Want to think philosophically here about autism...

[PeterPan]

Bear with me, but I'm trying to think through something and want to know if someone has research or evidence or what their BCBA says or whatever, so we can see the effects of various approaches to sort this out.

 

It seems like the gig of Floortime is the child is in his world and you go try to join his.

It seems like the gig of ABA is that the child is in his world and you incentivize him to come into yours.

It seems like the gig of RDI is to help the dc notice there is another world he might want to join.

It seems like the gig of unschooling is be in your world because then you're becoming really proficient at what is in your world.

 

That's really vague and generalized, but I'm just trying to say there is this CONTRAST to philosophies on how to approach ASD.  If the dc was at school, they'd have the ABA thing pulled on them and they'd be told to come into the teacher's world, because the school says.  Homeschoolers will take this approach too, and they have strong arguments.  However there are also homeschoolers operating on more of this sort of Floortime, I'll try to come into your world, kind of approach to things.

 

What I want to know is, if you approach it one way or the other, are there CONSEQUENCES??  There must be.  Does the act of compelling the dc to come into your world promote some kind of flexibility or have research/evidence base?  Or is it actually just CONVENIENCE?  Are there long-term negative consequences to approaching things this way?  I mean, we all know our kids will get extreme.  So if they're spinning or stuck on Lone Ranger or whatever, we just LET them under this philosophy?  Does it do them neurological GOOD to go to battle in some way over this?

 

And conversely, is there any research to indicate it does HARM to insist the person of spectrum come into your world and comply?  Does it increase oppositional behaviors?  Is there evidence for that?  In that Barkley video AM listed, he mentions an ingrained pattern of negativity and opposition.  Does forcing compliance increase oppositional behavior?  But then does caving and rolling with them so completely negate the opportunity for them to learn to be flexible?  

 

I don't know.  I just have been thinking I need to understand this better and be more intentional.

 

 

[sbgrace]

Well, I think certain approaches are probably beneficial for specific things.

I think the absolute best approach would probably incorporate all.

But I do think they are different.

 

There are certain things, like say self help skills, though that benefit from a behavioral approach. So ABA type stuff would shine.

 

RDI is, at it's heart, about helping the child discover others (parents) as guides and helping them deal with the inherent unpredictability of life. Relationships? Well, those aren't predictable so RDI would, in imo, be better for that sort of thing compared to behavioral approaches. In the time we did RDI it did help develop that guide relationship and flexibility. We stalled out in progress around stages 3/4. I still don't know why.

 

Floortime. You join the child but you are moving them through developmental stages in a relational and experiential way so it shares some overlap with RDI in that way. For example, you join the child in his repititive play, but you might introduce little variations of your own. At least that is my long ago experience recollection. Floortime seems really strong in building relational connection with the parent and developing play skills. I think it helped my son in both of those areas.

 

There is certainly a lot to be said with developing your own individual strengths (your unschooling part). The other approaches are focused on remediating problem areas. Both things are important.

 

So I do think there are consequences to our choices--positive and negative.

 

My son is a lot more disabled than I thought he would be when he was younger. I'm not sure anything would have made a difference, but sometimes the outward conformity that ABA might have brought (?) seems like it would have been a benefit. Would we have lost the creativity, flexibility, and relational progress we made though? I don't know!

 

I feel kind of down about autism right now. So this is mostly babbling....

[PeterPan]

My son is a lot more disabled than I thought he would be when he was younger. I'm not sure anything would have made a difference, but sometimes the outward conformity that ABA might have brought (?) seems like it would have been a benefit. Would we have lost the creativity, flexibility, and relational progress we made though? I don't know!

 

I feel kind of down about autism right now. So this is mostly babbling....

That is haunting.  So sorry.  And yes, that's exactly what I'm trying to think about.  If we were sending our kids to school (autism school, any school) they would use some kind of ABA approach and be done with it.  And when I go to the autism charter school, the kids are HAPPY!!  They are not sitting there all unhappy.  So are they happy because they have ID and they wouldn't be so happy if they were gifted and knew what was happening to them?  I'm sorry to be blunt, but I think it's a reasonable question.  I think the answer is no.  I suspect the answer is that diligent ABA and predictability is calming and lowers stress, allowing them to have more peace.  When we unschool autism and roll with their interests, are we inadvertently feeding things that will leave them LESS peaceful and less employable over the long run?  Like they might be fine in our home, where we can cover up for the rigidity, but an *employer* is not going to cover up for that?

 

I just don't know.  And I think it matters, because those are pretty big spreads in how you approach a day.  But that idea that maybe different approaches for different components of the day, that's interesting.  So how have you handled that?  You have curriculum listed, but do you collaborate and pick or top down it?  Does he drive portions?  Does his daily plan depend on where he is in his worlds and how readily he's coming into your world vs. staying in his?  Does the list vary daily with where he's at, and then over the course of a semester it can be spun to look like something more traditional?

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[Storygirl]

Thanks for bringing up this topic, Elizabeth. DS11 does not have an ASD diagnosis at this point, but I'm looking at the stack of papers that we need to fill out to launch his evaluations at the autism clinic, and I've been thinking a lot about how to make sure he is prepared for life as an independent adult. So I'm interested to see what the rest of you have to say.

 

I really don't know anything about ASD specific therapies, because we have not been down that road yet. But I've been reading a little about long-term employment prospects for people with ASD, which has been discouraging. And I often think about another WTM poster's experiences with her adult son who is academically gifted but has trouble with life skills and functioning in the workplace. DS11 has so many layers of disability that thinking about the future is worrisome. He has LDs even in his areas of strength. Because we've just completed evaluations for his IEP, things are on my mind.

 

I think my philosophy at this point is to figure out what will enable him to function at his best in general society when he is grown. So I would probably ascribe to the "pull him into my world" camp. DS does have an oppositional personality, but he has always been this way; I don't think that we have done anything to increase that, but who knows. He has a lower IQ (low average), but is still often discontent and argumentative, so I wouldn't guess that has anything to do with level of happiness, at least for him.

