Monday, October 3, 2011

When is ABA appropriate?

One of the first therapies recommended to parents when their child is diagnosed with autism is ABA therapy (Applied Behavioral Analysis).  While I have nothing against ABA in and of itself, I am frustrated with the manner in which professionals tout it as if it were 100% effective for every child on the spectrum.

There are cases in which it is clearly the best resource, but there are also cases in which it is possible that it will not only be ineffective, but potentially add to the child's isolation.

When my son was really young, and violent and non verbal, it was a lifesaver- we did it full time for nearly a year and tapered off (still using it daily) for a few more months until the total time was about 18 months.  We had a few very bad experiences with it during that time, but it was not the therapy itself that was the problem- ethics were not adhered to.

I know many children for whom ABA therapy is the single best therapy. I also know a few who are not good candidates.  My son (I use him as an example as I don't like to use other people's kids without permission) is now 7 years old.  He is verbal- extremely verbal- he still has some speech problems but he tries very hard!  He has extreme sensory issues which we do sensory integration therapy for and he is happily engaged in all of those activities.  He does not argue or refuse to do things very often (occasionally there will be an icky piece of food that he says no to)  and he actively seeks out advice in confusing social situations.

He already has very robotic movements and speech- he appears to be "programmed" at times and he is actively trying to correct that.

Why do I bring this up?  I have been asked "Why do you not have him in full time ABA? It is the only therapy which can be effective for him- don't you think that is irresponsible?"  I was asked this by a peds nurse.  My son has a team of many many professionals- including annual evaluations from.... an ABA therapist!  The therapist feels that if he were to start full time ABA again then he would simply become more "robotic".  The therapist has not really found anything as far as issues that the therapy would be beneficial for- he works hard in regular speech and OT and SIT, he is "compliant" so it seems that at least right now ABA therapy is NOT necessary for him.

I had a run in with that nurse before, it was the same issue.  Sadly she is not the only healthcare professional that we have worked with who does not seem to understand that although it is effective, ABA is not a one size fits all "cure".

If you are being pressured into ANY therapy for your child that makes you uncomfortable or that you truly doubt is the best approach for your individual child, please... speak up, get a second opinion!  Often simply following through with the therapy evaluation will answer any questions you have as to whether it is necessary or not as the therapist can explain it far better than the doctor and nurse.  Our ABA therapist does not see a benefit in my son's case, but we would not have known if we hadn't at least done the eval.

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