ABA Help --- I really need advice (this might be long)

First just a little history...DS is developmentally delayed. It started with just gross motor skills. Now he is caught up witht hat. Then it was language, pointing, etc. He started EI for these things in March of this year.

I had him evaluated by a ped. neuro in June who diagnosed him w/ GDD (global developmental delay). He said off the bat it wasn't autism. At that point EI increased DS's services to 6 hrs per week (4 of "DI" and 2 of Speech).

The last 6 weeks have been amazing in terms of progress. He has between 75-100 words/approximations. He is learning in leaps and bounds it seems. He knows his body parts. He knows his colors. He is affectionate to me. He is starting to enjoy playing with other children. He loves to be a performer. Jumping. Dancing. Being silly. etc.

Then earlier this week I had another appt with a different neuro. I kept the appt for the heck of it even though I had no concerns at that point.

However, she diagnosed him with PDD-NOS. She told me he is on the cusp of the spectrum almost elluding to the fact that she is giving him the diagnosis so we can qualify for a lot of services.

She wants him to get 30 hours of ABA. The next day I spoke to his social worker and his main therapist. His main therapist is wonderful. I love her and so does he and I attribute most of his progress to her. And him of course.

Anyway, she is floored by the dx. She works with children with autism and does ABA also. If he qualifies she would do the services for us. However, she strongly believes this isn't the way to go with DS. She believes that the therapeutic process is to teach the child in the least restrictive envrionment. Right now he gets his services at daycare plus she also shadows him for an hour after his sessions. And he clearly is learning. She doesn't think that ABA would benefit him because he doesn't need that type of structured and rigid treatment. It would essentially take him out of the classroom and she feels that she would never be able to reproduce that experience for him in an ABA session.

Here's my dilemma. Basically she's told me that the choice is mine. If I want ABA she will get it for me. But if I want to just increase the DI that she does she can do that too. I trust her completely. She thinks maybe instead of two day per week (2 hrs per day) we should do 4 days per week (still 2 hrs) of DI. However, the doctor (who we only met with for a half hour) thinks 30 hours of ABA. I'm so confused.

Here's my question for those who know about ABA --- as your child started to pick up on the learned behaviors did you find that ABA was still a useful technique? Do you believe that maybe ABA isn't the right way to go in this case? What would you do? Is there maybe a hybrid I could consider?

The ball is in my court and I have no idea what to do.

Please help and thank you so much for reading.

Re: ABA Help --- I really need advice (this might be long)

I am a mother of a child with Aspergers as well as one with PDD. I totally believe in the least restrictive environment and have fought for it for my children. They are doing amazing (now 10 and 7) and nobody even believes me anymore when i tell them their diagnosis. Go with your gut.. stick with what works!

Re: ABA Help --- I really need advice (this might be long)

I was a teacher at a private school for children with autism. I have experience in special and general edu environments in public school as well. I totally believe in the LRE! I would go with the recommendation of DS's therapist who knows him wella nd has had progress with him. Has the Dr observed your DS in a school setting, home setting, social interaction, ect.? What is he basing the recommended hours on?

Also I would find out, if going with the increased hours with his current therapist doesnt seem to be woking well... can he be reveavaluated or can he then be placed in and given those other services??

Also.... LRE i believe is where he will get the best and most social interaction which is a huge goal of children on the spectrum!

Best of Luck!

Message edited 9/10/2009 10:52:02 PM.

Re: ABA Help --- I really need advice (this might be long)

I don't know anything about ABA so I cannot guide you in that direction, but I do have a child who was misdiagnosed with autism twice.

My son had a severe language delay, and a cognitive delay. I took him to a neurologist who diagnosed him with PDD-NOS just by looking at him for 10 minutes, never actually did any testing. Also suggested we do ABA.

Then I made an appt. w/ a development ped. who did the same thing, again w/o testing him. Told us that are son would always be severely delayed, and that we should get ourselves therapy instead of him.

Anyway, I listened to his therapists, who told me that he def. did not have PDD. We increased speech to 3x45 and ED (which I imagine is similar to DI) to 5X60.

