I need help chosing between ABA or RDI...

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And I need to disagree with the spirit of Amy Sequenzia's post (linked to earlier in this thread). I think independence is a worthwhile goal for parents to have for their children, and I also think that almost nobody on this earth wants to spend the rest of their lives actively taking care of children. So, Sequenzia's arguments against ABA ring hollow to me, and sound very selfish, as opposed to a being a rigorous evaluation of the methods and impacts. Everyone, NT, ASD, everyone else, has to change to be able to live independently in this world. Nobody gets to just "be who they are" and expect to get what they want. And demanding that seems to negate or dismiss the impacts that that has on the lives of others, most noticeably, the parents who are still worrying, paying, overseeing, managing critical elements of their children's lives.

So, I like much of what Sequenzia writes, but the demand to be left alone is more than any kid (or adult) on this planet gets. That's a super entitled position. And therapy isn't bad just because it exists. Whew - rant over. That one just really bothered me!

Her POV also dismisses the fact that any given therapy changes over time. Advances are made. Refinements in understanding occur. If we were to hold today's doctors accountable for what doctor's did in years gone by, no one would see a doctor. The inventor of the lobotomy was given a Nobel prize for it, for Pete's sake. And there was a point in time in which children were routinely given opium to "calm them down." And people were told to take mercury for almost any ailment. All of which, today, are considered ludicrous and would definitely be deemed abusive.

What happened at the hands of ABA practitioners during the therapy's infancy stages is tragic. There is no way around that. But in all of my current travels, I have yet to meet anyone involved in today's ABA that continues to practice ABA in it's original form. That doesn't mean it doesn't exist, of course. But it seems to me that the most verbal critics out there are criticizing something that rarely, if ever, exists today.

I think parents should know the history and be forewarned of the potential dangers. This empowers them to take advantage of the potential benefits. I believe this is true for any "method" we may employ with our kids, whether or not they have autism. You should be aware of the good, the bad, and the ugly, the potential for harm and the potential for help, and the pros and the cons. Once you have all of that under your belt, you are able to be an educated consumer on behalf of your kids. For this reason, I think that Amy Sequenzia's post serves a purpose.

The problem is, there are too many people out there who have not learned how to think critically. Too many people hear a single POV and adopt it without the consideration that there may be more to it than one person's, or even many person's POV. I'd like to say that that is what is "wrong" today, but I think that is likely a human trait that has always existed. If anything, I think what has made it "worse" today is that people are bombarded by so many POVs due to being in the "information age" that I think they feel overwhelmed and therefore even more cognitively lazy about trying to parse it all out.

But to bring this back to the OP, I think you should do your due diligence with research and then decide, based on all evidence you can gather, what is best in your situation. And be prepared for the fact that no matter what you choose, you will be criticized. Don't let that bother you. It's just part of the road we walk, and the sooner you can get passed getting caught up in it, the better for your own sanity.

Great points and advice, InThisTogether. I especially liked your recommendation to research ALL of the history and as many viewpoints as possible, and I echo your warning to the OP: you will be criticized and second-guessed regardless, so might as well get prepared for that and get very clear on your personal criteria for decision-making. Because no one knows your children/family/situation as well as you do, so trust yourself to make the right choices or the right adjustments along the way (cuz no one gets it right the first time 100% of the time).

I realize this does not help answer your therapy question, but thought I would offer the suggestion since it helped my son.

My son was never diagnosed with ASD, though it has since been suggested, but he was non-verbal until the age of almost 3. His receptive language skills were fine, but expressive was nonexistent. Beginning at about 18 months while he was getting testing done, we as a family learned ASL. He was able to communicate with us, and others, very effectively this way. Having a way to expressively communicate reduced his frustration levels, and gave him a greater ability to interact with his world. Once he became verbal, which was only a word or two at first, he still continued to use ASL along with his limited speech. He used the ASL/speaking combination until probably close to 5, at which point he had achieved age appropriate expressive language skills and he slowly dropped it.

ABA does have its place, but I'm a lot more comfortable recommending RDI.

The thing is, it's easy to misuse ABA unintentionally and end up hurting a child - and I've encountered several ABA therapists who I strongly feel were harming the kids they worked with. (For example, using 'time with Mom' as a reinforcer for twins with severe separation anxiety - to the point where they had to be physically restrained to get them more than 4 feet away from her.)

