To ABA or not to ABA

This is a very touchy subject and I will attempt to answer this in an unbiased manner and I will try not to offend anyone.

A bit of background first. Most people that work in the field of ASD have heard or probably been trained in ABA, which stands for Applied Behavioral Analysis. It is a behavioral approach, as the name suggests and it became popular in the early 90s as the “top treatment option for children diagnosed with ASD”. I am sure you are familiar with its “stardom” if you have a child on the spectrum.

When I started in the field of autism, I was young, naive and determined to help the children I worked with. I would have done (still would) anything to help a child to communicate their needs and wants. I was firstly trained in Verbal Behavior (VB) which has a major focus on language acquisition. My main purpose in each of my sessions that I had with the cutest little girl, who is still one of my best friends, was to “get” her to speak more frequently. To expressively state what she needs or wants. Now, years later, reading that sentence makes me cringe. You should never “get” anyone to do something that they are extremely uncomfortable with.

That said, I do believe that I used my integrity and heart when I worked with her. I have asked her recently – she is now 17 years old – if she liked our time when she was about 2 years up to 4 years old. She calls me her “bestie” and she also asks me multiple times (per day sometimes) if we can “work” again together. So, I think I have asked the true expert here whether my “style” of therapy was too harsh and I also remember all the fun we had.

I was then recruited by a reputable school at the time. This school implemented ABA principles and I was trained in this type of therapeutic modality. This is where I will make a distinction of what I personally believe in as well as AIMS Global compared to other organizations. Some of the strategies that behavioral therapists use are good to implement.

These are some of the strategies we do believe are good to implement. But please note that these are not ABA-specific, it is just more frequently used by ABA therapists:

  1. Consistency and routine – these are probably the most important concepts to instill in your child’s program. They have to know what it expected of them, what’s next and how long before they can have a break.
  2. Visual schedules – this is a way to instill consistency and routine in your daily schedule by visually showing your child what is next and when their breaks (which should be frequent) are.
  3. Natural environment teaching – this is usually implemented later in a child’s program for an ABAer, but we implement learning in our environment from the start.
  4. Generalization – although we believe that true ABAers generalize in a strict and structured manner that is not conducive to learning naturally, we do believe in the concept of generalizing to a variety of environments.
  5. Preparing for a transition – we believe it’s important to prepare our children before one activity changes (especially if it’s something our child really loves) to another or if he or she needs to change environments. This was something we learnt as ABA therapists, but really – it came very natural to us…

Now, doesn’t that just sound like good parenting strategies? It does to us!

These are the things we don’t agree with ABA:

  1. Reinforcement – yes, we let our children know that they are awesome all the time, but we do NOT believe in giving them small pieces of treats or even one puzzle piece at a time for clapping or looking us in the eyes for a certain amount of seconds. We focus on natural reinforcement and also not taking what our children love away from them, but rather working with their interests and teaching them skills by utilizing these toys, activities or their fascination towards lining up certain objects.
  2. Stopping them from engaging in self-stimulatory behaviors (“stimming”) – this is another touchy subject and we will speak about how to understand your child’s stim better in a different blog. We don’t stop our children or “block” them when they want to flap. We would rather let them stim for a bit and then we try and see what sensory input they truly need and also what coping skills can we introduce before a child engages in stimming behavior. Now, this is if a stim is used to ease anxiety. For some children stimming is used when they are excited. We do the same – we let them be happy and show their excitement. If it’s really a problem and can lead to bullying we will help our children understand when it’s better for them to stim and maybe give some ideas of alternative ways of getting that excitement out.
  3. Eye contact – we do not require absolute eye contact before we ask a question, make a comment to our child or “request” anything. We believe that “dual processing errors” can be present and some of our children listen and hear more when they are not looking us in the eyes. We respect our children enormously and we will teach them when they should probably look (especially when there is a dangerous situation ahead), but generally we wait until our child feels comfortable to give eye contact (which by the way – almost always happens quite quickly if we don’t take a forceful strategy).
  4. Compliance training or taking away the ability to say “no” – yes, you read that right. Some ABA therapist refuse the word “no” to be added into some children’s PECS (Picture Exchange Communication System) or AAC device (Augmentative and Alternative Communication) or their repertoire of words. Their reason? Children will say “no” to “escape” a situation. Our perspective: a child HAS TO BE ABLE TO SAY NO TO ESCAPE A SITUATION. Compliance training is another one that makes us, at AIMS Global a bit frustrated. We don’t “teach” our children compliance. We have fun with them, we work with them, we support them and comfort them when they are sad. This leads into behavior management…
  5. Ignoring behaviors – as an ABA therapist you were told, trained and quizzed on different behavior management strategies. The one that I never understood was to “ignore” a child in distress. Yes, we understand that if a child is blatantly looking for attention that giving him a giant lollipop will undoubtedly increase that behavior in the future. This is obvious. What is not obvious and actually a bit cruel is when a child is notably in distress, truly sad or frustrated to “ignore” the behavior. We will never do that to our children. They are trying to tell you that they need your comfort, not your back turned to them. And this leads to the biggest problem we have with ABA therapists’ philosophy.
  6. ABA’s principle of our children need to “recover” – we strongly oppose this. Although our children need support, they do not need to change who they are, what they love or how they see the world. I can write a book about this, but I will keep it short in stating that we absolutely adore our children and everything about them. We merely give them better ways to cope in the world and ultimately we want our children to grow up into adults that can live, work and love independently and without judgement.

Well, there you have it. It is still up to each parent (and their child hopefully) to decide what is best for him or her. Our only mission is to give parents as much information as possible through our years of experience. So, to answer the original question of this blog – should you do ABA, 40hrs per week with an expensive supervisor that flies in to see your child for an hour or two? I would say no, but we hire ex-ABA therapists before we train them in AIMS, which is more holistic, but our children show more progress this way while they are happy. We like to untrain the strictness and rigidity of some of our newer therapists, but we like that they have some of the basics of good parenting. In the end of the day – you have to assess the person that you want to hire for your child. Do they like children or are they only speaking about statistics (and money)? Do they want to see your child smile or do they want him to stare them in the eyes? And the most important question – is your child being trained to smile or are they actually laughing spontaneously when they are with this therapist?

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