the centre and gives as much importance to the antecedents (triggers/setting/what happens before behaviour occurs) as it does to the consequences (rewards), so you would usually begin with a period of recorded observations to try to get to the bottom of the 'cause' of the behaviour as well as look at why the reward is rewarding. I.e. WHY does someone walk out of the classroom? What causes that behaviour?

You would need to know that in order to find out what would be rewarding enough to keep someone in, and what was rewarding them for walking out (i.e. pain relief). I agree this could be difficult to work out, which is why you would take a very systematic approach in your observations, checking off each potential cause of the behaviour. I suppose it is possible that with a child with communication difficulties this could take some time, but I would hope that through other parts of their education, the communication improves enough to express themselves. Regular systematic Analysis is the most crucial part of ABA and should be done at pretty much all times as environmental variables change all the time.

No idea if this is a convincing argument for you. It's certainly a convincing argument for me as to why you need someone properly regulated and supervised as amateurish application of ABA could indeed mean a child is stuck in the classroom with pain.

Ahhhh. Yes, I missed that part of it.

I still think, from my experience of my 2 kids, that I had no idea what the underlying cause was. Until I bought the 'snake oil' that turned out to not be snake oil, but was actually something that worked (combined with ignoring the professionals and experts :) )

So, I stick by what I think :) ABA sounds great, but make sure you don't see everything in terms of behaviour, and keep also looking for underlying physical causes that can be cured......

(i.e. I'm guessing it would be very easy to start to see everything in terms of behaviour once you have some success with it and you are trained in it....)

For example DS never sat still. So it would be impossible to work out from observation that this was actually due to vestibular and proprioception problems, instead of behaviour....

I'd back up Star there.
A functional assessment/analysis would have got to the true function (ie reason) your child walked out of the class. It would be pointless to reinforce something the child found aversive, like sitting in a class in a way that caused physical pain.

ABA doesn't discount organic causes for behaviour (at all.It recognises fully ontogenic and phylogenic issues).

I'm a bog standard NHS SALT and ABA is the best and most useful tool I have acquired in over 15 years of work. Hundreds of my public sectoir colleagues in health and education agree with me. We need to get ABA into the public secote and stop its repuation as being a weirdy hugely expensive private thing that only middle class parents from hell get by raising hell.

I'm kinda where Indigo is on this - especially as my lads sensory issues seem to be getting worse as he grows. He's at the VERY mild end of the spectrum though.

It is worth noting it was aba techniques around data collection that helped me identify there were serious sensory issues in the first place. As an untrained Mum antecedent, behavior, consequence resonated with me big time. I've never done a programme or even met a tutor, but my reading about it makes it seem so much more based on sheer common sense at first glance than many other interventions iykwim.

If I had a severe child I think I'd fight for it tooth and nail. I'd also like more info on how ABA can help adhd kids as I'm disctinctly underwhelmed by the prevailing drug therapies as I've seen them applied locally.

Yesa indeed.
ABC charts are invaluable and get people moving on from unrestrained personal opinion and prejudice (rife amongst professionals in SN world) to facts and dealing with thme objectively.

Bochead- my dd1 had a paed app yesterday and I mentioned aba for her ADHD and was told unless funded privately I'd have a fight on my hands to get it! they want to trial medication with her in summer hols so I'm trying to explore all other routes asap

Chundle - my lad is awaiting a cahms assessment for adhd - luckily the waiting list gives me at least 6 months investigation time to research other avenues ; ) I have zero faith in my local cahms team basic competence - to the point I wouldn't let them pet sit, much less medicate my kid. It was a major factor behind my moving goals.

I do have a question for the aba experts on here. Whats the easiest way for a new TA to record behavior - the new school is willing to do this which is amazing! I'm not even gonna mention aba to them but it'll be the first time ever a formal behavior log in the school environment has been kept and I'm thinking there might be a basic daily pro-forma floating around somewhere on the net he could use. He's new to the role and quite young, earnest and keen so it musn't be too onerous or complicated. I want something a professional could "flick through" at appointments. Am I asking for the moon?

