In a seminal article in the Harvard Business Review, Peter Drucker wrote about the different ways individuals learn. Not just learning in structured environment like a school, but also learning in a professional and social environment. Some are readers, others learn when they discuss, talk or listen.
Sometimes I wonder how the autistic children learn. What is the best way to get across life skills and other education, including formal education, across to them. That is truly one of the major exploration areas in the search for therapy and treatment of autism.
Based on our experience with Adi, learning for autistic children is hard but not impossible. It requires patience, lot of initiative on behalf of parents and lot of practice and rework. Be prepared for a journey with stops, delays, frustration but also some wonderful happy surprises ! In some ways, the journey is the process. And sometimes, it takes a lot to sustain the spirits - for progress is incremental and slow. There are no magic pills here.
And it depends as much on the instructor as anyone else.In the initial stage, when he was 3 and diagnosed with severe autism, we were very lucky to have a young, enthusiastic lady as his home therapist - who had the basic command of ABA and was also a teaching aide in his early intervention program and was also working towards her Masters degree in Special ED. She loved Adi and created a wonderful program for him - filled with lots of fun, play, trampoline, treats and songs and through these media - learning. Among early successes - learning to point, speaking his own name, calling us out as Ma and Baba, learning to eat at the table and learning his home phone number. Learning to wash hands, do potty in the bathroom(from the kids training potty) and eat with spoon and fork. It required significant patience, he would cry, yell, have repeated breakdowns - but she persevered. Later I would realize - this was her innovative way of combining ABA with Playtime and many other ways of therapy. And slowly the rays of the sun started to peek through the clouds. An early start wth the right therapist is therefore critical. We had about 10 hours of home therapy per week during that initial period on top of full day early intervention program in school. It was invaluable - the home therapy focused on development of language and social skills.
One other thing we learned - learning for him is not a continuing ramp up. There are periods of plateaus and there is regression if the follow up is not maintained. We evidenced real regression during the summer vacation months and from then on, have always requested for extended year programs where ABA practices are continued.
Sometimes, specific therapies and interventions were required to achieve specific objectives. Adi initially had serious issues with food - he would not eat most things and everything that he would eat had to be mashed so that he could swallow. For several months, I took him to a private therapy where they basically taught him how to chew and eat. My wife gave him specific foods like vegetables and other chewy items like pasta etc. It took time - but soon his food options had started to increase. The therapist used to place the food right near the molars and physically, gently prompt movement of the jaws.
An example of an undesirable behavior was constant raiding of the refrigerator in search of goodies. At substantial cost, we did several months of private therapy at specific intervals to take care of this undesirable behavior. The way - replace an undesirable behavior with a liked desirable behavior.
As I mentioned above, the journey is often the process. And it pays to be alert as much as possible during the journey. During the early intervention program, we quickly learned that Adi loved music. Specially the Hindi Movie catchy dance music videos. So we started creating a library for him and put it into the iPad and iPhone. It has proved to be a real life saver on numerous occasions - where we were free to engage in social conversations and other activities like shopping while he busied himself with his songs. And that in turn, made him like the iPad immensely. Here was something he could relate to - his friend, somewhat with whom he could spend time. Now when we thinks of ice cream - he does not raid the freezer (for most of the time), he goes to google>types in ice cream> Images. He loves water - so will check out music videos involving rain and be happy seeing people getting drenched. And will remember the words swimming, water, rain - for they help him to visualize what he likes. And we, in turn, realize that here is something that we were desperately looking for - a way for him to spend time when not in a educational or learning environment, almost like with a friend who understands his need. And today, when I see him play Temple Run 2 and run up scores in excess of 50000, I know how fast his mind is working to achieve that. So here is what we learned - if he likes something which is not destructive, use that like to further learning objectives. Teach him how to operate an iPad to see videos of water, pictures of ice cream and so on. He will lap it up. He loves water - encourage him to take up swimming starting with treading water.
And never take anything for granted. Don't generalize. Adi hates it if a drop of water lands on his dress - but the same boy just loves jumping into the pool or the lake or the sea and will spend hours wetting his whole body, pants and so on. Why? I don't know completely - maybe it is because he does not like his dress to get wet. But it is not hydrophobia in any way as I have indicated his total love for water. And after we practiced and practiced long enough, the same love for water translated to an acquired skill for swimming in deep water and staying afloat on his back !
Sometimes I wonder how the autistic children learn. What is the best way to get across life skills and other education, including formal education, across to them. That is truly one of the major exploration areas in the search for therapy and treatment of autism.
