ABA report - help

[inappropriatelyemployed]

I was really annoyed today. I got the ABA report through that I am paying for but it was emailed at the same time it was sent to school, OT and SLT giving me no time to comment or discuss inaccuracies/concerns with the therapist. I don't find this acceptable do you?

The therapist came in fora second visit last week on a day that DS did not want to go into class. He does this every so often. He gets into a panic about everyone looking at him. He wanted to work outside and arrangements are made for this. He always go back into class the next day. I think part of this is that there are no arrangements to support him in class when he is there, e.g. by allowing breaks.

On the day the therapist came in, his TA was not around - we found out half an hour after drop off that she had a hospital appointment. She had told the receptionist last week but not thought to tell DS. I basically TA'd for him for most of the morning and he was fine. Then the ABA guy decided he wanted to see him in class. I knew this would distress him but I didn't want to look like the indulgent mum so I let everyone try and persuade him without success. I intervened and got him as far as the end of the corridor. He got really distressed about working outside the class as he didn't want people to see him. He wanted to work at another table a few feet away. His teacher said no and he got more distressed than I have ever seen him and although he sat at the table he refused to work. The ABA guy was telling him to do as he was told and do as his teacher asked. He said to me 'I see what the teacher/TA mean about non-compliance' which I got a bit annoyed about as this was a pointlessly engineered confrontation.

I withdrew from the situation with DS in tears. I just thought people would blame me for the upset because I was there. I let him down. Big mistake. He ended up massively distressed and doing a half day. He ended up out of class for two days. Why did I not just tell them all to stop and move him myself?

His TA has been whinging about how he'll never go back if he is indulged. I told her to have faith and today he did. Good as gold. The head agreed with me entirely. He said ask the ABA guy to deal with him rather than teacher and TA.

Instead, the report is circulated to one and all before it is even circulated to me.

The report mentions all the behaviour he saw but gives it no context at all. It was as if DS was just sitting there for a regular lesson outside class and that he decided to throw a wobbly.

It talks of not using the term 'anxiety' and how he will need to do a functional analysis to decide if the bahvioour is anxiety - how can you do that?? and why would it make any difference if it was behaviour you needed to change?

Despite not wanting to use labels, he then talks of tantrums and non-compliance and then all the petty problems teacher and TA have with his issues about sitting on chairs in assembly etc. Stuff that was agreed with the EP and SENCO months ago. It's like teacher and TA just used this as an excuse for a good old moan and he just listened to them.

I feel really let down. There's no bloody way I am paying for an intervention to get him to line up or sit on a chair. This is a child who was out of school last year and who didn't speak to anyone. He has come a long way. I wanted the intervention to skill him with social skills and help him deal with change not criticise him and make him sit on a chair.

I was going to email the multi-disciplinary group with a response but I don't want to be too angry. All the therapists involved are therapists we are paying for so it is not gone to the LA.

Would anyone read it for me? Star, Agnes, sickof, Moonie?

[inappropriatelyemployed]

Well I think there is no chance of her changing her ways. She just as she wants based on her world view that you just need to put your foot down. It's probably because her techniques work so well!

[StarlightMcKenzie]

Oh that's good. If new person starts to get results, perhaps old person will model herself.

[inappropriatelyemployed]

Head is trying to get a plan agreed via EPs recs before he goes.

I honestly think you can lead a horse to water but you can't make it drink sums up the TA and no matter how much effort you put in she will remain steadfast in her view.

Head said, unprompted, he is going to organise recruiting someone else to TA for DS for half the week to break this dynamic.

[StarlightMcKenzie]

LOL, Incidently, I'm having my own spat with an ABA Consultant who isn't even hired yet. Give me strength! Some of them think they are Gods!

[MareeyaDolores]

Head helpful, ed psych helpful, aba man not helpful...
This sounds most unusual behaviour
I think it helps to do an ABC analysis of the participants' behaviour

[cansu]

I hear what you are saying. I stopped using the consultant for moment as school senco was so obviously on side that it was no longer necessary. In many ways having these people on side and willing to make that extra effort is the most important aspect in my experience. from reading your posts over past few months what stands out is your frustration with TA in particular. If she became your ds biggest advocate that old be incredibly powerful. It may well be impossible there are some who can and won't see but it might be worth considering. I agree head is important but if he moves on you have no guarantee about the position or priorities of who will replace him.

