How effective is Applied Behavior Analysis (ABA) Therapy?

Just how effective is Applied Behavior Analysis (ABA) Therapy? Several studies have been conducted on the effectiveness of this therapy since it gained popularity via the Lovaas method. The great thing about this therapy is it is so comprehensively tested most insurances cover it for children with Autism. ABA is proven to be extremely beneficial.

Here are several sources that state just how crucial ABA is for children with autism:

Current Opinion in Pediatrics, 2011; Vol 23: pp 616–620: Found that behavioral interventions are effective for cognitive abilities, language, adaptive behaviors, social skills and reduced anxiety/aggression.

American Journal on Mental Retardation, 1993; Vol. 97, No. 4: pp 359-372: Children who received ABA were tested again at an older age and were found to have benefited from long-term progress.

Journal of Consulting and Clinical Psychology, 1987; Vol. 55, No. 1: pp3-9: 9 out of 19 children attained average functioning after 40 hours a week of ABA.

Pediatrics 2012; Vol. 130; S186: Forty-eight autistic patients received ABA at the age of 2, their IQ and communication improved significantly.

Committee on Educational Interventions for Children with Autism, National Research Council: States; 40 years of testing ABA has shown that it decreases problem behaviors and teaches new skills to those with autism.

American Psychological Association website: “Since medications on their own rarely improve behavior, behavioral interventions are crucial.”

ABA is not an experimental therapy that pokes and prods at your child in hopes of finding a ‘cure’ or something that might help. ABA is a proven method that will help your child with autism reach a level of skills and functioning you may never have thought possible.

Applied Behavioral Analysis therapy (ABA) is amazing because it isn’t designed to tackle autism by itself.

Sometimes Autism isn’t the only diagnoses that a child on the spectrum is diagnosed with. A child who has autism may also be diagnosed with Attention Deficit Hyperactivity Disorder, Oppositional Defiance Disorder, Anxiety, Depression and more. There is a 30% chance your child may also have a specific phobia, and a significant number have intellectual disabilities. Autism isn’t as straightforward as some may believe which is why it’s difficult to tackle it with most conventional therapies.  

Applied Behavioral Analysis therapy (ABA) is amazing because it isn’t designed to tackle autism by itself. It is a therapy used in all areas of life, from career, to sports, to businesses and other disorders. When you put your child into an ABA programme, you’re not only providing help with life skills they lack (due to the way their brain functions), but also skills to help with a variety of issues and other disorders.

If you’re concerned your child may have issues outside of autism, such as ADHD, you can ask your DR to refer your child for further testing. Here are some symptoms and behaviors:

ADHD: Aggression, excitable, fidgeting, hyper, impulsive, irritable, no restraint, repetitive words and behaviors, absent-minded, no focus, forgetful, short attention, angry, anxious, bored, excited, mood-swings.

ODD:  Aggressive, antisocial, impulsive, irritable, screams, self-injures, vindictive, argumentative, angry, anxious, depressed, lack of attention.

Anxiety: Tired, restless, sweating, hyperventilates, irritated, racing thoughts, intrusive thoughts, excessive worry, fear, feelings of impending doom, nausea, trembling.

Depression: Apathy, discontent, guilt, hopelessness, not interested in anything, seems bored, mood-swings, tired, insomnia, agitated, cries a lot, no appetite or extreme appetite, slow movements, suicidal thoughts, no concentration, weight gain or loss, repeats thoughts, obsessive thinking.

What kind of therapist will be a good fit for your child?

Not all therapists will have the same style of implementing common ABA therapy techniques. Some may be very gentle, others firm, where some may want to explain situations to a child who works well with logic, and others may want to make simple demands instead. Applied Behavioural Analysis (ABA) is a therapy that is implemented in a way that molds to your child's unique personality and needs.

