Applied Behavioral Analysis (ABA)

So what is Applied Behavioral Analysis?  First of all, explore behavioral psychology. What?  You don’t have time to research all the different psychological methods?  You only took psych 101 and that was forever ago and with a few hangovers?  Oh..well…in that case.  Basically, behaviorism is a theory that all behaviors can be conditioned.  Basically, Pavlov’s dog.  You combine a stimulus and response (if you ever took any level of psychology in high school or college, this should sound vaguely familiar to you).

So Applied Behavioral Analysis….it is a therapeutic style that, in it’s classic form, sounds absolutely awful and completely unrealistic:

In it’s classic form, which we learned about in the various heavy, thick, and expensive text books our Behavioral Psychologist told us we simply HAD to have, a child is to be in a room that has absolutely nothing in it but a table and a chair.  The child and a “therapist” will sit in the room with the “therapist” saying “do this” or “touch this” in order to get a desired response.  Then the child is rewarded with a treat.  It is very much like dog training.  Yeah…we’re not interested.  So we waited.  In the meantime, we had started speech therapy (you know, sent from God…) and school and things seemed to be improving.  I started to research other therapy techniques and methods.  Let me just say there are some CRAZY ASS (Oprah TM) things going on out there….and I’ll leave it at that. There are also some very interesting things going on out there.  I read about Stanley Greenspan and Floortime.  Floortime, while another type of behavioral therapy, is in stark contrast to ABA, in that it involves the parent and/or “therapist” to get right down on the floor with the child and engage them.  So…rather than training them to do what you want, without having any idea if they KNOW what they’re doing or are just being conditioned to respond, you are getting into the child (who is by definition disconnected) and pulling that child out of autism.

Naturally, I thought this idea was genius.  If the number one thing is a disconnect from people and the inability to properly play with toys, why would you NOT force yourself onto the floor, into her world, and SHOW her how to play?  What’s that?  You don’t know what I mean by “properly play with toys?” Well, I don’t know what it’s like at your house, with your neurotypical children, but if you were to come to my house, you would find toys lined up in perfect rows.  Everywhere.

Not only that (and yes, that is 48 penguins sorted by type), she tends to sit on the floor in a pile of, let’s say, stuffed animals…which she will then throw at, well, herself, over and over again.  Or she will memorize a book/tv show/movie and act it out with her toys.  This sounds 100% “normal,” right?  Except for when she either finds a line that she REALLY likes or can’t remember the next line.  Then it’s like she is Grandma’s old Victrola and the damn needle is stuck.  Yeah that’s not normal…  But that is what I mean by “appropriate play.”  So I tried to use some Floortime techniques on my own.  Naturally, Sophia doesn’t take to change well.  One of her favorite phrases is “go back to the chair” when you try to play with her (if she acknowledge you at all.  In the early days she just got up and moved or threw a tantrum).  I then looked for Floortime consultants to administer the technique/therapy/program in our home.  YAY!  There’s one relatively close to Columbus….and this, of course, isn’t covered by insurance….or the Board of Developmental Disabilities….this would be 100% out of pocket.  Moving right along….
So right around March, we started to see some “behavioral changes.”  I immediately called the Behavioral Psychologist on our case to seek advice.  Straight to voicemail.  So I then consulted my BODD caseworker for Behavioral Psychologists covered by the County, and found one that immediately set up a consultation with an in-home behavioral consultant.  Now, the doctor was flat-out a jackass, and I was pretty much hesitant to even consider working with him in the first place.  His first suggestion, without ever meeting my child, in a phone conversation, was to medicate her for ADHD, because the problems I was describing could not be dealt with through ABA alone.  Never once met her.  But I figured the county was paying for the consultation, so I’d give it a shot.  Now, I should mention ALL of the reasons why we decided to pass on ABA right from the get-go.  Not only do you have to have a psychologist and a program consultant, you also have to hire several “therapists,” trained by your consultant, to work in-house.  If you remember, it was suggested that we take the $20,000 Autism Scholarship from the State of Ohio and just do a 40-hour/week in-home ABA program.  Now, I realize that math is BY FAR my worst subject (I fully subscribe to the notion that I am a musician and counting much past 4 is pointless), but I’m quite certain that $20,000 is not going to last very long when you are paying a psychologist, behavioral consultant, and 3-4 in-home therapists.  Now, though, we are facing a situation where the consultant and psychologist are paid by the county.  All we have to do is find some in-home therapists…which can be family members, friends, anybody.  Did you know that Ohio State students majoring in Special Ed have to accumulate so many volunteer hours before they can apply for their major?  Weird….
But, none of this could be decided because I don’t like the doctor, and if I don’t like the doctor, chances are I won’t like the consultant. I don’t even know if I like ABA, but when faced with 9 psychologists at Children’s Center for Autism Spectrum Disorders for a behavioral consult, 3 different people were able to engage her through 1:1 ABA techniques.  So the consultant schedules her visit…
We started talking, and she gathered information about what Sophia is like, how she handles things, etc.  She reviewed her diagnosis, it’s recommendations, her IEP, etc; and scheduled her first meeting with Sophia.  So I asked the difficult question: “Should I clear out a room or something?”  She looked at me, then said, “well…that is the traditional format, but in my opinion, that’s not the way the world works, so that’s not how I work.”  BINGO.  I was in love.  Instead of the traditional “dog training” approach, her approach is more like this:
A combination of floortime and ABA.  One of the short-comings of ABA Therapy is that a child will “master” a skill in the stripped-down, unrealistic, and plain setting, then not have the ability to carry it on in the “real world,” which is loud, busy, and chaotic.  She teaches skills in multiple settings with real world scenarios.  She uses the child’s natural reinforcements as rewards.  For Sophia, this means she is rewarded for doing a good job by basically doing whatever she wants, be it play with her penguins, dance to music, read a book, watch a show, eat a snack…whatever it is that she wants to do, that is her motivation.  When you think about it, this is how the real world works.  “Gosh, I’d really like to watch Survivor but this place is a mess.  If I clean up the living room, I can sit and watch Survivor without feeling guilty.”  BAM!  Success.

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