Thread: Help for son with HFA

mlwear, I split your topic off in hopes that it would get more attention.

For others -- this came off the ABA VS TEACCH thread!

Bitsy

First off, congratulations that your son is doing well. I assume that when you talk about a “peg board” you actually mean a “PECS board” [url="http://www.difflearn.com/products.asp?dept=23"]http://www.difflearn.com/products.asp?dept=23[/url]. The PECS system is actually an ABA tool, and there is no problem continuing that aspect, though even the developers of PECS believe (or at least used to believe) that the tool should be phased out over time.

As much of this thread proves, many people are on one side of the fence or the other with ABA or TEACCH. Every professional who knows my son has said that an intense ABA program would not be good for him because of his anxiety/frustration issues. My son's IEP does specify elements unique to TEACCH. I'm not going to say ABA doesn't work or shouldn't be used, but I hope the teacher is as open-mined about TEACCH. I hope he can somehow blend the two or at least be willing.

Whether your new teacher is open-minded about TEACCH is off cause something you will have to discuss. ABA as such should not rule out any use of TEACCH tools, as the premise of the system is “trial and error”, and any tool that works on objective criteria can be used. I would expect the teacher to be happy about tools that work, but I would also expect that a focus area should be to reduce your sons reliance on a defined structure, and gradually work to reduce anxiety and compulsions when his routine is changed.

When you say, “Every professional who knows my son has said that an intense ABA program would not be good for him because of his anxiety/frustration issues”, I assume that these professionals are TEACCH schooled professionals.

It is important that your teacher understands that the last A in ABA stands for analysis, and that the program is not primarily about behavior modification. If your program is run like a “real” ABA project you will be equal partners with the teacher and adjust focus areas and goals on a weekly or bi-weekly basis. It is important that ambitious yet realistic goals are set for your son – ie. that he does better in a week than today.

What an ABA trained person should bring you is a solid analytical basis that will accentuate you goals/IEPs. They should teach you how to work with your son, and show you exactly how they work with him.

When your son is high functioning, he should spend proportionally little time in a DTT setting and more time in natural learning environments.

With regards to new teaching methods, you should really just tell the new teacher about your fears and have them respond firsthand as your totally rational fears might disappear after the meeting. If the teacher is good you will likely be very relieved after the meeting.

My goal is to be sure he understands it is important to keep most TEACCH elements for my son even if he doesn't believe in that method and keep as many things the same as last year (same cubby, same unpack and pack routine, same snack routine, etc. I also want him with one of his aides from last year.

I think that it is also very important that you keep an open mind. You are 5-6 years into a program that still leaves you with a son that is very rigid, and I assume that your daily routines are centered around him. One high probability result is that your son could become significantly more flexible as a result of the ABA programming. That I think would make yours and his life significantly easier to live.

At the end of the day, you are your son’s champion, and I think that you are on the right track. You need to ensure that the programming is appropriate, and I will strongly recommend that you read the book “Let Me Hear Your Voice” by Catherine Maurice [url="http://www.amazon.com/gp/product/0449906647/102-6771318-5848135?v=glance&n=283155"]http://www.amazon.com/gp/product/044990 ... e&n=283155[/url] as it will give you great insight.

