Frequently Asked Questions: ABA
Is this programme a cure for autism?
No, this is a programme for teaching children with autism in a way that is meaningful to them so that they are able to learn. Research has shown that behavioural intervention could help improve the lives of children affected by autistic spectrum disorders. When properly developed and implemented it can improve the lives of children with autism by helping them acquire complex skills such as language, play, self-help and social interaction. It is not difficult, but it needs consistency to be effective.
How effective is behavioural intervention?
In research by Dr Lovaas in 1987, 90% of the children made progress. 47% progressed to the point that they could attend regular school. 43% made good progress but still needed support and supervision. In a recent study undertaken by Southampton University, children given early behavioural intervention did significantly better than those who received standard LA provision (see section on research).
Where does a programme of behavioural intervention take place?
Because this programme needs to be intensive to achieve the best outcome, it is initially taught in the child’s home by a team of tutors under the direction of a case manager/consultant. As the child progresses, the programme can be generalised to other environments.
How many hours per week are recommended?
The original Lovaas research was done based on 40 hours a week and it is recommended that each child is tutored between 30 and 40 hours a week, in two or three hour sessions. Some families run a 5 day a week programme (and work on generalising skills on weekends), other families combine nursery placements and behavioural intervention and therefore run the programme on weekends too. It is important to realise that this programme is flexible and can incorporate the individual needs of children. Younger children may still need a nap or breaks to `run in the garden’. The team can help parents decide which activities the child benefits from and should continue with, and which may need to be postponed or stopped. Consistency in ABA programmes is important. You will need to discuss hours with your case manager/consultant to find the optimum for your child.
Who provides the programme of behavioural intervention?
A team consisting of several tutors, a senior tutor or supervisor and a case-manager or consultant provides the programme. Each family puts together their own team. Because tutors are trained by the service provider and are closely supervised, they do not necessarily need any previous experience. Parents tend to do two to three sessions themselves per week. Some families have tutors who are volunteers from local church groups or are extended family members. Most families hire tutors through local universities or colleges, or by placing ads in local papers, town shops or in Speach (Peach members only). Sometimes other families in the area that are also doing home programmes have experienced tutors that wish to work additional hours. (Please contact the Peach office for additional details about this.) In either case, remember that you are looking for someone to work very intensively with your child. When interviewing, ask questions about their experience with children. You may wish to have your child present during some of the interview to see how they interact with your child. It is essential to have the individual give you the names of two or three people as references. Parents need to check these references, asking questions about dependability, promptness, reliability and experience with children. Course work in psychology is not as essential as a willingness to learn and a good rapport with your child. Criminal Records Bureau details should also be checked. (A list of service providers is given at the end of this pack).
What is taught?
This programme follows the curriculum for nursery education, and in addition works on language acquisition (what is said as well as what is understood), behaviour, social skills, play and self-help skills. Parents have input into which areas are worked on with their child. Good service providers will also integrate the national curriculum into programmes.
Is this the right programme for my child?
This is a question that ultimately only you can answer. We believe most children can benefit from behavioural intervention, but understand that it may not be right for all families. Some issues worth thinking about when making this decision are, the ages of siblings, (as the schedules of young siblings can be difficult to run a home programme around,) finances, job demands on parent/s, extended family support, and tutor and case manager / consultant availability.
Could this programme be detrimental to my child?
No, a properly trained team will encourage your child to learn new skills through positive reinforcement. Your child will be actively engaged and motivated to learn during the daily sessions.
Will this programme put too much stress on our family?
That is a decision that only your family can make. This programme is hard work, but it is extremely rewarding. While it is recommended that your child participate in 35-40 hours per week of this programme in order to fully develop their potential, it is comforting as a parent to know that your child is learning important skills and appropriate behaviour during this time.
What about my other children?
When your autistic child is actively working with the tutor, you will have uninterrupted time with your other children. Some families are able to use this time to do special activities with siblings. Some families include their other children in certain parts of the programme and have found that this can strengthen the relationships between the children.
What should I do if my child has not been diagnosed yet?
It is often a lengthy procedure to get a diagnosis for an autistic spectrum disorder, because many health care professionals are reluctant to give this diagnosis in young children. Included in this pack is a copy of the CHAT assessment. This is a diagnostic assessment tool developed by Dr. Simon Baron Cohen to detect developmental delays that could develop into autism in children as young as 18 months. This form can be taken to your GP or other health professional, who can use it and then perhaps refer you to an appropriate specialist. Please see the section: Obtaining a Diagnosis in this pack.
What if my child has a diagnosis other than autism?
A number of families are using a behavioural intervention programme for children with problems other than autism. These include learning difficulties, Speach and communication problems, and gross and fine motor difficulties. These parents have found behavioural intervention to be a vital learning methodology, with a dramatic impact on their children's learning. There are some types of diagnosis which might make it difficult to deliver ABA. You should always discuss your diagnosis frankly with your case manager/consultant.
What’s the difference between this programme and a specialist provision in a classroom for autistic children?
The main difference is proven effectiveness. Behavioural intervention is the only method of helping children with autism that is scientifically proven to be effective. Original research shows that 47% of the children following this programme at the recommended intensity progress to the point that they can be mainstreamed into a primary school without additional support. Compare this to the National Autistic Society’s estimate that only 5 to 10% of children with autism will become independent as adults. Also, it is important to remember that with behavioural intervention each child is taught individually with one teacher in an environment free from distractions. This can be difficult to achieve in a specialist school, which usually has a teacher pupil ratio of 1 to 3 or even 1 to 4.
Is this programme beneficial if my child is older than 4 years of age?
Yes, research is being conducted into ‘older’ children (4-7 year olds) and preliminary results indicate that this programme is also successful with them.
How much does it cost? (Currently being reviewed)
Most tutors earn between £7 (untrained) and £8 (with some experience) an hour. Senior tutors (team leaders who work one to one with the children, do additional work running team meetings and basic administrative work) earn between £10 and £15 an hour. Supervisors usually earn between £15 and £25 an hour, again depending on experience and qualifications. The rates for service providers at consultant and case-manager level varies. The total cost per year is determined by the combination of services your child receives and the number of paid tutor hours. Many families have successfully appealed to their Local Authority for funding. Currently, more than 100 LAs in England and Wales are funding ABA programmes. Many have not chosen to fund the programmes, but do so because parents have fought successfully for ABA at Special Educational Needs Tribunal.
Do you know of any books I can read to find out more information?
A useful booklist is included on the website in the Reading List page. Many of these books can be purchased or ordered at any bookshops. Jessica Kingsley Publishers specialise in SEN and disability and have a large catalogue www.jkp.com. Taskmaster www.taskmasteronline.co.uk stock a large catalogue of useful books and teaching resources as well as the National Autistic Society. Some of the books we recommend target very specific skills so may not be appropriate to your child. It is a good idea to discuss what literature might be useful with other parents and your case manager.
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