I can complain. I can complain that I'm a bit sick of the tutors. They're lovely but sometimes I wish they would just get out of my house.

I hate tidying up for them. I hate it when they want to move my ds onto the next part of the programme and suddenly need pictures of vegetables or something and I have to buy them or print them by the next session.

I hate having to make sure I have in the particular drinks that the tutors like when we have team meetings.

I hate the fact that our standard of living is low as we have to pay privately for what should be delivered in school. I hate that our time is poor as we have to commit to hours of support that should be delivered in school.

Having done "hardcore"!! ABA man years ago I am completley convinced and supportive of it. But I do agree that you must not see your child only as a set of behaviours. Although we never went for what i term as "mumbo jumbo", often against great peer pressure, we still did other things that were not counter productive, sometimes we tried something and assessed it and dropped it. Other times we tried something and, although it may have been in my list of mumbo jumbo, carried on because it offered other things. I did not invite opinions from our ABA team on other activities or theories we tried, but I always found I had to understand why we were doing something or, indeed not doing it as everyone has an opinion! How many times did ABA tutors ask me if i'd heard about gfcf diet, sensory/auditory integration, secretin etc etc!!

That's an interesting point Justa. It's a complicated old area. That child has the right to be the best he can be. The thing is, one way or another he has to be 'occupied' during his school years. Now this could be in a residential school with ineffective provision, or one with effective provision. It costs the same to the tax payer, except perhaps as an adult tax won't have to be spent on personal hygiene support as an adult.

I think the issues around ABA programmes are really to do with the impact it has on the family, financial and time-wise, but that isn't anything to do with ABA per se, it is just that most people can't access it through their LAs. This is why I get so angry when LA's suggest that ABA programmes shouldn't be funded by them as it is 'bad' and 'stressful' for the family. If they just embraced it in their education system, then it wouldn't have to be an 'alternative' option.

The truth is though, that the stress of running a home-programme is far less for most than the stress of having to see your child being misunderstood, poorly provided for with low expectations and barely progressing.

But for some people, they make the decision that a programme is too 'one child' centred and detracts from family life (it does), but as a questioning and challenging parent you can insist that there is enough flexibility built in for it to be less of a problem, and retain control of your own tutors and dictate the supervision frequency etc. Of course though that you then have the responsibilty of arranging everything which is hard.

Hope OP that you are getting some balance. SOrry you've not got any more anti. Perhaps there just isn't any.....................

I think it is fair to point out that ABA does not in itself change the fact that there is no magic answer to the underlying difficulties and I know some families locally who have spent a great deal of time and money yet have not seen significant results - tbh, seeing their experience did put me off ABA in the early years. However, for us, it has been a much more positive experience and has given us a method of teaching for ds that was not available by any other means - though this may be a reflection on how poor the moribund 'ecletic' provision by LEA schools is as much as anything else.

I agree with this justa.
The negative opinions I have seen about ABA have been either those who had a bad / inexperienced provider; those who did it minimally with occasional input so the programme lost any real integrity and outcomes were disappointing; some people on the spectrum who say they did ABA and found it very intensive (although they tend to be adults now and probably did a less playful, less modern version of ABA); and those whose children were SLD and severely autistic who felt disappointed as gains had been small. I agree in cases where progress is always going to be small I think the argument between which approach to use is less relevant - other approaches may achieve as much for less money and be less disruptive to the family.

The Sense and Nonsense Book by Ron Leaf etc says you can usually tell within the first three months if a child is going to make good progress with ABA. In particular they say the children who went on to have the best outcomes all achieved certain milestones eg number of imitations gained, in those first three months. My DS achieved these within the first 6 weeks of ABA so that gave us the incentive to keep going. Although it also made us feel we had no choice but to keep going! Thats why I always say to people try it for three months and then decide. Thats what we did take it 3 months at a time then step back and evaluate it. That way I think its a less scary commitment.

