Julian Hung's son was diagnosed with Autism Spectrum Disorder at the age of two and a half. His son has since had three years of applied behaviour analysis (ABA) therapy and has made tremendous progress. Julian is writing this blog with the hope that other parents might benefit from his experience.
When we started Intensive intervention therapy for my son, we knew that to be a success, it would have to be a team effort. As parents, we needed to support what the therapists were doing and to do this, we had to learn as much as we could about what they did and how they did it. We were therefore very happy that the Gold Centre, where our son was getting his therapy, offered excellent training for parents as well.
Their parent training series covered many topics ranging from introductions to Autism Spectrum Disorders and ABA therapy (short for Applied Behavior Analysis) to dealing with anxiety and disruptive behaviours, and more technically, how encouraging communication and co-operative play. We were even invited to benefit from a full ABA course which, while aimed mainly at therapists, was also made open to parents who wanted to know more about the background and techniques of ABA therapy so that they could be better informed about the services their children were receiving as well as to continue to integrate the techniques at home to generalise those skills acquired with their interventionists. I attended almost all of them, encouraged my wife to do the same and the techniques that we learned have helped us tremendously.
In particular, we came away with a greater appreciation of the principles and techniques underlying ABA, and how to best apply these useful strategies for dealing with a variety of situations while providing an overall approach to parenting which was positive, constructive and empowering.
The first thing I learned about ABA is that behaviour does not exist on its own but instead is part of a chain. Specifically, every behaviour is preceded by a cause and followed by a consequence. And depending on the cause and consequences at work, different behaviour will be observed. (In ABA, the cause is referred to as the 'antecedent' and the chain of "antecedent - behaviour - consequence" can be usefully remembered as "a -b -c".)
Once I understood this, I realized that the puzzle was then to figure out what were the causes and consequences at work in relation to a particular behaviour that I was observing and how I might adjust them to produce the appropriate or required behaviour.
So for example, when our son showed very little eye contact, interest, and engagement when we played with him early on, we were initially at a loss. We had tried to make interacting with us exciting, but nothing had worked. We were then amazed to watch his therapist ask him to imitate her banging a drum and the wonderful look of happiness he gave us when she gave him a loud cheer after he did it!!! In this case, the antecedent of banging on a drum was used and the consequence of cheering him on was enough to produce a glance and a smile! As it turned out, this was a breakthrough moment which started everything.
Strategies for shaping behaviour
With some understanding of the framework of ABA, we were able to pick up a number of techniques for dealing with various situations. Some examples:
- recognizing attention-seeking behaviour and not encouraging it by rewarding it
- recognizing when the initial desire for something turns into a desire for control
- breaking down desired behaviour into smaller pieces so they are easier to handle and teach
- letting our son try different things and activities to identify his preferences and thus potential reinforcers
- redirecting inappropriate behaviour so that it becomes appropriate or replacing inappropriate behaviour with appropriate behaviour
Videos, both those from studies and those made at our own home, were especially helpful to reveal what is going on and how different responses and strategies give different results!
Many strategies can also be gained at parent training seminars simply by sharing with other parents.
With a better understanding of ABA and it's clinical application in the Early Intensive Behavioural Intervention setting our son attended, and armed with a few techniques, our approach to parenting has changed, not only for our child who has an ASD, but for both our children. Instead of reacting to situations emotionally, we started thinking about them rationally. Instead of getting upset, we became more calm and patient with the knowledge that things would get better as long as we were positive, creative and didn't give up. Instead of thinking of our glass being half-empty, we thought about how it was half-full and how we could fill it further. In other words, frustration and despair has now been replaced by hope, opportunity and empowerment to rise to the challenge!
There is no question in my mind that parent training has made me a better parent. While there is a difference between the theory and practice of ABA therapy (practice being more difficult) and while there is a difference between being a parent and being a therapist (it's important for a parent to be a parent as well), the knowledge gained from the parent training offered by our early intervention team has been invaluable.
I would add that aside from the topics already mentioned, there are many others which have been useful in other ways including seminars on how to Navigate government and community-based services,, tax planning and preparing for school entry.
Whenever I am in parent training, I often think about parents who have not heard about these wonderful classes or for one reason or another cannot attend them. For those who have the opportunity, I would strongly recommend that they try them.
ALSO ON HUFFPOST:
According to the most recent Centers for Disease Control and Prevention estimates, 1 in 68 children in the United States has an autism spectrum disorder, based on health and education records. That figure represents a significant increase from previous prevalence estimates, released in 2012, which estimated that 1 in 88 have an ASD.
Autism is roughly five times more common in boys than girls, according to CDC estimates. One in 42 boys have been identified with autism, compared to 1 in 189 girls. Children born to older parents are also more likely to have an ASD.
According to the NIH, early indicators include: No babbling or pointing by age 1, no single words by 16 months, poor eye contact, little to no smiling or other social responses and more. (Click here for more information from NIH.) The CDC says, "Health care providers will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior. Some screening instruments rely solely on parent observations, while others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of an ASD, a more comprehensive evaluation is usually indicated.”
According to the Child Mind Institute both genetic and environmental factors could contribute.
Autism is treated with therapy, education plans and medication. Doctors and scientists say that early identification and intervention for children with an ASD can help them thrive in academically and socially in the future. There are still studies being done to find better treatments and perhaps one day, even a cure. A paper in Cell, a scientific journal, discussed a study with more insight into what could cure autism. The study found that feeding rats with similar symptoms to autism a gut bacteria called B. fragilis lead to an improvement in their behavior. "They became less anxious, communicated more with other mice, and showed less repetitive behavior,” according to the Atlantic.
Even when multiple vaccines are given to a child on the same day, they are still not at risk of developing autism.
Studies have also shown that if a child with an ASD has an identical twin, the other will be affected anywhere from 36-95 percent of the time.
There is an 83% chance of co-occurrence for developmental disorders and a 10% chance for psychiatric disorders. These disorders include Bipolar Disorder, Fragile X syndrome and Down syndrome according to the CDC.
Children whose language skills regress before they turn 3 have been found to have a higher risk of developing epilepsy.
The CDC recommends children be screened when the are 9, 18 and 24-30 months.
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