|What a good behavioral program should be - playing lego! photo copyright the author|
In the ABA world, that means if you have therapists coming to your home and sitting your child at a table with flashcards for any number of hours a week, then you need a new therapist. Sitting at table style ABA is from the work of the original study on Applied Behavior Analysis for kids on the spectrum, which is from the 1980's. It is old, obsolete, therapist-driven, boring, and really out of date. That therapists still use this style is unethical. The job of kids is to play, not sit. Kids should be doing things they like and enjoy, and ABA therapists who have good training or who just care about children, should be helping them play.
Bottom Line: Don't work with therapists who say the only hope for your child is hours and hours of table work. Kick those therapists out.
(If this is hard for you, practice ahead of time. Say nice things, such as, "Right now, we don't have time for more therapy, but thank you.")
There are plenty of behavioral programs that focus on play, and seek those therapies out. In fact, if your child is playing, I would consider that an important program whether it is called "therapy" or not. However, if you have a program called "therapy," then you can get it covered under insurance, no small thing. But even if insurance pays, you want therapists who will actually help your child grow and learn. Sitting at a table with flashcards won't accomplish this.
So look for ABA therapists and other therapists who bring fun activities. Look for ABA and other therapists who encourage play-based learning. OT's and PT's should be helping your child play with new activities that your child finds fun, and they should be helping children learn to enjoy new sensory experiences and environments. If all an OT or PT does is teach your child to "soothe," then that is not play and your kid deserves more.
Same with ABA. ABA therapists should be using the Early Start Denver model, which is a play-based and relationship building behavioral program for kids with autism diagnoses ages birth to 48 months. It encourages parents to play with kids, using the child's interests. The goal in Early Start Denver is for everyone to have fun together and for children to enjoy spending time with their parents. Kids who do this learn more language than from sitting with flashcards! Or look for therapists who are trained in Pivotal Response Training (PRT), which encourages parents to get kids doing things that kids choose and enjoy. PRT therapists are the ones who have demonstrated in lots of studies that when kids on the spectrum go hang out with other kids who share their interests, they learn more "social skills" than from any class or therapist.
There is far more research showing that playing with kids on the spectrum improves communication, family bonding, and "social skills" than any other type of behavioral program. When I'm working with kids they are busy exploring shaving cream or learning gun safety or taking walks in the woods or drawing or playing with empty boxes. Parents learn how to sit and share with their kids and build relationships based on trust and sharing. Everybody has a grand time. A good sign: we usually all get out of breath and sweaty from running around.
That is a good program. Demand that for your kids.