Because of this, not all Applied Behavioral Analysis (ABA) therapist will be the right fit for your child. When you decide to terminate services, you may consider if you want somebody else. If this is the case, think about what it was about the last analyst that caused issues for you. Understanding what you disliked about the therapist style of teaching, and communicating it to the company, can help them find you a better fit. Making a concrete list of what you are looking for gives the therapist/company a way to meet your needs, and either refer you or find someone like that.

Whether it’s tone of voice, certain techniques you don’t agree with or simply the personality of your therapist, making sure all of those issues are met to your desires are important. Never be afraid to go with a different therapist until you find the right fit for your child. Every therapist practicing ABA will bring their own unique style and personality into the mix. Just like every child will bring their own personalities into the relationship.

Applied Behavioral Analysis (ABA) Therapy has techniques to help teach an Autistic child empathy

People with autism often struggle with empathy; as a parent of a child who shows little empathy, it may be pretty terrifying to wonder what might happen to your child in relationships or how their morals might develop. A child with little empathy may laugh when another is upset, or take a toy from another child and not understand why they should share, or even be violent with little remorse.  

The good news is Applied Behavioral Analysis (ABA) Therapy has techniques to help teach a child empathy and how to respond to situations appropriately. Which is a huge relief when you’re the parent or even child. The other great news is lack of empathy does NOT make someone with autism an awful person who’s choosing not to care. The issue doesn’t lie in choice (typically seen with people who have autism, it’s caused by abnormal neural connectivity), and when given the option to learn and choose to care, a child with autism absolutely can!

First, the ABA therapist will likely teach your child to recognize emotions. Once they can recognize what an emotion actually is in a simple way, it will be way easier to teach them it in everyday interactions, and how to respond to those emotions. This is done through pictures of faces, the therapist demonstrating or even silent clips of facial expressions.

Apart from recognizing emotion, there are two other steps to mastering empathy. Taking someone else's point of view into account and controlling how we respond. This can be done through role-playing situations, using life skill books demonstrating situations where empathy is needed, having the child role play another's emotions through facial expressions, or even asking questions in everyday conversation when an empathetic response is needed.

The other cool thing about empathy is there are actually three types.

Emotional Sharing: Where you feel what another feels

Empathetic concern: Where you want to help others in distress

Perspective taking: Which is when you can see someone else's point of view

Knowing this as parents of autistic children can help us to understand why your child might run to help their sibling up when they’ve fallen down one second, but call them names and laugh the next.

ABA is a fantastic therapy which can help so many children with autism thrive and live a far more high-functioning life than they would have. The vast amount of things the therapists can teach and help your child with is so worth the time investment and bond you will build with both the therapist and your child.

Emotions for an ASD child

Almost all children struggle with recognizing emotions in others, but for a child with autism, this skill is even more complex. Their inability to read body language or facial expression well lends to even more complications throughout their life, which is why it’s important to teach this skill early. Learning how to recognize emotions impacts all areas of a person's life, from school, to work, to making friends and strengthening family bonds.

One great thing about teaching a child emotions is that they have to look at faces to achieve it. Something that people with autism struggle to do. An applied behavioral analysis (ABA) therapist can teach this in a variety of ways, one way is to show pictures faces that are sad, happy, worried, angry, etc. They ask the child which face is which and have the child point or tell the therapist.

Therapists can also teach this through expressing the emotions to the child and having them identify it. They express the emotion in an overt way, by grinning and clapping and asking what the child thinks the therapist feels.

The more the child practices identifying emotions in an artificial setting, the more likely they can recognize emotions in an everyday setting. Once a child can label and identify emotions, they can move on to learning how to deal with the emotions in themselves and others.

ABA is a great tool that helps children to learn a range of complex abilities that will help them with life skills across a range of areas, from school, to home to friends. Learning emotions is just one tool of many.

Researching the Therapy

As a parent new to the diagnoses of Autism or with little knowledge of Applied Behavioral Analyses (ABA) therapy, the whole process of researching the therapy and life your child could face is overwhelming. But reading about the nuts and bolts of the therapy and what kids with autism go through, in clinical dry ways, only gives us so much information.

