Primine

I would recommend starting with: "What is there about Asperger syndrome that is curable?" - by Dr. Digby Tantam, University of Sheffield. to spark your interests and then going through abstracts to find another topic of interest.

Hey all... Sorry I haven't been able to keep this discussion alive. It is simply too time consuming. Thank you all for the valuable lessons. There is an online conference being offered for free that I'd recommend everyone check out. You need to register, but it is entirely free. It appears to be a wealth of knowledge and has forums itself to discuss issues with the authors of the papers. Maybe you can even gain a little tolerance for us behaviorists. http://www.awares.org/conferences/ I'd ask everyone to post comments from the conference in this thread so that I can easily follow up on them. (even though I will likely not reply) Thank you all again for everything, and I wish you and yours all the best. Don't put it off too long! THE CONFERENCE IS ONLY BEING RUN FROM 17th to 21st October 2005.

It's so sad that people like this are out there... I remember in my early elementary class, one of my peers raising his hand and offering as a solution to overpopulation in China: Can't we just nuke the... <insert racial slurs here>. I believe he mows lawns and shovels snow for a living now...

Also we are now in the top 5 for most replied to threads... Hazzah! And I meet with my supervisors tomorrow to decide what my topic will be. I'm going to propose the one looking at stims (you all know what I mean), and the one looking at PECs vs Signing (developing initial criteria for when each is more likely to benefit the child, or skill checklist for existing requisite skills)