 

But I may change my opinions as I learn more along the way.

[PeterPan]

OhE, I know the stage you are going through. I've been through it myself. I don't want to belabor because I know my beliefs are not usually the popular ones, but I saw positive and negative in all these approaches and at some point I just made the decision to pick what worked for us based on my kids' needs. If you read Uniquely Human you will see that those considered by Prizant as the best therapists do not fit the kid into the therapies to suit their agendas but adapt the therapies to suit the kid. It is why he is a bit negative when it comes to behaviorists and I totally get his point.

 

One thing I will say though, my personal belief, unschooling isn't the best approach to them having a normal life some day. Build the relationship with your child. There was a good post from geodob on ODD and building trust between the child and parent or therapist. And while that activity is just an example of things one can do, I think that building trust is the most important to focus on. That, and being their support system with a well balanced, loving, and firm hand.

 

Sbgrace :grouphug:

Our library has that book, so I guess it's time!  I've seen you mention it a lot, but I think it was answering questions I wasn't yet asking, if that makes sense.  But that's sort of interesting that you're shying away from behaviorism but not seeing yourself in an unschooling camp either.  I guess I was using extremes there, like unschooling to mean childled, and then contrasting that with ABA to mean sort of a top-down educational approach.  I hadn't really thought of it with in-between variants...

[Lecka]

I have actually just read through Engaging Autism.  It is a good book.  It makes a lot of good points.

 

I just do not believe it is all so black-and-white in practice.

 

I think all the good programs are meeting kids' needs and trying to help them to develop skills.

 

I think (from reading things) that there used to be a lot of weakness and lack of knowledge in the area of initiating vs. rote skills.

 

I think that there is a general knowledge about this area that has just spread and is not limited to only one or two approaches. 

 

I think there are a lot of best practices that all the approaches have in common, and/or that depend more on the person and the person's teaching style and beliefs (about autonomy, encouraging autonomy, etc) than the approach.

 

I don't think any approach "owns" anything. 

 

I don't think things are "opposites," either where you can set up two approaches to be opposites of each other and make them into opposites.

 

I have heard about things like ratios/proportions where a certain proportion of time can be spent on direct instruction, a certain proportion of time spent on encouraging naturalizing skills and providing opportunities to be in a very natural environment.... and it depends on some specifics going on at a point in time.

[PeterPan]

Lecka, maybe I need to get Engaging Autism again!  I got it from the library, read parts, found it resonating, and then returned.  I thought Floortime made sense till I got these HORRIBLE videos from the library that were supposed to be teaching about it.  You saw this psych/practitioner and these parents and a child, and their whole approach to the child was SO bizarre and screwed in the head, I couldn't stand it.  Of course, you know me, all or nothing, extreme response.  Maybe there was some good there.  I just gave up.  Then reading on the Joyce Show blog, I got interested in Floortime again.  

 

My interest in the therapies isn't so much to debate whether one is good or bad.  It's more about what they can TEACH us about how to interact with our kids in homeschooling.  I think the philosophies and attitudes toward the child directly speak to how we could choose to interact with our kids in homeschooling.  So then I think it's good to be intentional, kwim?

 

Like, if I intentionally always go with my dc's flow, go with their world, quietly find ways to expand their world (Floortime them educationally), then am I HINDERING their ability to CHOOSE to come into someone else's world?  Like if I ABA'ed him educationally, saying no you're coming into my world at this time with this incentive because I said so, then is that giving him SKILLS or developing something good neurologically?  Or is ABAing someone educationally merely a matter of *convenience* for the teacher?  Is there research to demonstrate this?  And does IQ or functional level of the child matter?  Like if you're looking at HFA/aspergers and maybe gifted, are they MORE employable and more flexible if schooled with an ABA approach rather than sort of a floortime, childled, I'll come into your world and expand it approach?  Or is it just the opposite?  I doubt there's any data on that, but I'm just wondering.

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[PeterPan]

Cricket, that actually makes sense.  So when you're saying you used your version of ABA for skills acquisition, you mean social/adaptive living skills or academic skills?  And you mean using that other book you referenced a while back, yes?  

 

That actually makes sense to say (for a homeschooling philosophy) you could floortime (educationally) into most things and pull out your ABA tools for the things that need a little nudge.

[PeterPan]

Prizant and others have developed their own approach. It is mentioned at the back of the book but that is not why he wrote the book and you therefore barely see mention of it in the there. It is pricey though (over $300 if I remember correctly) and I don't know if (in my case) I could apply it at home or if I need to at this stage in the game. I would have to know more about it so it's on the backburner for now.

Prizant's approach to behavior or education?  And the $300 is a book or training?  

[Cynful]

 When we unschool autism and roll with their interests, are we inadvertently feeding things that will leave them LESS peaceful and less employable over the long run?  Like they might be fine in our home, where we can cover up for the rigidity, but an *employer* is not going to cover up for that?

 

 

My son has Aspergers but not diagnosed until later and didn't have formal therapy for it.  He has had other therapies for learning issues and severe OCD (which I believe is directly correlated to his Aspergers).  I've been fairly child led with him though his OCD also dictates  alot of it.  What you've posted above is my issue now that he is older.  He's fine in our home, he's fine in a setting he's completely comfortable with like our co-op, but, put him in another setting, and he can't function.  How is he going to work, do any possible further school, live.....etc.?  I definitely feel like "keeping the peace" so to speak has not necessarily been the best approach for him as far as preparing him to be independent.  I didn't see this until later though - hindsight you know...  But, would his OCD have been even worse if we hadn't kept things going peaceful for him?  I'll never know but I suspect yes.  It's his control when things are out of control.  I wouldn't say we were unschooling but more structure, more out of comfort time would have been good.  