Researching the step by steps, understanding the language, and talking to a therapist about your concerns are all legitimate ways to discover what you’re getting into—but it can’t prepare you for how it feels or even looks like living it.

There is however a book When Everybody Cares: Case Studies of ABA with People with Autism  by Bobby Newman which is a first-person account of ABA. It can show you in a very real way how this therapy affects a child’s life and what issues arise with someone on the spectrum.

The book When Everybody Cares: Case Studies of ABA with People with Autism gives a unique insight into the life of a behavioral analysis and the solutions they develop for common problems. The great thing about this book is you aren’t just reading step by step, you're reading the struggles and insights and even the raw emotions that come along with working through difficult behavioral issues: such as a child refusing to eat or learning how to follow instructions.

Like a diary, this book doesn’t tell you what ABA will be like, it shows you like a story, a biography of sorts. ABA is a beautiful journey for everyone involved, so it’s little wonder such a beautiful book has been written because of it.  If you want to really see what ABA looks like, or even feels like, then give this book a try.

Echolalia in Autistic children

A lot of children who have autism will start their speech journey with something called echolalia. Echolalia is when a child repeats what you have just said back to you. It is done for many purposes, but the main reason a child does this is because they have a hard time with fluent or creative spoken language.

Some good news about echolalia is it can be a sign your child is trying to speak and they may grow out of it. In some cases however, the child never fully overcomes echolalia.  There are some classic examples of this, as some children began with echolalic speech which slowly filters out as they speak more fluently, but rears its head again when they are under stress.

Some parents are told their child would always use echolalia and never speak but through ABA they can form fluent sentences and communicate effectively.

Applied behavioral analysis (ABA) therapy often works with a child's speech. After-all, speech is used for everyday functioning. The way they go about this is by modeling the correct response. As a child can already repeat what has been said this is quite easy to implement. For example;

Therapist: Do you want a cookie?

Child: Want a cookie? (Whilst holding out their hand indicating yes)

Therapist: Yes, please.

Child: Yes, please.

Therapists: (gives the child the cookie)

Basically, this teaches the child that when they say yes to this question, they receive a cookie.

You may notice once this is put in place your child uses an echoic response first and THEN the correct response. For e.g. “Want a cookie? Yes, please.” This is wonderful news as the child is now using the echolalia to process the question before they answer it. Much the same way we do.

Have you ever been in a situation where you weren’t quite sure what somebody said and you repeated it in your head to understand it? This is the function for an echolalic response in this circumstance. It’s quite normal really, and remarkably intelligent problem solving for a child who's having trouble processing the outside world.

ABA can help in so many ways! Echolalia is just one of the many struggles a child with autism faces. ABA looks at the behavior your child uses and normalizes it, trying to both understand it and change it so they still receive the benefits they are looking for.

7 dimensions of ABA

Applied Behavioral Analyses (ABA) is based on 7 core dimensions. Any interventions your therapist uses with your child will fall within or be defined by these 7 categories. Therapists use the anagram GET A CAB to remember each part of the therapy.

G is for Generalization: This is moving skills from one situation to another. Sometimes your child with autism may perform certain skills like using the potty in one location but not in another. Generalization is the process of moving this skill from one place to another.

E is for Effective interventions: All interventions are monitored to ensure effectiveness and to see how they impact the behavior you are trying to change. They must be strong changes that affect something for the better.

T is for Technological: Where interventions and procedures are described thoroughly enough that anyone trained can implement them.

A is for Applied: Socially significant behaviors are worked on, more so than others.  

C is for Conceptually Systematic: The concept of the interventions is chosen from a specific theoretical base, rather than just a trick.

A is for Analytic: All decisions for an intervention or anything within the therapy must be data related.

B is for Behavioral: Only behavior that can be observed and measured should be targeted.