Just when you thought the carnage was over... the thread returns from the dead. Sorry it took some time guys, but I?ve been doing this on my free time and it takes hours to read, comprehend and respond to all the posts! I am considering printing it all off and leaving it in my office so that my colleagues can comment (many have much more experience than I) First some general points to clear up: We don?t FORCE eye contact. We reward it, so that it happens more frequently. If the child performs and demonstrates they are learning the skill without eye contact that is just as good. We don?t require eye contact most of the time. We just need to know that they are involved with us. Eye contact is a key indicator of attention, but if we are sure the child is attending even without making eye contact that is just as acceptable. The fact of the matter is that time and time again the children learn more, retain more, and perform better if they are involved throughout the session. I am not saying that all children will indeed do better if they had been making eye contact, I am saying that every child I have come across has done better in each lesson if they had been making eye contact, looking at the task, sitting, or had hands ready. IBI is incredibly flexible however. If a child did not perform better under such conditions we really would have no trouble letting them do their own thing. If they are learning (and not disrupting the environment outside the tolerance level) then there is no problem. Eye contact is just one of many ways of getting the child to attend us again if they had stopped. It is not a requirement. I never actually said that we should take away a child?s comforters. I was saying that as they grow older we should try to transition from one comforter to a more appropriate one, and most of you actually repeated this point. There is nothing wrong with comforters, and in fact often should be encouraged as a healthy outlet for all sorts of inner workings. But some comforters simply don?t work. For example a child who cannot release his mother?s hand for more than 30 seconds outside the house will have a wealth of troubles if something were to happen to the mother, or when the child needs to start going out on his own. The point I was trying to get at with my comment was that if an counter-productive stim is used as a comforter, then we need not remove it if it is possible to transition it to something more functional. We start at the same point with all kids. We take them and assume they can do nothing and probe for a couple weeks a HUGE range of skills to find out exactly where they are developmentally speaking. We then pick up from there, using that data as the baseline. With the cultural points on inappropriateness: I think you are all correct on the danger of the word, the connotation it is used, and the intent with which it is used. I believe that cultural differences should be embraced and understood by everyone, especially those in an educational position. �And I noticed that the teachers, most of whom are white, accept the eye contact as normal - are they actually encouraging the children to be insolent by accepting this rather than expecting the child to use the cultural sign of respect?� I think you would need to ask the children if they understand the cultural difference themselves, and what is going on with them. From everything I am reading on II it seems to be VERY similar to IBI, more similar than I had initially thought. You out there who have researched and hate ABA, which parts of ABA do you disagree with and aren?t present in II? ARTICLE MATERIAL The article Jaded posted �Greenspan, S.I. & Wieder, S. (1998). The Child with Special Needs: Intellectual and Emotional Growth. Reading, MA: Addison Wesley Longman� shows a very strong and solid opposing model to current early intervention. It coincides and diverts from our model at various parts. It cannot be used strictly to determine which model is better. Also the article mentions some of the problems with early intervention that I cannot explain because they don?t exist in our model (ie. The exclusion of parents) There's a fairly thorough overview here: http://www.autcom.org/behaviorism.html� This is why we encourage peer play at least once a session: �If the child is not helped to find manageable, rewarding interactions, he or she will begin to "shut down" the baffling environmental input and a form of self-imposed sensory deprivation will begin to set in.� From the same article: �The typical newborn learns to regulate its sensory system and shows interest in the world.� This is what I was saying when I said �observe their environment in it's entirety�; it is important for children to be taking in their environment at an early age. They need to absorb what is out there. Also: �For example, instead of signaling to Mommy that she wants to have the toy or cookie that's out of reach, the child may withdraw, become perseverative, or tantrum while the parent searches desperately for the unconveyed reason.� This is why we focus a great deal on teaching communicative skills (PECs, signing, verbal) �Finally, if there is a discrepancy between what the parents say about the child and what the observer sees, this needs investigation. In order to intervene productively, parents and professionals must come to a shared view of the child.� This is why we encourage family involvement and to attend clinical meetings and the sessions we have with their children. �Drawing on his vast clinical experience, Greenspan finds that as much as 50% of the group presenting with severe relationship, communication, motor, sensory and cognitive difficulties -- that group typically labeled with autism/PDD -- is actually "ready to take off." With appropriate relationship-based therapy this group will respond with surprising speed to play, will become joyful, and will learn to cue off their own affect rather than off artificial prompts or rewards.