That ended up being the right decision for us. My son does not have PDD-NOS. I had him tested for it many times.

Anyway, after 17 months of EI, my severely delayed child no longer has any delays.

I just thought I would share that with you. Good Luck, I know it's a difficult decision to make.

Message edited 9/11/2009 10:09:13 AM.

Re: ABA Help --- I really need advice (this might be long)

Hi,
I am a special education teacher and I work with many children with autism. This is JMHO, but I too am floored by what this doctor told you. ABA is a VERY intense process and the idea of 30 hours a week when she thinks he is just "on the cusp" is ludicrous. He would pretty much be completely isolated all day if he did ABA for 6 hours a day. If he seems to be making progress with what he is doing in the least restrictive environment, I fully believe in "if it ain't broke, don't fix it." Stick with what you know is working, especially if the main therapist is in favor of it. I wish you luck in your decision!

Re: ABA Help --- I really need advice (this might be long)

Posted by KerriSteve

I don't know anything about ABA so I cannot guide you in that direction, but I do have a child who was misdiagnosed with autism twice.

My son had a severe language delay, and a cognitive delay. I took him to a neurologist who diagnosed him with PDD-NOS just by looking at him for 10 minutes, never actually did any testing. Also suggested we do ABA.

Then I made an appt. w/ a development ped. who did the same thing, again w/o testing him. Told us that are son would always be severely delayed, and that we should get ourselves therapy instead of him.

Anyway, I listened to his therapists, who told me that he def. did not have PDD. We increased speech to 3x45 and ED (which I imagine is similar to DI) to 5X60.

That ended up being the right decision for us. My son does not have PDD-NOS. I had him tested for it many times.

Anyway, after 17 months of EI, my severely delayed child no longer has any delays.

I just thought I would share that with you. Good Luck, I know it's a difficult decision to make.

Re: ABA Help --- I really need advice (this might be long)

Re: ABA Help --- I really need advice (this might be long)

You know what I think of 30 hours of ABA per week. NUTS!!!!

Even DS who is 2 AND diagnosted with austism does not get that many hours.

I do like ABA in term that for kids that have focus issues, that to go back and forth in the room, it "forces" them to work in a structured way.

BUT I told you that I informed our team leader after she mentioned more ABA (we currently have 12 sessions of 90 minutes per week) that I WANTED DS to be also a "normal" 2 yo who experience normal things like going to the zoo, the park, GTGs. I refuse to "isolate" DS from the World. 30 hours is WAY too much. He needs to play with other kids. They all "study" each other and learn from it too.

We took a 4 day vacation and I cannot tell you how much DS improved in those 4 days just on sensory issues. It's like they were gone. He was "free". Went to the beach, the lavender farm. DH was worried about the bees. I told him to "let go". He has to experience the World. That's part of growing up and learning too.

Re: ABA Help --- I really need advice (this might be long)

30 hours of ABA is LUDICROUS...

my DS is 25 months and he has a LOT of therapy so i cannot imagine tacking on 15 more hours on top of his schedule.

AJ is autistic.. he receives 10 sessions of ABA a week (15 hours). He also receives 2/45m speech & 2/45m oT and he goes to school 3 days a week, at 2.5 hours a day.

we had him evaluated by Hofstra and they recommended 40 hours plus school...

we did what we felt is right for our DS and kept him at his 15 hours of ABA... we have seen such GREAT improvement on so many levels, he goes to school for socialization and we still (yes i know it seems impossible) have time to socialize with NT children.

do what you your gut tells you... and if you choose the ABA route, start off slow... ask for 5/90min sessions to start off with, and then increase if you feel he will need it.

i hope this made sense...

Re: ABA Help --- I really need advice (this might be long)

Lisa - was it Dr. Morse who suggest ABA? Because she suggested it for Sophie too so I'm just wondering. We did not take her advice for that and I don't think she needed it to be honest. I do have to say for us, she recommended it because Sophie had such a small attention span and thought the structure might be helpful for her.

Re: ABA Help --- I really need advice (this might be long)

Message edited 9/11/2009 1:28:40 PM.

