Applied Behavioral Analysis

               I've been reading a lot of negative things about Applied Behavioral Analysis lately. I really do not understand the claim that there is something malignant about ABA. I think it is untrue, and those who buy into it are making some serious errors in judgment about

a) Human Nature, and more broadly

b) Animal Nature

c) Responsibilities of a parent

d) Rights and Freedoms of a Child

                There is this misperception that those who use ABA methods to teach and modify behavior completely ignore the “whys” of behavior. That because behaviors are caused by sensory, anxiety, or comprehension issues, trying to change those behaviors is equivalent to dismissing those issues. I do not believe this to be true. One has to learn appropriate behaviors, at least to the best of one’s capability. Most ABA concepts used to treat autism involve programs of functional analysis, where behaviors are really scrutinized for their underlying functions and better behaviors are introduced to serve the Same function, if necessary. Factors like anxiety, fear, and confusion are not ignored. Coping strategies can be introduced.

Setting rules for behavior isn’t outside the normal scope of parental authority. I find it bizarre (and a sign of the times) that people compare it to brainwashing. Parents are supposed to strive to influence the behavior of their children. Certainly this leaves a lot of room for the subjectiveness of different value systems, but that is just a reality of different perceptions. We accept that not all parents will discourage or encourage the same things as the next parents. Parents are imperfect, are not always going to “get it” or be right, but it is their responsibility to raise their children to the best of their abilities and arm them with life skills.

                And realistically, when we are talking about something like early intervention in the first few years, there’s very little controversial influence on behavior. The focus is mostly on learning skills in areas such as communication, social interaction, and self care. Yes, meltdowns, screaming episodes, hyperactivity, and inattention may be things that are discouraged, but although these are almost always sensory related and never the fault of a young child who is lacking coping skills, they still hinder learning, can be harmful, and need to be addressed.

                How behaviors are encouraged or discouraged through ABA methods is another aspect many people take issue with. I have heard ABA compared to dog training, since oftentimes, children are given a single task (a “trick”) and are rewarded with something tangible (a “treat”). That is an emotional response. All behavior is based on motivations and reinforcement. Just because neurologically typical people find it easy to respond to more naturally occurring, often less tangible reinforcers, doesn’t mean a child with ASD will always find it as easy. My own son had no interest in sitting still and attending his lessons when he first started learning skills through ABA. While a child without autism would be more likely to respond to praise or their own satisfaction of pleasing their parents by following their instructions to take a seat, my child would not (at first) be reinforced by these things. In fact, at first, he wasn’t reinforced enough by any toys or games at all- the only thing my son found worth working through 2 hours of programs was edibles- little teeny snacks. He doesn’t know that learning these skills is important. He’s 2. A typical child doesn’t know these things, either, really, but may find learning through socialization and communication much easier and more naturally reinforcing. As a parent, it is up to me to find a positive way to encourage the emergence of life skills. Positive reinforcement with tangible rewards is really okay in my book.

                Now, punishment, on the other hand, isn’t widely used anymore. When Dr. Lovaas was first treating autistic children, he used punishments. If anyone has read Catherine Maurice’s Let Me Hear Your Voice, she talks about mild punishments like firm “No!”s and even mentioned shock therapy in her book. The debate is sort of over in regards to punishment- punishment CAN affect behavior, but not nearly on the same level as positive reinforcement. Avoidance behavior can result, making a bad situation worse (children can develop an aversion to their therapists/parents, they often misbehave any time they know they are not being watched… this is animal nature. Animals, such as dogs, do this as well). That being said, there are times when parents have to discipline their children. Temple Grandin talks a lot in her lectures and books about knowing there were going to be consequences to her actions and how that helped her find ways to deal with her behavior when she was a child. If she got in a fight at school, her mother would not let her watch her favorite TV show. I think it is a very important lesson to our children of all ages- even if behavior is sometimes unintentional, or unavoidable, there are consequences. It does not have to be over the top. Screaming or hitting children is not nice, not effective, and has no place in any therapy program (or child rearing or anything, in my opinion…) But I think minor inconveniences for our little innocents are worth the lesson. That being said, in my opinion, a good ABA program would not involve punishments. At all. Appropriate behavior and correct responses to direction would be reinforced, and problem behavior such as tantrums or meltdowns would be probed for its trigger, and then redirected to more positive/appropriate behavior.

                There is more, but this would get really really long. It’s cool if you don’t dig the scene, and there are some valid objections to it, but ABA just should not be dismissed out of ignorance of the facts or mistakes from history that have since been corrected. It doesn’t dehumanize our children by turning them into puppies or brainwashed robot-zombies. Anybody who wants to take a swing at your kid- run, run, RUN, and then maybe alert the proper authorities. Individuals with ASD DO have rights, of course, but, like with NT’s, less rights while they are children. My two cents on the matter, anyway. Feel free to add yours, I’m pretty open minded.  

