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Applied Behavior Analysis

September 20, 2017 by  
Filed under Uncategorized

by Monica Lee, MD

 

“Point to red” is a common refrain I hear daily. My son says it out of the blue several times a day. He is probably thinking about one of his Applied Behavior Analysis (ABA) therapy sessions he gets at home six times a week. A therapist will sit with him at the dining room table and repeatedly ask him to point to red and reward him with a treat when he does. They will continue this until he masters the task at 80 percent in two consecutive sessions. Ever since he started 15 hours or more of therapy a week, he has been making huge improvements each month. I kick myself for not starting this therapy sooner. His Behavior Interventionists (BIs) work tirelessly with him every day to help improve his joint attention, speech, and social skills. ABA is a growing field where there are just not enough workers to fill the need. BIs are entry-level workers who receive several weeks of training and then usually independently work with children with autism. They get paid just above minimum wage and are subject to often rough treatment from their subjects, who often kick, bite, and scratch when frustrated.

I have no excuse for not starting ABA that first year after my son was diagnosed. I was still in shock and too depressed to read anything educational. I couldn’t even get through the Regional Center’s parent training program. Because of his declining skills, we tried speech therapy right around the time he was two years old. He made no progress after a month of weekly sessions there. And all the speech therapist could say to us was how much he was likely to have autism. A few months after that, we started ABA for three hours a week; it was not enough. We wanted to keep him at the same day care since we had such a difficult time getting him child care, but the day care declined to let an ABA therapist work with him there.

Finally, I moved and we needed different child care anyway. We tried a neurotypical preschool, but he didn’t do well there, so we finally had to get a nanny. That is when he really started to improve. We were then able to get at least 15 hours of ABA a week in a consistent and peaceful environment. He was finally potty trained when he was five and a half, and he even started answering questions with “yes” and “no,” which was something I never thought he would be able to do. He is now able to name relatives in photos. We also found an amazing speech therapist who works with him twice a week. And just two days ago, he finally greeted me excitedly at the door with, “Mommy, Mommy, Mommy.” This was something he had never done before and hasn’t replicated since, but it gives me so much hope. He is almost six years old, and I hope with the help of ABA and speech therapy, this will be the year he will start calling me “Mommy” consistently.

Here are some tips if you suspect your child might have autism:

  1. Get a diagnosis from your pediatrician, pediatric neurologist, developmental pediatrician, or psychologist ASAP.
  2. Have your pediatrician then refer your child for ABA therapy, speech therapy, and occupational therapy. Most health insurance carriers in California will cover this. If not, switch to one that does or move to a state that does.
  3. If you live in California, your Regional Center will cover costs for therapy not covered by your insurance carrier.
  4. During a child’s first five years, his or her brain is most “plastic,” or flexible and able to change and make neural connections based on what the child experiences. This means that the earlier an autistic child receives therapy and the more hours of therapy he or she receives, the more likely you will see progress. Studies show that if children get 40 hours or more of early therapy for two or more years, they have a much higher chance of having a normal IQ.*

About the Author: Monica Lee, MD, is a mom of one son and an ob-gyn in the LA Metro area.

*Lovaas OI, “Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children,” Journal of Consulting and Clinical Psychology 55, no. 1 (Feb 1987): 3–9.

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The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.