[inappropriatelyemployed]

That is a good idea but I suppose the problem is cost. Do I want to pay an ABA therapist to change hearts and minds? Head's view is we could achieve same with Ed Psych who is very helpful

[cansu]

Could the report help you to get these people back on side? the other advantage to the consultant I mentioned was her ability to get the teachers on side in what was crucial. Because they felt she was listening to them as well as me they reacted very well to her and tried to show that they were taking her advice on board. For me this opened doors to new ways of approaching problems. Might also be worth considering if your head is moving on?

[inappropriatelyemployed]

Thanks. I understand what you mean but his advice is not really saying anything but it is entertaining the possibility of re-opening accomodations which have previously been agreed.

It has demonstrated that teacher and TA (rather than ABA therapist) have a particular position on compliance at all costs which is not shared by the head.

I have spoken to the head and he would strongly reject any attempt to apply a 'compliance model' to DS as he believes DS is compliant, he only exhibits difficult behaviour when stressed and this needs accommodation and the development of skills. He thinks we can agree this internally without paying for therapist.

This is not the therapists fault. I had instructed him to look at one thing, but it has become clear that teacher and TA just think he needs to be the same as everyone else at all costs. This meant the discussion, and the therapist's attitude became diverted. But this is not the view shared by the head who knows him well and understands ASD.

[cansu]

Ok I agree he shouldn't have shared the report until you had seen it and discussed. However, I think also that you need to consider his advice and maybe accept that it reflects his prof opinion that day in that particular circumstance. to me it seems you have two choices dismiss his report because you no longer agree with his opinion or consider it. That will sound harsh and I understand your anger because I have also paid for many independent reports. I completely agree you should have seen it first and have had the opportunity to veto it being sent to the school. You then can decide to no longer use this person as you disagree with their opinion. FWIW I have used a consultant who has sometimes told me things I disliked and disagreed with but I have continued to use her because I let she had integrity and a willingness to say it how she saw it. I would however expect to have the final say about whether this view was shared with outsiders.

[inappropriatelyemployed]

Thanks that is really helpful.

I was very clear about what I wanted and what I didn't want but the whole process appears to have been diverted by staff concerns which the head doesn't share himself and has told staff not to bother about, e.g. sitting on a chair.

[ABAtherapist]

I think it is worth ringing your ABA guy and asking him some questions.

You are paying him, have you agreed that he could share the report with others? He should have had this permission before he circulated the report; if not, you have a legitimate complaint about confidentiality.

Trained behaviour analysts don't even think in words like "tantrum" and "anxiety". We think about specific behaviours, and the possible functions of those behaviours. However, the language of ABA is awkward and it can create a barrier to acceptance from schools, SALTS, etc. We might use those words in an attempt to be understood by others. Anxiety is a really tricky one. Often schools will use this as a way to avoid dealing with behaviours: "there isn't anything we can do, he is anxious." This places the problem on the child rather than the environment. Often we see challenging behaviours because the child wants to escape a situation or seeks a different kind of attention. When a functional analysis shows that the behaviour happens more often in one circumstance than another, it suggests that changing the circumstances can change the behaviour. This places the responsibility with the school staff. In my practice, I always defer to the FA when staff want to place the blame for the behaviour on a trait of the child. Conducting an FA and showing the data is much more convincing than saying to the staff "you are wrong, it is not anxiety".

You are paying for ABA, have you worked with the ABA guy to set targets? He should have known that you are not worried about him sitting in chairs (sitting with a group can be a very reasonable expectation of a child in mainstream school). It sounds as if you haven't really spoken to him about what you want from an ABA program. This is more likely to be his fault rather than yours, because you can't be expected to imagine all these potential scenarios and he should be able to anticipate these issues. I never sign a contract with families until we have agreed on goals and a method of working together. Is he very inexperienced? You might want someone with a bit more experience who can help anticipate these kind of problems.

[inappropriatelyemployed]

Great idea. Not sure she would go for that ABA programme for the TA! Your idea of a trial and maybe some understanding of what ABA is about to see if it would be workable is important.

[StarlightMcKenzie]

or that might be going too far!?

Though it is how you start off early behaviour programmes for little ones. Once they are used to doing as they are told, they stop resisting, or resenting and then hopefully the learning becomes rewarding enough to keep them on task.

[StarlightMcKenzie]

LOL yes, but tbh, would a week or so of her 'simply' trying to win your ds' cooperation and that is all all? Practise and practise,

You know. Get her to tick something every time he does as she asks, and write down the details every time he doesn't, with her incentive being that every time he doesn't she and you have to sit down and talk through the scenario and make suggestions how she could have changed what she did to get him better to WANT to comply. Idea is to increase the number of ticks daily.