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[kbutton]

I would like to ask how you know whether your are provoking a child or stretching a child? How do you know if your child can come into your world until you try? If you don't try, I think you are cutting off an opportunity for growth. All humans grow and change with some amount of stress. I think the key is managing that stress appropriately. But you may not always know where they are at until you try. You could always move the line too close to their comfort level to allow them to grow. There are adults that learned helplessness--we all know a few. Our BCBA has some autistic clients that have learned helplessness. It's possible. By all means, if you are totally freaking out and stressing out a child, then stop. But, sometimes learning takes place just past the comfort level, and sometimes that looks grouchy. (I mean, really, my son would not throw any fits about compliance if I let him watch TV all, day, but he'd be grouchy at the end of the day. I'm not going to decide to let him watch TV all day because it's easier on the front end. He thinks that TV watching makes him happy. It rarely does. I don't let him binge, and I don't refuse to let him watch at all. It's a balance.) Sometimes the child is okay in the moment and melts down later. Maybe not one single thing you asked of your child today was at all inappropriate, but the NUMBER of things you asked in one day is! I think that all of these therapies provide a window into and a context for discovering competencies and for avoiding potholes and are dependent on the skill of the person doing it. Maybe, just maybe, you are actually seeing a meltdown late in the day, and you think it's because of x when it's really because of y, but y happens at breakfast, and you have NO IDEA until you get someone to help you sort it out with ABA, RDI, etc.

 

I like a lot of what Cricket has said on this particular thread (though I know more posts are popping up as I write), but I think it's unusual for most parents to be equipped to cobble things together in the way that she is advocating. 

 

So if they're spinning or stuck on Lone Ranger or whatever, we just LET them under this philosophy?  Does it do them neurological GOOD to go to battle in some way over this?

 

And conversely, is there any research to indicate it does HARM to insist the person of spectrum come into your world and comply?  Does it increase oppositional behaviors?  Is there evidence for that?  In that Barkley video AM listed, he mentions an ingrained pattern of negativity and opposition.  Does forcing compliance increase oppositional behavior?  But then does caving and rolling with

them so completely negate the opportunity for them to learn to be flexible?  

I think your questions are kind of black and white. Is the child spinning while watching dust motes in the light during a time when he's free to do what he pleases? Is he spinning briefly because something made him excited? Is he running over small children when he's spinning, and he's old enough/aware enough that he should not be running over small children? Is he at the dentist's office spinning and insisting that the Lone Ranger will shoot the dentist if he has to stop spinning and get in the chair? 

 

I think my philosophy at this point is to figure out what will enable him to function at his best in general society when he is grown. So I would probably ascribe to the "pull him into my world" camp. DS does have an oppositional personality, but he has always been this way; I don't think that we have done anything to increase that, but who knows. He has a lower IQ (low average), but is still often discontent and argumentative, so I wouldn't guess that has anything to do with level of happiness, at least for him.

 

Personality can't be divorced from all of this. There are a lot of people in the world that don't like to be happy. There are a lot of people in the world that aren't as grumpy or as happy as any one person thinks they are. it's in the eye of the beholder to some extent. Some happy people are not stable. Some unhappy people are unhappy but doing the right thing--life is just like that.

 

I have actually just read through Engaging Autism.  It is a good book.  It makes a lot of good points.

 

I just do not believe it is all so black-and-white in practice.

 

I think all the good programs are meeting kids' needs and trying to help them to develop skills.

 

I think (from reading things) that there used to be a lot of weakness and lack of knowledge in the area of initiating vs. rote skills.

 

I think that there is a general knowledge about this area that has just spread and is not limited to only one or two approaches. 

 

I think there are a lot of best practices that all the approaches have in common, and/or that depend more on the person and the person's teaching style and beliefs (about autonomy, encouraging autonomy, etc) than the approach.

 

I don't think any approach "owns" anything. 

 

I don't think things are "opposites," either where you can set up two approaches to be opposites of each other and make them into opposites.

 

I have heard about things like ratios/proportions where a certain proportion of time can be spent on direct instruction, a certain proportion of time spent on encouraging naturalizing skills and providing opportunities to be in a very natural environment.... and it depends on some specifics going on at a point in time.

 

:iagree:

Like, if I intentionally always go with my dc's flow, go with their world, quietly find ways to expand their world (Floortime them educationally), then am I HINDERING their ability to CHOOSE to come into someone else's world?  Like if I ABA'ed him educationally, saying no you're coming into my world at this time with this incentive because I said so, then is that giving him SKILLS or developing something good neurologically?  Or is ABAing someone educationally merely a matter of *convenience* for the teacher?  Is there research to demonstrate this?  And does IQ or functional level of the child matter?  Like if you're looking at HFA/aspergers and maybe gifted, are they MORE employable and more flexible if schooled with an ABA approach rather than sort of a floortime, childled, I'll come into your world and expand it approach?  Or is it just the opposite?  I doubt there's any data on that, but I'm just wondering.

 

It's not either or on going into their world, expanding it, whatever. What if expanding their world from the inside is necessary before they will enter yours? What if they enter your world for some things but not everything? What if knowledge comes before natural compliance? What if you a parent insists on bringing the child into their world, and then the child develops a natural affinity for that activity? Does that mean it was wrong for the parent to do it that way. Frankly, my son needs strong, firm insistance, and he has THANKED me for it later--he is aware enough of himself and his goals to know that he needs help to avoid derailing himself. In the moment, this is stressful, but then he's glad and feels competent later. I would NOT know that if I hadn't sometimes insistend. And frankly, I often insist because i'm at my limit. If I insisted over nad over, and he wasn't capable over, and over, I would need to call in respite care. But, there are time I insisted on a hunch, and I was right. And he's learning and growing. If I were winsome all the time and mostly went into his world, he would not be as capable as he is. (That's our life and our circumstances, but how do you know they are not yours?) 

