ABA for very young toddler (14 months). Possible? How?

[LemonGoby]

Hi. Quite gutted to be posting this.

I strongly suspect DS (14 months) has ASD. Development all seemed fine until just before his first birthday when I started noticing certain signs.

We are already running a part-time ABA programme for his sister, DD (4.4, diagnosed with autism at 4, high functioning). She has just started reception and is doing mornings at school with tutoring at home in the afternoons (started ABA aged 3.11). I observe how our tutors work with DD, but because of the age difference between her and DS, and because she can articulate/negotiate things such as doing some work for her preferred reinforcers, I can't really work out how to translate the principles to work for a very young, non-verbal toddler.

So, what I want to ask advice about is this: are there any age appropriate ABA approaches I can use for DS at the moment to give him a head start and make the most of what I read about the young brain's supposedly amazing 'plasticity'?

I guess I am thinking along the lines of things like trying to get him to look at me if I am giving him something he wants, for example. (At the moment he just looks at the desired object in my hand, and doesn't look at me when I hand it over or once he has it.) Also, are there any other tips for positively reinforcing interactive behaviours (I already give lots of claps, verbal praise, hugs, kisses etc), and for simply making
interacting with me and others more reinforcing in and of itself?

Obviously the logical person to ask about all this would be DD's programme consultant, and I intend to in due course, but tbh I am just not quite ready to 'out' my anxieties about DS just yet, not least because he is so little still and I suppose there is a chance I might be jumping the gun, (although I don't think so), and also because there are issues with DH's acceptance of the implications of DD's diagnosis, and he already thinks I am an over-anxious worrier, seeing problems where there are none in relation to DD, and I frankly can't face another round of incredulity and denial just at the moment. Will save it for later!

Any advice/pointers much appreciated, thanks.

Bumping...

Sorry you have worries about your ds, as well as your dd.

Am trying to leave aside the issue about your dh and acceptance of dd hard not to say what I think but ffs the over-anxious thing makes me so cross ... I'd talk to your consultant or tutor informally. I know of course how awful it is to voice things out loud, it makes it seem real, but can you talk to them without telling dh yet?

Anyway, that aside - yes I think there are things you can do even at this age, to encourage interaction and non-verbal communication especially. As you say, just giving massive reinforcement in a way he'll enjoy (tickles, claps etc) for interaction will help. Yes, I think you need expert advice about the developmental stages, and especially, how to use motivations and reinforcements at this age, as well as doing this with no language, but in theory I can't see any reason why the fundamentals of ABA can't be used.

Also might be worth looking at rdi too for this age - your consultant might know more about it?

Even if you are jumping the gun, or it turns out there is no cause for long-term concern, if you have some worries now, the absolute best thing to do is start intervention even at the simplest level.

I also think you could definitely use ABA approaches.
In terms of the eye contact/responding to name what we did with our DS was to sit about a metre in front of him and call his name, every time he looked at us we would immediately reinforce with a sweet and say 'good looking'. When he was doing it at that distance fairly consistently we moved a little further away, then we started at one metre but at the side, then behind and eventually from a different room. You should always give social praise when delivering the reinforcer (sweet) so that your DC associates the praise with something nice and eventually the hope is that the praise on its own will be reinforcing enough. Also anytime he did make eye contact in any other situation we would try and remember to praise him.

It would probably be an idea to try working on basic imitation now as that is such a key skill. So sit in front of DC and clap your hands while saying 'do this' amd then prompt him to do the same (hand over hand if necessary) and reward him for doing so. Eventually fade the prompt by say just touching the back of his hand or his elbows etc..

In terms of making him see others as fun, play lots of games that need another, such as blowing bubbles or pushing him on a swing, jumping with him on a baby trampoline etc

I'm not sure whether you have a copy of the ABLLS or VB-MAPP (your tutor or consultant will though) and having a look at those curricula might give you an idea of other things you could start with.

Thank you both for your replies. Very helpful, and food for thought.

Bialy, you are right of course, I do need to talk to our consultant, and I will, sooner rather than later and, most likely, without involving DH just yet. (Re. DH, let's just say we are getting there although it's been a slow process. I think he needs some time to catch up, as it were, before we start thinking ASD for DC #2.) Thanks for mentioning RDI too, I will look into that as well.

And Boobybum, thank you for all the great tips on things to try, this is exactly the kind of thing I want to work on, but (until your post!) my notions of how to had been vague. It's funny because at times DS is brilliantly interactive (loves being chased up the stairs, playing peekaboo round door frames, being pushed in swing etc) and will spontaneously do all the things I hope to see (ie. looking at me to share enjoyment/see my reaction, holding eye contact while he giggles, bringing me things etc), but then at other times I look at him and I just feel that something's not right - endless emptying out of cupboards, bookshelves, recycling bin, only to then put it all back in and start again, total fascination with odd things like the hair dryer which he will just hold and wave, looking at it intently for ages. Also - and I think this is really my main concern - it is just hard to get a smile out of him quite often. He grins and chortles if it's a game, or if I do something silly to amuse him, but those spontaneous smiles just because he is with his mummy have stopped, so I feel, and he often seems rather solemn with me at home. Also no pointing or waving. So... I do feel there's something there.

Anyway, great advice both, thank you. I'm off to dig out the bubbles and raisins...

Booby bum makes fab suggestions and I would also really really try and draw words or sounds out - so that the synapse in the brain which is marked "different mouth sounds give me different outcomes" is activated (= speech). Wish I had started this early, oh well !

Another great suggestion, sickof, thank you! I will try this - how should I do it? Just by really saying a word in context over and over, very clearly? So, 'ba-na-na, ba-na-na' etc, if he is enthusiastically eating a banana, for example? I have discovered (only today ) that if we are looking at a simple picture book, and I ask him where the apple or the bird is, he does point to the correct picture and, sometimes, looks at me to see if I have seen... which is obviously good as far as understanding goes, but he still feels no desire to point to spontaneously share something, which is the big thing, isn't it? Thanks for your reply re speech.

That is shared attention! And very good receptive language (eg comprehension). Looking at you to see if you've clocked it! Now you could try and shape his little finger into a point as you do it.

The words thing is about constantly pairing words with favourite items, yes, but also teaching him that "do this" first means "do the same movement I am doing, eg clap hands" but then move onto "do this - banana" or "ba" so he learns to imitate your mouth movements too (= words)

With the words start with things that he really wants. So for example if he is on a swing say 'push' before you push him and then stop the swing and wait for him to say 'push' or 'puh' or any vocalisation if he can't say that, and then reward him by pushing the swing.
If there is a food that he particularly likes give him a little at a time and get him to vocalise for more. So it may be that he just says 'ba' for more banana.
You can do this with loads of things, tickles, bubbles, bounces etc.. Basically anything that he wants.
And if he can imitate you then oral imitation is a great idea - so copying you sticking out your tongue, blowing raspberries, opening your mouth etc

Sorry, we had a busy couple of days and I went quiet, but I just wanted to say thanks also for the last couple of posts and the ideas and suggested approaches. They are hugely helpful and I feel more positive already knowing I can try to make a difference from right away.

X

Similar to ABA, in relation to imitation. The speech therapist Laura Mize has a manual called 'Building verbal imitation in toddlers'. Basically going through a step by step guide on imitation I.e imitating toys in play, imitating actions and so forth. You can get the manual front her site... www.teachmetotalk.com... Or go on the video link on her page and look out for the video displaying the Mr potato heads, which shows you how the building the verbal imitation works.

Look at the Early Start Denver Model.

Thank you, Adrianna and Starlight, I will look into both of these. So much to think about!