Does the thought of BEHAVIORAL treatment make you twitch?

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Yes, back in the day, things were rough. However, treatment was bad all around for anyone who suffered from what many deem to be a mental disorder or something that couldn't be explained. Lobotomies, shock treatment, ice treatment, restraints, solitary confinement...all of that was par for the course in the good old days.

I've said it before: I thank God everyday my son was diagnosed in today's age. It will make all the difference in the world.

My son's programs have been nothing but positive. Even if he messes up royally (patterns and sequencing are huge problems for him) the therapist simply adjusts his mistake without telling him he's wrong, then praises him for trying. When he gets things right, there's clapping (which he loves--he's oddly hammy), cheering, and a break to enjoy a preferred activity.

Two summers ago my parents (who've mellowed greatly since my day and are doting grandparents) were kind enough to buy him one of those Rainbow systems and both the therapists we had at the time--seeing how much he liked it and the outside--began conducting his sessions in the clubhouse part. Breaks were spent running around the yard (my son loves to be chased) and jumping on our trampoline.

I agree that ABA often gets a bad rap, as people seem to believe that it's still conducted today like how it used to be. I'm a speech therapy intern in a school for autistic children, and we use ABA to encourage kids to do things like make eye contact, request items, and produce some language (tailored to the individual level of the kid). Higher-functioning kids learn turn-taking and social skills. The kid gets to choose what they work for, and they are regularly rewarded for each success. Kids are not chastised, but simply redirected when they are having difficulty participating constructively. The programs are flexible, as the therapist responds to the child's level of functioning and particular abilities during a particular session.

What about occupational therapy? I never honestly know about the difference on these two...It seems some people see them as related and others don't. I can't imagine sending my kid to behavioral therapy...I think honestly, they are full of it and no way I'd send my child. His speech therapist continuously tells us to send him to occupational therapy, but I'm a little hesitant of that as well.

I don't know...but I just don't feel that "humans" need to be "trained" by anyone who believes they have the "right" way of doing things...Example, some teach kids to wait in line...Well, guess what? My kiddo cannot wait in line, when he couldn't care less about the outcome...but he's fine if he is excited about the outcome. I just see it as some people out there believing they know the "right" way for everyone to behave and honestly, I think they need to instead learn to deal with people's differences instead of focusing so much on making everyone fit "their" mold.

As far as ABA...well, I've heard good and bad...and until today, I have heard of recent "tie your kiddo to a chair with a towel" because that helps them calm themselves and they can sit at the table through a meal and eat...No thank you!

Zwerfbeertje:

I agree.

Quite frankly, Zwerfbeertje has given a rather apt description of behaviorism in its pure form (that is, Skinner et al.). Initially, behaviorism was built on the idea that an individual ought to be treated as a "black box", whose inner states and emotions cannot be examined or measured and are basically of no consequence (and thus can be conveniently ignored), and that it is only one's external behavior that counts. By definition, this is a system which is innately unethical, which is exactly what Zwerfbeertje was talking about.

Disrespect for an individual's personhood, their preferences or feelings (what is inside the "black box" doesn't matter, so one may well be suicidally depressed, and it will be fine as long as one acts in a way that is deemed "proper" on the outisde), reduction of an individual to a set of behaviors which are "acceptable"/"desirable" or "unacceptable"/"undesirable" (again, one's experience of the world doesn't matter, neither does one's unique identity, it is only one's external actions that are taken into account), and forced behavior modification against the patient's will (the underlying reasons behind behavior are not addressed, so that behaviors which cause discomfort or are stressful may be forced upon the individual, while those that are comforting or beneficial may be eliminated) - they are all there, summed up neatly in that one single description.

I suppose I needn't comment on the enormous potential for abuse associated with this approach. It practically gives the therapist the right to do ANYTHING to their patient, as the latter is not a human being but merely a "black box". Black boxes are not supposed to hurt, or to have minds of their own; they are only supposed to look and move the way others want them to, and if they do not, well, one can make them comply at any cost. Even if a couple of them end up breaking, it's not that much of a loss.

(that metaphor is a strikingly good one)



Yes and they must be real bad - stinking black rotten - because there have been cases of children DYING in these programs in appalling circumstances. One of them was forced to wear a helmet with a dark visor and full-arm restraints for the last weeks of his life; he ended up developing pneumonia and just lying there on the floor until he died, because nobody bothered to pay him any attention. Some others died of suffocation while several staff members were sitting on top of them in order to restrain them. Other children have ended up suffering fairly severe emotional trauma and developing PTSD, serious anxiety and other related conditions. Etc.

The system at the JRC is also based on a behaviorist approach.

