ABA gurus: if a dev ped is associated with a private practice and indep SN nursery that services ASD kids but does not do ABA, should I even bother taking ds to him?

[Mamax4]

I know that ABA is the best for ASD, or just delayed dcs who don't learn "incidentally". And it is the best method of delivery of speech and other therapies, which are far less successful otherwise. Am I right to have this uncomfortable feeling that any ASD "specialist" who does not support ABA 100% is behind the times?

I think it all depends on the child and the nature of the ASD. Our son is receiving ABA at his state nursery but we have found that his SN nanny who uses Hanen/real life situation therapy has had far more success - to such an extent that he has stopped speaking at all at nursery but is coming on leaps and bounds at home - but that's another story. Most experts will support the view that ASD children need structure and repetition to learn and that 'backwards chaining' events is useful, but few will say that ABA is the way to go for all ASD children. We are about to start a new therapy program at our local hospital and they were not pleased to hear about the ABA as their method is child led. For the stage we are at now, that suits us and we might not continue with ABA - but every ASD child is different.

I can't see the point of going to the expense of seeing someone privately if they are not offering or supportive of what you want to do. But then I'm not sure how many Dev Paeds of any sort you are going to find who will say categorically that they recommend ABA and ABA only, very unlikely I would have thought tbh.

No, I don't mean that they will say "ABA and ABA only" but that at least they should use ABA as one of the options. For ex., a private nursery I looked at in london serves ASD kids, including severe cases, but does not offer ABA at all. Not to offer ABA for severely autistic children? So same with this ped- if she dx's ASDs but then presumably sends them onto a practice that does not have ABA as one of the options - it simply excludes ABA from their offerings- seems almost irresponsible. But if i am wrong, please do tell me- I am still learning at this stage.

I don't think any standard SN nurseries would offer ABA formally as an option. But, as said on other thread, many use "behavioural strategies", e.g. count downs, visuals inc PECs, prompting, chaining etc. Have you looked at TreeHouse? It is an ABA school from nursery age. Although most places are LEA funded they do have some children who are not entitled to a statement due to country of origin but can guaranteed fees through expat package or some other way. I think it is the only way you will get formal ABA consistently in an SN nursery setting, otherwise self-funded home prog. There are other ABA schools, ask PEACh for info.

Mamax, I have a lot of sympathy with what you say as not one of the many autistic psychologists, behavioural specialists/paediatricians etc I have seen in the last 2 years in the UK has even mentioned ABA. Two very eminent paeds (incl. Daphne Keen actually) recommended an autistic specialist nursery which uses TEACCH, and which was completely useless for my son. I think that the establishment here think of ABA as a bit of an offbeat "cult" and haven't bothereed to investigate much beyond their prejudices. They all just trot out the same old truisms about autistic kids being visual learners, and therefore needing PECs or visual timetables.

we too are struggling with getting most professionals involved with dd1 to accept that ABA might work for her.

we are in the very early stages of a home programme, but have already had her pre-school and her SALT comment that they've noticed huge (positive) changes in her.

Then I go to pick her up from pre-school yesterday to get told that SALT is going into pre-school today to "have a good session with PECS".

FFS. dd1 does not get on with PECS. She is verbal, and able to ask for anyhing she wants. she is a fantastic vocal imitator, and we are using that to get her to ask for things appropriately. The problem is that at preschool she tends to ask very quietly (she gets quite withdrawn when it is noisy) and people miss her requests. We are working on this at home (getting her to use names before a request - it is easier to pick your name out of a background noise than just a muttered request lost in general hubub) and within 10 days, dd1 has successfully asked me, dh, and her nany for things ("mummy", pause to see if I am listening, "I want some raisins"; "daddy, read lion please" "nanny, I want a drink").

This has all been communicated to pre-school, and they have had nanny going in to give examples of how we are speaking to dd1, etc, and seemed to have taken it on board. Now SALT is off in to "work" on dd1 using PECS, rather than working on her 1-2-1 listening to her!

we ahve also just had a chat re: TEACHH methods, and how they have not worked for dd1 so far. But instead of changing methods to something which is working, they are all having a meeting to discuss how to get their methods to work...

Snap again Silverfrog. Our nursery introduced PECS without consulting us. We tried it when he was younger and it didn't work. He is verbal now - well minimally and his understanding is quite good . However he has stopped speaking at nursery and they don't seem to believe us when we say he is speaking at home; if anything they seem quite resentful of reports of our Nanny's success where they have failed. Oh and PECS hasn't worked for him - what a surprise ! Anyway on a positive note, his speech is really picking up a bit. He answered a question yesterday. 'Do you want to help me put clothes in the washing machine?' 'No, See Garden' and he walked right past me to the garden. He is picking up new words more easily too. He learned his third colour today - red !

oh, answering a question is fab - well done mastercyber!

today, dd1's SALT is at te pre-school, so i dread to think what they are discussing...

we have eliminated all questions to dd1 atm, as she s far too god at vocal imitaion, so we were getting "would you like a drink" when she was thirsty. Within a week of this, combined with extra work on names, she came out with "muumy, I want a drink". I was practically in tears, as it is the first time she has properly called me iykwim. She now asks properly for anyhting, or she doesn't get it. She is well able to, and we ahve to go with her natural motivations.

