ABA - recruiting therapists

[BialystockandBloom]

Hi

Having spent over a year in a turmoil over whether 3 yo DS is/isn't autistic, we have realised we cannot bury our heads in the sand any longer , and are in the process of having him assessed. We are also embarking on ABA - regardless of what diagnosis he gets/doesn't get, his behaviour is becoming markedly different from his peers and we need to help him.

Can anyone advise, please, on what to look for when it comes to finding tutors? I've put an ad on Gumtree and have had a couple of responses so far. Other than experience in working with ASD kids, what other qualities should we be looking for in a tutor?

TIA. Will also start joining in on this board - have spent 2 years on MN hoping I wouldn't have to join the SN board (iykwim - hope that doesn't offend anyone!), but have to face up to it now , so look forward to getting to know people here.

TBH you need to interview.

We gave every tutor two activities to engage with with DS. One was one he LOVED, and they would find it easy to get his cooperation, and the other he found more challenging.

I watched them play, assessing their ability to quickly tune into his interests with the first, and then watch how they handled the more difficult behaviour that the second task produced. If they got a bit stressed, cross or impatient then they were off.

I also listened to their level of language. You want to avoid the ones that talk 19 to the dozen, and chose ones that use short key words and make sure they have attention before they utter them.

Hope that helps. Where in the country are you?

And don't worry about not wanting to be here. None of us do. But it is invaluable for support.

Thanks for replying.

Justa, yes, we are going to do it under a programme (Duncan Fennemore).

Star, that is really useful, thank you. It might be a challenge finding something ds really loves that other than ones we don't really encourage - eg throwing soil, pouring water, throwing himself around etc

Is experience of doing ABA the most important thing, do you think? Or is enthusiasm just as important? And if you don't mind me asking, how is it going with your ds - how long have you been doing ABA, and has it made a difference?

I'm in London.

I think it is sensible to have at least ONE tutor with ABA experience, but not essential for all.

I also think that the most important thing you can do is get yourself as knowledgable and as trained as you can, as you are always going to be the consistent link between tutors. If you get one with experience, spend time observing and shadowing.

This also means that you take the programme into your normal parenting and your child will beneift from that level of consistency.

My ds is doing very well. He is catching up with his peers. He has been on the programme for 8 months. I'm sure you don't need me to tell you that ABA is not a cure, nor is it any guarantee that your ds will become indistinguishable from his peers. It is simply an individualised systematic programme to optimise learning at the fastest pace your ds can manage.

IME (admittedly not great) having someone on the team with experience is really helpful. We have one tutor straight out of uni, first job while our other one has over 10 years experience & supervises a number of programmes. It works really well - they both bring different skills. Our programme is non-ABA ABA - after a rough start we're now completely play based (no DTT, table top etc) we do a lot of RDI & also speech therapy during sessions. Our inexperienced tutor has no bad (for us) practices that need to be unlearned & our experienced tutor enjoys the challenge of turning everything on its head.

I ran the programme before we got tutors & I act as supervisor, we only do 18 hours with tutors so ds has far more time out of session (i.e. with me) than in so I need to be involved. We have fortnightly meetings, consultant training every 2-3 months and I try to have crossover sessions with all three of us every couple of weeks.

Good communication is vital - you will be sharing your home with the tutors (!) so you have to get on with them - as is punctuality/reliability. More experienced 'career' tutors are less likely to decide they've had enough & leave but can be tempted away by someone offering more money. They need to be calm, flexible, enthusiastic, self directed & quick thinking. DS hates being taught (PDA was considered as a diagnosis) - our tutors must be able to work around that. They need to really like & enjoy your child - I was only willing to have consider tutors that convinced me they were fiercely committed to ds' progress . All our hiring has been based purely on gut instinct.

Incidentally we started before ds had a diagnosis - and even now his ASD diagnosis (which we're unconvinced by) is irrelevant to the programme.

Phlebas, thank you that is really useful. It's rather daunting embarking on all this I must say - even the initial step of trying to recruit people when we don't really know exactly what will be involved.

