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Source: About Health
Most doctors and schools recommend behavioral therapy for children with autism. The most common form of behavioral therapy is called applied behavioral analysis (ABA).
In its most basic form, ABA is deceptively simple. It’s an old-fashioned reward and consequence approach to education. Do what you’re asked to do, and you are rewarded. Don’t do what you’re asked to do, and the reward is withheld. Over time, the learner associates rewards with good behavior.
In the long-run, the good behavior continues even in the absence of the reward.
Parents of children with autism may be familiar with ABA in the form of an approach called “discrete trials.“ This approach to therapy involves a therapist who sits across a table from a child with autism and ask for a behavior (give me the spoon). When the child complies, he receives a reward — very often a bit of food. The the therapist asks for another behavior, and another — sometimes for as many as 40 hours a week.
Training for this type of behavioral therapy is relatively brief (it can be as short as just a few weeks). But therapy at this level, even for many hours a week, is unlikely to be ideal.
According to Jim Partington, PhD, board certified behavior analyst and director of Behavior Analysts Inc. in Pleasant Hill, Calif., a child engaged in behavioral therapy should be having fun, responding to the therapist’s facial expressions, and working not just at a table but also in natural settings (playgrounds, classrooms, and so forth)
Know Your Therapist’s Background and Training
Some parents have the luxury of choosing and hiring their own behavioral therapist. Others have therapists selected for them by their child’s school, early intervention agency, or other institution. No matter what the source of your child’s therapist, though, you should be able to learn more about the therapist. Questions to ask include:
- Does this therapist have Behavior Analyst Certification Board (BACB) certification? Most qualified therapists do have this certification. If yours does not, you can almost certainly find a qualified local therapist through the BACB database.
Ask About the Tests Your Therapist Used to Design Your Child’s Program
- Assessment of Basic Language and Learning Skills Test Revised (ABLLS) is a well-regarded assessment tool that looks many different areas of development and learning, and helps therapists and teachers to design an appropriate program for your child.
- Partington suggests that parents specifically ask for this test. He says, “If you don’t know what a child knows and doesn’t know, you can’t teach them. What you want to do is ensure that the level of teaching is at the appropriate level.
Observe Your Child’s Therapist in Action
- Observing your child’s therapy sessions is important for several reasons. Of course, you want to know that your therapist is doing a good job — but it’s also important to know what words, concepts and techniques the therapist is using. This way, you can build on the therapist’s work. Ideally, you’ll be meeting with the therapist on a regular basis to discuss your child’s progress, but seeing the process in action is equally critical.
- As you observe, pay attention to the process, the content, and the relationship.
Ask for Change As Appropriate
If, after you’ve reviewed your child’s therapeutic program, asked about his therapist, and observed his therapist in action, you feel the program is inadequate — it’s time to act.
If your therapist is working for you, and you’re paying out of your own pocket, you’re in the driver’s seat. Ask for the changes you want, or ask for a change in therapists. If you don’t get what you feel you need, go back to the BACB (Behavior Analyst Certification Board) website, ask other parents for suggestions, and find a different therapist with the qualities you’re seeking.
Find Help In Improving Your Child’s Therapeutic Experience
If your school can’t or won’t make reasonable changes in your child’s therapeutic program, you may choose to find a consultant who can help you to move forward. Ideally, you’re looking for a trained and experienced behavioral therapist who has and will work with schools and parents. In some cases, school districts may be able and willing to bring in an acceptable consultant of their own; just as often, the parents are the ones to bring a consultant to the table.
“You have to find people who know what they’re doing, not just people who have a degree in behavior analysis or speech or education,” say Partington.
Oversee Your Child’s Program
Once you have an appropriate assessment and a well-trained therapist in place, you can take a deep breath — but you can’t rest on your laurels. The most important aspect of any therapeutic program is progress, and it’s up to the parent to be sure that appropriate progress is being made.
To stay on top of your child’s program, you may need to continue to observe therapy sessions from time to time. Watch to be sure your child is having a positive experience and receiving good emotional engagement.
Know That Your Child Is Never Wrong
It’s important to remember that, when it comes to therapy for children with autism, failure to progress is never the fault of the child. If you hear from a therapist that your child doesn’t progress because of his behaviors, attention span, intelligence level, or stubbornness, it’s time to question the therapist’s technique.
- The view of the behavior analyst should be that the subject is always right. If the child isn’t learning, you need to know why. It’s not that the child is defective, it’s that the approach isn’t working. The therapist needs to ask, “what do I need to do to teach this child?”
…Being autistic shouldn’t stop children from learning. It has nothing to do with their ability to learn. They just don’t learn typically. That’s the problem we have. You can’t use “autism” as way to explain behaviors: it is the behaviors. Why do the behaviors occur? We don’t always know. But that doesn’t mean we can’t teach children with autism language and social interaction. They don’t need us to have fun — they can create their own reinforcers. The therapist has to find a reinforcer that’s better than what the child can do on his own. That “better thing” should always have a social component.