 

I am not sure you can ABA someone educationally. It's theoretically possible to educate a person in all kinds of ways. But, can they respond with flexibility to a situation just because they know it (regardless of methodology)? NO! My son knows tons of things that he cannot apply across the board. That is where ABA or RDI might help. But, you can't just apply ABA and bam, the child learns something--the therapy is for the behavior, not the content. The ABA is shaping behavior or the RDI is shaping behavior to motivate them to learn or to motivate them to be ready to learn. It's not a way to present the actual material, but it is a way to gain compliance. I"m sorry, but humans have to comply with things, or there are consequences. iF they can't comply, there are consequences. If we cannot gain compliance, and it's inhumane to gain that compliance, there are consequences, and there are people that have to live in that situation. That's not fun. I am not advocating that they traumatize a child in order to make sure the kid never has cavities. They can take measures to slowly ramp up to brushing teeth, etc. If that doesn't work, then it's all on the teeth to rot or to stay okay. Maybe it's best if they rot, you pull them all out under sedation, and the (presumably young adult by now) gets dentures, lol! I know SN families that have to live in that tension,a nd they aren't all families with autistic kids.

I feel like people in general want discussions like this to be about all autistic kids equally or about safety or whatever, but the reality is that your son is functional enough that there will be times he'll be expected to comply (if not by you but by others), and he must do it unless you plan to be with him all the time forever and pave the way. It's not like kids only refuse to do things they are incapable of. It's not like an autistic kid can't figure out that they expectations are low, and they don't have to do more if they have a meltdown. My son's level of functioning means that he can sometimes learn in near meltdown mode. In fact, the more he's asked to navigate learning or doing things in near meltdown mode, the better he gets. I am not going to provoke a meltdown--life does that already. I didn't necessarily provoke meltdowns to find this out, but now that life has done that for me, I know he has capabilities in this area. Because of that, the kid gloves have come off a lot, and he has to suck it up buttercup at times (not all the time, not every time, etc.). I won't know that if I'm not letting life make waves sometimes. I am also not going to "ask" my son to do things, and always say "please" wiht a little Susie Sunshine voice either (unless the modeling is particularly necessary, which it's not for my son right now). NO ONE treats my son that way--he looks and mostly acts NT, and that's how people treat him. If people on here met him, they'd realize that Susie Sunshine persona would be totally inappropriate for him. It's reasonable with my son at his level of functioning to tell him to do something and expect him to do it on a learned task. If it's a new task, I can still expect those things, but I might have to provide supports for learning it. THose could be based on RDI or ABA, but it wouldn't be like I'm stressing over "should I teleport him out of his world, or will that make him metldown" But, he doesn't live in his own world all the time. He often forces his perspective on others, but he is not in his own world. We got past that a long time ago, and we got past that pre-diagnosis.

This is different for all autistic kids. There are kids that have to be sedated to have their teeth cleaned. That's a health/safety issue, and I hear people say things like we need to insist on compliance for health and safety. However, for some kids, this is totally bypassed in favor of knocking the child out with heavy duty sedating drugs! It's not black and white. 

 

He's fine in our home, he's fine in a setting he's completely comfortable with like our co-op, but, put him in another setting, and he can't function.  How is he going to work, do any possible further school, live.....etc.?  I definitely feel like "keeping the peace" so to speak has not necessarily been the best approach for him as far as preparing him to be independent.  I didn't see this until later though - hindsight you know...  But, would his OCD have been even worse if we hadn't kept things going peaceful for him?  I'll never know but I suspect yes.  It's his control when things are out of control.  I wouldn't say we were unschooling but more structure, more out of comfort time would have been good.  

 

See, therapy is meant to help generalize skills so that they are useful in myriad ways. That's empowering! Does that have to be balanced with concerns about OCD or other conditions? Absolutely. Again, not at all black and white. If the OCD is that bad, I think it's entirely reasonable to list that right up there with the autism as a disability--they reinforce each other, and it's definitely not going to look like that for a child who is not also dealing with OCD. That doesn't mean that the approach to the autism failed, necessarily. (And hugs to you, Lucidity.)

 

And when I go to the autism charter school, the kids are HAPPY!!  They are not sitting there all unhappy.  So are they happy because they have ID and they wouldn't be so happy if they were gifted and knew what was happening to them?  I'm sorry to be blunt, but I think it's a reasonable question.  I think the answer is no.  I suspect the answer is that diligent ABA and predictability is calming and lowers stress, allowing them to have more peace.  When we unschool autism and roll with their interests, are we inadvertently feeding things that will leave them LESS peaceful and less employable over the long run?  Like they might be fine in our home, where we can cover up for the rigidity, but an *employer* is not going to cover up for that?

 

I just don't know.  And I think it matters, because those are pretty big spreads in how you approach a day.  But that idea that maybe different approaches for different components of the day, that's interesting.  So how have you handled that?  You have curriculum listed, but do you collaborate and pick or top down it?  Does he drive portions?  Does his daily plan depend on where he is in his worlds and how readily he's coming into your world vs. staying in his?  Does the list vary daily with where he's at, and then over the course of a semester it can be spun to look like something more traditional?

 

I think it's not either/or. With ABA you target specific things and then work through a process, right? I think RDI is the same way. It's not like you just therapize everything a child does all day, every day. So, let the kid free range some things and expand their universe with RDI, ABA, etc. a little at a time in a respectful way. Go into their world for play (or for history, or whatever).

 

Also, is expecting their compliance the opposite of going into their world? I don't think it is, but it sounds like some people think it is. I don't know. I've been on here too much today, lol!

[PeterPan]

My son has Aspergers but not diagnosed until later and didn't have formal therapy for it.  He has had other therapies for learning issues and severe OCD (which I believe is directly correlated to his Aspergers).  I've been fairly child led with him though his OCD also dictates  alot of it.  What you've posted above is my issue now that he is older.  He's fine in our home, he's fine in a setting he's completely comfortable with like our co-op, but, put him in another setting, and he can't function.  How is he going to work, do any possible further school, live.....etc.?  I definitely feel like "keeping the peace" so to speak has not necessarily been the best approach for him as far as preparing him to be independent.  I didn't see this until later though - hindsight you know...  But, would his OCD have been even worse if we hadn't kept things going peaceful for him?  I'll never know but I suspect yes.  It's his control when things are out of control.  I wouldn't say we were unschooling but more structure, more out of comfort time would have been good.  

That's a really hard thing to have to admit, sigh, and I appreciate you baring it here!  Yes, that's what I'm concerned about.  Not like in a freakish way but a REALISTIC way.  