Such cases seem far too regular, and can hardly be considered isolated instances where individual therapists had been abusive and incompetent. It would seem that there is something about the entire approach these programs are based on which allows these things to take place, again and again. This seems especially true given that it was possible to construct the whole ugly system at the JRC on that approach (and other places as well, I just don't remember any exact names at the moment).

However, I'm also aware that a number of other behavioral approaches have branched away from the original version of behaviorism, and I often hear good things about therapy programs based on these approaches. To really form an opinion about them, I would have to see them being administered; but it does seem that some of them are quite beneficial, and don't involve anything that might hurt the child.

If your son is in a similar program and it is helping him (and he is finding it enjoyable and not stressful), then I'm glad for him and for you.

Occupational Therapy is very important as well, but it's not Behav Mod. OT primarily deals with fine motor, gross motor and sensory integration. But, many STs today who work with spectrum kids, have ST and PT skills and they will administer some of those during the sessions as well. When my son was echolalic, the ST really incorporated direct question/answers during the session. My son's EI program has ST, OT, PT, ABA and in the very near future, a separate Social Skills class. However, it all depends on what the kid needs because they're all different.

If your ST thinks your kid needs it, I'd look into. It's best to have the OT at the same location or facility where the ST is done so they can collaborate. Even if it's at school. Good luck with it.

I'm quite familiar with B.F. Skinner and if you and Zwerfbeertje want to insist that the current programs are disrespectful of the individual and cruel, without having ever observed a behav mod program, particpated in one, read up on them (awesome books out there) or talked to others who are actively apart of them, run with it. Peace.

For those interested, HBO is airing "Autism: The Musical." It premiered last night and it is about a group of high-functioning (and one Asperger) kids who put on a musical. At the end of the program it mentioned that several of the Autistic kids would be starting ABA and Social Skills (which is also a form of Behav Mod). These are high-functioning kids, but there is definately a need for it.

The Asperger kid in the program is the son of Crosby (Crosby, Stills & Nash). He has an obsession with dinosaurs and that's all he talks and thinks about. He can't take his mind away from them. The mom says he's being teased at school because of it. It didn't say if he would participate in Behav Mod to change that, but the kid is really struggling.

Neale, LostinSpace, I agree with you all and sounds like you've got experience with it.

Neale, we still do patterning and sequencing. Until ABA, I had no idea of how this builds cognitive skills and strength. At his age, patterning and sequencing is also a big part of standardized tests and I think he's going to do okay on those when the time comes.

Neale,

Your son's program sounds fantastic! Makes me feel happy for him.

You seem to have either overlooked the final paragraph of my previous message or not read it altogether.

I have never said that ALL contemporary programs are like this. I only said that some of them obviously are, and this is a great difference. The fact that your son’s program happens to be quite good, and that there is no abuse involved there (which I am really happy about), does not mean that there is no abuse happening elsewhere. It’s happening, and it’s probably always going to happen – only today it is, thankfully, not as widespread as it used to be.

Have a look at the Judge Rottenberg Center and try to deny that there is any abuse going on. They STILL routinely administer electric shocks to children, and it is only one of the things they are doing.



He should become a palaeontologist.

In light of this, I don’t know how to understand your previous assertion that behavior modification is not aimed at changing one’s personality. Trying to discourage someone from doing something they like or are interested in means precisely that: trying to alter the person that they are.

Frankly, I wouldn’t want to swap places with this boy. If they are going to do anything like try to prevent him from talking or reading about his interest, I imagine how he is going to feel, and I also have doubts that they are actually going to be successful. If anyone tried to force me to stop doing something I find engaging, not only would I not quit it – I would come to find it even more engaging than before, and would end up with a very unflattering opinion of the person trying to do this, which would likely never change. I know because up until very recently, my parents have been actively discouraging me from doing anything I enjoyed (from drawing to translating and earning money off doing so), as they had other plans for me. Has this put me off becoming an artist? Absolutely not. All it taught me was hide my drawing supplies, draw at a friend’s or while my mother was away, and then pretend I had quit drawing for good.

I can only imagine the reaction of someone who is even more strongly interested in things than I am.

Also, from the purely technical point of view: how on Earth can a method as external as behavior modification address something as internal as an obsession? Granted, they can forbid him to talk about his interest or something, but he will still be free to think about it all he likes. So far there are no means to get inside somebody's mind and change it to one's convenience (thank God).

Basically, I could think of behavior modification as acceptable in this case only if it helped him control his obsession and channel it into something constructive, rather than try to remove it altogether, but I have no idea whether it is this that they are actually going to do.

Actually, it isn't Skinner who was the problem. Most Behavior mod programs seem to model their therapies on Pavlov. Look it up.

Operant conditioning? Oh yes....I don't know why I forgot, thanks for bringing it up.

I read quite a bit about Pavlov as a child, and later in grade eight while preparing for a biology contest, but I forgot almost all of it because I was never too keen on it to begin with.