� Here is a major point of divergence. IBI uses a combination. We used relationship-based therapy with (at times) prompts and rewards. Kathryn I could not disagree more. A teacher?s problem is everybody?s problem. Problem behavior needs to be eradicated because it is a PROBLEM. If a NT child was disrupting a class in any number of ways should we let it continue because it?s the teacher?s problem, or should we try to change their behavior? It?s not an attack on who they are. It?s an effort to teach them the rules, norms and boundaries. If a stim is extremely disruptive to everyone else, because we are working on inclusion into the mainstream, we need to find out why they are stimming and then find other, less disturbing alternatives (perhaps if possible something more constructive?) With your child being docked marks for looking while singing? that is a serious problem in my opinion. In a formal concert presentation you may be expected to look forward, just as in a marching band all members must step the same time, for the synchronization and appearance. That point should not be evaluated in a school setting; I firmly believe the knowledge is more important than presentation in schools. Alphazebra Thank you for your insight on the various reasons why you stim and what you think as you make eye contact. I think the difference is that these children, even if they are uncomfortable, learn more when they do make eye contact. We don?t demand it every instruction. In my experience if a child is getting the same instructions incorrect, especially if they have already been mastered, asking the child to make eye contact or �sit ready� that will suddenly provoke correct answers. If the child NEVER looks at us, or even what he is doing, and is learning all the same then that is just as good. Zemanski I think that is something I maybe haven?t made quite clear about IBI. It is EXTREMELY flexible. It does start with general guidelines and approaches but it does adapt to the children. That is one of the benefits of our ?one on one? approach. Autism, as you said, has its good and bad sides. We aren?t trying to �cure� autism and take away the good parts. We are simply trying to minimize the bad parts to make life more comfortable for the children. We aren?t trying to make them �look like everyone else� by taking away what makes them different or special, we are trying to help include them better with societies laws, rules, and general norms. I think this is where we agree. We need to teach children the skills to get along in society, but society should also demonstrate more flexibility and tolerance and acceptance. I think that was a marvelous way to deal with the comfort blanket, but what if the �comforter� is a vocal stim like screaming as loud as possible? I agree that we should look for a compromise where possible. I don?t know why you would consider a problem with early intervention to be that it is used early. It is a system to be used if we were lucky enough for early diagnosis. If there is a late diagnosis (as I am noticing is quite common from the poll) then there needs to exist another system for that, not a reform to the system in place for another group. bid Of course this is possible. But it isn?t difficult to get the child to make eye contact. They just got distracted. They are children. They get distracted. We all do. Hell? I do more than any kid I have ever seen. Most often they are just temporarily distracted and needed a reminder of what is going on. Lucas You have made some very excellent points. Within your homosexuality analogy you expressed concern that behaviorists are targeting dysfunctional, maladaptive or inappropriate behaviors that they should not be. Could you tell me which ones? I agree and disagree. I agree that it makes complete sense that they are not being distracted by the stim, the stim is a response to a distracter. I still disagree that an autistic person cannot be distracted by a stim. If their stim, while automatic, also requires their complete involvement (running back in forth the length of the room) they may not be able to concentrate on anything else or if the stim is more rewarding than paying attention (if the stimulation of the visual receptors from staring at a light is more exciting than looking at anything else) the child has no reason to stop so long as the light is there. (and while we established that a child can learn without making eye contact or directly at an item I don?t see how you can teach the child which animal is the cow if they won?t look at it at all). How would you teach a child to pick up food and eat if the sensation of air rushing over hands in hand-flapping is more rewarding than even eating? There is a great deal of research done into the necessity of visual modeling, especially in birds. What would be done is a bird would be chirping near the newly hatched chicks, but the chicks would never see the bird making the sounds. The chicks would grow up and learn singsong, but they would sound completely different, and other birds would not respond to them. Similar research (although obviously not identical) research is conducted on adults. I will try to look through my resources on my spare time to find the exact references. I am not saying that a child will not learn to talk because he isn?t ever looking at who is talking to him, I am saying that visual models increase the rate of learning, which is what we are trying to do. Help children catch up in some skills they are a little behind in. call me jaded You are right. We cannot teach a four year old to understand their differences. But that child may not learn the same way a NT child might. We have many completely nonverbal and illiterate children in our service. Maybe we can?t teach them to understand everything, but we can teach them to read and write where the mainstream education failed.