 

So then do you have any hindsight on how *much* of that other kind of experience would have been necessary to build those skills? 

[PeterPan]

OhE, I agree you are seeing things in a bit of an extreme and I think it may have to do with specific scenes you watched from specific therapists. It's why I say, a therapy is as good as its therapist and that is basically what Prizant says. Focus on the quality of the therapist, not the therapy. One thing I found very interesting in the Denver Model, I'll find it and quote directly.

 

"Most of the research on early intervention has focused on studies in which the treatment is delivered by trained therapists. The research on parent-delivered early intervention is still at an early stage. However, studies show that parents and other caregivers can learn to use many treatment strategies as well as trained therapists, and that when parents use these strategies, the quality of their interactions with their children improves and the children become more socially engaged and learn to communicate better with others."

 

The quote is from the Early Start book. I had bought it and forgot about it because I had bought many books at the time (on Kindle) that it got missed. My husband and I did something really similar when we were trying to reach my youngest. I think that it's one that can be seen as therapy and parenting for the younger children.

Ok, I'm such a goober, I got the Early Start to Autism (also by Goddard) a while back from the library, didn't have it speak to me (for whatever reason, likely that I was hasty, as I usually am), and gave up.  But that Early Start *Denver Model* book looks much more rich in theory!!  I really hate the patronizing simplifications.  Just tell me the theory so I can figure out how to apply it in our unique situations, mercy.  

 

And yes, that's how it SEEMS to me, that it OUGHT to be that *I*, knowing everything about my dc, if I had the proper training in methodology, could actually do BETTER than some random $12-15 an hour paid therapist provider implementing ABA skills.  I'm not knocking that bulk service provider gig, because it's good.  I'm just saying my boy is gifted, has language holes, his interests, etc.  I just do not think that some random $12 an hour person is going to pull all that together as well as I could (with equivalent instruction/training).  I'm already burnt on therapists ($100 an hour) who can't think through complex things.  

 

So no, I'm with you there.  The trick is just getting that training or having that info to make those plans.  

 

And, yeah, no one ever accused me of failing to be b&w.  ;)  I always start with the most polar, b&w options, and if other people help then I can see nuances in between.  As you say, they're there.  It just takes time to think through it and be intentional like that.  And I seem to have to hyper learn anything before things make sense and come together, sigh.  Or just say I'm dense.  :D

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[Lecka]

Of course you can do as good of a job as a random $12/hour tutor, if you have the same training.  Of course you can.

 

I need that for generalization, though.  I can't generalize skills as well as another person, I can just be one person generalizing skills.  This is a known area of need for my son. 

 

Then, it is just like, I do a lot.  Why not let somebody else do some, too?  It takes a burden off of me.

 

But please don't think it is like "oh, I don't do anything, I just sit back and leave everything to other people."  That is not the case at all. 

 

But, it lets me have weaker areas, too, and there are some things that are frustrating to me, and I don't have to do them as much.  It is nice.

 

My insurance pays, though.

 

I think when you get started and know what your scholarship pays for ----- you will be able to schedule an amount that you want.  If you realize you are getting more than you want, you can cut hours.  If you realize you want some days off, you can have days off. 

 

Right now my kids can play nicely together after school, so two days a week they are just playing. 

 

If my son is wandering around aimless and not engaged after school, then it makes a lot more sense for me to schedule therapy during that time.

 

I have 3 kids, though, and all are about the same age, and my older son is a hands-on kind of kid in a lot of ways, too.

 

But no, it is not like the $12/hour tutors are super special.  They are nice, though.  I like them.  It is a good thing for us. 

 

But I have cut hours, before, feeling like it is just taking up too much time, and like we are not having enough time for other things.

 

But I worried about that kind of thing a lot more before I started. 

 

It turns out I am pretty involved, my son comes out to talk to me, my son can come and ask me to come with him, he can pick to sit in my lap, he can pick he wants me to read him a story for his story time (and asking him to "make a prediction"). 

 

But there are things that I am not as good at, and there are things that are kind-of boring/frustrating to me (just because, or because of certain things going soooo slooooow).  Also there are things where they do need to take data and while I take behavior data, I do not really track things like spontaneous language, initiations, questions, etc.  I don't track programs with +- or p.  This is needed for some things, b/c it takes that level to be able to look and see, either there IS progress but it is real, real slow.... or there is NOT progress, it is not just that it is real, real slow.  Like -- if he is going from 30% correct to 30% correct to 50% correct to 50% correct to 50% correct to 20% to 50% to 85% ------ there is no way to have a sense of that, and know how to tell "is it going anywhere?" and know whether to get disappointed with the 30% day or to look and say "well, it is just one 30% day." 

 

Separately -- we absolutely have educational programs within ABA.  It is not only behavior.  My son's reading program is within ABA, even though it is not an ABA program.  It is still a one-on-one direct instruction program, and they take data on his targets (just lessons in the program) b/c he does not go through the lessons in one session, he may need multiple sessions for one lesson, so it is how they track to tell how he is doing on the lesson.   

 

It is not just "getting him to do it."  It is actually helping to determe when he is ready to move on, or when he needs more time. 

 

It would not be like for everything educational ---- but it is pretty helpful when it is helpful, and anybody who has gone through a curriculum and not known if their kids were mastering the material, or when to move on, or moving on and then finding out previous lessons are forgotten, etc...... it has got to lot to offer for that kind of thing, for some things.   

 

For the more speech-therapy kind of things, too, it is really nice that they track what he is getting correct and incorrect, b/c they can really target what they are working on, to where he is missing some but not too much.  A really sensitive speech therapist can do this, too.  But sometimes I think they do their lesson and don't realize how many answers kids are really getting, and how many answers may be memorized, and how many answers may be "independent" responses that were not memorized in a previous speech session. 

 

Sense I am pretty concerned about memorization, that is a concern, I need to know if he has independent responses or if he only has memorized responses. 

