Sunday, July 26, 2009

Myths about ABA ... What a GREAT therapist should do!

When I tell people what I do, and these people know of ABA, I'm always met with one of two responses.  Half of the people smile and say things like "My son receives ABA and we love it", "Oh my friend's little one gets ABA services" or "Wow, you must love your job".  The other half of the people say things like "Really? Why?", "Don't you feel mean?", or "You really think that works".  When I first started this position, I had first encountered this latter reaction by being given a simple eye-roll by a member of the field not working in ABA.  This obviously made me curious, so I went home to research some anti-ABA material and realized there was TONS of it out there!

I'd like to take this opportunity to dispel a few of the "myths" about ABA I've heard over the years.

1. ABA Workers are Cruel.
This is my least favorite.  We're not cruel, we're consistent and expect quite a bit from your kids.  When all else fails, if you have a GREAT ABA therapist, he or she will ALWAYS follow-through.  
When beginning a program with a new family, we often tell parents that sometimes you may hear your child cry during therapy.  First of all, this is YOUR child so you have every right to check on your child when he or she is crying - however, please do so discretely so your child doesn't see so as not to encourage crying/tantruming when a demand (ie, drill work, sitting at table, following game rules) is being placed on your child.  Any GREAT therapist will encourage you to discretely peek in the room when your child is crying if you feel you need to.  Feel free to talk to your therapist about when they will come ask for your help - for example, I personally call for a parent each and every time a child cries appropriately (ie, fell down).
The reason I say your child may cry during therapy is because often during the first few weeks to months of therapy is when a child will resist the most.  The child is often "testing" the therapist and learning what he or she can get away with and what will gain the attention of the therapist or parents.  Even nonverbal kids know how to stall! Give your kids more credit! In the first few weeks to months, the therapist is trying to establish a understanding and relationship with your child and this can be tough.  However, if you ever truly feel as if your therapist is pushing your child too far - talk to them!  
Just know we truly are trying to help your kids - not TORTURE them!  Please give us a chance! A few years ago, I began working with a three year old boy and he cried A LOT every time we expected him to transition from play to the table.  He would walk on his own to the table and sit, but then cry for at least 5-10mins per transition.  Mom or Dad would peek in (without the little boy knowing) and check on him - as any parent would want to.  After a few weeks, the length of the crying shortened and after a few months it was rarely seen at all.  After working in the house for over a year the mom said to me one day "You know, when you first started I told my husband that our son was loudest and cried the longest when you (compared to the other therapists in the house) were here.  At first, I thought it was because you were a bad match for him.  A year later, I realize that he now has a better relationship with you than the other therapists and you're able to get more out of him.  Thanks for making my son cry."  Maybe worded funny - but it touched me.

2. We teach rote skills.
Yes, sometimes we do teach rote skills BUT this can be for different reasons.  Firstly, we sometimes teach rote skills for safety reasons (ie, the child's address, phone number, mom's name, etc).  Sometimes we teach rote skills for daily living (ie, washing hands).  Many children with ASD learn best when rules or rote instructions are given to them and some of us believe this can come in handy at appropriate times - like safety and daily living skills.  
To understand ABA is to know that we are TEACHING KIDS HOW TO LEARN.  Yes, sometimes we teach the basics in a rote manner, but only to get to more advanced and creative learning later.  You'll see this is most preschools or kindergartens for typical kids.
A GREAT therapist will not teach your kids rote social skills, though.  We obviously don't want children speaking to each other like robots.  We want them to learn how to interact and read others.  But first sometimes we need to figure out how they learn best and sometimes this involves teaching rote skills.  Just know it's used as a means to ends when it is used - it is not the final product.

3. We ONLY do Drills at the Table

No way!  A GREAT therapist should do WAY more than just discrete trial training.  Yes, this is a major part of the therapy, but it certainly isn't the only part.  Your therapist should also be working on social skills, daily living skills, and play skills. Of course, each program differs depending on your child's needs. If you pay attention and you have a GREAT therapist, he or she should be working to generalize skills learned as drills, away from the table. For example, if your child is learning to correctly label (either receptively or expressively) his family in pictures, your therapist should be pointing to mom and dad and either labeling them his or herself of having your child label them.  When your child is away from the table and playing, your therapist should also be away from the table and playing!

4. We Don't Work Well with Others

I've heard that ABA therapists don't get along with Speech Therapists, OTs, DAN doctors, PTs, or classroom teachers.  From a professional aspect, this shouldn't be true EVER.  It is hugely important that the major players in your child's life work cohesively as a team unit.  How silly for your therapist to not be implicating skills being worked on at school while at home!  The best thing anyone can do for your child is help them to generalize skills - the best way to do this is to incorporate the skills in a multitude of settings.  
If the people in your child's life aren't working together - make them! As a parent, don't ever feel you can't speak up!

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