Applied Behavior Analysis

What is it?

A therapy with a scientific approach to understanding and improving or changing behaviors. AKA Change the environment to change the behavior.

Wait…

What is behavior?

Seems simple enough, but before I go on, let me first express that often the word behavior is associated with “bad behavior”, but there is big importance in that little adjective before the word behavior.

Behavior is simply what we do and how we act.

The dead man’s test…

To better understand what a behavior is, we were taught to use “the dead man’s test”. Can a dead man do it? If he can, then it is not a behavior. I know, a bit confusing, but once you think about it and kind of test yourself it all starts to make sense.

How does ABA therapy work?

ABA therapy is not based on figuring out how and why one behaves, but replacing any given behavior with a more appropriate or beneficial behavior.

How is this carried out?

A lot of positive reinforcement and repetition.

The therapists chart everything, and I mean everything. Therefore, there is data to back up what behaviors are being improved upon or changed.

When & Who?

You most often hear about ABA therapy used for persons with autism BUT ABA therapy is also used for people in relationships and for elderly to help them better cope with memory loss and loss of certain abilities as they age.

It is important that children begin ABA therapy before the age of 4 to see the best results, especially in those with autism.

It is an extensive therapy with best results being carried out 20 hours a week.

ABA therapists are licensed psychologists that have completed a training program and obtained certification through the Behavior Analyst Certification Board. Based on what the U.S. Beareau of Labor Statistics reports, licensed psychologists must complete at least a bachelor’s degree. Psychology Today states that to obtain the Board Certified Behavior Analyst (BCBA) credential, the ABA therapist must complete at least a master’s degree and a specific number of hours of clinical education and experience.

ABA therapy is becoming more and more recognized as an effective therapy for anyone needing changes in behavior.

I was told by Gus’ first psychologist he saw when he was diagnosed with autism spectrum disorder and sensory processing disorder that ABA therapy was seen as the “gold standard” for children with Gus’ diagnoses.

The Controversy

ABA therapy is a very controversial subject among those with autism and parents of children with autism. As I do with everything in life, I extensively researched, studied, and consulted. Per my findings, I decided ABA therapy would be beneficial for my son. I read the horror stories from those that received the therapy in the past, and those who are vehemently against it. Thankfully, things have changed in the medical field and things aren’t as they used to be. There is still some controversy even with ABA therapy today, but I stand by my decision and am glad I did because at three weeks in we are already seeing amazing things.

Also, nothing is addressed or worked on in therapy without MY consent. I am 100% welcome to attend Gus’ therapy sessions, and I do.

Gus’ ABA therapist has and is working hard to build a relationship with him. She will be a big part of his life for a long time. He adores her and that will make things that much easier.

During this journey with my son, I have seen him with a lot of therapists. Some go through the motions, but then there are some that go the extra mile.

ABA THERAPY & GUS

What is Gus working on in ABA therapy? A little bit of everything. We set specific goals, and he is already nearing completion of some of them. He is working on eating with utensils and keeping his hands out of his mouth while eating. He is working on following verbal commands. He is working on using his voice to request things. He is working on communication in many aspects. He is working on conquering his fear of public restrooms. He is working on generalizing things. He is working on joint attention. He is working on appropriate play with others. He is working on so much more. All of his goals are broke down into steps, and as he masters one step we move on to the next until he has conquered the task and goal. He is thriving!

ABA Therapy & The Family

My husband and I also attend sessions with Gus’ ABA therapist to be educated in ABA therapy itself, as well as what we need to do at home to apply what he is doing in therapy at home. Gus is very smart. If we don’t have the same expectations of him at home as are expected of him in therapy he will figure out that he just has to work in therapy and home will be a free for all. ABA therapy also works with all of his other therapies and therapists to be sure everyone is on the same page and that he is shown consistency in all aspects. It sounds like we will also have meetings with all therapists at once here and there to go over things.

Applying things at home takes a whole lot of patience and a whole lot of time. While I am not perfect and sometimes let things slide, I try to remember that all of this hard work now while he is young will more than pay off as he gets older.

Our Schedule

Gus has been receiving ABA therapy for 3 weeks now. We started at 1 hour a day 3 days a week and quickly moved to 1.5 hours 4 days a week. This coming week, we plan to do 2 hours 3 days a week moving to 3 hours a day 4 days a week in July and going from there.