 

ABA is on top of that, imo, b/c they are on top of working with kids who may memorize answers, and speech therapists might be really on top of this, or they might not be. 

 

I actually really like my son's speech therapist and OT right now, but they are both specializing pretty heavily in autism and not just autism, but early language skills. 

 

B/c it is just mega-frustrating when answers are memorized only, and it is not known and addressed, it is just "seems good." 

 

My son is expected, in general, to need to memorize a certain number of answers before he will make an independent response, as just his learning process of how much exposure he needs.  So -- if he is moved on too soon, it is not good for him. 

 

We also need to know if he is generalizing this stuff into other environments and using it in spontaneous language, and if he is not, then that needs to be addressed. 

 

But for some of this ----- sometimes it involves them keeping track of individual words and individual responses, and it is a lot of paperwork, and I do not really want to do it, but it is really helpful to make sure the right things are being worked on and worked on enough.  But -- I can know the information and exactly what he is working on and focusing on, without having to keep the paperwork myself.  B/c really, I don't want to do this level of paperwork.  I don't want to do it, it is a lot of work. 

 

But, it is not like I can't do it. 

 

Some things are really good, but they are not really something where we are doing something fun together or something more family-ish or parent/child-ish. 

 

But if he needs this level of speech therapy stuff to make progress in speech therapy, at a certain level, then it needs to happen, but it is not something I want to do all by myself. 

 

But if I did want to ---- I could, and some parents do more of this, b/c it is what they like to do.  It is not like a "gatekeeping" thing imo. 

 

But it is like -- it frees me up to have time to focus on other things that are more of a good choice for me in every way.

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[PeterPan]

Lecka, that's an interesting explanation.  I actually do a lot of that mental data gathering on language.  It's sort of an obnoxious habit of mine, sigh.  Right now I'm listening for how frequently he uses Wh- words.  We've been working on asking questions, so it was a logical step.  So then it's how many times today did he use it, did he answer mine, did he shy away because he didn't seem to understand the wh-question, etc.  

 

Cricket, someone else here on the board had said something similar.  I had wondered if I was making ds WORSE taking him so many places, and the behaviorist said something similar to what you're saying, that it was good.  That quote though is quite interesting and makes it more clear WHY it would be good.  :)

[Cynful]

That's a really hard thing to have to admit, sigh, and I appreciate you baring it here!  Yes, that's what I'm concerned about.  Not like in a freakish way but a REALISTIC way.  

 

So then do you have any hindsight on how *much* of that other kind of experience would have been necessary to build those skills? 

I can't say how much as I'm pretty sure it depends on each child.  I agree with others though in saying that creating that trust relationship is most important.  I used to say that I was my son's security blanket.  I still am, in certain situations.  I've always been ok with that, but, he should have had some other "security blankets" too.  He and I are very close; I know what he's feeling even when he doesn't have the words to tell me or doesn't even know himself.  I am so thankful for that.  

 

For me, in hindsight, it's like some of the homeschooling threads here about how skills build upon other skills.  When he was young, I thought it was silly say to worry about a 3 year old having to tie his shoe or button buttons, etc.   But a few years later, you can see where those skills (not the actual tying of shoes or buttoning) come in and how they help achieve further skills.  I also felt, since I was the only one who entered his world, that "I" could do it better than the therapists.  Big mistake on my part.  Not because I couldn't do just as well, possibly even better since I had entrance, but because the exposure to others would have been better.  

[Lecka]

From the original post.... I think I think of things as "best practices" and "guiding principles." 

 

These really do have a way of overlapping. 

 

For example, one is "make it relevant" or "be relevant."  ALL the approaches say to do this.  This is even recommended for NT kids!  But I think the depth of how to look at this, that comes from different guiding philosophies, is just adding to the concept and how to apply it. 

 

For NT kids, I see this come up in two ways.  One, follow the child's interests.  This is self-explanatory, I think.  Two, though, is to make a point to expose a child to experiences and background information and fun things, in order to build a foundation for the child where they will find things relevant. 

 

So, for NT kids, we have a combination of child-led, and meet-the-child-where-they-are but with an idea of "why isn't this relevant?" and then "what can we do to make this relevant for this child, if it is not currently relevant?"  For an NT child, you mostly are not going to go, "well, he doesn't find it relevant, so we are just not going to stick to the things that are already relevant, and forget about this totally."  Maybe sometimes you do, b/c it is not something where it really matters in any way.  But for other things, there are all kinds of strategies to make children find things more relevant to their lives.  Mostly along the lines of:  provide information about how it is related to something they do find relevant, provide a fun experience that could make something more relevant, look back and see if providing more background information would make it more relevant, etc. 

 

I think in a child-led experience, the child's environment and exposures are still determined by a parent.  It is child-led within an adult-led environment.  Like -- with Montessori, oh, it is child-led, but look at all the background work that the parents/teachers are doing ---- it is not like it is child-led with no input from the adults involved.  There is huge involvement.  But you set the structure and environment, and then the child is child-led within it. 

 

For Floortime, I have just read Engaging Autism.  His take on "be relevant" is that children need to be actively engaged and have an emotional connection to what they are learning, in order to learn and be engaged.  He is really big on getting the emotional connection, and looking for the emotional connection.  That is what it means to be "relevant" in this book.  So, if something is not relevant, the thing to do is to go back and work on emotional connection, and then build on the emotional connection, and expand the emotional connection, and then take that emotional connection and use it to make more things relevant over time.  It is about taking an emotional connection with a person, and using it to expand to an emotional connection with every other thing a child can be engaged with, and then use those things to build to other things.  But, always with an emotional connection to someone or something the child is already connected to, and starting with the first steps of a parent and child engaging. 

 

This seems really good for me, to look for and think about when trying to "be relevant" and/or look for relevant things to use to help expand into other areas. 

 

But it is also like -- you don't just sit back with your 5 things you have an emotional connection to, you want to be adding more and expanding more. 

