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Source: about health
It’s still possible to find behavioral therapists sitting children in chairs for forty hours a week. Over and over again, the therapists hold out a spoon, or a fork, or a cup, or a plate, and ask for the proper word. When they get the response they’re looking for, they give the child a “reinforcer” – often a small piece of candy.
This form of therapy, which comes out of the behavioral tradition, is called “discrete trials.” It’s a very clearly defined technique, and because it has extremely concrete goals (learn to say “spoon” when you see a spoon) it is easy to see and report on progress.
In fact, it was on the basis of seeing that type of therapy in action that I decided behavioral therapy (sometimes called Applied Behavior Analysis) was not in my son’s best interest. He was engaged and verbal enough, I felt, to learn in a more humanistic manner.
Though a “discrete trials only” approach might not have been in my son’s best interest, I was wrong in thinking that ABA is nothing but discrete trials. Through interviews with two top ABA experts, Dr. Jim Partington and Dr. Laura Schreibman, I’ve learned that a discrete-trials-only approach to teaching a child with autism is not only outmoded, but likely to have very limited results. That’s because, in part, the child will learn only what he is being taught: that when an adult holds out a spoon, the correct response is to say “spoon.”
This, of course, is only marginally helpful, since it doesn’t teach the child what to do with the spoon, how to find the spoon, or how to put the spoon away. Very often, the outcome is a child who can say the word spoon — but only under controlled circumstances, and never when he actually wants or needs a spoon!
Perhaps worse, it means that the child who says “spoon” may well continue to expect to receive a piece of candy — not a spoon.
Says Dr. Laura Schreibman: “You want the natural environment to become reinforcing … If you say ‘I want car’ you get a car — not a candy. You learn purpose as well as behavior. This approach enhances generalization. This is how typical kids learn: they use language functionally in the environment. The content of the program should be functionally significant, and you can conduct naturalistic therapy in a naturalistic environment.”
Dr. Partington agrees wholeheartedly: “What you’re really looking for is not only developing but also USING skills in naturalistic settings. The real world has to provide reinforcer for the behavior — not the treat you get.”
All of this is certainly good news. ABA is probably the most commonly provided therapy available, and it’s increasingly provided through schools, agencies and state programs.
The bad news, however, is that the ABA provided is looks all too often like hours upon hours of rote teaching of disconnected words, phrases and behaviors. Children may learn words, but they are likely to have no idea how to use them in context. Meanwhile, they miss out on the ordinary interactions, experiences and situations that are a part of a full, rich life. While other children explore, climb, and learn from experience, far too many children with autism sit at a table for hour after hour.