Can someone explain VB (Verbal Behaviour) in a nutshell ?

[chickeninabox]

I have tried looking on t'internet and in library for books on the subject but can't find anything which really explains what it actually is. I understand it's a form of ABA and sort of understand what ABA is all about but beyond that I am foxed.

Thanks for your help folks.

I personally did not have to fight for the ABA nursery place which we got quite soon after diagnosis - which we got at NHS hospital with Autism Unit after getting frustrated with CDC delays. As far as I know, the Council responded to requests from parents and initiated a test scheme for the ABA approach and then launched the program for real in 4 Nurseries - which means about 8 places for entire city but hopefully it will become more widely available. They do place emphasis on progress which so far for us has been positive but I am not sure what the response would be if they felt the child was not progressing.

I thought maybe it was apraxia. Alright when autistic children have apraxia the problem isn't behavioral so the behavioral intervention and reward system of ABA and VB doesn't work. HOWEVER the regular speech program given to a child with apraxia and not autism doesn't work for a child with autism. In this case you need to find a speech therapist and a behavioral analyst/teacher who can work together. The speech techniques need to be given to a child within the framework of and ABA model. This is tough to do, but it does work. You need two committed professionals who believe that he can do it.

Has your speech therapist done bubble and horn therapy with him? Kaufman cards are a bit advanced if he can't do those things. He is also gonna need BIG REINFORCEMENT for any verbal progress that he makes. Apraxia and autism together is so tough for the kid, the child has to work for the best reinforcer in the world while doing the speech techniques. So it works together in this way. For him to gain speech he needs to learn how to blow a horn (lets just say this where he is at as an example), but speech therapist can't get him to do it, but the aba therapist can. So he will blow the horn and get a reward.

Do you know any other parents who have this same issue and what they have done. If not I can put you in touch with some by email who might be able to help you with some of their experiences. Just out of curiousity does your son have food aversion issues?

We are paying about £25k a year on ABA, so pretty similar to the $50k you quoted. Firstly we paid by remortgaing the house, but after some wrangling the council now pay 2/3. But that only came about because we had the proof based on a year or so of our own ABA to point to - so it's a vicious circle: if you can't pay to prove it works, you can't prove it words and therefore get funding! Which is of course totally unfair in a country which came up with the NHS.

Am very interested in what you say about Apraxia, as our speech therapists over here don't seem to know as much as those in the US. My son definitely fits the bill, as finds vowel sounds easier than consonants and can say the name Hugh far better than any other word, though you would have thought it would be harder!
I have dreamed of finding a US speech therapistm, who knows all about apraxia, and who happens to be living/working in London, don't suppose you know anyone? Would be very interested in your project too, as I'd like to help other mums beat the system on behalf of their kids!

The system sucks that's for sure. The project I'm currently working on is for parents in the US, but I don't see why it wouldn't work for parents in the UK. The idea is the same, although I don't know about the politics of autism in the UK.

Also I realize that I could have given some more info on apraxia. One thing I've had to do with my apraxia kids is a speech therapy program built into their ABA program. A good ABA program should do this anyway along with occupational therapy or sensory needs. But for apraxia much more needs to be done.

I've had two cases of severly apraxic and moderate to severe autism cases (with less severe cases you shouldn't have to start as this basic approach).In both of these we had to start with oral motor activities such as horn blowing and bubble blowing (not having them blow bubbles themselves, but us blowing bubbles catching them on the wand and having them try to pop the bubble or blow it away with their own air production).

We also did exercises with their face and tongue to get their mouths ready to do the activities. Such as tongue lateralizations, lip stretches, facial massages, etc. This warms those muscles up and gets them ready to perform. Then we would have them blow on a horn. The horn therapy comes in a system and once they master one level a harder one is introduced.

We also physically manipulate their mouth into the correct position to make the sound. This is basic and first such as giving them a physical prompt in where to place their lips and/or tongue. In severe apraxics this is helpful, it gives them a oral "memory" of what they should be doing. So they don't have to naturally recreate the sounds just by listening, in the beginning anyway.

Maybe this description is more helpful. I don't know many speech therapists who do this, but this is the only technique i've seen to be effective. It's messy work, but you have to get in their mouths.

I remember Nancy kaufman talking about physically shaping mouths. I live in a pretty rural area - and have no chance of finding the combination of pros you mention . Some consultants travel, but then I can never afford them.

What do you mean by horn? We do all the mouth exercises you mention (he can do those quite easily now) and can blow into a recorder (new- he use to suck or hum).

For the physical manipulation do you start with easy sounds like 'ah' (just thinking easy to physically prompt). I'm not sure how aware he is of the sounds he makes. The other day for example he was saying 'mum - ee' over and over again so I said "es mummy' and tried to get in with a do this and he didn't seem to realise I was talking about the sounds he had made.

yurt1, if your son can make NO imitative sounds, then I would start with the easier ones like "ah". For that I take my index finger and put it horizontally under their bottom lip and push down on their chin, so that their mouth opens. You can try it on yourself to see what it feels like. This isn't a forceful thing, it's very gentle. Then you model the sound a few times and then prompt them to make a sound, "now your turn" "you try" "do this". Reinforce any sound they make intentionally, do not reinforce stimming sounds.