(ugh, I don't specifically like the "slide show" this gives me: dogs with dribbling saliva in cages - trained dogs and seals - stick and carrot - be graciously allowed to do something you enjoy in case you comply, or be electroshocked or tied to a chair in case you don't....)

I did read your post in its entirety and I responded.



I know all about the Rottenberg Center. Everybody does. Have you been there yourself? Have you seen their program in action? Have you monitored their facilities? Even though people on the outside find it barbaric, there are many parents who say this school changed (and saved) their kid's lives so that they can actually live and function in society. However, you cannot hold The Judge Rottenberg Center up as an example of the "typical" kind of ABA treatment that kids get today. To me, that center is atypical. This is a "facility" run much like an institution. And, like I said and I quote myself, "You will always find a bad apple in the group." Most parents of Autistics are not going to be shipping their kids to Massachusetts for ABA. They will do it in the privacy of their homes, at a local clinic or at school. And, most parents would not consent to their shock therapy. For those who haven't heard of Rottenberg, here's a synopsis of their Behavioral Program. I'm sure you can find more on the net:

http://www.judgerc.org/





It takes a college degree to become a Palaeontologist. And, if you're going to work in the field, an employer is going to want to see some credentials. How in the world is a kid who can't focus on anything else but a dinosaur going to get a degree? Or, get the skills needed in order to work with a team out in the field. Because, that's the biggest part of Palaeontology... group research and teamwork. You can't have a career in this field unless you've got some solid social skills and are able to rely on and communite with your team. This kid, on the contrary, might one day flunk out of school because of his obsession. He'll never make it to college! Having an obsessive knowledge of something doesn't mean that person's qualified to become a professional or make a living at it.



Here we go with the "changing personality" thing again. First of all, did you see the program? Who said anything about discouraging or removing the obsession? I never said that. They never said that. What I'm saying is that he needs to modify his obsession in order to make it in this world and behav mod could help with that. You think a dinosaur obsesssion makes a personality? A dinosaur obsession is NOT WHO HE IS. A dinosaur obsession is WHAT HE DOES. I have a golf obsession. Does that mean golf is my personality? Heck, no! It's something I like and enjoy, but I can turn it off and enjoy all the other things life has to offer. Golf isn't a personality. And, what's Tiger Wood's famous quote, "Golf is not who I am." I may be able to turn it off, but Autistic kids cannot turn it off. And, it would be ludicrous for anyone to suggest that just because I have that obsession I'd become a pro. I'm not saying do away with an Autistic kid's object of desire. What I'm saying is that in order to grow and development the obsession into something worthwhile or even meaningful for the individual, the kid must be able to build upon that obsession and in order to do it, you need to function. Plain and simple. This is how Autistics like Temple Grandin were able to become successful. They got intervention and as a result, she took her obsession and was able to get an education and become a millionaire.



Well, that's sad. I am sorry your parents don't understand you or what they're dealing with. If they had been introduced to the program my son and many other's get, they would think otherwise. Our program does not in any way, shape or form discourage like this. What would be the point of anyone discouraging a talent like that? That's not AT ALL and I repeat AT ALL what I'm talking about and what our program does. Quite frankly, I think what your parents are doing to you is downright mean. What ours does (and others like it) is take an obsession and teaches the kid how to manage it in a way that's productive. If our ABA therapist saw that you had talent, she'd probably use that talent to build upon some of your other skills, all the while giving you the ability to control it and not use it as an "out" for anxiety or a stem when you couldn't cope otherwise. Watch the program. Whenever the kid gets nervous or a simple questions is asked of him, he resorts to dinosaurs. How far in life will that get anyone?

Back to your drawings, you would always have that talent and probably get a lot better at it. There are kids in our program with lots of talent. Ironically, it's normally in the form of art or music.



This question is the reason why it won't hurt to educate yourself about modern-day behav mod programs and see how they work. And, see the successes that people are having. And, understand why parents are pushing for insurers and schools to cover. Temple Grandin says ABA is one of the most effective tools today to help spectrum kids. She says that at conferences and on one of the DVDs we have of her.

Skinner also received a lot of flack for putting his own daughter in a confined box as an experiment. Abuse wasn't his intent, but that's how some saw it.

I'm all for supporting a child's interests. But if he/she can't focus on or talk about anything else they may not be able to become a paleontologist (or astronomer or geologist or whatever) because they have to study other things and give those other things an equal amount of attention. Plus, assuming they get the degree, they need to be able turn the dino talk off lest an equally qualified but potentially less-annoying-to-NTs get the job. As parents, it's our job to support their interests in a way that helps them realize them to their fullest.

No. But I was hit by electricity once after touching a plug that was half bared (it was my own stupidity, but that is beside the point).