Thank you so much for your response. I already feel more at ease and think a good compromise is probable.
Actually, I do mean a peg board. Perhaps this is something my son's teacher developed on her own? My son ALSO has a PECS "board", it is a folder with his daily routine that he checks off as he goes through the day. The peg board is a piece of rubbery foam with 9 holes in it glued to a thin wooden board. Each time he finishes a task he inserts a peg into a hole When all nine holes are filled he gets his reward that he decided on earlier in the day. At the top of the board it says "Today I am working for..." and he starts his day by choosing one of the 8 rewards the teacher has velcroed to the back and velcros his selection to finish the "working for" sentence. The rewards are things like 10 minutes of videos, play with blocks, fruit snacks, draw with markers, etc. I don't know which method this falls under. :?
Anyway, I do understand what you mean about breaking the habit of relying so heavily on routine. It definitely would make life easier as you are absolutely correct that much is centered around him and his routine. I guess after years of tantrums and self-injurious behaviors and the like finding that following a strict routine eliminated those behaviors it seemed easier/better to conform to the routine. Of course, we aren't robots and do have some life but have to prepare him for changes and I don't think I need to go on as most reading know what I'm talking about.
As far as professionals having concern over intense ABA, actually some are TEACCH educated and some are more on the ABA side of the fence. In particular his neuropsychologist usually favors ABA but also sees value in TEACCH, I think it is the "intense" part that is most concerning. I think all of us are open to some ABA elements (I imagine some are already being used), but have seen what sudden change causes and have concerns that too much stress will cause him to regress.
Since we have been using primarily TEACCH, I certainly don't claim to understand ABA completely. I've read some, including Let Me Hear Your Voice, have gone to a couple of lectures and talked with friends who favor ABA. This is a concern I have, though, and I don't know whether or not it is well founded. My son is highly (HIGHLY) motivated to please his teachers and do things correctly. Of course, he doesn't get his school work perfect, but it is handled in a way that is very gentle. He doesn't get away with doing things incorrectly, but he is told to "fix it" or "try this one again". It might get to the point that a different method is used or it is put aside. If anyone told him anything like "you didn't do this correctly" or "no, that is wrong", he would obsess abouit it for months and this would lead to regression. For example, in reg. ed. he was working on a paper and after so many "fix it's" he had a lot of erasure marks, so many that the paper I suppose was beyond hope. His aide said "let's start a new one" , she then crumpled up his paper and threw it in the trash. She didn't mean any harm. It was just as anyone would discard a paper to start over. But, oh my, I am told he cried at the time. This was six months ago and he still talks about it. The first three months almost every day. Now it is about once a week. I've tried to work with him, the school has worked with him, his psychologist has worked with him, but it is like he has post traumatic stress disorder or something. Again I ramble--but when I think of ABA, I think of him continually being told no while working on a task until he gets it correct and then getting his reward. As I write it, I realize this is a bit neurotic and that the teacher could still use a gentle approach. I know that aversions were used in the past, but now read that they have been discontinued. But, I have been at friends' homes when their child was working wth the ABA instructor in the "classroom". The child is yelling and crying and the parent later tells me that the protesting would last for hours but after a few days the child complied. Sigh. It just left me with a bad impression. I saw this with two seperate children. I just don't think it is right to treat anyone like that. I think I really just want someone to tell me that this is not the norm. I don't want anyone to take that as a slam against ABA (I don't know if I how feel is being conveyed correctly in a written form), but am truly professing my ignorance about the way things are done.
Jens, I am very grateful for your reply. It is very important to me to approach the new teacher in a way that expresses my concerns but doesn't get the year off to a bad start and you have given me some ideas as to how to accomplish this.

Originally Posted by mlwear

My son is highly (HIGHLY) motivated to please his teachers and do things correctly.

This is a very important aspect to keep in mind. Because your son is highly motivated it should be very easy for the teacher to use a gentle approach. The social enforcers (praise/contact) will also be very effective in situations where you try to increase his acceptance of stress.

One year ago my son, for example, had an extremely hard time when he did something wrong and was told to correct his behaviour. He could not understand that we could be upset with his actions, but still love him. We repeatily told him that we loved him but that we wanted him to stop screaming, eat his food... We gradually approached normal communication with him about things he does wrong, and we are now in a situation where we don't have that problem anymore.

Ron Leaf - one of the leading ABA authors - suggests a stress hirachy, where you gradually work your way up the ladder. It might be that your son is extremely particular about his eating habbits, but less so about whether he wears one pair of shoes or another. Then you might try to give him his blue shoes when he expects his brown ones.

An ABA teacher does not have to tell your son no/wrong etc. if other things work better. Everything done should have a positive purpose.

Everything is about taking steps that are small enough that they are not counter productive and big enough to matter.

The professional and human qualities of the people involved with your son are essential and cannot be judged by anyone outside your intimate circle. With regards to making progress or regressing, it is very important that the school is diligent about teaching you to log data for behaviour, so you are 100% on top of what improves and what doesn't.

I hope that you and your son will experience a positive development, and that you will post back as things develop.

Good luck and best regards
Jens

I have a few thoughts.

First, I want to applaud you for your desire to already be planning for your childs future. I think that is something great.

Even though as I teacher I have my favorite base method, I think that it is great that others are looking at the child's needs and what can be done to help the child.

I think that you are getting some really good advice here. As a teacher, if a mother comes to me with concerns about the changes in the teaching methods, my response can depend on how the parent approaches me. Just remember to ask a lot of questions from the teacher and see what they have in mind. Don't forget to share as much information as you can with the teacher about your child including what does/doesn't work, likes/dislikes, and basically everything that you can think of. I'd share this verbally as well as written because sometimes a good teacher will keep notes and will like to have a "file" on their students as well.

Always remember that so much depends on the teacher and not just the "method". A good example of this is my mother-in-law. She recently retired as a K-1 Teacher in a normal classroom. About 15 years ago she was given a high-functioning autistic child and she was provided with no training or even an aid to help her. At the point where she provided her letter of resignation, they agreed to give her a part-time aid and "some training". This training was considered by the city, county, and state as being sufficient, even though it took up a grand total of 4 hours on Saturday morning.

It came to a point where the presenter was presenting a lot of theories and she began tapping her pencil on the table for 30 straight minutes. When the presenter got mad and yelled at her to stop (she had asked her several times already) my mother-in-law said "no. I will stop when you provide me with some answers and real ideas on what I can do."

She devoted hours upon hours, days upon days, and literally months upon months working with this child. A lot of sweat and tears were traded for hours of sleep and in the end, the child was able to work within the classroom as much as could be expected. As a side-note, the child has now finished High-School.

