Dad, I need you...

ABA…

I am replying here, rather than privately because this is too important not to share it with the board at large.

When working with the bulk of autistic students (the 50-65% who would fall in the middle range of the bell curve for degree of impact of their autism) the most effective educational method to date for providing meaningful improvements in behaviors, ability to learn, cognition and communication is the Lovaas method of ABA-DTT. It is the only methodology to date which has documented outcome studies with later follow-ups to demonstrate it can work. (If anyone tries to suggest otherwise, ask them to please cite their references).

ABA_DTT is not the only effective method available, Higashi works, TEACCH has some degree of success, and I am sure there are others, but none work as well as ABA, and certainly none work as quickly as ABA. It is for this reason that the NY State Dept. of Health, the PA State Dept. of Health, the MA State Dept of ED and the Surgeon Genral of the US (in his 1999 report on mental health) have all called Lovaas the prescribed method for remediating autism in young children.

here are a few links describing the need for intensive 1:1 for children with autism:

Early Intervention links

http://www.health.state.ny.us/nysdoh/eip/menu.htm

http://cecp.air.org/links/ei.html

http://infocusmagazine.org/1.2/autism.html

ABA is not the most expensive method (both Son-Rise and Higashi are more expensive) and it is not the cheapest method (TEACCH is much cheaper, and cheaper still is dumping these kids in multi-disability rooms without an aide to more or less provide respite for the parents.) A typical ABA program does run about $30K per year, and runs at least 25 hrs/wk intensive 1:1, commonly using paras for the hands on with a paid consultant to keep the program moving by updating periodically, and it will run all year long for 3-5 years.

ABA Consultants

http://rsaffran.tripod.com/consultants.html

When seeking ABA from the districts (I will assume the parents do not have the money tree in their backyard and would just skip the bs and buy their own services privately) it is important NOT to seek ABA strictly by name, and to avoid using words like “best”, “most effective”, etc. We all know the courts have determined the schools do not have to use the Cadillac method, only one which is viewed as appropriate.

So when seeking ABA, a much better route is to ask for a method whuich has a documented positive outcome effect. It is much harder to be denied when only ABA has the documentation to back it up. In absence of documentation, other methods become reduced to “effective in the opinions of those who are practitioners”.

For a complete “primer” on how to put parents’ back in their place see:

http://www.iqonline.net/murphy/bradley/how_to_avoid.htm

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In addition to ABA, the child will also need OT to work on tactile issues and motor skills (optimum 3 hrs/wk+) and at some point ST as well (optimum 3 hrs/wk+). After some of the worst of the isolationary behaviors have been reduced, integrated play time in a structured environment is also needed to begin teaching the child how to interact appropriately and effectively with peers. (Besides, even the little odd flappers like to have fun and respond to being with people their own size…)

If their is one single factor that overrides all else, it will be the belief in the minds and hearts of all the adults involved that the child IS worth the effort needed to remediate, that the child CAN be reached, and that any and all expenditure given to the child is because the child IS worthy of it. If these core assumptions are not present, no program stands a chance, and you might as well stasrt shopping for a group home or institution for the child now.

We all know the cruel reality that a percentage of these children will not progress regardless of our efforts. That doesn’t mean we should not try. Last fall I posted a story of an autistic girl with a 19 IQ who went on to graduate with honours after one teacher found the way to teach her how to type and found that tho she may never speak, she could learn academic material. We have no way of knowing which autistic child is going to fail regardless, and so we must try to reach them all.

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For higher functioning autistic children:

Microsoft Research and the Seattle university’s Autism Center have developed a program called KidTalk that aims to teach much-needed social skills online. A pilot-test program begins in about a month.

KidTalk looks much like a typical computer chat room, with lines of text from different participants running down one side of the screen and smiley-face icons representing the participants on the other. But instead of just letting the kids chat, the program presents them with a script for social interaction, such as a birthday party, and asks them to perform specific social tasks.

Kids who participate well are rewarded with points and smiling faces. Those who don’t chat or chat too much will see their oversized face icon move away from the group.

A therapist moderates the session and can send messages to the participants privately, offering tips and rewards.

http://seattletimes.nwsource.com/html/localnews/134418400_asperger11m.html

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Finally, bio-remediation needs to be looked into seriously. Many autistic children imprve dramatically using the elimination GFCF Diet. ( see www.gfcfdiet.com ). Others respond to the Feingold Diet ( see www.feingold.org ). Neither is easy, convenient or cheap. Both must be adhered to 100% faithfully if they are going to work.

Many autistic children have elevated levels of toxic metals (my boy was one). This can be tested for and treated using DMSA chelation. (see the yahoo group autism-mercury or recoveredkids ).

Most important, these children need acceptance of who they are. They need their parents demonstrated unconditional love so they can avoid the stress associated with being rejected. They may be autistic for life, but they still have the human need for physical affection and the compassion that goes with being a child. Hug these children often and firmly so they can know that they are worthy people and that someone cares about them.

I do not believe that the depression and Bi-polar that is noted in many teens and adults with autism is a true co-morbid of the Spectrum disorder. I believe it is the result of a lifetime of rejection and abusive trewatment by those individuals around these people who could not look past the stereotypical behaviors and social isolationary barriers and see them for what they truly are, a human being. Think about your own selves, and how your emotional health would be if your entire life all you got was negative feedback.

I hope this has been helpful socks. Good luck to you.

Okay Dad, questions and humble opinions.
I so agree with your last comments in regards to emotional problems. I am a nurse in a group home a large chunk of our clients,are Autistic or have autistic tendencies,they are again misclassified,because if they were anything but MR,they would not qualify for placement in the home. It is a very good placement,(in my humble opinion:-) but the emotional needs are all but forgotten,by vurtue of the placement and medicaid reimbursement. Not to mention the communication needs of a nonverbal client.

Anyway,getting back to my little 4 year old. FBA done,stating there were not 6
delta’s,therefore no aide,or therapy for behavior. It was not done with a CBA so an Independent is being pursued.
Varying exceptionalities is the name of the placement,OT once a week,of course the district is probably not addressing sensory needs,this little guy also has motor difficulites. I remember right off the top of my head ABA,by reading your posts,but we are not there yet,still trying to get good evals. I also instinctivly knew not to say the name,but to describe it,how do you do this?
Kid appears very smart also. will be getting IQ testing done again. Can tell you what make model and year car you drive,but not your name. Very good in technological info.,Math.