Got to pre-school on monday in time to see her 1-2-1 giving her choices for lunch - "dd1, would you like raisins, or berries?" dd1, unsurprisingly said "would you like raisins, or berries", and reached for the berries, and they handed them over. It is so frustrating.

SALT wants to work on dd1 making choices- she doesn't understand choices, and tends to parrot the question back instead, beofre reaching for one item, playing with it then expecting the other item. I could cry, honestly.

It's fascinating to hear all the different experiences that parents have had. if I had a friend whose child was diagnosed tomorrow with ASD, I really wouldn't know what to suggest because her child would probably be very different to mine. I am not rigidly anti PECS or rigidly pro ABA, all that I would recommend is keeping an open mind about what might work for that individual child. It seems that many SALTS don't have the time or the flexibility to offer anything except the PECS steamroller. 'He can't talk like a normal child, oh PECS is for him' And then when it doesn't work, they blame the child

ps my nursery claims to offer ABA but from what I'm reading here, PECS is not ABA?

PECS is an ABA technique.

Done properly.

So the child learns by tangible reinforcement.

Things like visual timetables that are sometimes called PECS (but aren't) are not an ABA technique. But PECS is. Andy Bondy who developed it is a behaviourist and if you read their broader curriculum manuals they are all ABA based.

these for example are all ABA

That's what I sort of thought - It is all behaviourial with re inforcers etc but wondered if there were doctrinal divisions at some other level. Real life learning/Hanen seems to be working best for us so we could be switching religion anyway...

I do find it encouraging tbh that SALTs are now recognising that PECS can support emerging speech- a few years ago - when ds1 started it was impossible to find a PECS trained SALT and they would say daft things like it would prevent him speaking.

There is research showing that children who are learning to speak will produce longer spoken sentence when using PECS as well - which is probably why the SALTs are keen on it (I'm stunned they're that up to date tbh).

However, no system is right for every child and if your child isn't responding to PECS they should perhaps be exploring whether Makaton for example will support emerging speech. They should be Makaton trained- 7 years ago they were all Makaton trained (which was hopeless for us as ds1 couldn't imitate) but not PECS trained. Again there is research showing that children with disabilities who use Makaton have bigger spoken vocabularies than those that don't.

I do think that if you have a child who is non-conversational it is well worth trying to find and AAC system that works for them (doesn't matter what it is) because all the research shows that it aids in speech acquisition.

Nope PECS is pure ABA. Which is funny because lots of SALTs will advise you against ABA but then lap up PECS.

SALTs should be well versed in Hanen.

Which is funny because lots of SALTs will advise you against ABA but then lap up PECS.

I've notice that too which is why i've wondered were the division lies given that it is behavioural. ie based on same principles.

The two SALTS who introduced Hanen at the orientation meeting seemed to know their stuff and were very knowledgeable so I'm really looking forward to starting. There are 12 parents looking for places on the program and they normally like to work with a group of 8. They are debating whether to include us all or start one group in August and the next one in November.

PECS does seem to have a high success rate even for severely autistic children. The chlld in 'A Real Boy' learned a lot from it so I'm pleased the system is gaining popularity but like everything, it's not going to work for every ASD child.

PECS is about the only thing that will work ime if your child can't imitate. If your child can't imitate then I would go so far as to say that PECS is about the one way that a child will learn.

Once your child can imitate then you have all sorts of choices about what you can do.

There's no division it's just a subgroup. So all PECS is ABA, but not all ABA is PECS.

SALTs just don't realise that (because they know bugger all about ABA ).

(DS1 couldn't imitate until he was 7, so PECS was essential for us until then, now we've broadened out a lot and use all sorts of things- but until he 'got' imitation....... everything else was pointless).

Now he communicates using PECS, Makaton, Informative Pointing and is about to start typing. So every way except speech really.

It's great that he can use Makaton. That's something else that my son has no interest in. DS1 has delayed imitation. He doesn't imitate spontaneously the way DS2 does ( He could be a Makaton maestro by now) but he files things away and produces them later - actions and words etc

He doesn't have a great deal of Makaton- toilet, apple and a couple of others, although all bastardised so not really understandable to people who don't know him.

He can ask for anything with PECS - although he's lazy about using it.

I'm hoping the typing will give him proper sentences though.

We'll see- long road ahead and certainly no guarantees.

I'm probably guilty of basing too many assumptions on comparisons with my high functioning ASD brother. Despite the family link, at this stage I have no idea if DS1 will be able to achieve as much as my brother. However I do know that my brother could not learn Makaton to save his life as he has no understanding of gestures or facial expressions. If he 'sees' me to the train station, he would never wave or give any indication that anything was happening that concerned him.

I think ds1 understands them- he just has a lot of problem with fine motor skills and sequencing movments (hence the total lack of speech - he tries to talk all the time- he just can't).