Hello and sorry all... I am still here and will do my best to reply and carry on the conversation, but like I said... it's me against the world and there is much to say! I don't have time to read it all right now, but I am planning on it tomorrow. Hope you all don't miss me too much...

Am I the only pro-ABA person on this forum? I could use some backup people! I'm outnumbered and it's hard to keep up! Makes for really long and boring posts! I tried to bold specific names for specific responces. While some people are okay being called autistics, some are not. That is awesome that so many parents speaking here are accepting of their children being "autistic" and those of you on here who are autistic yourself, calling yourself "autistic". But some people are not so comfortable with the term. They don't like the label, and have various other issues with it. We are simply trying to be professionals and accomodating as many people as possible. It seems from all the links given me here that some behavioralists are trying to cure it "as a cancer". It is MY experience that in my network of centres (5 major community organizations with multiple teams all opporating in one city) that that is not our goal. We are just trying to help these SEVERLY autistic children with any soical/communicative/behavioral deficits/excesses. I agree with Lucas and others that autism is part of the individual. Because it is an integral part of them that will be a part of them for life we need to make sure that they have the skills to function as individuals in a society that is, sadly, rather cruel and judgemental. I am certainly leaning towards "my research project being directed at 'stimming' and whether it is counter-productive to correct this behaviour?" Jaded. That actually came up in my training when I was playing with my pen and an instructor commented that I was "stimming" on it, but I was still paying attention. That night I went through every psych textbook I have (I nearly have my own library) and there is NO mention of stimming being counter productive OR productive if it is unattended. I then hit the library, and found there is little research done. I don't know why we interfere with minor stims, or unattended stims. If I do research and find EXPERIMENTALLY that stimming in fact HELPS focus, this would be very big indeed. I understand it seems like common sense to you parents, and even us ITs, but you need to understand that there isn't alot of experimental research with controled and manipulated variables existing. And we try not to use sweets as well. We pair it with praise so that our sincere "GOOD JOB"s and "AWESOME!"s will be effective, but we also use toys, fruits, and activities they really enjoy. Further, I believe it is correct to say that a goal is for these children to fit in with their peers behaviorally (although I disagree when it is said we are targetting personality specifically). I understand parental concern that behavior is a part of a personality, but please also remember that we are trying to teach skills and socially acceptable behaviors. (This is an extreme example, bare with me) but if it is someone's behavior to steal and this is corrected by the penial system then, while their personality is being modified, it is to conform with society. Correct me if I'm wrong but is this one of the key points of our debates: Some of you feel it is unethical for us to be modifying behavior because it compromises the child's personality and who they are? If this is the case then I'd say it is a gray area, and while one may believe it is unethical (and people are entitled to their opinions) the laws are unclear and open and other people have the opposite oppinion. People are free to lobby their opinions, and even bring about change if possible, but not free to cast judgement on the opposition. Bid: I understand how the term "programming" can be seen as cold and rather inhumane. You are completely right. I shall use teaching now, and I hope that's better. A question I pose to you barefoot: would you let your child carry a comforter until he is 30 years old, or would you try to (NOT FORCABLY) persuade and aid him to manage without it? Again, this is assuming that the stim is an anxiety relief and not something functional (this is where the forementioned research could help: how to distinguish if a stim is an anxiety relief or a functional behavior like focusing). All who said that you need to see what was causing the stim are quite correct, but it is no easy task. Carole: Back to our trampoline scenario: I too believe that in a perfect world education would wrap around the child and not the child wrap around the education, but the fact of the matter is that the funding is not there (and will probably never be there) for every child to have his or her educational needs met perfectly. I think it is the opinion of the government that if we can spend some money 2 or 3 years (my job) to teach the child to learn without the trampoline than we don't need to pay to have a trampoline there for all 12 years of his education. (We do use trampolines in our teaching, by the way). Also, teaching a child to play with peers is attempting to help with any social deficits. If