Based on our experience with Adi, learning for autistic children is hard but not impossible. It requires patience, lot of initiative on behalf of parents and lot of practice and rework. Be prepared for a journey with stops, delays, frustration but also some wonderful happy surprises ! In some ways, the journey is the process. And sometimes, it takes a lot to sustain the spirits - for progress is incremental and slow. There are no magic pills here.
And it depends as much on the instructor as anyone else.In the initial stage, when he was 3 and diagnosed with severe autism, we were very lucky to have a young, enthusiastic lady as his home therapist - who had the basic command of ABA and was also a teaching aide in his early intervention program and was also working towards her Masters degree in Special ED. She loved Adi and created a wonderful program for him - filled with lots of fun, play, trampoline, treats and songs and through these media - learning. Among early successes - learning to point, speaking his own name, calling us out as Ma and Baba, learning to eat at the table and learning his home phone number. Learning to wash hands, do potty in the bathroom(from the kids training potty) and eat with spoon and fork. It required significant patience, he would cry, yell, have repeated breakdowns - but she persevered. Later I would realize - this was her innovative way of combining ABA with Playtime and many other ways of therapy. And slowly the rays of the sun started to peek through the clouds. An early start wth the right therapist is therefore critical. We had about 10 hours of home therapy per week during that initial period on top of full day early intervention program in school. It was invaluable - the home therapy focused on development of language and social skills.
One other thing we learned - learning for him is not a continuing ramp up. There are periods of plateaus and there is regression if the follow up is not maintained. We evidenced real regression during the summer vacation months and from then on, have always requested for extended year programs where ABA practices are continued.
Sometimes, specific therapies and interventions were required to achieve specific objectives. Adi initially had serious issues with food - he would not eat most things and everything that he would eat had to be mashed so that he could swallow. For several months, I took him to a private therapy where they basically taught him how to chew and eat. My wife gave him specific foods like vegetables and other chewy items like pasta etc. It took time - but soon his food options had started to increase. The therapist used to place the food right near the molars and physically, gently prompt movement of the jaws.
An example of an undesirable behavior was constant raiding of the refrigerator in search of goodies. At substantial cost, we did several months of private therapy at specific intervals to take care of this undesirable behavior. The way - replace an undesirable behavior with a liked desirable behavior.
As I mentioned above, the journey is often the process. And it pays to be alert as much as possible during the journey. During the early intervention program, we quickly learned that Adi loved music. Specially the Hindi Movie catchy dance music videos. So we started creating a library for him and put it into the iPad and iPhone. It has proved to be a real life saver on numerous occasions - where we were free to engage in social conversations and other activities like shopping while he busied himself with his songs. And that in turn, made him like the iPad immensely. Here was something he could relate to - his friend, somewhat with whom he could spend time. Now when we thinks of ice cream - he does not raid the freezer (for most of the time), he goes to google>types in ice cream> Images. He loves water - so will check out music videos involving rain and be happy seeing people getting drenched. And will remember the words swimming, water, rain - for they help him to visualize what he likes. And we, in turn, realize that here is something that we were desperately looking for - a way for him to spend time when not in a educational or learning environment, almost like with a friend who understands his need. And today, when I see him play Temple Run 2 and run up scores in excess of 50000, I know how fast his mind is working to achieve that. So here is what we learned - if he likes something which is not destructive, use that like to further learning objectives. Teach him how to operate an iPad to see videos of water, pictures of ice cream and so on. He will lap it up. He loves water - encourage him to take up swimming starting with treading water.
And never take anything for granted. Don't generalize. Adi hates it if a drop of water lands on his dress - but the same boy just loves jumping into the pool or the lake or the sea and will spend hours wetting his whole body, pants and so on. Why? I don't know completely - maybe it is because he does not like his dress to get wet. But it is not hydrophobia in any way as I have indicated his total love for water. And after we practiced and practiced long enough, the same love for water translated to an acquired skill for swimming in deep water and staying afloat on his back !
Hi,
ReplyDeleteI needed your advise to help me make the right decision. We are caught up between Centerbased ABA vs Home Based. Some argue that center based is good since it will give exposure to other kids to socialize. Some say there is a danger of imitation from other kids. And some also say that home based is very stressful and not creative. Please provide your input.
ABA is one of the foundation treatment streams for Autism. The location of imparting ABA should be such that maximum benefit can be derived by your child from it. In the case of Adi, he had a major challenge in functioning in social environment. We believed that during the foundation years, it would be too much for him to absorb both ABA and also the nuances of a social environment. Plus ABA is instruction based therapy - sometimes a class based environment with many people would be extremely distracting and upsetting for the child and she/he may be unable to focus on the instruction based ABA. If the instruction is being imparted on 1:1 basis by an instructor within a center - it is better for such a child. And as far as home based therapy not being creative- it is dependent on how you set up the therapy room. We had, for example, a room with a trampoline, rolling mat, activity toys, learning desk and a music system. It allowed lot of creative ways to reward Adi for desired response as well as giving him "breaks" which such children need very often while they learn.
