Applied behaviour analysis (ABA) versus Speech and Language Therapy

[TLSP]

My DS is a 5 year old an autistic child. I would like to get some private help for him but I am confused by what ABA, and private S&L Therapist can provide. From my internet research there are private S&L therapists who claim they have experience working with autistic children, but will such therapists just concentrate on speech and language or include social interaction?

ABA seems to focus on social interactions, but I am confuse with the structure as it talks about having a supervisor, finding a therapist/ tutor and getting training for parents and therapist then creating a programme. Does ABA include speech and language?

Money is limited so I wish to use it wisely to get the most benefits for my DS.

I have spoken to the school's S&L therapist and was told that she will only provide a consultative service to the teacher assistant, teacher and the SENCO; she does not do any actual S&L session with my DS.

Any advices and recommendations will be greatly appreciated on the benefits between and ABA and private S&L therapy especially if you have used either or both. We live in North East London.

The problem with ASD specific schools is that they usually use TEACCH which is not evidence based and has no curriculum so you can't possibly measure progress, where ABA will show in black and white from week to week (if data is properly taken) what is being learned and what is mastered etc. It can be very empowering to see your child making progress.

Not sure why anyone says it is controversial. I use ABA with all 3 of my children, and two of them are NT, so am hardly trying to remove their autism.

It's always up to the child what they want to do. You present them with choices all the way through. You spend and awful lot of time working out what things they would enjoy MORE than what they are currently choosing to do, and the learning is an incidental part of that.

I've never seen any pain, only enthusiasm, though if the therapist doesn't understand properly what they are doing they might get frustrated with the child and/or blame them, but this is currently rife in most of the alternatives, and properly run ABA will have on-going supervision from someone trained in the ethics to avoid this.

'You first of all need to decide whether VB or Lovaas ABA programme style would suit your ds.'

I'm not sure this is all that relevant now tbh. We did neither and/or both plus some. It really is about keeping on top of what works for the child and what helps them get the skills the fastest, and by skills I mean fundamentally being able to communicate their needs and wants and make choices affecting them.

DS was on a 12 hour programme for a 8 months and then a 8-ish hour programme for another year or so, and now he is in an Indi SALT school and we do some ABA at home, and the school is learning bits. He would never have had the skills to access the SALT school without the ABA.

I really don't agree with the pain thing. DS is free to choose whether he communicates or not at home, with no incentives at all that are of my making. He choses to talk. I don't expect he would if it was painful.

Joined Yahoo group ABA-UK and found www.abatutorfinder.com for tutors. Read up on both VB and Lovaas and VB seems more appropriate for him at the moment.

Where do I go to get a supervisor and a programme created? It is Peach or are there others?

Well there are providers like Peach, UKYAP and Autism Partnership who provide a package that you pay a flat fee for - the latter two are very much Lovaas though. You might want to choose a consultant who uses VB and put together the team yourself. The consultant will come alone first of all and get a baseline view of your ds.

To get tutors you can advertise on the ABA UK list. I also used to put up posters advertising in the local university for psychology students to train as tutors. Where you live you may be able to get people already trained though - there are lots of programmes in London.

Good luck TLSP.

Lottie I don't know about UKYAP as I have only seen one session of theirs when we were trying to make up our mind, but Autism Partnershio are definitely not Lovaas. They might have been at one point but the program we are running with them is very much VB. From what I could gather after talking to UKYAP and watching them in action, I don't think they call it Lovaas either.

OP I don' think you will have trouble finding tutors but do make sure you take plenty of time finding people who are right for you. The providers I know are..

Autism Partnership
PEACH
UKYAP
Sean Rhodes
Duncan Fennemore
Skybound Autism Therapy

I have experience of dealing with 4 of them on that list so PM me if you want further information.

Sorry - I'm probably behind the times dev! When my dd started ABA (9 years ago!!) AP was completely Lovaas so I see that they must have changed. UKYAP was also totally Lovaas and at the time when my dd was part of their study, they advertised themselves as being Lovaas providers.

It doesn't surprise me that things have changed though.

One more thing, OP - the consultant you choose should be a Board Certified Behaviour Analyst.

Ds is 6.5 and ABA has covered all his language needs so far and of the two I trust ABA more as they understand the autism as well as the language difficulties and the interaction between the two.
We do stop DS doing things which might be regarded as stopping him being who he is but only with good reason eg they interfere with him learning (eg he is not allowed to do those things in learning time but can in free time); they are harmful to him eg we have stopped stims which involved self harm such as picking his skin away so much that he was in danger of infection; and we always check what the outcome is and usually its that he has learned to enjoy something new which he would not have tried had we not distracted him from his activity to ours. So for eg he can now swim without armbands across the pool which he loves and its clearly the favourite bit of his week when before he would just circle the edge of the pool looking at the lines of the tiles. I know if my child is happy or not. He has few sensory issues and what we are doing is not causing pain. He spends a lot of ABA time laughing and giggling and gets bored when he has weeks off and is aimless and unable to

Oops!
Unable to occupy himself.
I also force my other NT kids to do things they don't want eg eat healthily and exercise / get off screens. I don't see the sort of ABA we do as any different than good clear teaching to widen his opportunities and encourage good choices. My other kids would also vote for no school, junk food and endless screen time. That doesn't mean I should let them. ABA is a whole lot more fun than school.

zzzz Verbal Behaviour is very focussed on language/communication. My ds has never had massively challenging behaviour, even at 3yo when we started. The focus of his programmes have always been 90% communication/language, and play. Once the communication really developed, interaction naturally followed as he had been equipped with the skills to do so.

