In-Depth Therapy Overview
ABA Therapy
ABA therapy is
intense. It’s complicated to explain and
complicated to understand. Essentially,
ABA interventionists take a task and break it down. They teach the simplified task and gradually
expand it as the student progresses.
They positively reinforce good behavior with different types of
reinforcement that are the most reinforcing to the student (hugs, candy, toy)
and they do not react to “negative behaviors,” such as scratching, biting,
kicking.
The best way to think
about it is that it’s kind of like dog training. Of course this is way
oversimplifying it-but you get the point.
For example, when you are first teaching a dog to sit, you say, “Spot,
sit!” and then you proceed to help them sit down. When they do sit down, you give them a treat,
tickles or verbal praise. Gradually, you
stop forcing the dog to sit, and you give them less and less prompting to
follow the command, but you still reinforce them with a treat when they
complete it. Eventually, you fade the
treat out completely.
ABA is very
similar. For instance, there is the, “Get
Ready,” program. This is the program
where they teach students that when they hear their name, they should look at
who is speaking and get ready to listen.
They break this down into the smallest of steps. First the command is, “Whitaker, get ready,
feet down,” and you hold his feet down.
Then once he learns the command, you fade the holding of the feet and
move on to the next step. The next step
is, “Whitaker, get ready, feet down, hands down.” And over more time it becomes, “Whitaker, get
ready, feet down, hands down, quiet, look at me, 1,2,3.” Then into, “Whitaker,
get ready.” And then eventually the prompt is, “Whitaker.” The goal is that after we learn all the small
steps, that when he hears his name, he will put his feet down, his hands down,
look at the speaker, have a quiet mouth and be ready to listen.
One of my favorite
things about ABA is that it is data driven.
They make the determination of whether or not a child is ready to move
on to the next step based on the data and if they have, “mastered,” out the
program. Mastering a program is a little
different for each place, but in general, it means that they can complete the
tasks with 80% accuracy in 3 different trails in a row. The reason why I love the data is because it
is objective and measurable. It shows
how much they are learning and how fast.
Not only is it exciting to have data that they are progressing, but you
can watch the data and trend it. So, if
one of the boys had a bad day and the data was off that day, I can go back and
think, “were they tired, do they not feel well? Did they just have a rough day?” One of the hardest parts about autism is that
so much of it is subjective-so objective data is rare and helpful in measuring
progress.
With Whitaker, I was
really skeptical to start ABA therapy. I
hadn’t heard great things and I didn’t want him to become this command driven
child where, yes he could follow commands, but he had no social interest or
desire to play with peers. I was
fortunate enough to have a sister in law who was ABA certified tell me that she
thought he would benefit from ABA and that is when I seriously considered
it. It was honestly the best thing we
have ever done. With Parley, we started in August and have seen HUGE gains. It is super exciting.
Before ABA we were in
a private special needs inclusive preschool and participating in private speech
and OT. While we had seen some progression in OT, we had seen regressions in
speech and regressions at the preschool he was attending. I inquired after my sister in laws recommendation
and also feeling panicked as he was losing skills.
Within 3 weeks of
attending an ABA based program, he was using a full sentence with prompting and
sign language. I honestly could not
believe it. I had been trying to sign
with him since he was 6 months old with no success and here he was signing, “I
want candy please,” with his angel aide, Caitlin, who we LOVE. After watching it in the observation room
that day, we went and practiced with chocolate chips that night. We were SOOOO excited that something was
working.
While ABA has been
great, it doesn’t mean that it has necessarily solved all of our issues. He is still pretty far behind. But what I do know is that it has worked and
he is learning things that I honestly wondered if he would ever be able to
learn.
It also has come at a
huge sacrifice. You can see our schedule
on the post below-its crazy right? And
one thing that I probably didn’t mention is that when they boys are at therapy,
that means I am at therapy-I’m not making dinner in the background while they
are working. I am just as much a part of
it as they are. I also am not able to
really take the kids anywhere by myself, so anything I need to do that is not
at home has to be done during school hours.
It’s honestly been really hard to give up so many hours to ABA at
home. I feel like there is constantly
people at our house-and while they are great-there are people always at your
house. I’m not complaining too much
because it is so much better for them to come to my house than for me to go to
their location-but it’s hard to always feel like people are there and you can’t
fully relax. I also have had to be a
huge part of therapy with Whitaker-holding and carrying him, holding him back from
getting too aggressive with his therapist, getting bit and scratched and kicked
by him-it’s really taken a toll on our relationship because I’ve had to be the
bad guy and the enforcer. It is slowly
getting better, but that’s been hard. A
lot of time after the therapists leave, I have a good solid cry because it’s
hard. Parley is pretty independent, but
still asks for me as a reinforcement for doing his work, so I have to spend
lots of time reinforcing him.
It’s also been really
hard on June. For 3 hours 3 days a week
I am totally busy and she is left to do whatever. It doesn’t sound like a lot, but for a little
baby, it is. I have often felt guilty
that I am not able to be more attentive to her during that time and that she
has to hang out while I am so focused on the boys. But that is another post for another day.
We’ve been really
lucky that we have had therapists and helpers who have been great and willing
to work on other stuff that is just as important as ABA programs. For instance, we have been working on sorting
silverware, making him bed, cleaning his room, getting dressed and other
functional skills. It’s been a good way
to break things up and to teach him other things that are just as important as
learning to match or whatever. We also
occasionally go on outings to target or the local grocery store. We are hoping that this will help so I can go
somewhere on an errand with all three of them. On Wednesday, we had a cousin come over to
play to teach them to ask her for certain things. Our ABA teams, both at school and home, have
been really great at making socialization a part of our ABA treatment plan,
something that has been very helpful.
It’s also hard
because I’ve had to rewire how I parent.
I am so far from perfect in ABA parenting techniques. I reinforce negative behavior when I yell at
the boys to stop fighting. I laugh when
they do things to tease that aren’t appropriate and I am horrible about giving precision
command-but it’s getting better. As much
therapy as they get, I feel like I get in instruction. We talk about how to diffuse situations, how
to move away from fixations and I ask questions constantly. It’s been so refreshing to have the
professionals around to help me navigate the process.
But most of all,
Parley and Whitaker are happier while they do ABA. While we have to be careful about how much
therapy we do total, ABA has made them happier because they can feel more a
part of their environment. They love the
attention and the praise and I can’t forget to mention the fact that they are
being successful. We keep finding with
Whitaker that he likes to be successful, he likes to feel like he accomplished
something and gets overwhelmed when he feels like he can’t. But how great is that? He actually cares about completing the task
to be successful, not to complete the task to get the reinforcer.
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