Therapy and ABA...worth anything?

creditcards

Fri, Jun 28 2019, 1:10 pm

amother [ OP ] wrote:

We could have sent my son to a special school, and he would have gotten full days of therapy of every kind. Here's the thing.... It's a one way street 90% of the time. One you set personal goals, and not institutional goals, anything the child accomplishes is great. Rarely does a child switch from special needs to mainstream full time, and in a special needs classroom, what kinds of behaviors and social skills will he pick up?

We made the decision to keep him mainstreamed as long as we can, as long as he's within range, why switch? Therapy in the regular school system where I live is pitiful.

Ok so when my daughter was 3 I decided to put her into special needs school. There were some well meaning people who tried convincing me to put her into mainstream school. My opinion is that I would rather she should be doing very well socially in a special school than be the kid without any friends in a mainstream school. She is so happy in her special needs class. She has down syndrome friend and it's a small class with 7 kids. They are such a nice group together and they all love each other. My goal is that my child should be happy and confident. She doesn't feel different. They all have different issues. In a mainstream school I don't know how confident or happy she would be. The teachers love her and have so much patience for the kids. She wouldn't get that kind of love in a regular school. So when I look for a therapist, my most important requirement is that the therapist should have a loving and kind personality because that is proven to work wonders for any child. My second thing that I look at is how skilled the therapist is.

amother

Ivory

Fri, Jun 28 2019, 1:31 pm

I'm a speech therapist and 90% of my caseload are kids with ASD who are in the moderate to severe end of the spectrum. I work in a clinic as a specialist and see kids ranging from 2 years all the way to 21. I work with some kids who got no therapies or interventions until they reached school age, and see a tremendous difference in their communication and interaction skills compared to kids who presented similarly at diagnosis but got good quality therapy when they were preschool age. I think you are bH gebencht that your child isn't in the more severe range. I see kids with terrible frustration behaviors due to not being able to communicate, kids who are tearing their homes and their families apart with their behaviors. When we get good therapy going, it takes time but things get so much better!

I'm not a huge fan of ABA as it's practiced by many poorly trained practitioners, and IME ABA from the frum agencies is sometimes not what it should be. I personally am a fan of the Early Start Denver Model that focuses on developing connection, interaction, and play.

I also think that many families don't understand that they have to take the techniques they learn in sessions and use them consistently throughout the week in order for their child to really make progress. The speech therapist isn't going to wave magic talking dust over your child; you have to put in the effort and time at home, across contexts and across communication partners, to see real benefit. I find many frum families very much want and expect that the therapist will do the work and they'll pay for it and that's all they have to do. Nope.

Also the reality is that some therapists just aren't very good with this population, so their sessions might be a waste of time.

aricelli

Fri, Jun 28 2019, 1:33 pm

amother [ Ivory ] wrote:

I'm a speech therapist and 90% of my caseload are kids with ASD who are in the moderate to severe end of the spectrum. I work in a clinic as a specialist and see kids ranging from 2 years all the way to 21. I work with some kids who got no therapies or interventions until they reached school age, and see a tremendous difference in their communication and interaction skills compared to kids who presented similarly at diagnosis but got good quality therapy when they were preschool age. I think you are bH gebencht that your child isn't in the more severe range. I see kids with terrible frustration behaviors due to not being able to communicate, kids who are tearing their homes and their families apart with their behaviors. When we get good therapy going, it takes time but things get so much better!

I'm not a huge fan of ABA as it's practiced by many poorly trained practitioners, and IME ABA from the frum companies is sometimes not what it should be. I personally am a fan of the Early Start Denver Model that focuses on developing connection, interaction, and play.

I also think that many families don't understand that they have to take the techniques they learn in sessions and use them consistently throughout the week in order for their child to really make progress. The speech therapist isn't going to wave magic talking dust over your child; you have to put in the effort and time at home, across contexts and across communication partners, to see real benefit. I find many frum families very much want and expect that the therapist will do the work and they'll pay for it and that's all they have to do. Nope.

Also the reality is that some therapists just aren't very good with this population, so their sessions might be a waste of time.

Beautiful post. Your clients are lucky to have you

creditcards

Fri, Jun 28 2019, 1:47 pm

amother [ Ivory ] wrote:

I agree that traditional ABA is not the best way to treat a child. But most frum agencies modify the ABA or mix it with floor time and other approaches so it is not harsh on the child at all. My condition for ABA was that my daughter needs to love the therapist and never cry during the sessions. If my daughter would cry during sessions or not be happy that the therapist came then that therapist was very quickly replaced.

Mommyg8

Fri, Jun 28 2019, 1:56 pm

I didnt read through the whole thread, so maybe someone said this already, but here's the thing: you will never know.

Presumably all therapy is tested and has been proven to show results, which means that there is documented evidence that the kids who get therapy will make more progress than the ones that don't.

That said, each child is an individual and each therapist is an individual. Some children are programmed to be late bloomers, and would have done fine even without therapy (or outgrown their behaviors in the case of ASD). Some therapists are naturally more skilled than others and their therapy will have a better outcome.

