ABA for high-functioning kids

[Innisfree]

Does anyone have experience with this?

 

Dd10's greatest needs are in the realm of emotional control and frustration tolerance.

 

Her BCBA started out doing lots of social skills games and working on things like looking people in the eye and asking reciprocal questions. All nice, but icing on the cake compared to not melting down over small stressors.

 

I've asked them if they can focus more on the emotional regulation stuff, but they don't seem to have much.... I'm not sure.... experience? Nothing in their bag of tricks for this.

 

I gave the BCBA my copy of Zones of Regulation, which she did not know. At first she said it was more mental health than ABA, then she read more and said she thought they could use it and she liked it. They haven't started yet, though.

 

I also suggested coming up with a "fire drill" dd could practice for when she started to get angry. The BCBA liked that idea, they've been doing it, and I think it's helping.

 

But I feel like I'm the one trying to steer them toward what we need, and it's not something they are instigating. And, for this, we are paying $$$$.

 

So am I asking them for something which is outside their expertise? Is this not what ABA does?

 

What does ABA typically look like for kids who can function fairly well in society? Is it usually the social skills stuff? We may get (I hope) to the point that that's my biggest concern, but we're not there now.

 

And the notebook and charts! I'm feeling very bad at this, because I'm supposed to note every time dd, for example, is gentle with the dog. But she's gentle with the dog maybe 1,000 times a day, ordinarily every time she interacts with him. It's only once in a blue moon when she is not gentle, somewhere between once a week and once a month, but those times, when she is angry, are the problem. Do you keep on noting constant good behavior? There are lots of things like this. Good behavior is the rule, not the exception, and noting each instance seems ridiculous. But the meltdowns do occur, and the cranky rudeness, so they do need addressing. How does this work?

[Lecka]

I think you  might look for a different provider who focuses more on what you are looking for.  

 

It does not sound like you are getting what you need, or that it is effective.  

 

For you to make suggestions that they then work on, or to bring up things you have heard of ----- that is normal.

 

But to not feel like you are getting anything from them?  It doesn't sound good.

 

I think if you have options -- call around, ask for references.  Ask for references that will come from people with similar children.

 

I do not really know the answer -- overall -- but it sounds like it is outside *this* person's expertise.  

 

I think you might consider asking if she can refer you to another provider, also.  That would be gracious of her and maybe leave you with a reason to give her a good recommendation to others.  

 

You also might look for a psychologist, who has some kind of specialization in this area.  Or a speech therapist.  Whoever might work with the older kids.  

 

I think it sounds like you have pinpointed what you are looking for and if you asked this woman what her core areas are, she would not say "this is what they are."  

 

I am a big believer that professionals from different backgrounds can develop a specialty area and be really good at it, and that can matter more than what their profession is -- it can all get so similar sometimes imo.  

 

Do you know a professional you like?  Ask them.  Do you know any parents?  You can even just say "who have you heard mentioned" to get a list to call.  

 

I also don't get the noting 1,000 times a day of being appropriate.  Have you said this to the BCBA?  What does he/she say back?

 

It is really fine to not think this person is doing what you need, though, and look elsewhere.  I don't know if he/she is just not the right person, or if it is time to look for a different field.  But you need someone who is familiar with your child's age and her needs, not where you are the learning experience, if they cannot learn and be effective at the same time.  

[Innisfree]

Thanks, Lecka. I need to ponder this. I'm not sure if ABA is focused on what we need, or if it really is more in the mental health realm.

 

The BCBA and her assistant-- I forget the proper acronym-- have both developed good relationships with dd, and they are willing to adjust what they do. We don't have other agencies that seem like a good choice, but there might be better providers within the agency.

 

I guess I just wasn't sure if I was asking them to do something that would be better done by another type of professional.

[SporkUK]

I think they may be right that this is more cognitive and emotional skills than social skills and ABA typically and traditionally is more about compliance training for the later which is why many adult Autistic people don't use it as much for our own kids. Another type of provider may be better for you. 