Children with apraxia don't do well under pressure, it makes the problem of not being able to control their muscles worse. If he can still say "ya" in imitation I would pick something and make him use that sound to ask for it. If he can purposefully sign and use pictures then he should be able to transfer that to spoken language once he can control his mouth.

I do mean a recorder, but this should get harder for him to do in order for him to build stronger mouth muscles and increase air flow (another apraxia problem). So he should use different horns and blowing items to increase the difficulty. There is a kit called Talk Tools that is pretty good, but really all the items in it you can find elsewhere and for much cheaper, they just have it all together.

You should ask whoever does his speech if they have any real experience with apraxia and autism and if not if they can find someone who actually knows what they are doing. A lot of times an unqualified speech therapist will tell you that your child won't be able to speak, when really they just don't know how to work with the child. So the faults of the therapists are put on the child as being something he just isn't able to do. This can also happen with ABA when they can't get a child with no speech problems to talk and that is why they won't move them past pictures. True not all children will develop speech but a lot more will if they are actually helped effectively.

yurt1, if your son can make NO imitative sounds, then I would start with the easier ones like "ah". For that I take my index finger and put it horizontally under their bottom lip and push down on their chin, so that their mouth opens. You can try it on yourself to see what it feels like. This isn't a forceful thing, it's very gentle. Then you model the sound a few times and then prompt them to make a sound, "now your turn" "you try" "do this". Reinforce any sound they make intentionally, do not reinforce stimming sounds.

Children with apraxia don't do well under pressure, it makes the problem of not being able to control their muscles worse. If he can still say "ya" in imitation I would pick something and make him use that sound to ask for it. If he can purposefully sign and use pictures then he should be able to transfer that to spoken language once he can control his mouth.

I do mean a recorder, but this should get harder for him to do in order for him to build stronger mouth muscles and increase air flow (another apraxia problem). So he should use different horns and blowing items to increase the difficulty. There is a kit called Talk Tools that is pretty good, but really all the items in it you can find elsewhere and for much cheaper, they just have it all together.

You should ask whoever does his speech if they have any real experience with apraxia and autism and if not if they can find someone who actually knows what they are doing. A lot of times an unqualified speech therapist will tell you that your child won't be able to speak, when really they just don't know how to work with the child. So the faults of the therapists are put on the child as being something he just isn't able to do. This can also happen with ABA when they can't get a child with no speech problems to talk and that is why they won't move them past pictures. True not all children will develop speech but a lot more will if they are actually helped effectively.

yurt1, if your son can make NO imitative sounds, then I would start with the easier ones like "ah". For that I take my index finger and put it horizontally under their bottom lip and push down on their chin, so that their mouth opens. You can try it on yourself to see what it feels like. This isn't a forceful thing, it's very gentle. Then you model the sound a few times and then prompt them to make a sound, "now your turn" "you try" "do this". Reinforce any sound they make intentionally, do not reinforce stimming sounds.

Children with apraxia don't do well under pressure, it makes the problem of not being able to control their muscles worse. If he can still say "ya" in imitation I would pick something and make him use that sound to ask for it. If he can purposefully sign and use pictures then he should be able to transfer that to spoken language once he can control his mouth.

I do mean a recorder, but this should get harder for him to do in order for him to build stronger mouth muscles and increase air flow (another apraxia problem). So he should use different horns and blowing items to increase the difficulty. There is a kit called Talk Tools that is pretty good, but really all the items in it you can find elsewhere and for much cheaper, they just have it all together.

You should ask whoever does his speech if they have any real experience with apraxia and autism and if not if they can find someone who actually knows what they are doing. A lot of times an unqualified speech therapist will tell you that your child won't be able to speak, when really they just don't know how to work with the child. So the faults of the therapists are put on the child as being something he just isn't able to do. This can also happen with ABA when they can't get a child with no speech problems to talk and that is why they won't move them past pictures. True not all children will develop speech but a lot more will if they are actually helped effectively.

Thanks walesh that's really helpful. We don't have a SALT on board at the moment- the NHS avoid treating complex cases!! (if you can be fixed in 6 weeks you'll get SALT, if not forget it). There is a SALT at his school but not enough to go round and the children have to take it in turns. It's not his turn atm. The only private SALT I know with the right sort of skills/attitude is no longer working in private practice.

I'll give it more a go again though, whilst carrying on with the typing/letterboard stuff.

This has turned into a really interesting discussion. I am relatively new to all this - my son was only diagnosed last DEcember, but my eyes have been opened in that short time, as to how political it all is. How services in this country are dire compared to what walesh describes in the States...how your child can essentially be left to flounder in mainstream school if he or she doesn't tick all the relevant boxes...

It's so saddening. I can live with my son's asd - I love him dearly anyway and his condition doesn't change that. What I find horrifying is the thought of the struggles ahead to get any of the meagre support he deserves to get the best chance at life. It makes me feel ill just thinking about it.