"He doesn't seem autistic to me"

"He doesn't seem autistic to me" is one of those common phrases heard by parents of ASD children that can provoke all sorts of emotions. My fellow moms have expressed their anger, frustration, and sadness when an ignorant person makes a remark like this.

Today I heard this from the woman who runs Wylie's school- a wonderful BCBA who knows Wylie personally and often remarks how much he reminds her of her little toe-headed toddler who can also be spotted running around the building along with the other kids. She works closely with his team, monitors his progress, and has always been proactive when it comes to his behavioral treatment plan. When she said this to me, I was mostly perplexed.

I think she's wrong, by the way. And I argued with her. I’m not even that puzzled that a professional might say something like that about my son, but. I find it strange. I find it strange because there are other MUCH more high functioning children attending her school than Wylie. I think I have to pull the other parents aside and figure out if she’s ever said such a thing to them, as well. HAHA! The conversation I had with her went something like this:

“What specifically do you think is missing from his characteristics to warrant an ASD diagnosis??”

“Well. I just wouldn’t call his problems ‘pervasive’ in the strictest sense. I think he has more of a language disorder than anything else. Socially he’s reserved, but not exactly withdrawn. He’s laid back. Aloof. Most of the kids I see are either withdrawn, overwhelmed to the point of not being able to interact, or socially anxious. That does not describe Wylie. He just isn’t really motivated to be social.”

“Hmm. It’s a spectrum disorder, right? It could manifest differently with different kids, right?”

“Yes… but he just is getting everything academically. Everything we ask him to do, he does. He understands everything.”

“Hmm. He’s 2 and he doesn’t really get 2 step commands. It took us a while to get 1 step commands.”

“Language issue.  Sensory processing issue, maybe.” (For the record, she has basically conceded that he has social, language, and communication dysfunctions at this point… now she’s bringing up sensory processing. Sounds… a lot… like autism… to me…)

This woman and my developmental pediatrician are, like, totally into each other, too. And my developmental pediatrician is always seeing Wylie in the WORST light, and seems to always bum me out using a pretty grim deficit model to describe him. Heh. They take each other’s opinions very seriously, and yet they are at opposite opinions of Wylie.

I’m just confused. It is really interesting how two different people looking at the same child from different perspectives can come up with completely different conclusions about him. I don’t find the BCBA ignorant or dense or less than diligent when it comes to her research or her ABA treatment. She has actually persuaded me several times when I challenged her course of action (most recently she has been suggesting replacing some of his one on one DTT (discrete trial training) hours with social groups and I originally opposed). It IS true that the people here seem to be more on the severe end of the spectrum. I don’t exactly see a lot of aspies at his school. Wylie is obviously intelligent, and even Mr. Pessimistic Developmental Ped has used the word “gifted” to describe him. He has no splinter skills and does not appear to be “profoundly gifted” or a “genius,” but he’s bright.

“I really think he needs to be in regular pre-school. I would even suggest not telling them about the diagnosis. I think he will easily get the academics of it. We are teaching him how to learn from his peers. The concern I have with Wylie is that he just seems like he could really care less about social interaction, and some pre-schools aren’t going to push that interaction. He doesn’t really have any serious behavior problems. We could go interview some schools together, tell them he’s shy, and see if they can pair him up with maybe a bossy older kid with an assertive personality to lead him around.”

Uh. Hmm. A little dumbfounded. But I think about it. Perhaps some preschool director WOULDN’T realize Wylie isn’t quite sure who “Mommy” is. I’m not really against hiding the diagnosis in this case, but it doesn’t really sit well with me that A) I think his therapist actually doubts his diagnosis at this point and B) I’m thinking he really wouldn’t “pass.” Then again, this isn’t really something that needs to happen tomorrow—I don’t think she is completely off base when she says he may be ready for preschool by the time he’s 3. He’s definitely a smart cookie and his language isn’t stagnant—he makes spontaneous requests for familiar items, his vocabulary has expanded since his 2^nd birthday, he sometimes (rarely) strings words together… his stims are still quite severe, he screams and squeals and jumps and jogs in place… repeats nonsense phrases like “Tickletickletickle DAH… tickletickletickle DAH…” I could see him distracting a whole classroom.

Oh, anyway. Who knows. Structured Preschool with academic credentials sounds a little expensive, too. I’ll start looking into it. I still haven’t really perfected his current treatment right now—  I still want to look at some additional speech therapy.

It’s a lot of work. Wylie, Mommy’s not trying to rob you of your childhood, I promise. But who are you kidding, you would waste a lot of it watching Spongebob reruns if it weren’t for me.