Teaching Children with Autism

Common ABA Errors In my experience, about 90% of young children with autism will thrive if provided with good ABA-based instruction. Unfortunately, that leaves about 10% who don’t. About that 10%: We know that there are both genetic and environmental conditions that can produce or exacerbate autistic symptoms. For example, I have seen one child (out of hundreds of children with whom I have worked) whose autistic symptoms more-or-less cleared up when placed on a casein-free, gluten-free diet – not very good odds, that – and many anecdotes support the hypothesis that gut issues contribute to the autism picture. So, I would want to explore biological issues if I wasn’t seeing success with a learning-based approach, in case there are any biological problems which, if addressed, will make it easier for the child to learn. In addition, I have seen children whose autism was so severe that it essentially prevented them from being able to attend to even good instruction improve when placed on medication, so medication is an option worth exploring if your child appears unable to make adequate progress with good ABA-based instruction. Unfortunately, a lot of failure to learn can be attributed to poor teaching and, in my experience, it is rare that ABA-based instruction is delivered as well as it can be, in spite of the fact that ABA (Applied Behaviour Analysis) is not rocket science. The basic techniques are so straightforward that even an eighteen months old child can learn and apply them. Unfortunately, although the basics are quite easy, most instructors manage to find a way to introduce a host of errors into their teaching. Let’s examine a few of those ABA errors. Please note, however, that my discussion of the first two errors listed is very “psychological.” Don’t be discouraged by that; the rest of the errors listed are pretty straight-forward, and IT’s will recognize their own instructional weaknesses in them. Before doing so, however, please understand that I am NOT disparaging good ABA-based instruction. It is still the treatment approach that has the most scientific support, the one that has the best chance of success. 1. Teaching without reference to a broad-enough curriculum Any kind of teaching has to build step by step upon what has already been learned, so before you can do any significant amount of teaching, you have to determine what the child already knows, using some kind of curriculum such as the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP), the Assessment of Basic Language and Learning Skills – Revised (the ABLLS-R), The Carolina Curriculum for Preschoolers with Special Needs, the Hawaii Early Learning Profile – Revised, or any of the other common early learner curricula. Then break the material to be learned into relatively small steps and, starting where the child is, teach the next steps in each part of the curriculum. Measure the change, and modify your procedures and teaching targets as necessary to ensure continuing progress. In addition to assessing the child’s skills using one of the above-mentioned standard preschool curricula, I believe that you should assess the child’s social-emotional and adaptive living skills using tools such as the McKinnon and Krempa Social Skills Checklists, Solomon’s detailed analysis of play-based caregiver-and-child activities, and the Vineland Adaptive Behavior Scales. 2. Developmentally inappropriate choice of teaching targets Looking at teaching in terms of more mundane objectives, when choosing items to teach, it is important to teach to the child’s developmental level. Choosing to teach items that are beyond the child’s current capability, such as trying to toilet train a child that isn’t physiologically ready for it, is not only a waste of valuable time. It is a sure way to frustration and the desire to escape from the teaching/learning situation. I saw one parent, for example, whose immediate goal was for her son to be empathic. He might reach that point eventually, but at the time, we would have been happy to get him to line up with the other children in his class. 3. Inappropriate emphasis on ITT Holly Kibbe and Cherish Twigg of Establishing Operations, Inc. have recommended that Natural Environment Teaching (NET) be the main venue for teaching beginning and advanced learners, building on the learner’s motivation-of-the-moment, i.e., motivation that is natural rather than arbitrary, and that Intensive Trial Teaching (ITT, usually referred to as table work) be the main venue for teaching intermediate learners – particularly, IMO, for those children for whom an opportunity to acquire as much information as possible is reinforcing. Unfortunately, most instructors seem to think that their job is supposed to consist almost entirely of ITT regardless of the child’s developmental level. By way of contrast with what I have just said, however – which is why ABA-based teaching is as much of an art as a science – one of my very first exposures to really good ABA-based instuction was watching Marcie Norton working with a little three year old girl with autism. Marcie was a “natural.” With a background in Early Childhood Education (ECE) and really minimal training in ABA (not much more than a Vince Carbone workshop), she made learning so much fun that they could do mainly ITT for three hours followed by another hour exploring the community and teaching everything that could be taught there. I have since met many other excellent IT’s, too many to name, who were very knowledgeable about ABA but who also didn’t learn their “people skills” in a classroom, and I have met many newly-graduated ABA instructors who “wouldn’t recognize a ‘rug rat’ if it came up and bit them in the ankle.” Excellent instructors are excellent because they bring more to the table than a knowledge of ABA. This is quite a subtle point that I am trying to make, and I doubt if I am doing a very good job of it; but it is stimulated by my dissatisfaction with much of the ABA-based instruction that I see being provided, and my desire to do a better job of doing something about it.