 

Since you are already doing most of the work yourself, can you use Zone of Regulation yourself? I don't know the program to know how it would work at home. I'm using MindUP which explains how the mind works and mindfulness with activities to help with cognitive and emotional awareness to lead to self regulation along with some readings on emotions and videos on how the mind works. It's designed for class use but it's easy to tweak for home use I find. The programme has 3 levels, you can jump into any of them -- they all have the same plan [the table of contents is same for all 3 books] with reading and activities designed for different ages. So far it's going well, I've heard them using their knowledge from it for issues. 

 

Hope you can find something that helps :)

[kbutton]

Our behavioral person is more flexible, and she calls the soft, abstract skills hard to teach. She is willing and able to work on them. They do have an overlap with mental health--I think people recommend cognitive behavioral therapy (CBT) for this, and a lot of people can help with that. I am not sure how to get the most from that either.

 

Our behaviorist approaches things from several angles, but she uses her training to see what sets off the behavior (antecedent ?). Do you have any idea what causes your daughter to meltdown on a personal level? For instance, do you have any insight into why she melts down once in a while on the dog or whatever? We tend to flare ups where we have more overall meltdowns, and the situation is usually that last tiny piece that piled onto some kind of emotional component. It's often about a mismatch of expectations, difficulty transitioning, etc. Sometimes my son is feeling like everyone is down on him because he's down on himself. Sometimes we are down on him if he's been doing something really annoying (he's a good kid, but he's 11, and 11 year olds find annoying things funny--ASD 11 year olds don't know when to stop, sigh). When that happens, we have to show him we love and appreciate him--he's not as good at picking up on that either, so sometimes we have to do things for and with him that convey that (like sing a song, share an activity we normally wouldn't want to do, etc). We definitely tell him we love him, and he likes that, but his ability to "see" that love is a bit limited at times. If we talk about something he did when he was little that was cute, or something that he liked when he was little (like the song thing), and then we do it, he gets the point. And the cool thing about a lot of ASD kiddos is that they don't outgrow things they are fond of, so he doesn't feel patronized about it when we sing a sweet, little song, he feels loved.

 

On the Zones, I would encourage you to work on those at home until you resolve the provider issue. It's not rocket science once you get the hang of it, but you have to go a lot more slowly than you think. Our OT did it with our son, and she did a great job. He did give some pushback at some points, so slowing down gives time for an idea to marinate--you kind of what them to buy into the ideas almost as if they are coming up with them on their own (and the program does give ways to get their input, they have to monitor what strategies work, etc.). You might have to pick and choose some specific things to work on--in our case, one thing that drives us bonkers is being a pest in the grocery store. It takes a team effort to get that working. I found also that my son has an amazing vocabulary, but all negative emotions and expressions went into one or two categories, with angry being where most of them went. So, he's annoying us, and our tone of voice/face changes? Well, we must be angry (even if we're not angry, just annoyed or weary of the behavior). That's a lot for a kid to process if they think people are always angry or that all negative emotion and expression is on an equal and bad level. I don't remember if you have other kids, but you can involved the whole family in zones. It's an awesome communication and self-regulation tool for anyone.

[Innisfree]

Thank you, SporkUK and kbutton. You've given me a lot to think about.

 

I need to look into MindUp. I do remember reading about it and thinking it sounded good.

 

Right now the BCBA has my Zones book, and since she was receptive I think I'll let her work with it if I'm not really asking her to do something outside her proper area. If she does it, that frees up my time to work some with my older dd, which is important.

 

Kbutton, you are right that there is usually an emotional background for the outbursts, though really little stuff is the final trigger. One big problem is sibling interactions. Older dd is 13, complete with eye rolls and occasional attitude. She also has a very big backlog of grievances based on dd10's behavior over the years. Her sense of outrage is based on real, valid complaints, and she's not really mature enough to move past that. She's getting her own professional help, but it's a long journey.

 

So not always, but very often, it's a sibling issue that escalates. Dd10 sees her sister's eyes roll, and her response is disproportionate. And the BCBA has told dd13 that remaining emotionally neutral is the best way to help her sister calm down, but dd13 feels resentful over years of issues, and feels justified in expressing her emotions, even if dd10 is about to boil over.