 

With ABA -- "be relevant" and "make it relevant" are also important.  But I think it is more pragmatic.  I think it is more like -- when kids find things relevant, they will want to do them, so you are harnessing their natural motivation.  If something is boring, maybe it is boring b/c it is too hard, maybe it is boring b/c it is not relevant.  If it is too hard, you make it easier or break it down into smaller steps.  If it is not relevant, you either bring in something that is relevant, or you look back and realize "oops, the child has had no exposure to this content" and then either just change the content (like, if it was about baseball or something, and could easily be changed to swimming), or you go back and say "well, we will drop way back to an exposure level on this." 

 

There is also an idea that learning needs to be used in a child's life, so you look at the child's life.  If something is not going to be used, maybe it is not a good goal.  Or, maybe the child's life needs to change so that the learning can then be a part of the child's life.  Maybe you need to create a space and an opportunity for the learning to be relevant in the child's life. 

 

But the ABA therapist, while also thinking "oh, this is good in principle," is also going "b/c it is so frustrating if we teach kids things and then they just forget them, and then we have to do review/maintenance programs, and it is better when there is no need for a review program, b/c the learning is being practiced in the child's daily life.  Or, learning is building on other learning, so that the old learning is reviewed within the new learning (like -- if you learn addition in math, as you move on in math, you are still using addition, so it is reviewed as you move on). 

 

So, I think these are different philosophies and a different set of reasoning and a different idea of "what is important," but in both cases, people who have been working with kids with autism and seeing how they learn and seeing pitfalls that have happened in their practices that they have learned from..... both of them think "make it relevant" is an important guiding principle. 

 

I also think, really, in both there is an idea that you have a mix of "totally child-led" and "leading the child to finding it relevant."  The same as for NT kids. 

 

But then, if the two questions are, 1) how do I make things relevant for my child, who does not easily find a lot of things relevant, and maybe it is a lot of work and takes a lot of intention, b/c we can't just, say, go to a museum or do a project, and bam, relevancy.  And then, 2) what mix do I want between "following already-established interests" and "establishing new interests." 

 

For 1, how, I think the good people are looking for ALL the strategies.  For 2, I think this is where being sensitive to your child and how much you can push them or ask them to stretch, comes in. 

 

But I think all the approaches have a mix of comfort and stretching/pushing. 

 

And, in any approach, some kids can take more than others, just because of their basic personality.  And, sometimes you hope to increase how much pushing you can do, by going back to "relationship, relationship, relationship" (which I think ALL the good people do) and oh, that probably means not pushing so much for a bit, in the hopes of more pushing later.   

 

B/c I really do think that there ARE some guiding principles that ALL the good people are following, so I think there are places where there is a shared philosophy. 

 

I would rather look for that, than try to split hairs, at a certain point.

 

I agree, too, I really liked the book Uniquely Human.  It is a great book.

Edited January 11, 2016 by Lecka

[kbutton]

In response to deciding whether to use a therapist, I definitely agree that more people and more variety the better in some ways--my son will do things for me that he won't do for others, and I didn't see this as generalization until lately (probably because I was shy as a kid and still have times when I have a negative association with certain things). 

 

I would also suggest that therapists can be an extension of you--that may sound radical, but it can be. The tutor and BCBA that work with my son are people that I can talk to like I talk to all of you on here. We can talk about philosophy of treatment and such. They see my son for who he is, and they want to see growth where I want to see growth. Then, they have this big set of background knowledge and experiences to bring that I don't have. It's awesome. At first, there was a bit of a dance to learn personalities, figure out what I wanted from them, etc. It's been a very positive thing. 

 

I also know that they see a lot of kids and have a balance between kids' world/my world that is tailored well to each kid. Both of these women are very intuitive about this. They have good stories and they have horror stories in their background--his tutor had a student who had an area that needed big behavioral remediation, and the parents refused to remediate it or even see it as a problem. They discouraged her from working on it if she tried to do so. Well, this young lady found the PERFECT job--she loved it, her employers loved her, but she ended up losing the job over this behavioral issue. (It was about cheese. CHEESE. She lost a job over cheese. And I believe it was an office type of job, not food prep or something.) So sad. So, I trust the tutor and the BCBA that comes. They enjoy my son and have a lot of experience to offer. Time has proven that they have made differences that i could not have made, and some of that is totally because they are not me. They are also not afraid to test my son a bit. He needs that. As we discussed just this week, better that he learns plans don't always work out perfectly before a plan doesn't work behind the wheel of a car he's driving, etc. Before he's working on something dangerous or feels pressured from a person. But, that's the stage we're at--he can talk the talk, but he has to be able to generalize that practice to all kinds of situations.

[PeterPan]

The PRT Pocket Guide: Pivotal Response Treatment for Autism Spectrum Disorders

 

Freedom from Meltdowns: Dr. Thompson's Solutions for Children with Autism

 

The Scerts Model: A Comprehensive Educational Approach for Children With Autism Spectrum Disorders (2 volume set)

 

Teaching Your Child with Love and Skill: A Guide for Parents and Other Educators of Children with Autism, including...

 

These are books I've added to my reading pile that all seem to address the things we're talking about in this thread.  I started (in the middle of course, haha) the Joyce Show book this morning, and she jumps right in with how the behavior stuff connects to learning and how to get in ready to learn as part of a morning routine.  Love how analytical and detailed she is!

 

The Freedom from Meltdowns book is 300+ pages, making it longer than the Baker book on Meltdowns, and it's endorsed by Lynn Koegel who seems, along with her dh, to be a big name in the autism community. That PRT book is on more contemporary approach to ABA.  It was actually  REALLY fascinating and gets DIRECTLY to what I was thinking about, that if we can nail concepts (what is most important as we approach our kids), then we, as homeschoolers, will probably be able to apply those concepts creatively to our situations.  The PRT version of ABA seems to be heavily evidence-based, and just from the intro on amazon it really looks like it could influence our approach with homeschooling.  The P of PRT stands for pivotal, by which they basically mean the crux, the point on which a bunch of other skills or issues will pivot.  One of the Ps is motivation.  Well obviously that's something we deal a lot with in homeschooling!  

