“Copy me and you get a Marshmallow” (1/3)

Part 1: ABA (Applied Behavior Analysis)

Part 2: An alternative draft

Part 3: Critic

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My unpleasant encounter with ABA (Applied Behavior Analysis)

 

2014 I started a new job at a daycare in Canada. In the morning I worked as a Special Needs Support Teacher with Joe (* name changed), a five year old boy with autism; in the afternoon I was his Behavior Interventionist.

My role as a Special Needs Support Teacher included one-on-one-caring during the daily daycare routine. As a Behavior Interventionist I was asked to do ABA with Joe.

 

Before I write more about this form of therapy, I would like to write a few words about Joe:

Joe is an extraordinary, wonderful boy; a discoverer and explorer. He loved to touch and taste the world. His favorite meal: Pasta and bananas. Joe loved music and stories.

 

But he was also nonverbal, in stressful situation and situations of anxiety he flapped his hands, rocked the floor and stretched. Sometimes he screamed. When he ate sugar it had almost the same effect like ecstasy. Then he rocked and stretched and flapped his hands even more.

 

Most of the time, Joe avoided eye contact, but when I sang “row your boat” to him, he looked in my eyes. Sometimes he stared at my mouth and after a while he started approximating the move of my lips (without sound).

His parents and siblings gave him unconditional love. It gave him the needed security to feel comfortable and to be himself.

 

I have learned from Joe to be very aware of my environment.

 

I saw him as a competent person with special needs. A boy who wanted to learn, just like other kids. He just learned slower and the learning conditions and learning methods had to be right.

 

It meant that in the morning he was able to learn „naturally“. I had the freedom to create learning moments just for him or in a group.

But in the afternoon my hands were tied and Joe and I had to stick to the strict ABA plan. We both experienced a very unnatural program.

 

What is ABA and what is it about?

“Behavior analysis focuses on the principles that explain how learning takes place. Positive reinforcement is one such principle. When a behavior is followed by some sort of reward, the behavior is more likely to be repeated. Through decades of research, the field of behavior analysis has developed many techniques for increasing useful behaviors and reducing those that may cause harm or interfere with learning.

Applied behavior analysis (ABA) is the use of these techniques and principles to bring about meaningful and positive change in behavior.” (source: https://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba)

 

ABA is based on classical and operant conditioning (Pavlov https://en.wikipedia.org/wiki/Classical_conditioning and Skinner https://en.wikipedia.org/wiki/Operant_conditioning)

 

Learning trials and successes as well as desired behavior are amplified as directly as possible, whereby primary amplifiers (eg food) and secondary amplifiers (eg toys or praise) are used to reward desired behavior.

 

Learning by reward – and by drill.

 

ABA is very popular in North America. But also in Europe this therapy finds more and more supporters. This development should be observed very closely and critical as you will found out in this article.

 

My experience with ABA

Before I started I hadn’t heard yet of ABA. My experience with autism included few of months of working with a five year old boy with autism in New Zealand, a boy in primary school with Asperger and one year with teenagers with autism in the field of vocational orientation in Germany.

 

But I was new in this job, in a different country and open for new approaches. I was skeptical from the beginning, but I at least wanted to try this method to be able to form an opinion about it.

 

I got a short training and after (careful, spoiler!) the ABA program wasn’t very successful, I requested another introduction because I was unsure if I was doing it right – just to find out, that I exactly had done what was expected in the program.

The program was done five days a week, 40-60 minutes each day.

 

The first part was about imitation.

 

I showed a specific gesture, said „copy me“ or „do what I do“ and then there were two possibilities: Either he imitated (which was extremely rare and only approximated) or he just sat there and did nothing. It was my job then to make him do the gesture. For example, when I knocked in the table, said “copy me”, no reaction, I had to take his hand and knock with it on the table.

 

In the first phase of the program every behavior gets rewarded – no matter if successful imitation or not. So I praised him exuberant, gave him a toy, let him play for 2-3 minutes and took it away again.

 

His reaction: Screaming and crying.

 

Second part: Play

 

Play with cars, trains or balls. This part was more natural than the others. I showed him how to play with cars (drive back and forth, made car sounds) or I rolled to ball to him. Joe didn’t like to roll, throw or kick balls. But he liked to lie on them or lick them (like I said before: He loved to taste the world).

He showed poor imitation as well as poor generalization.

 

Third part: MRE (Match-Receptive-Expressive)

 

I gave Joe a card with a picture that he was supposed to match with the picture on a lotto board. In the beginning Joe showed no reaction. So I pressed the card on his hand and put his hand on the matching card on the Lotto Board. As a reward he received a toy (same procedure as in part 1: Imitation)

After a while he got better and enjoyed the task.

But he got bored by using the same pictures and

his verbal language didn’t develop with this task.

 

Joe’s development with ABA

 

Joe cried every to every other day. He flopped and I had to pick him up, place him on a chair and had to go on with the program. Joe didn’t want to imitate, at least not the gestures that were expected of him in the ABA sessions.

 

It hurt my soul to see him suffering like that.

 

Every other week a Behavior Consultant came to overlook Joe’s progress. She explained that his behavior would be normal.

After two months I asked her when I could change the program content. Different gestures, different pictures (I already had switched the toys without her approval). Her answer: “When he reaches 75% of successful imitations.”

 

After three months I couldn’t deal anymore with his daily crying, screaming and flopping and I calculated the percentage of successful imitation. After three months, 4 – 5 times per week, each day 40-60 minutes he had reached 30% of successful imitation.

 

Should I go on doing the program for the next 3-5 months to reach 75%?

NO!

From then on I refused to do ABA with Joe. I had full support from the parents when I suggested that I would create and implement a program specifically for Joe – with success!

 

In the next blogpost I will describe in detail how the alternative draft to ABA looked like, but at this point I will give you a glimpse of what I did:

The focus was on Joe’s strengths, interests and needs. I used his intrinsic motivation and integrated the adult’s goals for him (increase language skills, increase fine and gross motor skills, regulation of sensory needs) in easy tasks that Joe enjoyed very much.

 

He made progress, although slow, but the new program showed that it included the right learning methods for Joe to increase and extend his skills continuously.

 

But then it was time for Joe to go to school

My job was done. Although I was still a contact person for Joe’s parents and teachers, but my direct work with Joe was finished. My have written down my results and documentation in two reports and (with the approval of his parents) gave them to the school he was attending.

 

I could also have thrown my reports in the garbage!

 

The daycare I worked at was in the same building as the school. Every day I passed Joe’s classroom and I held my breath when I saw the following situation:

 

Three adult women were sitting at a table with Joe in front of the classroom. I recognized the ABA material on the table. One woman said something, Joe didn’t show a reaction, she took his hand, made a gesture with it and then she put a Marshmallow in his mouth.

 

Shortly after, he wildly rocked the floor and flapped his hands. A reaction caused by the high amount of sugar.

 

It broke my heart to see him like that.

What especially made me sad:

I had edperienced that there is another way.

 

The school didn’t care about the success he reached without ABA. The school didn’t care about the parent’s nutrition plan for Joe.

 

Everything that counted was the he was obedient.

So that adults would have an easier life.

 

Part 2 coming soon…

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