In ABA when measurable behaviors are targeted based on how well it will help your child cope in society, data is collected and explainable interventions are tried and tested, then your child will go far. ABA is a therapy where you record the changes in your child for the better, or worse leaving nothing to chance. This is why this therapy is so effective and gets results more often than any other intervention.

Reinforces: How to make them effective

We talked about token boards and how they help reinforce good behavior during Applied Behavioral Analysis (ABA) therapy sessions. But there is a way you can improve on the token boards and other reinforces to make them as effective as possible. Your therapist should use some of the following methods to help your child move forward through their skills quickly.

When offering a token or sticker for each completed task, your therapist will ensure it is given as soon as the child completes the task. It is here reinforcement will be the most powerful, mostly due to instant gratification. If you promise a treat later for doing something they were asked to do, the behavior change will not be as rapid. This is why stickers and tokens on hand are such an amazing tool, there’s no wait period.

The stickers, token or reward must also mean something to the child/teenager. If the reward isn’t very exciting, then it’s not motivating. Sure they might do it for the benefit of getting a sticker, but they’d do it with more gusto and energy if that sticker was of their favorite cartoon character and not a gold star.

The therapist should give the treat frequently. It would be a little ineffective to tell your child, ‘if you behave all day you can get a sticker.’ Not only is that unrealistic (who doesn’t make mistakes? What child doesn’t misbehave once or twice?) but the goal is out of reach, and the reward isn’t tangible. It’s not something they can easily imagine themselves receiving. Giving your reward frequently reminds your child how awesome it feels to get it.

The therapist should also make the reward exciting with the use of social engagement. Compliments, hyping up the gift, and being as positive about the reward as possible are some examples.

Another mistake newer ABA therapists make is turning the reward into a negative. Instead of saying, ‘if you don’t do X you won’t get this’, the therapist should say, ‘if you do X you will get this cool sticker!’ In an upbeat happy tone. Now the sticker is exciting, the praise is rewarding, and the outcome is something they want to work towards.

Just think about how it feels when someone tells you that you can’t have something unless you do as they say. Instantly we evaluate if we want that thing anyway, which makes us less likely to be happy about getting it. This is just human nature. One simple change in language can do a lot for any child.

ABA therapy is such a simple therapy really when broken down. From the outside it can be confusing and even a little scary at first, but when we look at it from a common sense angle, it’s little wonder why this therapy is so vastly used in all sorts of fields. Tokens, and stickers are nothing new, and if you ever have any issues with how they are used you can always ask the advice of your BCBA certified analyst or therapist.

How prompting can help during ABA

Prompting is a wonderful tool in applied behavioral analyses therapy (ABA) and probably the reason some children learn to communicate at all. This simple way of moving a child through the motions of an action/response so he/she can see the consequence is so powerful yet so simple. It really answers the question, how do you teach a child that can’t understand language intuitively, what you are asking of them?

My son was completely non-verbal until his speech therapist used hand-over-hand prompting to show signs and slowly weaned him through the process of prompting until he could mand (request things) for himself.

Here is a list showing some most invasive to the least invasive prompting.

Most invasive: Full Physical Prompting

This is when your therapist will essentially use your child’s hands to carry out a request. For instance, she/he may say, ‘pick up your toys,’ then take the child’s hands and close them around the toy, guiding it to the toy box.

Next Invasive: Partial Physical Prompting

In this case the therapist will put the child’s hand onto the toy to show them what she means and wait to see if the child carries out the rest of the direction. Normally this is the first step taken once the child has mastered full physical prompting.

Next Invasive: Modeling

The therapist will act out what she wants the child to do. For instance, she will pick up the toy and put it in the box after asking them to do it and wait to see the child’s response.

Next Invasive: Gestural

Where the therapist will point at the toy and the toy box to gesture to the child what is needed of them.

Next Invasive: Positional Prompt

The therapist places the object close to your child and tells them to clean it up.

