What's Your Opinion: Are Autism Treatments Like Diets?
After years on the job as a mom of a child with autism, I've begun to think to think that many behavioral and developmental autism treatments are very much like "revolutionary diets." Each -- RDI, ABA, Floortime, Sonrise, and many others -- touts an amazing new way to -- maybe you guessed it again -- spend lots and lots of quality 1:1 time helping your child build social, emotional and reasoning skills.
ABA is the Jenny Craig of the bunch. It's ideal for the parent who likes a pre-determined, doctor-approved system that can be administered appropriately without a great deal of prep or cleanup time. Sonrise is more like Weightwatchers: it offers a tremendous amount of personal support, but requires an awful lot of time, effort and dedication. RDI is good for a parent who needs structure but doesn't want the warm fuzziness of a support group -- think South Beach. And Floortime is probably best for those do-it-yourself parents who, when dieting, need nothing more than a calorie counter and a fridge full of healthy choices.
Am I nuts? Are these programs really qualitatively all that different? Or are they really different ways of providing our children with what they need most: a great deal of intensive 1:1 time from a caring, supportive adult? What's your opinion?!
Comments
I think there is some difference. My son got some Floortime-type help when he was two and three, and limited (less than three hours a day) ABA-type help from about 4-8, and a combination approach through most of his life. He is now 12, and looking back, I think the ABA worked best as far as actually teaching him.
I designed my own approach and that seems to work best now. It includes some elements of ABA and RDI/Floortime, but also includes insights gleaned from books targeted for kids with Down Syndrome (even though my son doesn’t have Down’s Syndrome). I also consider my own feelings about him, and check out new approaches regularly to see if I think adding something would be beneficial for him.
Cynthia
I think for some kids a particular approach might be far more beneficial than another, but for other kids, a combination or established or totally alternative approaches might work best.
My autistic son, who is 4 now, recieves intensive ABA therapy. It has helped him in so many ways and also for a year he actually recieved 40 hours per week of ABA in home therapy. This wasn’t just helpful because I wanted a “pre-determined, doctor-approved system without a great deal of prep or cleanup time,” 40 hours of therapy a week in my home meant that I had therapists on rotating schedules in my home for 8 hours a day, 5 days a week; all the while working a full time job at night so i could be home with him during the day while he recieved therapy and my husband was at work.
Maybe I took it the wrong way but it just seemed as though your perception of these therapies is that it’s just for parents who don’t want to spend 1:1 time with their children. If I interpreted that inncorrectly I apoligize, if not….another view may be that there is a lot of knowledge that goes into ABA therapies and they can help Autistic children a great deal; in addition most of these parents spend a lot of time with their children and are very loving, caring and supportive as well.
Actually, my point was absolutely NOT to point the finger in a negative way at any of the many approaches to therapy. But it does seem to me that all of them, no matter how different in philosophy, come down to this: lots and lots of 1:1 working with an adult on engagement, emotional and reasoning skills, social skills, etc.
In fact, having learned a great deal about ABA from the folks at Lovaas (check out “All About ABA” in the Treatments section of the site), I don’t see ABA as all that different from Floortime and RDI. It certainly USED to be strictly behavioral — but now that it’s practiced in naturalistic settings, and works on a wider range of skills, I see that it’s quite similar!
So my thought is — since the therapies are really very similar, do most of the differences lie in how they are presented? And are those differences most significant to the child, or to the parent? (Since there are very few studies out there, and NONE really compare therapies head-to-head, we really don’t have the option of making an informed choice based on what is most likely to work best for any individual child.)
I think the therapies are actually quite similar, however, they seem to differ mainly in their presentation.
Presentation can be quite significant, I believe, depending on the child it is being presented to. My son required lots of structure so ABA worked best for him. Floortime was too unstructured for him and he was easily distracted. Anyhow, I think each therapy can be useful…it is just important to evaluate which one will work best for each individual child.