Autism and Behavioral therapy

be.th

I'm a behavioral therapist (ABA) and have been working with toddlers and children with ASD for over 3 years. Seeing that there're some questions regarding Autism from different parents, I would like to offer help in providing answers and to clear some miseries. Questions about behavioral therapy is also welcomed!

(both English and Chinese is OK~)

be.th

There's good ABA therapy and bad ABA therapy. There're a few things that sounds wrong to me from your passage:
- the hours are not enough: only 4 hrs per week can hardly be effective for a child who's new to ABA therapy (i'd consider your kid as new to therapy, because he can have a lot to catch up in the first year). Usually we'd encourage parents to arrange 10-15 hrs per week.
- using food as reward: we usually call the "reward" a "reinforcer" (I hope ur therapist uses this term because it is an official term in ABA therapy). We are reluctant to use food as reinforcer because the kid can get satiated easily, and the effectiveness of it as a reinforcer will go down. We'll only use food if the kid is not interested in any other tangible reinforcers. We'll also try very hard to sell different toys and make them a reinforcer so we don't have to use food.
- Behavioral problem: a good ABA therapist should be able to teach you how to deal with your kid's behavioral problem. He/She can also design a program to reduce your kid's vocal stimulation. Maybe it'll take time, but the therapist should not ignore it, nor leave the issue to the parents to deal with.

I've seen kids that have good memories and sensitive to negative feedbacks, and they can all benefit from ABA therapy. It's a matter of the skill of the therapist, but not ABA itself. A good ABA therapist can design programs that are tailor-made for the child, so no one is NOT SUITABLE for ABA therapy.

If you can tell me more about the programs that your therapist is working with your child, I may be able to spot out the problems.
You can also PM me with the name of your therapist and see if I know him/her. I know therapists that are not capable enough to work private, but since ABA is a new industry and parents are not familiar with it, they can always cheat the parents with crappy therapy.

[ 本文章最後由 be.th 於 08-3-29 21:22 編輯 ]

momtc

I have an autistic boy who's now 5.5 years old.  He has received ABA therapy for about one year.  He has an ABA private tutor who came to our house twice a week to arrange a 2-hour lesson each time.  Recently, we found that he's bad tempered than before and always asks us to follow him and repeat sounds or short phrases without meanings.  His father considered that it's the bad consequences of ABA and decided to quit the service this month.  Is that the case?  Because one of the ABA methods is to use flash cards and ask my son to repeat the words until he could memorize it and give him some favourite food as reward. My son has good memories in hearing and very sensitive to negative comments or bad emotions from others.  Is he not suitable for such therapy?

wendyhoy

Thanks

原文章由 be.th 於 08-3-26 21:44 發表
The first thing is that he needs to have something that can motivate him to learn (we usually call it a reinforcer). A reinforcer can be toys, books, a praise or even letting him go away from the work ...

be.th

The first thing is that he needs to have something that can motivate him to learn (we usually call it a reinforcer). A reinforcer can be toys, books, a praise or even letting him go away from the work table…anything that he will try hard to earn for (just like money or holidays for adults).
Once he has the reinforcer, he needs to learn contingency, which means he understands that complying to a task will earn him a reinforcer. So you can start with very simple request and give him the reinforcer once he complies. This can help him to build contingency. Gradually you can increase your request so that he needs to do more in order to earn the reinforcer. I will suggest following the hierchy of instructions:
1. come sit down (reinforcer given immediately once he listens and sits)
2. come sit down (reinforcer given after he sits for 3 seconds)
3. come sit down + do one simple table task = reinforcer
4.come sit down + do two simple table task = reinforcer
and you can gradually increase the time he sits and the amount of work he does before he can get the reinforcer.
For his impulsiveness, you may want to teach him to learn to listen to “stop” when being told to. Start with something that he's likely to listen (e.g. ask him to stop when he's drawing or something that he doesn't really enjoy much), and give him reinforcers when he listens. Then gradually move on to something more difficult for him to control and stop (e.g. stop running). You need to set the hierarchy very carefully so that he'll experience success.
For his age you can also introduce token system, which can replace tangible reinforcers (i.e. toys, food) in long term. So instead of getting a reinforcer everytime, he earns a token for listening to you. Once he collects a certain amount of token (e.g. six tokens), he can redeem a reinforcer with the tokens.
Advantages of token is that you don’t need to give him reinforcers every time, and it's easier to administrate so you can basically use it outside home.
One more point to note, for a reinforcer to work well, make sure he doesn't have access to it outside work! (imagine if you can have money even if you does not work, will you still work hard to earn money?)

Hope this helps!

原文章由 wendyhoy 於 08-3-25 22:26 發表
My son is turning 4 years old in this June. He has diagnosised as ASD, when he was 2.5 years. He has improved a lot after OT anf EIP, and now the problem is that he looks like a ADHD than a ASD. He is ...

[ 本文章最後由 be.th 於 08-3-26 21:50 編輯 ]

wendyhoy

My son is turning 4 years old in this June. He has diagnosised as ASD, when he was 2.5 years. He has improved a lot after OT anf EIP, and now the problem is that he looks like a ADHD than a ASD. He is very impulsive, very diffcult to get him to sit down, and hard to engage him to learn.

Do you have any tips to improve? thanks

原文章由 be.th 於 08-3-25 16:29 發表
I'm a behavioral therapist (ABA) and have been working with toddlers and children with ASD for over 3 years. Seeing that there're some questions regarding Autism from different parents, I would like t ...

be.th

About traits of ASD

I've seen children being diagnosed as having ASD when they're as young as 13 months, however many pediatricians are reluctant to give diagnosis for children this young and therefore parents delay treatment until a proper diagnosis is done at around 3 or 4 yrs old.

There're a few indicators that usually urge me to persuade parents with younger child, say 12-18 months, to seek professional assessment:
-No pointing or any gesturing
-No babbling
-Regression (i.e. not doing things that he once used to do, or not saying words that he once used to say)
-Not seem to be engaged easily

The above are signs for children who're relatively young and is not conclusive. If you're really in doubt, I think it's best to get a proper diagnosis for your child. Early training can always help!