The thing about ABA/VB is that you target whatever you want to, whether that's behaviour, language, self-help, play, or whatever.

Sometimes I think the inclusion of the word 'behaviour' in ABA is misleading and unfortunately leads to assumptions which aren't really true.

Amber I hope you don't feel browbeaten by the reactions to your post. All of us have our children's interests at the forefront of what we're doing to help them. It really would be sad if any of them turned to us when they were adults and said they wished we'd never put them through what we did. But if I (and I'm sure everyone here) ever felt that it was having a detrimental effect we'd stop in an instant. My ds has truly seemed so much happier since he's been able to communicate, to express himself, and to join in playing. Perhaps he'd have picked this stuff up by himself (and obviously your ds has done brilliantly) but at the point we started, he was showing no signs of doing so by himself, and seemed to be retreating into an ever-more rigid world, so how could we sit back and not help him?

So true Agnes.
As I mentioned earlier, I work with well over a hundred children and all my input with them is behaviourally based although not all the children are autistic.
I'm particularly interested in behavioural interventions for kids who have more general delays and disorders, the kind of kids labelled as 'slow' traditionally. What can be achieved is truly amazing, much to the joy an delight of everyone. I've just had a wonderfully reinforcing afternoon supervising some students who have achieved what looks like a miracle with maths with some really hard to teach kids.

It's not a miracle, it's the judicious application of scientific principles of
behaviour.

I'd also like to add that with my own dd, who has communication difficulties I have seen huge progress using behaviourally oriented intervention. She achieved more in a term, doing a bit of work after school, than she had in the care of supposed s/lt specialists.
Needless to say, I got her discharged from their care very quickly.

She achieved more in a term, doing a bit of work after school, than she had in the care of supposed s/lt specialists in over two years.

tbh, I think a lot of self-helpers on this board who have contributed to discussions on the topic probably do use a lot of ABA-type stuff. The need to find time-effective progress with a cooperative child leads to a flexible and determined adult who thinks carefully about what they are doing and refines like mad along the way with the aim of getting the best value for their time and the happiest and responsive kid possible.

Regular Formal Data is pretty important, but some of that is about sharing the responsibility with others or being able to be objective when working with others. Informal snapshot data is probably okay if you are a parent and the only one working with the child.

Thanks lottieandmia. In my DS case VB may be more appropriate. Did you develop your ABA program with PEACH? Would you mind giving me an indicative amount of money you have spent per stages of developing the programming, getting the parents's training, supervisor, tutor etc.

Just want to make such we can afford to budget for it.

Consultants vary between about £300 and £1,200 plus travel for a 4-5 hour day. They can visit anything between fortnightly to quarterly.

Supervisors/lead tutors often do weekly or fortnightly sessions of between 3 hours and 6 hours with all the tutors that may also include a direct session. They can cost between £18 to £45 per hour, depending on who you recruit (cost doesn't ime appear to be an accurate reflection of talent though).

Then tutors can vary between £0 - £8 per hour for a beginner student to £25 per hour and you'll need them for anything up to 40 hours for an EIBI programme.

Our programme was a consultant when we could afford it for £350 for a day (between 6-8 weeks), plus an experienced tutor for 6 hours a week at £18 an hour, with us as parents delivering as much as we could on top by sitting in on the 6 hours a week that the experienced tutor delivered and copying, insisting on a bit of training from the consultant when she visited.

At first we ran a programme with UKYAP - it was very expensive - £2,700 a month. We were very lucky in that family helped us out with the financial side. However, this programme was 40 hours a week and your child might not need anything like that. When we changed to Sean Rhodes he recommended 30 hours a week, and his programme was a lot cheaper - about £21,000 a year iirc all costs included (still a lot of money!). We eventually got our programme funded by the LEA via tribunal though which is a route you can take. It is stressful, it is time consuming but we ended up with ABA for years.

I always found Sean good - he would try to keep costs down as much as possible and he once very kindly represented us at tribunal for free. He also said you should never pay more than £15 an hour for any tutor unless they are supervisor level.

lottieandmia and all the other contributors; thanks you all so much. I am seeing the SENCO this Thursday and I will see what the school is doing in term of running ABA. If they are not running it, I will give the ABA providers suggested by dev9aug and lottieandmia a call to get more specific details.

Thanks again.

dev9aug; what does PM mean? If you don't mind I would like to ask you for more details of your experiences with some of your suggested ABA providers.

TLSP PM is private message. If you are on a computer or an Ipad, then on the bar that has my name, to the right you have three options. click on the Message poster button and that allows you to send a private message (PM) to that individual poster rather than the whole group.

TSLP, we use one of the providers listed by dev. If you would like any feedback feel free to PM me