the client (again - professional term for autistic child) doesn't wish to play with them, that is fine. Many of our kids do want someone there, and just lack the skills to initiate contact on their own. Further by encouraging peer play they can witness (I think you are going to hate this term) age appropriate play and then figure out for themselves (like many can) what the meanings are. Generally the children don't clean up not because they don't understand (they will demonstrate it on their own if they are bored and when completing a task often the children will naturally put the puzzle away on their own) - they don't do it because they want to and will keep playing. As a parent you must understand the importance of teaching that activities end: or else you have children with no bed time playing until they pass out. As for candy by the face... it only stays there until the child is making eye contact, so that they can learn the value of eye contact. I don't know how else to teach eye contact. And one of the key characteristics of autism is that they will not make eye contact or observe their environment in it's entirety, instead focusing on one point for long periods. This is theorized to be a significant part of why their learning is behind that of typically developing children, because babies especially learn so much because they are always looking around and watching. If someone is focused for extended periods then they are not seeing behaviors modeled. You are quite right that in a prompt (guiding a hand) we are making the choice for the child. First we teach them a cow (guiding if we have too) then we teach them to "put all of the animals together" selecting from a wide array of items to show that they understand that a cow is an animal. I don't know if that makes it clear at all, but believe me, we are trying to teach understanding and meanings. It very hard and largely dependent on the child's own cognitive abilities. We do try to find out why our children tantrum: sometimes it is something unavoidable like their playschool teacher left the room, or it is raining so play has to be inside, or someone walks by in a green shirt... these are all examples that have sparked meltdowns and we simply cannot avoid. The children are allowed to be themselves for a great deal of time at home and at school. If the child is playing alone in play time we are not firing kids every chance we get. If they have been playing for 15 minutes we may try once to get someone else involved. Maybe it works, maybe it doesn't and if it doesn't, they will continue to play alone until play time is over. Lucas: You are right. We cannot guarantee 100% we do not use aversives. Nobody ever can, including parents. We do not use what a rational person would consider to be an aversive or something we KNOW to be an aversive to the child. If the child does indicate that something may have been aversive we do something called a Functional Analysis (ABC) to find out exactly what it was and avoid it in the future. We record a great deal of data for this purpose alone because we want our experiences with the children to be pleasant and fun. We are teaching, but we can teach them through games and play! And we never take something away for a wrong answer, we always reward correct responses. Streamdreams: I believe BOTH the professionals AND the client can be distracted by stim. I think you bring out a good point that learning takes the attention of both the teacher and the child. Sorry to repeat but we understand they are children. That's why we do what we do in such a playful and positive manner. We do work on building self esteem. When a child is able to effectively communicate for the first time what they want, and they quickly learn to do it again, they are SOOO happy! It really is what makes this job worth doing! Seeing this kids brighten up so much when they learn a new skill... they are as excited as we are! Because our focus is so much on a child based approach I don't know how it would go working with a teacher or adult. We are generally forced to discharge at 6 (which I find to be terrible, and thank god is being appealed in courts as we speak). Zemanski: Congrats on reforming the system with Anxiety Management Plans! This is why it is so good to see parents taking the time to research, talk with other parents in forums like this, and question those ABA professionals! The comment on the Y6 report is awesome too! Should start marketing a bumper sticker or T-shirt! And Zemanski: I would like a copy of that clip if you can get it. To me it sounds EXACTLY what we are doing, and if it is, then showing it to everyone on this site might help them understand how it is we interact with the kids. If you could just see the way we are with them... I swear... they are having fun and learning at the same time. It is the way school should be for everyone! The only difference I read is that we work in 1 on 1 and not groups of 8 when we are home based, but when we are centre based (as we hope to be soon!) then it will be exactly like that. I am sorry I failed to get across what exactly we are doing with the kids. I hope everyone here is learning as much from this as I am... <'>