I do plan on being involved too as much as possible as am SAHM - though have 8 month DD to look after too so not sure how much time I can dedicate to it unless I get other childcare for her. But I can totally see why it makes sense for the parents to act as 'tutors' too; as Star says I guess it has to become the method of everyday parenting. We are doing VB ABA as I understand it's more based in the everyday environment than table top based (?).

Can I also ask - how did you find your tutors? And how did you run the programme yourself before finding tutors - did you have training, and if so, who from?

Sorry, one last question - what is PDA? I ask because I suspect ds doesn't like it when he knows he's being 'taught' too!

it's incredibly daunting - people management skills don't come naturally to me (!) & having people in the house everyday can be so tiring.

The programme evolves - ours was desperately slow to start with - it is really hard at the beginning when you're not sure how it is going to work. We had a looooong 4 months of pairing (VB programme) before we got down to anything even vaguely work-ish - it was hard on us (OMG the money) & the tutors (wanted to speed things up with what seems to be a relatively able child). We relied an awful lot on our consultant (daily emails/phone conversations/videos/lots of visits) - I did a lot of training with him before we got the tutors (I don't know your dc's issues but ds was non verbal when we started & I organised signing training privately (lovely NHS would provide anything except PECS which was not suitable not that I'm bitter )) for me & the the tutors. The slow start was definitely necessary for ds - he's not typically ASD (is there such thing?) but has lots of issues around confidence/avoidance as well as verbal dyspraxia & motor planning problems.

The PDA (pathological demand avoidance) pretty much summed ds up for the first few months of the programme - but I tend to think of it as a character trait rather than a pathology. The ed psych suggested ODD too. Our consultant felt that if we pursued a traditional approach to getting instructional control/compliance we might get there eventually - and we tried for a good month/6 weeks it would've been much easier if it had worked - but would probably end up with a child who could only comply within a session & was unmanageable the rest of the time. It also wasted ds' strengths of generalisation & imitation.

(totally waffling - but that's why ABA works because it addresses the needs of the individual child rather than those of imaginary autism kid).

I had a 3mo baby when we started - it was hellish (I have a 9yo at home too) to start with but works nicely now. The tutors enjoy baby dd (she's learning masses) & indulge big dd (she's highly reinforcing for ds). My dh has negotiated compressed hours at work so we have 2 afternoons where we split the children - one does a session the others the girls out. Most of the time the ABA stuff is just parenting though if there's a specific skill we're targeting dh & I make it a part of daily interactions (which is great for generalising skills). Most VB programmes I've seen are NET based - we're doing some academic stuff but even then we avoid doing table top (not because there's anything wrong with it but ds does not learn well in that environment).

ds was 2.9 when we started & pretty much mute - he took to signing incredibly quickly, then after about 3 months started using single words. We had a breakthrough when we got echoic control (took another month) - an from there he's made good progress. At 2.9 he was testing at 9-12 month level for pretty much everything other than gross motor, at 3.5 he was between 2-3years. The vast majority of that progress has been made in the last 12 weeks - we've gone from 2 word mands to 6-7 word utterances & some lovely early conversational skills. But we're constantly getting new issues pop up (e.g. ds has tracking difficulties which have only become apparent in the last couple of weeks & we're seeing new phobias emerge that require a huge amount of time to deal with (eggs atm)). We've just introduced cued articulation. We're also not working to a deadline - ds will stay in nursery 2 afternoons a week until he's 5.3 then will be HE-ed - we're not hurrying to get skills in place for school & that makes our priorities slightly different. I don't think in terms of cure btw - ds is who he is there's nothing to cure, I think he will always have difficulties in certain areas but I think this is the best way of helping him gain skills (since the alternative was an hour of portage a week not that I'm bitter it's the only way) & he is so happy now.

We advertised for tutors on gumtree, abayahoo & vbcommunity - our consultant also advertised for us. In the end we found both by word of mouth - one from another mn mum (thanks SWC ) and the other from a local aba family whose programme recently finished.

Don't know if any of that is helpful - when we were starting I was desperate to know exactly what we'd be doing & how it would work but it's so different for every child/family.

Thank you again phlebas, your posts have been extremely helpful.

"I don't think in terms of cure btw - ds is who he is there's nothing to cure, I think he will always have difficulties in certain areas but I think this is the best way of helping him gain skills" - that is exactly how I'm thinking too.