Least Invasive: Simple Direction

The therapist will simply ask your child to clean up their toys and expect that they will do it without further help.

When we move down this chart the child slowly learns what is expected of them, or basically, what you’re asking them to do! Much of the time, just telling them what to do and showing them won’t work for an autistic child. Going from most invasive to least invasive (depending on the specific skill set of your child and what they are asked to do) teaches them in a way that they will actually understand. It’s so simple and effective but works beautifully.

The Guilt of Active Ignoring and Why You Shouldn’t Feel It

It’s difficult navigating the autistic space when a child does something for attention. On the one hand, it’s hard because you want to give them all the attention in the world; on the other hand, they have a lot less ways than other kids of gaining the attention they need.

As caregivers it can lead our heads in a spin; is ignoring their behavior when it is attention seeking the right thing to do? Are we neglecting their needs? Shouldn’t we be their strength of communication for them by speaking/acting/advocating for them?

With Applied Behavioral Analyses (ABA) therapy a technique called active ignoring is used in certain circumstances, where the child is trying to get attention, or what they want, with socially unacceptable behavior, like spitting, whining, or violence.

We don’t ignore them because we want the child to feel abandoned or unheard, but because it encourages the child to search for new ways to gain the attention. We can’t explain with our words why they shouldn’t spit, so we have to explain with routine and patterns (or basically, in the way an autistic child can understand).

It’s important to not feel guilty when you’re ignoring whining for food, or other things that seem necessary or even neglectful to ignore. Remember, you are actively ignoring inappropriate behavior that won’t serve them, not ignoring their needs. You will meet their needs, just not right that second.

For example, you’re playing with their sibling so they take his toy, this forces you to turn your attention onto them to ask them to give it back. They now have your attention moved from their sibling and onto them. In their minds they’re not worried about the social repercussions, all they know is they have gained the thing they wanted;. You looking at them and talking to them instead of their sibling.

You need to speak the autistic child’s language here. Turning your attention to them to scold them doesn’t teach them anything when they don’t understand a full range of empathy, verbally explaining the situation does nothing when they don’t understand everything you are saying.

However, giving the other child tons of attention, taking the toy back without even looking at them, blocking the snatching, and actively ignoring, teaches: this action doesn’t get a desired result. But (and this is where we as caregivers can breathe a sigh of relief) once the undesired behavior stops, or the child uses a more appropriate way of asking for attention, you can lavish them with praise and affection.

The two should always be used together, otherwise ignoring will be in-effective and seemingly random for the child. This is all about routines and patterns, and giving your child a way to communicate and to latch onto that they understand.

Active ignoring is different from ignoring a child. You actively make a conscious decision to ignore a specific behavior and give attention to other behaviors. It can feel unnatural at first, but once you see your child blossoming into speech, or other appropriate means of asking for your attention, your relationship will be much stronger.

Techniques for Sensory Issues

The other week I discussed reasons for why a child would act out. We then went through techniques an Applied Behavioral Analysis (ABA) therapist uses when a child elopes.

But what about techniques for sensory issues?

Sensory integration is the process of normalizing sensation and making it easier for your autistic child to cope with them.

Occupational Therapy

Alongside ABA your child may benefit from Occupational Therapy if you find they have a lot of physical issues. OT in simple terms helps people do what they want to do in everyday life, be it taking off a t-shirt or using a pen. Sometimes these issues are accompanying sensory problems, like the feel of fabric, or not knowing you are squeezing too hard. An OT’s job is to identify the sensory issues and guide your child through them until they can physically handle the task. They’re a perfect addition to ABA.

Applied Behavioral Analysis Therapy

An ABA therapist identifies why your child is having an issue and either teaches them something new, or reduces it. When a child can’t handle, or process sensory information because of autism they may have extreme reactions to it, such as self harm, violence, or meltdowns. It’s important to identify when your child is behaving this way because they simply don’t want to do something or don’t know how to communicate, and when they truly cannot process what is going on around them.