That's a very good point. I guess another issue is that we need to teach gneralization, teach so that the skills are there across different settings. If the child can only learn, like you said - on a trampoline, it will be hard when there is no trampoline in his school. And we do try to find out what is making them stim, I believe often if not always it is anxiety and stress. It is very difficult to find exactly what is causing the stress or anxiety though. It could be something as simple as putting the wrong shoe on first. Am I right?

Thank you for educating me Zemanski! I like to think that is what a huge part of my job is: reducing stress and anxiety. Today in my CPI training (proper ways to respond if a child's anxiety is noticably rising and then if they get physical with you or another person) the first topic was looking at stress levels and ways to deal with it. We were told the best responce to anxiety was support. The question posed to the class was: what percent of the time do these kids feel anxiety or stress? Most of us answered between 60% to 90% of the time. The answer: 100% of the time. It then stands to show that our job is to be supportive 100% of the time.

Sorry for the late reply... different time zone and had to work all day without research time. This is really interesting. I have never seen/heard/read anything like this before. I don't pretend to know everything about the subject. Outside the actual area of applying the methods I know very little of the politics, diagnosis and upper-upper management (the clinical PhDs). Professionals are anti-stim because when we are trying to teach a kid it is really hard if they aren't attending to us. If they are kicking walls, or staring at lights, or spinning in circles it is very difficult to teach. We need to have their attention, and we try to get it without being too intrusive. (ie holding candy beside our face) The self injurious stimulation must be stopped because we can't let these children bang their heads against the wall until they are unconscious (and some will). As for stim that they don't attend - hand flapping, rocking, or toe wiggling, I don't know why we stop it. This is what I would research. Find out if it is pointless to try to extinguish the minor stims because they might really be beneficial. I mean it certainly is normal... everybody fidgets somewhat. I don't know anything about any exclusion of Autistic people or people with autism or however you feel like wording it. I assumed they could vote and had all the rights as everyone else guaranteed by the Charter of Rights and Freedoms. At any rate everyone I have seen in our centre has treated the children with nothing but respect, from the instruction therapists, to supervisors, to clinical specialists. If there is a problem going on it is buried out of sight and parents aren't telling us. But the government funds almost everything because we have free healthcare here. Over the last 3 years it has gone up from 2.5 million to (projected) 100 million by 2006. I am not sure why team meetings would be distasteful. It is open only to the parents of the child, the staff working with the kids, supervisor and any consults. We note observations, make sure everything is going smoothly and discus concerns. The initial meetings before treatment we have the parent tell us what they hope to see in their child after the service, be it able to sit quietly in church, do a play schedule, play with peers, handle a car trip for a 3 day camping trip. I am not entirely dismissing the article. I don't know enough about Lovaas experimental methods to say how the parameters were set. I just know that it is being ethically replicated. It is very possible he was using unethical practices. It's the dark history of psychology. We are always striving to be more ethical and even 2 decades ago horrendous things were happening. I know that ethical boards are getting FAR more strict. What I do dismiss about the article is the way it says ABA treats children. WE DO NOT USE AVERSIVES. We don't use physical interventions short of guiding a hand to a correct choice when asking "where is the dog". Even then we try to fade it as soon as possible. We know autistic kids are happy and not doomed, but with our help their lives can become easier because we can teach them to communicate better with others, which reduces stress and anxiety. We do not associate autism as a cancer. It is not something that can be cured or needs to be cured. Often people with autsim may be lacking in some skills and SKYROCKETING in others. Many of the issues with Lovaas method and data recording are not ethical, but statistical. (threats to internal and external validity, randomized assignment, differential sex proportions (inadequate chi-square analysis), selection bias, statistical regression, outcome measures, the problem of residual autism and how to detect it, the problem of replication, the perpetual how-many-hours-per-week question, etc) Yes it can make us question the validity of his results, but it does not guarantee strictly by that point that he went about in a controversial manner. I believe I already commented on the robotizing of children. MANY things in the past of ABA and any research has been disgusting. I mean mentally retarded persons used to be sterilized by the law. I don't defend the past. I say today the ethics have improved IMMENSLY. As for making children act like any other boy: if that means they don't kick and shout at a teacher, or they ask to go to the bathroom rather than just repeating what they here until they have soiled themselves, good, but I can see the concern if it looks like we are destroying the child?s personality. It may be hard to believe but that really is not our goal. Again: we don't touch gender issues. Locking kids in dark closets? Of course that's wrong! To my knowledge, or at least in our centre, that would never be considered. We don't even do time outs. I hope I didn't miss any ethical concerns. Are you thinking of anything specific I didn't mention (keeping in mind I don't know very much about the upper level politics)? It's not just parents who approve of our methods. I would LOVE to invite you to a session if it didn't violate privacy and confidentiality. I am almost sure you would approve of how we work. Here is the outline for a typical session for a child in day care: 9-10 we watch the child play with his peers, maybe attempt to sooth him if he has a meltdown or guide him if he doesn't follow a teacher instruction (such as clean up). We also may encourage him to interact with peers (if he is playing alone say: why don't you ask your friend to come over and play or we may ask the friend: why don't you go ask so and so if you can play with him?). We may also need to help with sharing. From 10 - 11 we do structured play. This is where the real teaching comes in. We have set programs we run: teaching verbal skills, how token systems work, body parts, animals, reading, counting, puzzles, various things you would teach a young child. But it isn't strict teaching. WE PLAY. It's games the whole way through. Yes they are games with a purpose, and yes we reinforce sitting nice and quietness, but we are often criticized by parents who aren't as knowledgeable as yourselves who say we come into the house or play school and just play games. These kids only have one childhood, we don't want them to waste it. Then we take them back upstairs for more peer interaction, whatever the teacher has them doing. Afternoons go similar. If a child tantrums we may ignore it (if it is just screaming or stomping) or we may reinforce them being quiet with praise of a mild reinforcer (we don't want them to learn to tantrum to get things). If the child is self injurious we get right in there, but we don't hold them, we find toys that are more interesting or reinforce more appropriate behavior. Is all of this unethical? Is it wrong to dissociate the "issue" from the individual? Every clinical psych class I have been in has taught that you need to understand that we are working with people. They are not autistics. They are people with autism. They are not manic depressives, they are people with manic depression. It's a way designed to remind the clinician that they are working with living breathing humans. Besides turning the words around, how is it we offend clients with our lingo? I'm not sure how we are offensive. (which I gather is the exact issue you are bringing up - please educate me). You must remember that it is impossible to see cognition. We can't ever know what someone, anyone, is thinking. We can see behaviors and must try to figure out what the person was thinking to create these behaviors. I mean if I sat and stared at you, would you know what I was thinking? Most likely not. If I grab myself and dance around doing the "potty dance" what would you think I'm thinking? (this is a very simplistic example, I realize this) I believe that autistic children can and will learn on their own. I also believe that we can help them learn more and we can help them learn faster; all with less stress. I do agree there is a fine line between "what is a not wanted behavior and what is the child". We try to tackle big things. Toilet training, paying attention, not engaging self injurious behavior, not screaming or tantruming. That can be seen as part of the child, but they are really non-functional. I would like to assert that I am confident a huge part of our disagreements are arising from the fact that I deal and am experience with severe cases of autism, and have little experience with higher functioning autism, adults with autism and Aspergers. Please keep this coming... I am learning so much! And please keep in mind that I am looking for research hypotheses, so if anything brings an idea to your mind, let me know. And I myself am guilty of being weak here too, but could we all work to be more specific in our examples?