 

Well that's as far as I got.  I think I need to read more and learn more.  I think I was just on the cusp of this iceberg of information that is now available.  I appreciate the comments and the discussion.  

[Crimson Wife]

Modern ABA has borrowed *HEAVILY* from RDI and Floortime and I don't think there is the same distinction between it and the other approaches as there used to be. I've read Dr. Greenspan's book and own the RDI for Young Children book and I definitely can tell that my daughter's ABA program incorporates a lot of the same techniques. Modern ABA is far more naturalistic and play-based than what Dr. Lovaas was doing with the flashcards and such.

 

ABA is about encouraging positive behaviors and eliminating negative behaviors. Social interaction would be a positive behavior that the ABA therapist wants to encourage and that could happen either by joining the child in his/her preferred activity OR by coaxing the child to participate in a non-preferred activity. A good ABA session includes a balance of both types. Preferred activities are often used as reinforcers for participating in non-preferred activities.

[PeterPan]

Hmm, that's an interesting way of thinking through it.  I hadn't quite thought through our day in that way, like which things are preferred and maybe which are non-preferred, hmm...  

 

So is there a book, a particular book, you've seen on ABA that seems to pull together this modern thought process?

[Lecka]

http://www.amazon.com/gp/product/B00BSE6EES/ref=dp-kindle-redirect?ie=UTF8&btkr=1

 

This is a good book about modern ABA. 

 

It is written to explain some basics to parents of kids who are starting out with this style of ABA, which in a lot of ways is the modern style.  

 

But it is not an all-encompassing book at all.  

 

I agree with Crimson Wife -- ABA used to not incorporate some things, and now they are incorporated.  

 

There is nobody going, "well, that practice clearly helps kids, but it is NOT ABA, and I DO ABA, so I won't do it."  

 

It just does not work that way.  It is not something that works that way.  

 

It is much more "it works?  I want to do that, too."  

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[Crimson Wife]

 

So is there a book, a particular book, you've seen on ABA that seems to pull together this modern thought process?

 

I haven't actually read any books on ABA per se because my DD attended an EI preschool that incorporated ABA and then she started getting 1:1 ABA through our health insurance. So I've focused my reading on the the things that she wasn't already getting IYKWIM.

[Crimson Wife]

 

There is nobody going, "well, that practice clearly helps kids, but it is NOT ABA, and I DO ABA, so I won't do it." 

 

Unfortunately, I've read stuff by very close-minded ABA therapists that do unfortunately take this attitude. I get that ABA is very much into "evidence-based practices" but there are some ABA therapists who take this to an obnoxious extreme. If something isn't the conventional wisdom that has been accepted for 20+ years by M.D.'s then it's "quackery". SPD isn't listed in the DSM so it doesn't exist and all the OT's who do sensory integration are just trying to con you out of your money, yadda, yadda, yadda. [insert roll-eyes smiley here].

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[kbutton]

Unfortunately, I've read stuff by very close-minded ABA therapists that do unfortunately take this attitude. I get that ABA is very much into "evidence-based practices" but there are some ABA therapists who take this to an obnoxious extreme. If something isn't the conventional wisdom that has been accepted for 20+ years by M.D.'s then it's "quackery". SPD isn't listed in the DSM so it doesn't exist and all the OT's who do sensory integration are just trying to con you out of your money, yadda, yadda, yadda. [insert roll-eyes smiley here].

 

The more I talk to people, the more that i find that these things vary generationally (what was happening ten years ago, five years ago, etc.), by specialty, and MOSTLY by location. Stuff that schools do automatically where Lecka lives is stuff that is hard to find with alternate providers here. And then some of it is very similar, but you have to find a private practitioner for it. I also think the referral networking among professionals here is either too territorial, or people are less curious about what other professionals are doing, and therefore, they don't intersect as much. The best professionals we've used are the ones quietly doing the thing we're having a hard time finding, or they want to know what others are doing and want good referrals. These people seek out information about other practitioners. Our psych has heard a lot of negative, negative, negative about various providers, especially when 2e kids are involved, so when we have a good experience, she writes it down. Our OT is familiar with VT but had heard mixed results and didn't know of local practitioners that had rave reviews, so when she found out that we had amazing VT results, they wrote it down. The rest are a mixed bag--a few suffer from total lack of curiosity. :-) (That seems to actually be a regional thing across the board, not just with therapy, lol!)

[Crimson Wife]

I remember when you mentioned Greenspan's book on here. I had looked at it but so much reading, so little time! And it makes complete sense that your reading would have a different focus. I was just wondering if Greenspan mentioned if this was specifically for Lovaas' approach to ABA, or Skinner's, or if this was just about ABA in general. There are some differences between the two and I get the impression that therapists tend to follow one or the other. At least some minor research that I have done seems to indicate that there are still to separate groups of behaviorists based on it.

 

It's been several years since I read Dr. Greenspan's book so I don't recall specifically what he talks about regarding ABA. I do know that his approach was developed in reaction to the type of behaviorist treatment done in the late '90's, which would've been heavily influenced by Dr. Lovaas.

 

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[Lecka]

We are in a small town, too, and there just are not that many autism providers, and there are not that many treatments available at all, that are available in some other places. 

 

It is really sad to be territorial if it means not doing things that are working.

 

My understanding here ----- is that they do look at evidence-based practices, but since they are taking individual data on kids, they are willing to try things and then look at the individual child's data.  If there is something, and you want to try, and it is something they are able to implement, then they are willing to try and take data to see if it is effective. 

 

It is not that everyone can do everything, people still have their areas of expertise, but I see people wanting to know what will be helpful, and if they are told something has helped, they want to use that information to inform their own treatment decisions. 

 

That is what I think I see. 

 

I think that maybe it is a change with younger people. 

 

It could also be ----- there is one person who is pretty influential in our community with autism (a school employee) and she is very open.  She is open to everything.  She just wants kids to improve and have their needs met.  It is all she cares about.  I think it may be (like with a principal at a school) a time when a person in a leadership position sets the tone.  She is in her 60s or so, but she has been working with kids with autism for many years. 

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