This is no easy task.

We cannot personally dive inside their minds, so we can only observe, watch and wait until we know the answer. Which is what your ABA therapist or analyst will do before they introduce an intervention.

Communication Skills

Sometimes, our children have a meltdown when there are bright lights or loud noises because they don’t know how to ask to leave the situation. In this case, the therapist would prompt the question of leaving and the stimulation would stop. For e.g.

Therapist, “Say, turn the light off.”

Child says, “Turn the light off.”

Therapist turns the light off.

This way your child learns that communication is a wonderful way to remove uncomfortable stimulation.

Reducing Stimuli

In other cases we can tell when a certain situation will be triggering in advanced, and know that our child has to go through it and get out the other side; like grocery shopping or school. In these cases tools are used, such as noise blocking headphones and weighted vests. These keep the child grounded and block out sounds, thus reducing the sensory stimuli to begin with.

Sensory Integration

Other times our child has to get through a stimulatory process, but there is no way to reduce it. Like brushing hair, or clipping nails. Either way they have to brush their hair and clip their nails, for health and cleanliness reasons. In this circumstance the child can’t ask to leave the situation and we can’t reduce it, so what does the therapist do?

Sensory integration is teaching the child how to handle sensory input, with breathing techniques, and practice. Just like when we as adults have irrational fears and have learnt how to face them—like public speaking, or roller coaster rides—our children have to learn how to face their fears and remain calm too.

It will be heart wrenching to watch at first as they scream and cry, but guiding them through it slowly, and teaching them how to step over their fears is something all parents should teach their children no matter whether they have autism or not.

The only difference here is that autistic children will often scream and tantrum rather than whine or talk about it, because they either have no other way to communicate or little understanding of the consequences of the tantrum in a social setting. All they know is, if I scream I won’t have to do this.

An Example of Sensory Integration

A child was petrified of nail clippers; he wouldn’t even let you cut your own nails. He would scream, cry, and have meltdowns every time someone used a pair. We would have to hide them and his nails never got clipped. This had the added down-side of learning to use his nails as weapons to cut open people’s skin, when he got mad. We couldn’t reduce the stimuli, and we had to clip his nails, so the therapist slowly introduced the stimulus to him.

At first she showed him videos and clippers.

Next she cut her own nails and the nails of others.

Then she placed the clippers on his skin.

And finally she cut one finger nail.

This took more than a month, and on every step he screamed at the top of his lungs like he felt petrified. He cried and fought and sobbed his eyes out, until he didn’t. Until he barely even noticed what you were doing. As a parent at first though, it was traumatic to watch every new stage brought with it a wrenching feeling in the parent’s gut.

But by the end? Even though he still screamed and cried, he would ask the therapist to do it! He had grown courage, and the ability to see his fear as irrational, despite still feeling it. He had learned something that takes even adults a long time to learn; fear will not kill me. A life lesson that will serve him. So although listening to his fear was uncomfortable for many parents, seeing how this process empowered him makes it all worth it.

Techniques on how to encourage your child to stick out

The behavior of trying to escape a situation in all children is common, but especially so with autistic children who have a lot going on and little to no attention span.

In applied behavioral analyses therapy (ABA) avoidance techniques are tackled head on, to build up the child’s tolerance to accept and even enjoy certain situations—such as sitting down to read a book.

A child won’t be allowed to escape a situation (since this will re-enforce that escape is preferable to getting through to the other side) so what does the therapist do to make sure the child feels they can make it through that moment?

ABA Techniques: How to Encourage a Child to Stick it Out

A lot of now vs then techniques may be used. Sometimes autistic children have a hard time understanding that this moment won’t be forever. Timers are set up to show this will end and posters explaining now vs then.

Rewards are also great. Rewards such as music, and toys when they finish a task can help a child get excited to finish, instead of unmotivated and blah.

Replacing behaviors is another tool. Instead of your child running away and hiding, the therapist teaches them to ask for a break. If they ask too often, it is lined up with the other techniques and tolerance built up.