Wow. Where to begin. Commentary on the article will be in SECTION 1, clarification on my possible points of research will be SECTION 2, so you can only read what you feel up to it. SECTION 1 Let's start with that article. First and foremost, while well written and seemingly well researched (although I did not check sources) is trash. I almost stopped a couple paragraphs in, but figured I'd read it all and give you my points on where I feel it went wrong. The whole thing is written voicing opinion as fact, which is exactly a huge part of what it is condemning. First of all I should clarify what I do. I am in Instruction Therapist (IT) working with early intervention. We typically work with children 25 hours a week, often in combination with preschools. It should also be noted that I work in Canada, and our service is entirely paid for by the government. While people are welcome to seek private services to avoid a waiting list, we are usually the first choice. I can't comment on ASAT because I have no knowledge of it. I am not sure if we are affiliated with it. Our goal is not to extinguish autism. The fact that anyone could refer to it as a disease is disgusting. It is a developmental disorder. They simply haven?t learned some basic skills. That can?t be fixed. They have trouble learning. Our job is not to make them normal. It is to increase their mental trajectory, their own ability to learn. We do this by teaching attention skills and then generalizing them across situations. When they start seeing things and understanding they don?t need us anymore. They can learn on their own. WE DO NOT USE AVERSIVES. We are entirely reinforcement based and do not use punishment even in the most severe cases. Further we avoid all physical contact if possible (short of tickling and big hugs). We won't even use hand cupping anymore to get a child's attention because it is too invasive. (Cupping the child?s face to it will look forward) Next: We always get informed consent. We take boundaries, confidentiality and privacy very seriously. We will not divulge any information to any person without a signed copy of a release form. Also we do nothing wrong. The parent is STRONGLY encouraged to watch the session, comment, regularly talk with supervisors, attend clinical team meetings, and we keep a daily journal of interesting events (which they must fill out daily as well). We also fill out government reports, are visited by supervisors, and make video tapes of sessions. Basically our goal is to help these kids generalize basic communication skills so others can understand them, and then hopefully when they are attending their environment they can learn skills their own, more readily. Initially our treatment is seen as robotizing children. That much is fair enough. But it is not forever. Once the child is responding, learning, we fade our prompts and then most importantly GENERALIZE. What good is knowing what a cow looks like if they don?t understand the concept of animals in general? We are constantly teaching, testing to make sure concepts are actually learned, then maintaining knowledge as best we can, and then using those new skills and concepts to learn others. We don?t go near gender behaviors, norms or stereotypes in any way shape or form. I don?t know what that was about. Of course the children communicate. It?s a matter of helping them communicate in a way that other people can understand. We start children usually at 2 or 3, and often nonverbal. We teach PECs or signing or vocal skills, whatever works best for the child. We can?t give them what they want if they can?t tell us what they want. The article said that we dismantle autistic people into series of bizarre and inappropriate behaviors. No. At least I don?t think so. I?m not really sure what they mean. They should really give an operant definition. I mean we teach them what different sounds animals make, or more functionally, how to ask for (mand) for a snack. As for Lovaas? the research is still new. It usually takes decades to work the bugs out of a study. And yes, there are current replications under different circumstances underway, without using aversives. It is my understanding (although I can?t site any here off the top of my head) that following reports accounting for many variables, including maturation, have been obtained with similar results. I guess what is really important is that we don?t teach skills to messed up kids. We teach the ability to learn skills to kids who got a slow start. SECTION 2 Often stress is an issue with our kids. We cannot create a stress free environment. We do our best to limit distracters, but it is hard. We work sometimes in the child?s home, sometimes in a playschool, sometimes in a centre. It varies. Each has its own problems. We hope that by teaching a child to manipulate their environment and functionally communicate they can avoid some stress. We do tailor each set of programs to each child. Every IT is given a �primary� with who they are in charge of creating programming (based on ABLS) for that child. These ideas for research are to find gaps in existing methods, and improve areas that are weak. Looking at PECs vs Signs: Under which conditions each should be used? we do look at what works best for the child, but often a vocal child may respond better to signing, or a PEC. Combinations however, generally do not work because the child is overwhelmed with two conflicting systems. To create a better, but not set in stone, criteria for generally where to start would decrease the immediate demand for a language specialist because specialists tend to be very busy and have long waiting lists, and they can be costly. Looking at unattended fidgeting and self-stim: should we pause programing and intervene if fidgeting/self-stim is unattended? we often can?t control the stress the child feels. We try to make them comfortable. Most of the time we are just playing with them. The stimming will hinder the learning process if they are attending it. We also stop stimming, however, even if the child is attending the instruction. I think this is because (I AM NOT SURE ON THIS) so that their peers in school (remember these kids are 4 and 5 when kids are very judgmental and blunt) are less discriminating. I too believe that this may not be right and would like to study if it actually is beneficial to stop the stimming. Looking at conduct issues comorbid with autism: should we get parents more involved to increase secure attachment and increase trajectory? Children display less problem behaviors and learn at a faster rate if they have a �secure attachment� (healthy relationship) with the parents. I would look for ways to improve this relationship. Looking at how parents interact with the children when no IT is present: should we offer a brief training pack? If parents better understood exactly what and why we do the things we do in a program (often they are scared to ask, especially if it works) would they be willing to do it on their own? Looking at schedule thinning: during a wait program would it be more beneficial to offer competing stimuli or a new activity while waiting? Children must learn to wait. Patience even for 5 seconds is essential in the �real world� and we are trying to create skills that will generalize to home and to every day living. Recent research is finding that if you offer a child an activity while waiting the child will more readily wait longer periods, with less disturbance. Looking at transitions: should we increase focus and use various methods to decrease problem behaviors that seem to arise or be strengthened? If a kids likes playing with a toy and it is time for school or church, how can you make them go if they don?t want to? This is a transition and a couple new methods are arising to decrease pouting and tantrums in these transitions. Looking at deprivation and satiation: because children will satiate on food and toys should we use this to create more functional preferences? It?s not bribery, it?s reinforcement. Very ethical. But often we use food and toys, which are not always available in every day situations. If we used pairing to transfer a preference from a toy or food to a favorite shirt or piece of jewelry would that be more beneficial? I hope that clarified it some. And I see that there is a inherit distaste for ABA among your particular forum. I am glad to see you are all still keeping an open mind. I don?t know if it is because of the age difference or the difference in severity, but a lot of what you describe I myself have not experienced. I hope you can also keep in mind that we are doing the very best we can. I am still open to any and all comments.