DeleteThank you for your valuable input. The problem with my son is that he has never been to a pre-school or day care. Hence the regional center is suggesting us to go for a center based ABA where they will have 1:1 for an hour and half in the morning followed by a snack break, circle time, out door play and lunch. As parents we thought home based ABA will be best for our son as he will get more 1 : 1 and natural environment will be best for him. So we finally have decided to go with Home based and the regional center send us a therapist yesterday. Since my son doesn't have Autism diagnosis Insurance has denied to fund ABA services and after a lot of struggle Regional center has agreed to fund his ABA. After a lot of documentation RC have decided to send a therapist home starting this week. Since i take my son to 'mommy and me' classes at City center i asked the therapist to come to the class so she can observe him on her first day. She came in inappropriate clothes with tattoos all over, the minute she entered the room the whole room smelled like cigarette. She clearly didn't have any ABA experience or related education. I badly want to tell the RC that i don't want her in my house but its going to be a whole new ordeal to get another approval to change the therapist. Now i can either send him to Center based ABA or stick with this tatto / smoking therapist or go through another ordeal of requesting for a new therapist, keeping in mind that i only have few more months before he turns 3 when the early intervention services end.
ReplyDeleteHi Happymom!
DeleteAs a parent of a child with Autism and a professional working in the field, I wanted to share some of my thoughts with you.
A couple of points stood out to me. You’ve mentioned that your child doesn’t have a diagnosis of Autism and that early intervention services would end soon. You would need to focus and start working on the biggest areas of challenge. Speech? Social interactions? Peer interactions? Stim behaviors? Zero it in.
Set yourself a goal and share with your therapist. Obviously you won’t “fix” anything in a few months as intervention is a process, not a treatment. Be prepared to supplement with private therapies once the services end from your center.
ABA is a huge umbrella. Be wary of professionals saying “We do ABA”. They don’t simply because there’s nothing to “do”! They may use some ABA techniques for intervention – nothing else. Be aware of the techniques used – verbal behavior, NET, Token economy.
1-1 therapy is not for everyone. Whether or not you should have an unqualified chimney or a qualified therapist (?) imparting a group based instruction completely depends on what areas you need to work most on. Time is valuable – I wouldn’t want to waste it on someone who is not qualified to do the job. If your goal is to get your child school ready – in a typical K class, then that group intervention is the right place. It has to be a small group- max 4 kids.
Good Luck! Hope it helps!!
Thank you 'Yes Bee'!! My sons biggest problems are Behavior and Sensory issues. His speech is delayed but it seems to get better with one month in to Speech therapy. His OT sessions have just started last week and i am hoping his sensory issues will be taken care by the OT Therapist.
DeleteHis main problem is behavior, very low sitting span , trouble sitting still, always running and jumping around, aggressive behavior , hitting others and hitting sibling and throwing tantrums. As you might see most of them are common for every 2 year old only problem is the intensity is more than any normal child.
I am not sure what ABA techniques they are using, i will check with the ABA firm. After writing my previous comment i escalated the issue to the Dir of the ABA firm and he promised me that he will look into it. He checked with the therapist and she said that she doesn't smoke but her husband does. So i thought of giving her few more weeks to see how my son is responding to her.
It has been a roller coaster ride so far , I was hoping ABA will do some magic with his behavior. I also requested them to give us parent training. I couldn't agree more with your comment ' Time is Valuable '. So i will give them few weeks and will shift him to group therapy as soon as they have a spot open. My goal is to get him ready for Pre-school when he turns 3.
Thank you for taking time to provide all your valuable input.
This comment has been removed by the author.
ReplyDeleteA very good article.
ReplyDeleteparenting.blogs.nytimes.com/2013/10/20/a-child-with-autism-becomes-a-teenager-with-expectations/?_r=0
Hi, I am reading your blog for the first time and so glad to find it.
ReplyDeleteI read on your previous posts a couple of years back that you were looking for a communication App for Adi.
Have you found one? Otherwise I wanted to suggested this brilliant Indian Augmentative and Alternative Communication App called AVAZ available on App stone and Play store http://www.avazapp.com/
Looking forward to reading more
Just beautiful : http://shine.yahoo.com/photos/father-capture-s-autistic-son-s-inner-world-with-stunning-photos-1384542156-slideshow/archibald3-photo-1384540814591.html
ReplyDeleteNice article. Really enjoyed
ReplyDeleteChildren's behavioral therapy