For older children the work you are doing together could be too hard, do they understand it or getting too frustrated by how difficult it is? Maybe everyone needs to step back and look at whether this is a reasonable ask.

For older children, help him/her discover their why, what positive thing they will get from learning or ‘surviving’ this task? Talk out the positives and help them view the task from a new light.

If the amount of time it takes is too overwhelming, a therapist may cut the work into parts, doing some now then taking a break and some later.

Our therapist uses awesome token systems, which are Velcro tokens of their favorite characters. Every time they complete one step they get a new token and they love it!

The Therapist Doesn’t Expect Perfection

The effort should get rewarded more than the outcome.

If your little one tried really hard but got the answers wrong, this won’t be penalized. For e.g. If we’re teaching a child to do the dishes, and stick it out, but they leave mess on a couple of cutlery, oh well! The point is they stuck it through and should be rewarded. Everyone makes mistakes and perfection isn’t the outcome we want here, it’s getting through the situation.

The therapist will always praise your child as they take steps through a non-preferred task, they deserve it. It is difficult to do anything when your world is full of noise and distraction, sometimes they just want to do something easy; but as we all know we can’t always do this as adults.

This is Something We All Do

Often ABA is just common sense. I bet you ask for help, know why you want things, take breaks and reward yourself for getting through boring tasks too! For instance,

“This meeting will take 20 minutes, I’ll learn some valuable things and when I go home and take a bubble bath.”

“I would like to be healthier for my family; I can ask my friends for help and have a special meal on the weekend. If I lose 10lbs I can get a new wardrobe.”

The procedures your ABA therapist uses isn’t alien, these are things even non-autistic people need to learn to optimize their days! And they set your child up to conquer the more uncomfortable aspects of later life, like boring work, meetings and chores.

Why your child is acting a certain way

Every child, anywhere, regardless of autism, acts a certain way for a reason. We don’t do things out of nowhere. Honing down those reasons are the key to helping a child overcome a behavior that won’t serve them in their adult years.

Let’s look at some common reasons people engage in certain behaviors so you notice what makes your child act the way they do!

Sensory

Sometimes we do things because it feels good to do them. Even though soda is bad for us, when we drink it the taste feels worth it, or the energy it gives us feels good. Sometimes we know we shouldn’t do something but we do it anyway because it makes us feel something we crave.

For an autistic child they may involve themselves in sensory stimulation, like flapping, rubbing their hands on things and spitting. This behavior is self soothing; they do it because it feels good! You may see it occur more when the child is frustrated, bored or even excited.

Escape

If you could escape from a painful situation without consequence, instead of facing it head on, would you? Most of us would!

Autistic children are known to bolt (they call it eloping now, officially) they run from situations, they hide under tables and do anything they can to escape doing something. Sometimes that something could be as simple as putting their plate in the sink. It’s not always because of doom and gloom circumstances.

A client of ours loves to use this behavior, he has several places in the house he knows is hard for adults to get to and as soon as you ask him to do something unpleasant (like chores) off he runs to hide under the bed.

There are other ways to escape situations like violence and yelling.

Children do this when they don’t want to engage in something. Maybe that something is boring, scary, annoying or too hard for them.

Attention

Yup, people do things for attention. This is a difficult one for some people to understand because it has such negative connotations wrapped around it. It shouldn’t, ‘attention seeking’ is just communicating that you want someone’s attention in the wrong way.

This is probably my middle child’s favorite reason to act out. He is a show star, he is loving, cute and by golly if he can be center of attention he will find a way! His autism (low empathy) means he often pushes children, hits them or bullies them so he can take their attention from them. It’s not about the child being a ‘bad kid’, this is just a child that doesn’t know how to say, “Hey I want a connection with you right now but I don’t know how to do it.”

Children do this when they want social interaction, or they want you to connect with them.