But the reality is that there is no way to know which kids will outgrow their issues without therapy and which kids won't. So currently in the USA they're treating each child as IF they would not outgrow their issues without therapy, simply because they have no way of figuring this out in advance, and they don't want to take a chance that any child would not grow to their full potential.

So, OP, you got lucky. Your child was programmed by Hashem to outgrow his issues naturally. But for those that have done therapy and are wondering if you did the right thing - you did. Because you have no way of knowing how your child would have turned out without it.

Fox

Fri, Jun 28 2019, 2:09 pm

My opinion is only second-hand: my DD, Clementine, is a BCBA with a BA, MS, and is starting a doctoral program soon. I feel like I've proofread enough papers to take the BCBA exam myself!

From conversations with Clem, the concern about unqualified ABA therapists is a valid one. ABA is extremely data-driven. That means lots of test-runs to determine what variables impact behaviors; what reinforcers work to increase/decrease behaviors; and how to best generalize progress in different settings and situations.

As Clem says, "When ABA is done correctly and consistently, it works miracles. When it isn't, it's just a cross between dog training and conversion therapy."

What I've noticed -- and what I don't necessarily tell Clem -- is that I think a lot of parents intuitively "do ABA" with their kids. In other words, they informally figure out what stimulus and reinforcer works to increase/decrease a particular behavior and implement that repeatedly.

So if your child's issue is relatively mild, it's quite possible and even likely that mom-based ABA is all that is needed.

The other problem, which is for some reason endemic to the entire field of education, is that people become absolute disciples and evangelists for a particular method. It's usually a bad sign when a therapist only has one tool in her toolbox.

Davening for everyone's kids to need as little therapy as possible!

amother

Lime

Sat, Jun 29 2019, 11:37 pm

To address OP's question
Let's say that 75% of kids with delays would grow out of their problems naturally and therapy wouldn't make a difference. It would be a huge shame if the parents of the other 25% didn't send their kids for therapy and would bank on their kids being in the first group.

Signed,
Mom of a kid who's made lots of progress while enrolled in a heimish ABA program (whether or not it's actually due to the intervention, I guess we'll never know)

amother

Sat, Jun 29 2019, 11:46 pm

Mommyg8 wrote:

He didn't really outgrow his issues, like I said, he's still "different" in many ways. I wonder though, if therapy would make a difference or not. And how would I know if it's the therapy that's helping, even if I did decide to break the bank.

creditcards

Sun, Jun 30 2019, 12:33 am

amother [ OP ] wrote:

As a fellow mother with an autistic child I would advise you not to break the bank if you don't have access to therapy and don't have the money. There is only so much you can kill yourself to make your child "normal" and there is no guarantee that it will work. I give therapy as much as I can afford. I spent a lot of money but I would never borrow for this. I also paid for some alternative treatment but stopped when it became too expensive for me. This is the way hashem made your child. The only thing I would spend money on is to make a child happy and confident and anything that would help a child have friends. There is no limit on how much money you can spend on special needs kids. Please don't feel guilty for not spending money and don't second guess decisions that were done already and you can't change.

Last edited by creditcards on Sun, Jun 30 2019, 12:35 am; edited 1 time in total

amother

Sun, Jun 30 2019, 9:29 pm

amother [ Fuchsia ] wrote:

It depends very much on your goals and the type of therapy.

Can you give me some examples? I have found that in the research I've done, therapy for autism is really so vague as far as goals go, in general.

(Yes, I know that ABA is specific, but the whole picture of a goal is still general. Not sure if I'm being clear.)

It's so frustrating. Like, if the child isn't walking, so you do physio until they walk properly. But the therapies for autism seen bottomless.

amother

Fuchsia

Sun, Jun 30 2019, 9:41 pm

amother [ OP ] wrote:

As the parent, you get to decide on the goals. I don't know your child, so my examples might be totally irrelevant. But one goal could be that the child can accurately predict how another child is feeling in different situations. Another goal could be initiating and participating in appropriate conversations with different family members.

creditcards

Sun, Jun 30 2019, 9:47 pm

amother [ OP ] wrote:

My daughter wasn't talking. She started ABA therapy at 2.5 and started having words a few weeks later and only the words they taught her. So yes. I saw it helped. Therapy also helped with some of her anxieties. Therapy also helped her express her feelings. She wasn't able to do that at all before. It's very obvious because she expresses her feelings in a very scripted way. Like memorized sentences that an adult taught her. But she tells me what she feels and has a whole list of emotions that she uses when she wants to. Some things she learned is very obviously from therapy. Other things you can't know for sure.

aricelli

Sun, Jun 30 2019, 9:54 pm

amother [ Fuchsia ] wrote:

So true about everyone having different goals! My goals right now is emotional regulation and my ds happiness
(Among many other goals!)

amother

Firebrick

Sun, Jun 30 2019, 10:24 pm

ectomorph wrote:

I live oot, and instead of paying for high quality therapy out of pocket, sent my child to an incredible specialized school (not necessarily frum) at toddler age.

My child has grown tremendously. One thing I realized is that this child has a lot of traits my husband and I have. We turned out ok without any therapy, and hopefully they will too iyh.

But were you happy as a child? My child reminds me so much of my brother- who was miserable as a kid. I want more for mine. He turned out awesome but the process was painful