Gus also receives speech therapy and occupational therapy at home on Mondays and Thursdays in the morning before we leave for Rapid City. He also still receives occupational therapy, speech therapy, and physical therapy once a week at LifeScape.

Yep, that means we travel 83+ miles (166 miles round trip) up to 4 days a week. It’s been a spendy venture, but once we get going insurance will reimburse mileage; it just takes a while. I also had to quit my job, as there was just no way to schedule work around therapy and therapy around work. I still fill in when I can, though.

I take Ada (Gus’ older sister) with us 1-2 days a week. She attends part of therapy with him and eats lunch with him and the therapist and then works on joint play with him. Then, Ada and I go play outside, as she understandably has a very hard time keeping quiet and allowing Gus to focus. The other days of the week, Ada attends daycare.

It’s hard on me…and all of us, really. BUT what’s important to me is how Gus is handling it. As long as it isn’t too much for him it’s not too much for me. We are allowed to back off on therapy at any time we feel we need to. Gus is thriving right now. I keep in mind that a few years of this very intense schedule and intensive therapy will pay big later.

I also failed to mention earlier that Gus is the very first ABA therapy patient to be accepted at LifeScape in Rapid City, SD. Until now, ABA therapy was not offered at LifeScape’s Rapid City location. For a long time, we were adjusting to the fact that we would have to move to Sioux Falls, SD part time for an undetermined amount of time. Talk about STRESSFUL, but we were ready and willing to do what we thought best for our family, and kept moving forward, which is why Gus was accepted as the first patient; we already had everything done and ready to start at LifeScape in Sioux Falls, SD, so they were able to just transfer all of that information to their Rapid City campus.

I’ll keep this shorter by just sticking to the topic of ABA therapy in this blog post. We have a lot going on, and I have lots I’d love to share, but will do so at a later date.

Thank you for reading and taking the time to learn a little more about a life a bit different.

I’m learning all the time, and am always happy to share.

Signing off now.

– AMomsFaithUnbroken

ABA Therapy

I will never forget Monday, October 15th, 2018 – My son’s long awaited Autism Evaluation at a LifeScape center in Sioux Falls, SD. I will never forget because this day made everything “official” and really “real”. I truly didn’t hear much I didn’t already know in my heart, but it’s still different to hear it come out of the mouths of medical professionals highly trained in the field.

THE DIAGNOSIS

  • Nonverbal moderate to severe autism spectrum disorder level 2.
  • Sensory Processing Disorder.

NONVERBAL:

Not involving or using words or speech.

WHAT IS AUTISM ?

Autism is a complex neurobiological disorder that impacts the development of the brain in the areas of social interaction, communications skills, and learning. Autism is a part of a group of disorders known as autism spectrum disorders (ASD).

LEVEL 2:

The DSM-5 notes those with level 2 autism require substantial support. The symptoms associated with this level include a more severe lack of both verbal and nonverbal communication skills. This often makes daily activities difficult.

Common Level 2 Symptoms:

  • difficulty coping with change to routine or surroundings
  • significant lack of verbal and nonverbal communication skills
  • behavior issues severe enough to be obvious to the casual observer
  • unusual or reduced response to social cues, communication, or interactions
  • trouble adapting to change
  • communication using overly simple sentences
  • narrow, specific interests

FB_IMG_1539747685302

SENSORY PROCESSING DISORDER

SPD is a dysfunction in the way the nervous system receives messages from the sensory system, and turns them into motor or behavioral responses. Misinterpretation of everyday sensory information like touch, smell, taste, and movement are indications of sensory processing disorder. Research shows that as many as 1 in 6 children experiences sensory symptoms signification enough to affect aspects of everyday activities such as bathing, dressing, eating, playing, and learning.

sensory-processing-disorder-11-638Signs-of-Sensory-Integration-Disorder-

PLAN

It’s a lot to take in…A LOT. I absolutely adored the team that did the evaluation. The team consisted of a psychologist, a speech/language pathologist, an occupational therapist, a graduate student, and a high school student. They were so knowledgeable and such kind and fun people. After the actual evaluation, we sat at a big table with everyone present and each specialist took the time to explain their findings and their thoughts on diagnosis. My husband and I were allowed to ask anything we wanted.

In addition to the above listed diagnoses, it is also recommended that my husband and I consider a dysphagia evaluation to address some oral issues.