The only caveat is children who are regressing may continue to regress for a while even if they are on ABA. We started ABA (having messed around waiting for other provision) 6 months after DS regressed and I think he had bottomed out and was ready to move forward again. Had we started ABA at 1 month I think we would still have seen a few months of regression until he hit rock bottom.

It is also for us (despite having a fully funded programme now) very disruptive to worklife as we have to ferry DS around to his various sessions in various places and both only work part-time as a consequence. It is a sacrifice worth making but it is financially a sacrifice which if he were in special school we would not have to be making to anything like the same extent.

I also think its worth saying that for a proportion of children the intensive bit of ABA is usually 2-4 years and then they either transition to mainstream without support, mainstream with TA support or special school. For our provider 70% transition to mainstream, peer level work with or without support. So for us we will see how far DS has got with 3-4 years of ABA (assuming the LA don't pull it before) and we may then make a different choice. Its hard to know at age 2-3 how far they will get by age 6-7. But the kind of ABA we are doing now is not designed to be a forever programme. And if DS still needs intensive support by late primary we will have to think about prioritising our finances, pensions, other boys university fees etc. For us we can't let life revolve around a fulltime ABA programme forever. There will come a point where we have to prioritise our futures and that of the other boys by getting back to better paid work.

For now the gains are worth it, but i do think you have to keep evaluating it as you go.

Absolutely justa and I can understand it. I wish they would post though. I post on MNSN to refine and adjust my beliefs to better support my ds, not so I can win arguments. That won't happen without challenge for me or the others that are fighting for ABA.

To hear the arguments against can either give you something alternative to think about or strengthen your case, or both.

i.e. 'You're only anti-ABA because you didn't do it right!'

I can see why that would infuriate anti-ABAers. It's pretty much what all campaigners like to use. i.e. conservatives think that there are no flaws in their ideologies except for the fact that EU regulate to prevent them occuring in pure form. Labour feel similar about having their ideologies never occuring in pure form. It's all common sense innit?

Thing is, crapola ABA is blardy dangerous. That's certainly a negative.

some interesting posts here.

I agree, justa, that there are posters here with children with ASD who do not htink ABA is right for them.

I am not sure that there are many of those who have had negative experiences with ABA though.

THere have been posts about bad tutors/bad programmes. But I have not seen anyone post who has given an ABA programme a good go, and found that the outcome was not worth it.

I can understand why people would choose not to use ABA, but I don't thik that those posters should feel they cannot post on a thread like this. neither, of course, should any posters who have had that experience of running an ABA programme, but not gaining enough from it.

your earlier post: re the mum who had spent years on ABA, and the gains were minimal. hmm. it might just be me, but it does sound rather as though you are placing a value on what amount of skills would make it "worth it" - surely htis is a subjective thing? I have had a child who can do nothing. and I really mean nothing. no communicaiton. no interest in anythign. dd1 would sit and scratch the walls until her fingers bled - she neither noticed nor cared. and carried on. it was all she did. she was 18 months old. no running around. no laughing. certainly no playing. she was unable to hold a spoon to feed herself or hold her cup. she could barely pick up a piece of toast. if you gave her a toy, she would hold it until her grip gave way, then not notice/care if it fell. there really was not much there at all.

if I had started ABA at that point, my goal wold have been eg holding a spoon. nt eating, or scooping food. but taking a ready loaded spoon and holding it while I guided it/helped her get it to her mouth. this was one of my goals, actually, but I wasn't on a formal programme at the time.

it took her a year to learn that. was it worth it? absolutely. did she care? not really. but it made a difference to me, and therefore to her too (happy mum, happy child, yadda, yadda). the stress of that time was more wrapped up in the fact that everyone around me (including family) were tellign me it was not "worth" spending so much time doing what I was doing - that dd1 woudln't manage it, or that it would drive me crazy. it nearly did, but that woudl not have been so if I had had some support.

I would have carried on with ABA if the results for dd1 remained so small. totally. because every step is a step worth taking.

you cannot place that kind of a judgement on whether the programme was worth it/where the line is between cost and value - as Star says, every person has the right to be/do the best they can be.