Here is something I just looked up from my resources: Evidence presented by Howlin and Moore (1997) found that in a study of 1300 families from the United Kingdon [this is a Canadian source I'm citing] with children with autism, fewer than 10% were given a diagnosis at the initial assessment at 2 years of age, despite that almost ALL of the parents had felt their child was not developing normally by 18 months of age. A further 25% of the families were required to have consults with 3 or 4 other professionals before a diagnosis was obtained. Howlin and Moore concluded that: a) parental concerns about a child's development need to be taken more seriously by professionals and diagnosis in itself is important but does not improve the child's prognosis unless accompanied by practical interventions and supports to the family. Should you be paranoid if your child seems to be different? No... but you should definitely have him checked out by multiple doctors are there seems to be a terrible flaw in the diagnosis system.

Mandyque: What was she formally diagnosed with? Was it autism, aspergers, childhood disintegrative disorder, or something else?

Here are some of the ideas that have been offered to me through different chat sites. Some of it may not make sense without formal training or understanding of ABA. They are geared more towards practical application than anything else so far: Looking at PECs vs Signs: Under which conditions each should be used? Looking at unattended fidgeting and self-stim: should we pause programing and intervene if fidgeting/self-stim is unattended? Looking at conduct issues comorbid with autism: should we get parents more involved to increase secure attachment and increase trajectory? Looking at how parents interact with the children when no IT is present: should we offer a brief training pack? Looking at schedule thinning: during a wait program would it be more beneficial to offer competing stimuli or a new activity while waiting? Looking at transitions: should we increase focus and use various methods to decrease problem behaviors that seem to arise or be strengthened? Looking at deprivation and satiation: because children will satiate on food and toys should we use this to create more functional preferences?

While signs are present as early as 12 months they cannot be formally diagnosed until 18 months to account for maturation and unavailability and unreliability of symptoms. I am very biased in the work I do. At my centre we work with the most severe cases of Autism so we are not exposed to many AS children. I am still shocked at the numbers I am seeing here. It is mandatory for us to discharge children at 6 years, regardless of how the treatment has been going. (no one is being discharged right now however, a case is pending in the courts)