RDI, on the other hand, it's pretty tough to think of how you could screw it up and hurt a kid, given how gentle it is.

My son is 2 and a half and has been in OT/ST and ABA for the past six months. I'm guessing he has apraxia as well, but that hasn't been diagnosed. He's pre-verbal.

Speech/OT and his general therapist have done zero. Six months now, and he has learned nothing.

I don't know if ABA is the best way, but he's learning something. He's pointing at things that he sees now. He waves a little bit to people. He's learned a lot of sign language. He can sit with other people for sometimes five minutes at a time. He's starting to pay attention to what some of the other kids are doing. He's starting to sound out a few letters. And he loves going. He goes 25 hours a week, and he runs into the center excited every day.

I have a feeling something play-based might be more effective if done properly. I've studied the methods a bit and tried to pull him out of his world but I can't do it. I can't teach him a thing. Every day we spend hours trying to teach him things, and I can't teach him a thing. At least with ABA we are seeing him learn. I don't know if it is making his brain and thinking more flexible, but I've read that ABA also helps form some links in the brain outside of the wrote things they are learning.

We're going to be updating his plan as we go, making a "custom" plan for him. Use what works and what he needs. I personally think he needs social help the most. My perfect plan for him right now would be for him to be at his ABA preschool for 4-5 hours, and then do a couple hours of something like floortime at night. I'm hoping I can learn it well enough to start to be effective.

I haven't really done floortime or RDI, but I can testify that my son is making progress through ABA, and I believe he'll continue to make a lot if his ABA continues.

I think the issue is that they can only pick one thing to be paid for, and that anything else would have to be done by the family.

Because of that, I think if you think it sounds like a good fit for your child, I would recommend the ABA, presuming of course that the family can maintain control over it and change therapists at any time, if needed and also can do less hours etc. (I agree that that 40 hours is too much for a little one---and I think the 40 hours is based on an old study that has been discredited in other ways, but I may be wrong on that)

The reason I say that is because the Floortime program is mainly a parent training thing, and you can get the information you need elsewhere, and so that you do have the advantages of both, like the others were saying.

A lot of the things we did from trial and error were a lot like this type of play therapy, and maybe I am wrong, but I don't think the learning curve is so steep that I would burn it as my free option igf the other one seems good to you also.

*Disclaimer: My child has a very inelastic response to behavioral strategies, so it is not something I would pick for that reason. If you also don't have a child that responds to that stuff well, I would pick FloorTime. It is about what motivates your particular child.

I think you completely missed the point.

Firstly, there is a vast difference between teaching someone useful skills and trying to change who they are. I understand it in the form of domains of behaviour - some behaviour falls under 'stuff that is important to my identity', some falls under 'things I could do to help myself', some falls under 'stuff that could hurt me', some falls under 'stuff that could hurt someone else', and so forth.

Telling a child that they aren't allowed to wear a dress is very different from telling a child that they aren't allowed to hit someone, or telling a child how to dress themselves. Telling a child to pinch themselves to the point of causing pain is also very different. One big problem with ABA is that they often don't stick just to useful skills and appropriate limits on behaviour - when they decide to eliminate stimming, or try to stop a kid obsessing on something, they interfere with behaviour that is important to express the child's sense of identity (just like wearing dresses is important to some kids' identities). And when they teach kids to make eye contact or give hugs to parents or so forth, they can end up training a child to do something that, due to the child's sensory issues, is actually physically painful for them.

The emphasis on compliance above anything is also a problem. Most kids don't comply with every command they're given. And most parents, while they will insist on something if it's truly essential, won't insist on something minor if it seems to be very important to their child. (For example, if the child refuses to let go of their favourite teddy, most parents let them keep it under most circumstances.) However, the typical ABA mindset isn't interested in listening to what the child wants or needs, and sees any protest as 'tantrum' behaviour to be punished or extinguished. They don't recognize any difference between genuine distress and an attempt to manipulate.