Tangibles

A few of our clients are obsessed with electronics. When it comes to trying to take them away the term ‘out of my cold dead hands,’ comes to mind. Sometimes children act out because they want something, plain and simple. They just don’t know how to communicate that want or they are terrified if you take it away they will never see it again.

This is the way that an ABA therapist looks at your child’s behavior, and a great thing to do for yourself as a parent. Sometimes putting meaning to situations helps us cope, and also gives us insight into how we can help our child in that moment.

Parent Training: Is your child's behavior getting worse?

How do you know whether you’re experiencing an ‘extinction burst’ or if your child’s behavior is just getting worse?

What is an Extinction Burst?

To understand what I mean by this, I’ll give an example. Let's say you ask your child to do something and they start hitting you. You've learned that not allowing escape is a great intervention so you ignore the child hitting you and repeat your request. At this point the child may start hitting more or harder (i.e. behavior just go worse).   

Why does this happen?

Because it used to work for them! This is called an extinction burst.

When you start to ignore the behavior all together they will up the ante and try to go back to the way it was before. Because that was easier for them than listening to you.

This doesn’t make your child a bad person in any way; in fact it makes them pretty smart! They’ve figured out how to get what they want in this world, and it’s wonderful. They can problem solve like this. Increasing the bad behavior is actually a clever thing to do. If you did something one way, and it worked, you would keep doing more of it to get the same reaction too!

When a behavior is done for attention, and we ignore the behavior it will get worse. But then it will start to get better, because your child will realize this is just too much work. Great!

But what happens if it stays the same? And doesn’t get better at all? When do you draw the line in the sand and try a new tactic?

What if an intervention isn’t working?

There will be plenty of data and charts to show whether your child is going through an extinction burst, or the behavior hasn’t changed at all. If the behavior hasn’t changed at all the reason your child is doing the behavior may need to be looked at again. Maybe the therapist was wrong, and they did it for another reason. If this is the case, the charts will show it and the data will help them change tactics. Some other ways the therapist could change the intervention to the behavior is;

-        Changing the length of time they ignore the behavior/child

-        Expand the plan to other places where the behavior may occur more

-        Have someone else also back up the intervention

If you feel a part of therapy isn’t working for your child, you can always speak to your therapist about it. They will have the data and charts to confirm or deny your experiences. They should work with you, not against you, to help your child better function, learn more and live a more productive life.

ABA therapy steers autistic children to work through sensory overload until it's no longer an issue

Many children with autism suffer from sensory overload. This could be sensitivity to noises, sensations, lights, textures, temperature and more. The issue with these sensory problems is they impede things your child needs to do.

We work with a boy who has autism and he hates people touching his finger-tips. Therefore, it is almost impossible for parents to cut his nails because he will scream and thrash around. But he also uses his nails as weapons to hurt himself, so cutting them is necessary. It’s a catch 22 and there are a lot of times this happens for our autistic children.

Take for example a potty; if they are scared of how it sounds or how it feels to sit on one, they won’t want to relieve themselves. It will be impossible for them to learn how to potty train. They may not like the way a hairbrush feels or a shower sounds. It hinders their life in a way you don’t always expect; sensory issues can stop your child from being able to care for them self.

That is why Applied Behavior Analyses (ABA) is so important. The therapist can use ABA as a way to run programs that eradicate this sensory issue for good. The name of one technique is systematic desensitization. This is where, a child is exposed to the stimulus on purpose and taught relaxation techniques.

For my son and his nail clipper issue it looked like this:

-        -Nail clippers were used on other people

-        -Nail clippers were brought close to him

-        -They brushed the nail clippers over his fingers

-        -They used the nail clippers to cut one nail

At every step this boy screamed and cried and fought, but eventually he could cope with that step. It became normal to him and he calmed himself.

Dealing with things like that alone is scary, especially seeing your own child in that level of fear or pain. An ABA therapist helps to steer them through these issues until they are no longer a big deal.