aba

ABA (or "applied behavioural analysis") has taken over our lives.

I won't go into huge detail about what ABA is but, in essence, it is a form of teaching that involves looking at certain behaviours and their context, and applying ABA methods to change that behaviour. A simple example might involve getting a child to sit on a chair. The ABA tutor would give an instruction ("Sit on the chair"), provide prompting (physical or verbal) if necessary and when the desired behaviour occurred, i.e. the child sat on the chair, a reinforcer would be given to the child straight away. This could be anything from edibles, to social praise or a favoured toy. Over time, reinforcers are faded out, desired behaviours are positively reinforced and hopefully occur more often. We all learn certain things like this naturally. ABA just formalises and intensifies the learning.

Our programme is mainly home-based. Blue has three hours of ABA a day at home, excluding weekends. He attends mainstream nursery for four afternoons a week and is shadowed by an ABA tutor for two of those sessions (soon to be upped to all four). He has two wonderful tutors. One, Dell, is experienced and working towards her BCBA certification and the other, Doda, is a novice we trained up - his baby sitter, in fact.

We set up our programme through PEACH after looking at a couple of other organisations, including UK YAP, but we found our experienced tutor on the ABA VB Community notice board. The PEACH consultant sets up the targets and suggests how they might be achieved and the tutors work on those targets with Blue. Our current programme includes everything from verbal imitation to fine motor skills.

The programme has been running for 3 months, though in reality with Christmas, illness and holidays, it's less than that. We've seen the most improvement in speaking. Blue had very limited expressive language before the programme, but now he is much more chatty. His echoics have come on tremendously. He will have a go at saying almost anything. His requesting has improved since the addition of the "Blue wants..." phrase to his repertoire. He tends to only request certain things ("iPad", "up", "help", "blanket" and "juice" are the main ones), so I'm looking forward to seeing an increase in the number of things he will request. His receptive labelling (e.g. pointing out the correct picture when asked "Which one is "duck"?") is excellent. His expressive labels are also good (e.g. giving a correct verbal response when asked "What is it?" and shown a picture of a duck), although a lot of his expressive labels are word approximations.

The other big area of improvement is in general compliance and following direction/instruction. Before the programme started, Blue simply would not to anything you told him to do.

We actually have two consultants. As well as our lovely PEACH consultant (who, it must be said, is overworked), we have a dynamic, firebrand, Norwegian. He had worked with a boy who attended Blue's nursery and achieved great results. We agreed to work with him on a documentary about ABA. I can't say much about the documentary at the moment, but I'll share more later.

Our Norwegian consultant managed to explain to me what the ABA programme is trying to achieve. He explained that neurotypical children learn incidentally during all their waking hours. Autistic children generally do not learn successfully in this way. If a child gets an ASD diagnosis at two years, we need to set about making up for two years of lost time. Personally, I think that's not exactly right. Blue was learning, but he was learning atypical things, like what a hexagon is. Even so, it made me realise that our teaching needs to permeate all our days. That's not to say Blue needs to have ABA from dawn to dusk, just that we need to be constantly on the look out for opportunities for learning. Reading a book is a chance to try out some receptive and expressive labels, playing with Playdoh is a chance to practice some craft imitation and so on.

ABA claims that it is the only research-backed early intervention programme: we take that with a pinch of salt. It is true that the research is out there and reflects positively on the programme, but a lack of research about other methods does not mean they don't work. On a visit to Queensmill School, The Sensible One and I told the Head, Jude Ragan, who we much admire, that we were contemplating an ABA programme. She said "Fine. So long as you do something." I think she is right. ABA is not rocket science and, to coin a further cliche, there is more than one way to skin a cat. The important thing is to look at your child's deficits and think intelligently about how to address them. This may well require the application of some expert knowledge, in the form of books, at the very least, or perhaps a programme like ABA or Early Bird.

There seems to be a lot of misunderstandings about ABA. It's based on the work Dr Lovaas who worked out of UCLA in California. His highly structured programme used "aversives" as well as reinforcers, i.e. shouting, striking, etc. With one controversial exception, aversives are no longer used in Lovaas-type programmes, thank goodness. Some people are also concerned that the programme will eliminate any individuality or creativity in the participant. The latter criticism is why I strongly believe that the programme should be parent-led. You need to make decisions about what behaviour should be targeted and what is harmless. For example, Blue has some mild stims (finger and hand posturing and a quiet verbal stim). I do not see the need in targeting these behaviours because they do not interfere with his, our or anybody else's life. There are other ethical objections related to the neurodiversity movement. I have some sympathy with the movement as I have no doubt that some of Blue's inherent blueness exists because of his autism and I would hate for him to lose that. Again, I think ABA can be used, carefully, to help autistic individuals in certain areas. When Blue has an opinion on these matters, the decision on what help he receives, or not, will be his but, until then, we'll just have to do the best we can.

I don't know how long the programme will run for. In September, Blue is meant to attend nursery full time. We'll have to think about whether he is ready for that, or whether ABA should continue to run alongside nursery for a while longer. Whatever happens, it really feels like ABA has put us back in control.