Explain that 'complying' can become a habbit. So if you ask the child to do something 10 times and all 10 times those things are fantastic and rewarding for them, then the 11th time you ask them to do something and it is more neutral or a bit worrying, the trust is there and they are so used to doing as they are told that they brave it and get on with it.

Her reward is when there is no challenging or non-complience behaviour and she doesn't have to see you - yay!!!!!!

[inappropriatelyemployed]

Thanks. And that she sticks to a programme I suppose and doesn't go off message!

[StarlightMcKenzie]

Broadly, the TA has to reflecton her actions to ensure that she 'wins' ds' cooperation. That you and the ABA tutor can help her do this. That you trust her to keep this at the forefront of her mind and to call on you regularly to support her.

????

[inappropriatelyemployed]

Didn' t see your second post. That is what I am worried about Star that it just becomes about 'putting your foot down'.

I wish I had had a chance to discuss all this before it was circulated.

I am seeing head today. What is the most important thing to raise to ensure that school can guarantee that the TA would be able to do this?

[inappropriatelyemployed]

Star that is very insightful as his response to me seems to suggest that is exactly the case. He said that many schools don't want ABA so he was trying to keep them onside.

This stands or falls with the right judgments being made about behaviour and with the TA. His visits have at least highlighted that agreements I thought we had reached are unwillingly abided by and that the teacher and TA resent being made to abide by them.

This cannot be delivered by this TA.

[StarlightMcKenzie]

'He has sent data collecting sheets too before programme is drawn up. There is no way TA can do that.'

Why?

'He needs to do as he's told'

Yes. Of course he does. But the success of ABA is in the fact that he WANTS to do as he's told, like my NT dd WANTS to do what she is told in school, broadly, - it makes her feel happy. No-one beats her into miserable submission/compliance. I would not expect anyone to feel that was appropriate for my ds either, just because he isn't motivated by the same things.

[StarlightMcKenzie]

IE, I honestly haven't a clue what is going on here. However, I do know quite a bit about the context and culture of ABA, so with that in mind could the following be happening?

The Consultant is used to parents treating him like some kind of saviour, and having blind faith, not due to his ability necessarily, but due to their desperation and there really being little in the way of alternative. So, he is used to not having to prove himself to parents.

The Consultant is used to schools/LAs having a negative view of ABA and going on the defensive, digging their heals in and generally refusing to cooperate or confide.

He has judged the situation to be as above and therefore written a report as a sop to the school, rather than to you to ensure his 'way in' for your ds, and possibly also his future employment?

I'm not saying this is what happened, but it does seem to be all a bit of a muddle somehow.

ABA has changed my life. I am hoping to study it. I am a huge advocate. But my motivation is not JUST really about being interested in it. It is because there is such crap out there in the name of ABA. And still, often, (and probably because there is little alternative) it is better than what is on offer. It's like these flippin legal firms. They're crap because they can be, and it is hard to fight a case that you'll still probably lose due to their failure, without them.

I want to scream for you. Not many people take things to the end of each road like you do. When you do, all you seem to be finding are more and more potholes. I'm truly sorry.

[inappropriatelyemployed]

'If avoidance, then ignore and repeat demand.'

This is what I am concerned about. DS shows little emotion and is high functioning. He uses the term anxiety to describe the odd day when he can't go into class. It is the odd day. He uses it sparingly and I trust what he says.

He still has to do his work. He don't upset anyone and he goes in to class again when settled without an issue.

The therapist who doesn't know him saw all this in action as he came on one of the rare days he is out of the class. Yet the implication seemed to be that DS was just picking and choosing what he wanted to do. Based on what? Not observable behaviour but teacher./TA comments.

He didn't know what to do to change the situation after DS was just forced into a corner which created confrontation. So it was all pointless.

I just don't feel confident that a therapist can unpick whether this genuine anxiety, demand avoidance or routine and the wrong decision could have catastrophic effects.

[inappropriatelyemployed]

Also, how does deciding if the behaviour is motivated by anxiety or anything else change how you address this.

My real worry, from Monday is, that his perception seemed to be 'he needs to do what he is told' and that will just lead to forced confrontation

[inappropriatelyemployed]

My concern is also - what are the strategies to be used to work on something.

All I saw on Monday was 'do as you are told'.