 

I think the issue of having a limited ability to classify and identify signals like the eye roll comes into it. Like you said, she knows it's negative, but she has a hard time judging the degree of negativity, or assigning causes, or putting it aside as "Sis is in a bad mood." And as you said lots of things look like anger to your son, what I see in my dd is a limited range of emotions *in herself*-- so she reacts with full-fledged anger instead of annoyance, say.

[Lecka]

If you end up finding someone else, maybe your current therapist would be able to implement things, too. 

 

For how our insurance works - -it is in our favor to have the ABA "tutors" implement things b/c they bill the lowest amount of money, and they are very able to do a lot of implementation. That might be a total non-issue for you, but it is a big factor for me b/c that is how our insurance works (through my husband's job in the military). 

 

It sounds like you might be looking for another person, but maybe you can keep who you have, too, if the things that ARE going well are worthwhile, too. 

 

This is where a team approach can be so good!  Fun times to be the mom team leader, lol, who makes sure communication is happening or else who takes one person's recommendations back and forth to other people so that things can be done consistently and effectively.  Fun times. 

 

Good luck, though!  Keep asking and looking around.  Good luck. 

 

[Innisfree]

Insurance, lol.

 

I wish.

 

Insurance will cover no ABA, no in-home therapy through the agency that does this and ABA, just regular therapy. We haven't had much luck finding a therapist they'll cover who has much experience with ASD. Maybe it's time to start investigating that again. I'll ask about CBT.

[kbutton]

As about OT or SLP since some of those folks will do things like Zones of Regulation or social stuff. Just more options if they work out--as long as you're making the call to insurance anyway.

[kbutton]

Thank you, SporkUK and kbutton. You've given me a lot to think about.

 

I need to look into MindUp. I do remember reading about it and thinking it sounded good.

 

Right now the BCBA has my Zones book, and since she was receptive I think I'll let her work with it if I'm not really asking her to do something outside her proper area. If she does it, that frees up my time to work some with my older dd, which is important.

 

Kbutton, you are right that there is usually an emotional background for the outbursts, though really little stuff is the final trigger. One big problem is sibling interactions. Older dd is 13, complete with eye rolls and occasional attitude. She also has a very big backlog of grievances based on dd10's behavior over the years. Her sense of outrage is based on real, valid complaints, and she's not really mature enough to move past that. She's getting her own professional help, but it's a long journey.

 

So not always, but very often, it's a sibling issue that escalates. Dd10 sees her sister's eyes roll, and her response is disproportionate. And the BCBA has told dd13 that remaining emotionally neutral is the best way to help her sister calm down, but dd13 feels resentful over years of issues, and feels justified in expressing her emotions, even if dd10 is about to boil over.

 

I think the issue of having a limited ability to classify and identify signals like the eye roll comes into it. Like you said, she knows it's negative, but she has a hard time judging the degree of negativity, or assigning causes, or putting it aside as "Sis is in a bad mood." And as you said lots of things look like anger to your son, what I see in my dd is a limited range of emotions *in herself*-- so she reacts with full-fledged anger instead of annoyance, say.

 

I am glad your 13 y.o. is getting some help for her issues with her sister. It's not fun to have to navigate this as the sibling. At the same time, it's just life. If she's safe and has what she needs, she simply has to put up with the rest at some point. As long as my older son isn't being mean, my younger one (does not have ASD), sometimes has to lump it. Maybe it's easier when the ASD kiddo is older though--the younger one doesn't know what life was like "before."

 

Do you keep them apart as much as possible? We have times when we have to enforce separation because the kids are too immature to see that they need the space to be nice. 

 

Also, as much as possible, we use humor to defuse things, though you have to tailor that humor to what works for and ASD kid and start by making jokes about yourself in similar contexts.

 

:grouphug: It sounds like you are doing a good job, and you just need to tweak your game plan. I think that happens more often at these ages!