Re: ABA Help --- I really need advice (this might be long)

Posted by lbelle821

Posted by Merf99

Lisa - was it Dr. Morse who suggest ABA? Because she suggested it for Sophie too so I'm just wondering. We did not take her advice for that and I don't think she needed it to be honest. I do have to say for us, she recommended it because Sophie had such a small attention span and thought the structure might be helpful for her.

yes, dr. morse.

I don't think Sophie would have ever needed it either. And she was never on the spectrum to begin with.

Maybe she's just on a quest to give every child ABA.

Message edited 9/11/2009 9:52:22 PM.

Re: ABA Help --- I really need advice (this might be long)

Posted by Merf99

Posted by lbelle821

Posted by Merf99

Lisa - was it Dr. Morse who suggest ABA? Because she suggested it for Sophie too so I'm just wondering. We did not take her advice for that and I don't think she needed it to be honest. I do have to say for us, she recommended it because Sophie had such a small attention span and thought the structure might be helpful for her.

yes, dr. morse.

I don't think Sophie would have ever needed it either. And she was never on the spectrum to begin with.

Maybe she's just on a quest to give every child ABA.

Maybe she gets kick backs! I was shocked when she recommended it for Sophie since she outright told me she wasnt thinking autism. I thought it was a little harsh for a lack of attention. But I have heard for some kids it works wonders. I would continue with your therapies and see how it goes.

Re: ABA Help --- I really need advice (this might be long)

Re: ABA Help --- I really need advice (this might be long)

I'm a preschool psychologist. Whenever we are having team meetings and discussing a child's placement, I ask, "what method does this child need to learn?" If your son is learning through direct instruction, there is no need for him to have ABA, IMO.

In addition, I would never recommend ABA for a child who is "on the cusp" of a PDD-NOS diagnosis. The majority of kids in our school who have a diagnosis of PDD-NOS (whether accurate or not), are educated via the language-based TEACCH method, or are in classrooms that provide direct instruction.

Re: ABA Help --- I really need advice (this might be long)

Doctors don't get kickbacks for recommending ABA!

30 hours of discrete trial training - a small aspect of ABA, is way too much for your child, but ABA is not synonymous with discrete trial training. I bet your special ed therapist "does ABA" and doesn't even know it.

The biggest travesty out there is that people only associate ABA with discrete trial training, and it is really sad. I don't expect you guys to know that, but professionals should and should be able to explain to you what ABA really is, and what is implemented to be appropriate for your child.

Every educator of any child uses ABA. ABA means arranging the environment to get a specific response or behavior to happen or not happen, and then shaping the future occurrence of that response/behavior based on the consequence.

When a teacher is teaching a kindergartener to raise her hand, she will only call on the child if her hand is up vs. calling out. By calling on her when her hand is raised, she is hoping that behavior will occur again based on the consequence. THAT is an example of ABA. 30 hours of that is great for any child that you want to gain a lot of appropriate skills. 30 hours of discrete trials for ANY child is usually too much if its at a table 1:1 with no other skills being addressed....

HTH

Re: ABA Help --- I really need advice (this might be long)

Posted by lipglossjunky73

Doctors don't get kickbacks for recommending ABA!

30 hours of discrete trial training - a small aspect of ABA, is way too much for your child, but ABA is not synonymous with discrete trial training. I bet your special ed therapist "does ABA" and doesn't even know it.

The biggest travesty out there is that people only associate ABA with discrete trial training, and it is really sad. I don't expect you guys to know that, but professionals should and should be able to explain to you what ABA really is, and what is implemented to be appropriate for your child.

Every educator of any child uses ABA. ABA means arranging the environment to get a specific response or behavior to happen or not happen, and then shaping the future occurrence of that response/behavior based on the consequence.

When a teacher is teaching a kindergartener to raise her hand, she will only call on the child if her hand is up vs. calling out. By calling on her when her hand is raised, she is hoping that behavior will occur again based on the consequence. THAT is an example of ABA. 30 hours of that is great for any child that you want to gain a lot of appropriate skills. 30 hours of discrete trials for ANY child is usually too much if its at a table 1:1 with no other skills being addressed....

HTH