I use behaviourist techniques to teach my dog, but I do not do ABA on her, because I take her perspective into account as well as my own. I consider her psychological needs, even the ones that are inconvenient or strange to me, like the need to chew or the need for regular exercise. I have times she needs to obey me, and times she's free to do what she wants. And I'm not trying to make her into anything other than just a well-behaved dog.

Totally get the point. But to me, that speaks more to how you apply ABA than the system itself. But, it's a hotbed issue for a reason. My kids took to it very well, and I was super vigilant about the goals and rewards. We did hugs and praise, and never took away stims or withheld affection. I think the idea of forced compliance is tricky, because every parent has to teach their children certain skills. And every parent incentivizes their children to learn those skills. And finally, every parent has to use good judgment in which skills/lessons they teach their children, and how to do it in a way that does not harm the children. ABA does not remove that responsibility from the parent. And removing ABA does not mean that the parent will make good decisions no matter what method they employ. You kinda just have to be a good parent with good values and common sense and an abiding love for your child.

It's a lot harder to be a good parent when you're getting bad advice from 'experts'. Whereas when the 'experts' model good parenting behaviour, it makes it a lot easier.

For example, I'm really interested in research on attachment. About 60% of the general population has what is referred to as 'secure attachment', which is the optimal style, and the other 40% have various insecure styles (placing them at slightly higher risk of attachment issues). Securely attached parents instinctively know how to foster secure attachment in their children, and unless something interferes with that, they'll generally raise securely attached kids. Insecurely attached parents tend to raise kids with the same insecure style as they have. However, parent-training programs that encourage parents to be sensitive to their children's cues have been shown to help insecure parents raise securely attached children.

Of course, parenting doesn't cause autism, but autistic kids are affected by parenting, and parenting can be affected by autism. In particular, unresolved grief over the child's diagnosis tends to make a parent less sensitive to their child's cues, and can lead even a securely attached parent to raise an insecure child. (Insecure attachment is overrepresented in virtually all disabilities diagnosable in infancy or toddlerhood, and correlated with parents' reaction to the diagnosis.) Also, it seems like when parents and offspring are discordant (NT parent-autistic kid, hearing parent-deaf kid or deaf parent-hearing kid are the combos that have been studied for this), the impact of insensitive parenting is amplified. (An insensitive parent is likely to project themselves on their kid, while a sensitive parent can learn to treat their kid differently because they're different.) This doesn't just affect emotional outcome - it can also influence social and communication skills, because those skills are first learnt in interaction with parents.

RDI, as far as I can tell, explicitly teaches sensitive parenting. (They seem to have stumbled onto this without knowing anything about attachment.) This means that it would help parents whose existing styles are insensitive, either because they're insecurely attached or because they're grieving, to switch to a more sensitive style of parenting. This certainly won't make the kid non-autistic, but it is likely to make them happier and improve social and communication skills.

ABA, on the other hand, teaches a lot of practical skills, but it also models an insensitive style. Some insensitive parents are kind of detached and uninvolved, but others are overly involved and controlling (basically acting like an incompetent ABA therapist). It certainly wouldn't help an insensitive parent to model the 'ABA therapist' approach to parenting, and it might even make them worse. (I doubt it would affect a sensitive parent, though, because they instinctively know what their kid needs.) So, while the kid is likely to learn useful skills, it could come at the cost of poorer parent-child bonding, or at the very least fail to help an already vulnerable bond.

So, while a sensitive parent is likely to do just fine with ABA, 40% of parents of NT kids, and an even higher percentage of parents of disabled kids are likely to be insensitive parents, and for them, RDI is safer and more likely to help. (At least as a frontline treatment - it might be a good idea to switch to ABA later, if the kid is progressing poorly.) Also, while sensitive parents can usually tell that they're sensitive, insensitive parents don't always know they're insensitive. So self-selection is not necessarily a workable idea.

Makes perfect sense and that was such a clear and well-reasoned explanation. I guess I'm a sensitive parent and was always attached to my kids. Also practiced attachment parenting as much as possible, and I always saw my kids as separate from me, and deserving of having their authentic selves honored. I've written here before that protecting their self esteem is my number one priority, so it's hard for me to imagine any parent letting anyone therapist, family (parents included), make their children feel bad or intentionally cause them anxiety. Thanks for the clear explanation of the risks!!