It was recommended that therapies be increased by A LOT. Right now, we are doing joint occupational therapy (OT) and speech therapy sessions for a half hour once weekly. It is recommended that we increase therapy to a minimum of 2x weekly with OT and speech therapies separate. I completely agree with this plan. It is also recommended that we utilize both the South Dakota Birth to 3 Program as well as outpatient therapy at LifeScape in Rapid City, SD. This is what we wanted all along…

MY FIRST LESSON IN ADVOCACY

This is what we wanted all along…I explained to the team in Sioux Falls that when we first started therapy before the official diagnosis, we had informed LifeScape in Rapid City that we wanted to do therapy with them most of all, no matter what, and would even choose their services over Birth to 3 (which is FREE). I played phone tag with LifeScape Rapid City, and I talked to several different individuals. We were told we would be put on the schedule for OT and speech therapy at LifeScape, and even went over what days and times would work best for us and them. I never heard back and never heard back. So, I finally called them. Again, I was kind of given the runaround, but told they would talk to the person in scheduling and get things going. Then, I randomly received a phone call from someone in scheduling. She stated: “It looks like you qualify for Birth to 3 and should be able to receive all of the services you need. Congratulations.” (click…hangs up) I have to admit, at that point I just kind of gave up. I more than got the impression that they preferred we just do Birth to 3. I know there are waiting lists, and I know Birth to 3 is free, BUT I want what I feel is best for MY child. I loved the therapists we saw at LifeScape in Rapid City when my son was seen for his therapy evaluations. The therapists were more than happy that we wanted our son to be seen there. It seemed to be scheduling that thought otherwise. Anyway, I learned my lesson. I have to PUSH and SHOVE and SHOUT and RELENTLESSLY work and NEVER TIRE to make sure my son gets the therapy, care, and support that my husband and I feel he needs and deserves. The therapists at LifeScape in Sioux Falls really helped me to see that. In fact, they said they would call and talk to the head person of LifeScape to make sure that those at the Rapid City branch are made aware of the situation. (All of the LifeScape centers are connected.)

I am actively working on getting us a social worker or some kind of advocate to sit in on meetings and such and to help advocate for Augustus, as well as help us know what’s out there in the way of help and support.

OUTLOOK

With early intervention the outlook always improves. Unfortunately, with autism there really is no outlook per se. A word they actually use with autism (other than spectrum) is fluid.  The autism level is actually fluid. Once my son is ready to start school, he may actually bump up to a level 3 as he is faced with new and difficult tasks, and may really struggle even worse than he does now. It is also possible that he could really grasp things in therapy, and for a while maybe even be at a lower level 2 or even a high 1. There are no answers. There is truly no outlook. I don’t know if I will ever hear my child speak a word, call me mom, tell me he loves me, tell me what he needs. I don’t know if he will ever be able to live on his own, use a toilet, be able to dress himself, have a job, have a family. That’s why I try not to waste my time worrying about the future. I want to enjoy the now and see where things take us. Otherwise, life would be full of worry, fear, and misery.

We will obviously be traveling a lot, and spending a lot of time in therapy. I’m not exactly sure what that means for us. It’s just one of those things we will have to deal with once everything is scheduled. The specialists on the team in Sioux Falls at the evaluation actually said one of their recommendations was for our family to move to Sioux Falls so they could work with my son, as they truly enjoyed him. Don’t think the thought hasn’t crossed my mind. I love where I live, and have never really had much desire to live in a bigger city, especially once starting a family…until now. Granted, that desire is only at about a 1%. You can bet your sweet butt I would do anything to make sure my kids have what’s best for them. That’s why nothing is ever off the table. No, we have no plans of moving right now; none at all. It was brought up, but not seen as being a necessity. Things will be wild and crazy for a while, but then it will become “our normal”. Therapy is always changing and adapting to where the child is at. Therefore, at any time, it could become more or less extensive. We shall see.

It is also highly recommended that we seek out Applied Behavior Analysis (ABA) and/or Early Start Denver Model (ESDM) therapies. These therapies are not offered at the LifeScape center in Rapid City, SD. Therefore, we are going to attempt to find another place to acquire these services in Rapid City, SD.

I’m sure there are plenty of words and things you may have never heard or do not understand throughout this blog. You’re not alone. I’m learning as I go. I have no choice. Never hesitate to ask. If you’re curious about something or don’t understand something, ask. I am all about advocating and educating.

That’s all for now, friends. I could go on forever. I hope you find these posts helpful or at least entertaining in some way.

Peace & Love,
– AMomsFaithUnbroken

DIAGNOSED