- Voice in the Wind Magazine Inc.
Today I’d like to take the time to offer some advice to parents and caregivers of people with Autism, as well as Autists themselves and any therapist who might be interested in some insight. Specifically, I’d like to talk about why ABA doesn’t work and what to do instead.
WHAT ABA GETS WRONG
I’ve looked at some videos of ABA being used and they are cringe-worthy, to say the least. The biggest thing that ABA gets wrong is that it ignores several issues that children with Autism have because it over focuses on the needs of the parents. Let’s consider this example: A child that you are trying to teach to say please and thank-you. ABA suggests rewarding the child for doing what you want them to do – using their manners. This is actually fine. The problem is when that child wants to go to the bathroom, but you’ve decided to try some ABA. Then you are ignoring several critical things about your child, as follows:
- They lack self-awareness or have an impaired interoception (internal barometer)
- Self-Care is a monumental struggle
- They can’t use “Theory of Mind” to help with conflict resolution or prevention
- Sensory Processing Disorders hyper and hypo-sensory issues
The first problem being ignored here is that most (if not all) children with Autism lack self-awareness. In other words, there is a good chance the child didn’t realize they needed to use the bathroom until it was almost too late. You’ve heard the saying ‘photo finish’? Well, that’s far too often what happens with an Autistic child. Saying no to them at this point, is basically torturing them. They are probably panicking too. It’s not their fault, and they really can’t do any better (even if they want to) without help from a psychologist. So what went wrong? ABA puts the ‘cart before the horse’. In order for the child to respond correctly to you, that child needs a way to compensate for the lack of self-awareness. In other words, you must teach the child self-care. But how?
HOW TO TEACH SELF-CARE
Teaching self-care is not not as easy as we would like it to be. It starts with asking your child a question: Could you accommodate you? It’s important that your child realizes that they won’t always be accommodated and that people have their limits or you will have set them up for confrontations (and hurt feelings). Most people do mean well, but no one wants to deal with a prima donna either. If your child is perceived as too demanding then there will be pushback or backlash. Heck, you might be the one with too much on your plate – and that’s okay. But you have to explain it to them. If your child is having trouble accepting this, try following up with this question: Could there be a difference between being neglected (or shut-out) and being unassuming? Most of the time it’s just more than other people can handle. They aren’t asking your child to “disappear” or accept being treated differently, they are asking for less on their plate. In this way, you can help with theory of mind too, by illustrating the other person’s position. Hopefully your child will see that being unassuming is actually healthy for relationships. This will come up often. Like when your child wanders off and you panic. They really don’t know what the world looks like through your eyes – so please help them understand.
In this case the child needs to “check-in” with themselves from time-to-time manually (by memory, for example). When I was growing up, I used to check-in with myself about every half an hour. I would ask myself some simple questions like am I going to need the bathroom soon? Am I thirsty? The goal is to teach a child to act on those needs sooner not later. Remember the ‘photo finish’ I mentioned earlier? This would have been prevented because the sooner the child takes notice of their own needs, the more room for error. This is key to giving the child the time and space necessary to deal with their needs, without a meltdown or confrontation. In my case, a clock was enough for me to get the idea. I have very few needs though. For others it may be setting a timer or an alert on your phone. It could be colour coated cards. Just remember it’s about what works for your child.
SENSORY PROCESSING DISORDER (SPD)
SPD is the term for sensory issues. When someone is over stimulated by lights and sounds, that’s called hyper-sensory issues. In the same way that a child doesn’t recognize they need to use the bathroom, they often fail to recognize that lights, sounds or smells are problematic until it’s too late to prevent a migraine. And by the way, a migraine is debilitating. It oftens ruins an entire day. It’s a common outcome of hyper-sensory issues and once you have one there’s no going back. For this, I learned to do an “environment check”. Anytime I went somewhere new, or where I’m not the one choosing the lighting or sounds, I would immediately assess the environment for anything problematic. This doesn’t mean I can (or should) change anything, but at least I know my time is limited, so I can leave sooner. It also means I have time to think of an appropriate excuse to leave. As an example, you could say you’re going out for “a smoke” (I’m not condoning smoking), but as an excuse it is unassuming, easy to use and gets me out of loud bars, house parties and just about anywhere else that is hard on my senses. You should probably think of a few of your own because mine isn’t the greatest, but you get the idea.
When someone is under stimulated by lights, sound and smells they are experiencing hypo-sensory issues. This is important to understand because the same child who hates bright lights, may not smell a dirty toilet very well. This is often why children with Autism will ignore cleaning type tasks. A lot of air time is given to hyper-sensory issues because of the child’s outward reaction. Hypo-sensory issues are often worse and may mean things are ignored completely – which means the child had virtually no response. That’s not always a good thing. It can mean the child is experiencing more physical pain than they let on (or show). Let me illustrate. A normal child that has a deep-knee bruise probably wouldn’t be able to walk on it very well or maybe at all. It would be easily noticeable because they are limping. A child with hypo-sensory issues would likely keep walking normally as the pain level would be less. This means that hypo-sensory issues related to pain can actually increase the chances of a worse injury. There is also a good chance that the person will not seek proper care, or seek help in a timely fashion. It’s a good idea to check your child for both.
WHY HYPO-SENSORY ISSUES MATTER SO MUCH
One of my biggest pet peeves, something advocates often get very wrong, is that hypo-sensory issues don’t matter. This is because they aren’t inconvenient for you. Ironically, certain charities (I will not name) are so hyper-focused on the parents (and caregivers), they don’t realize the message being sent to the Autism community: You don’t matter. Your needs don’t matter. My needs and feelings come first. It can make a child with Autism feel like they don’t have the right to medical care because they aren’t showing the pain as much. It validates a person’s need to feel like they belong. It’s also gaslighting because people around them act like there’s nothing wrong – or worse, like the Autist is a hypochondriac and literally made it up. It’s more important than you know to study hypo-sensory issues. Treat it like depression – just because it’s not visible, doesn’t mean it’s not serious. So please, please, please make sure you know what your child is under-responsive to so they don’t feel like an outcast in their own home.
Even in the simple example of using please and thank-you, look how much went wrong. The child was under-responsive to their own bladder, was lacking an understanding of how you see the situation, over-reacting to lights and struggling to learn how to take care of themself. It was never as simple as ABA made it out to be. The child comes first. Take care of your child and your child will take care of the rest. Thank-you.
Phone: 403-497-WIND (9463)