The point is that it is the devotion and the desire of the teacher that makes or breaks the experience. Stay as close with the new teacher as possible and do all that you can to help him. With a concerned parent like yourself, I'm sure it will be a good year.

Good Luck.

I just found a link to an old BBC production on ABA and autism (2000), that I believe is worth seing.

[url="http://news.bbc.co.uk/media/video/38225000/rm/_38225090_autism1130_newsnight_vi.ram"]http://news.bbc.co.uk/media/video/38225 ... ght_vi.ram[/url]

As I saw it (the hidden camera scene) and reflected over your concerns, I thought that the most important thing for you to learn from the teacher is how he deals with a situation if your son does not respond to treatment.

What I have heard from therapists is that they get "kind of a fix" (bad choice of words probably, anyway) from seeing the kids aquire new skills and make progress, and that it is hard when things are not developing.

My reaction from that hidden camera clip was; What a jerk! How can you loose your patience like that? Upon reflection, however, I don't know what the child did, how long the process had been, whether this was the result of working for months without results...

I personally don't see that you should be worried about ABA, but I do see that you need to worry about what if scenarios.

KR Jens

Originally Posted by Jens Agerskov

IAs I saw it (the hidden camera scene) and reflected over your concerns, I thought that the most important thing for you to learn from the teacher is how he deals with a situation if your son does not respond to treatment.

What I have heard from therapists is that they get "kind of a fix" (bad choice of words probably, anyway) from seeing the kids aquire new skills and make progress, and that it is hard when things are not developing.

My reaction from that hidden camera clip was; What a jerk! How can you loose your patience like that? Upon reflection, however, I don't know what the child did, how long the process had been, whether this was the result of working for months without results...

KR Jens

The hidden camera clips demonstrates my worst fear. Knowing my child and how it would affect him, if something like that ever happened to him, I would THEN become a lunatic parent.

The video does bring out some interesting points. The socialization is what stands out most to me. But, I don't think there is any way that the school will apopt the full on one to one fourty hours a week approach. They don't have the staff and it would have to be deemed needed in an IEP meeting. Plus, it would violate least restrictive environment. With my son's current TEACCH-like method he is in his least restrictive enviroment. He is in reg. ed. with aide support most of the day. He is in the sp. ed. classroom 1 hour for language arts, 1 hour for math and about 20 minutes for social skills (often they bring in typical peers during social skills). Of course, in reg. ed. he is with an aide, but she doesn't hover over him. He does require much redirection, though. The more I try to study this topic, it seems that a lot of the programs in the public schools claim to be either TEACCH or ABA driven, but they are indeed a combination of the two. I need to strike the right balance with a new teacher.

Your are totally right that in a class room you cannot have 1:1 training of all kids simultanious. Having a HFA you would never spend 40 hours in one to one. Lovaas comment has to be seen from the perspective that he was confronted with the claim that 40 hours was to much, and the statement that ASD kids do not benefit from social interaction was to me aimed at kids that are far from normal functioning.

One of the corner stones of ABA is integration in normal environments, which is startet much earlier than in other methods. Any basic skill goes through 1:1 with teacher, 1:1 with different person/child, 1:many in normal environments.

I beleive that your son will be in a firmly eclectic environment with at TEACCH program director and an ABA therapist

Today was the meeting. There were a few other unexpected issues to resolve that took precedent. One, my son's IEP explicitly states that he is to have a 1:1 aide in reg. ed. and they had scheduled him to share an aide with another student :x . I just have to hope that the admin. will do what they said and the issue will be resolved...but on to the ABA blended with topic...the teacher seems to understand some TEACCH practices will need to be incorporated and will do that, but he was clear that he is trying to move toward an ABA approach. I cautioned him about making the transition too quickly. The autism resource person suggested he could go to a TEACCH training workshop. He nodded, but didn't seem overly excited about it. I got the impression that he has a plan in mind and is going to go that route but will follow the IEP and the guidance of the autism specialist and his mentor. He is very pleasant, but my read on him is that he is a strong believer in ABA and thinks my son will progress more. Of course, I love to see my son progress and I will keep an open miind. I will also keep my eyes open, though, as I have to be sure that the right things are done for my son. I hope he can keep an open mind about TEACCH having elements that are beneficial. Time will tell.
Again, not trying to bash ABA, but the new teacher said that he is very big on data collection and will be recording all the ABC's (the autism specialist reminded him that TEACCH and all teaching methods for that matter involve data collection--so I sense a bit of conflict). The collection is fine. But, how much of his time is this going to consume? If he records ABC's for everything as he implied, it seems he will reduce the amount of time he could be teaching. Thoughts and/or reassurances? Overall, I think I am handling the situation OK so far. Open minds are key here. As soon as someone decides that their way is the only way, it is going to be rough.
Thank you, Jens, for all of your help.