Anything that has child torture in it (because yes, this is child torture, or "cruel and unusual punishment" if you prefer to call it that - let's refer to things by their own names) is wrong regardless of the purpose behind it, or the manner in which it is conducted. There is no "right" way of inflicting suffering.



There are also parents who beat their children and claim that they deserve it, that it helps them grow up better people, and/or that it is a legitimate Biblical means of chastisement. This doesn't make beating one's child any more acceptable.

Of course anyone would become quiet and compliant out of fear of getting an electric shock, or some equally painful punishment. But it's quite callous to consider this an "improvement". Especially in the case of a child who is profoundly autistic and/or ret*d and cannot even understand what was wanted from them in the first place.



It's not who he is, but it is still part of him. If he were, for instance, not a famous golfer but a famous physicist, he apparently wouldn't have been the precise same person.

I suppose what you said is only partially true. One's preferences are a manifestation of one's self - one of the many manifestations out there. They reflect the nature of one's relationship to the world (which transpires through a wide variety of things, from the most insignificant, like choosing to wear blue over orange, down to the most significant, like one's choice of career).

True, one's likes and dislikes, the things one enjoys doing, one's talents etc. do not constitute the entirety of one's personality, but they are part of it. They all spring from a single deeper source.

Of course, if you hold the view that people have no consistent personality altogether, and are in a constant state of change without having any constant "anchor" inside them, you might disagree. But then this is a matter which is open to debate.



Ancient wisdom: "Nothing in excess".

I agree completely about the need to control obsessions and shape them into something helpful and constructive, - it could well be the only way of dealing with them which does indeed work, - and I'm glad if your son's program (or others you are talking about) aids people with autism in doing just that.



I beg to differ about the intervention part. To the best of my knowledge, Temple never received behavior therapy as such. She was in speech therapy, and took part in structured play with her nanny, which involved a lot of turn-taking etc., and other similar structured activities which made sure she didn't zone out. Of course, these could be regarded as a type of early intervention as well; at least, this is how she sees it.

However, it was not these "early intervention" type activities that helped her fashion something worthwhile out of her obsession. You seem to be quite fond of her and her writing, and I'm sure you know that her obsession came much later, when she was in her teens. As far as I remember, she started dreaming about her "squeeze machine" as a child, but it wasn't until her teens that she actually built it. At that point, nobody was doing any sort of intervention on her. Specifically, nobody tried to work with that obsession of hers and turn it into something constructive. Her psychotherapist actually found her "squeeze machine" worrying, a symbol of some hidden Freudian horror ("what does it symbolize for you, a coffin or your mother's womb" - don't remember the exact quote), and there were repeated attempts to terminate her fixation on it. But, with a stubborn person like her, it didn't work.

If anything, it was her personal persistence and creative approach that helped her shape something out of that obsession of hers. And, most crucially, she was surrounded by caring, supportive people - her mother, her teachers and others, - who encouraged her to learn and explore her talents, and let her feel that her efforts were worthwhile. This is just - love, I suppose. Not "early intervention".



This is refreshing and good to hear. I've said this before, and I'll repeat again: I'm glad there are programs which are made specifically to meet the needs of every child, and which help them develop their innate talents.

It is not therapy I am against. It is pain, whether physical or psychological, and negative reinforcement.

I bet when Ana started this thread she had no idea it would generate such interest. Regarding the above quote, Temple Grandin did indeed get behav mod. She went through social skills programs and social skills programs are very much behav mod. They are the most important behave mod programs as far as I'm concerned for high-functioning Autistics who are fortunate enough to break into the competitive world we live in. They focus on the relationship between the Autistic, others and their environment and teach them how to function within a normal, ordinary context outside of a comfortable satey-zone. If you read her book, "Unwritten Rules of Social Relationships: Decoding Social Mysteries Through the Unique Perspectives of Autism" you'll see how important she thinks it is.



Okay, you're losing me a bit here. I think what you're saying is that her squeeze machine came out of an obsession? Am I following you? If that's what you're saying, that's not quite true. She has sensory integration dysfunction and the machine was created to help with that. The machine was not created out of any obsessions. However, she had other obsessions as a child that are typical of Autism. She obsessed over details, opening and closing doors, and things like that. She didn't just dream about the squeeze machine. In "Thinking In Pictures" she talks about her visits to her aunt's ranch in New Mexico as a child growing up and she took a fascination in cattles and the way they were herded/treated. When she saw how calm and relaxed cows were in chutes (sp.?), that's when she got the idea that maybe that would work for her vestibular problems.



You have to remember that it was a Neurologist who advised Temple's mom to get her into a therapy program when she was 3. She hired someone to basically do EI with Temple in the home. Temple is very emphatic about the terms she uses. She says what she received was "Early Intervention." If you go to hear her speak she specifically says "Early Intervention" helped her become functional and grow into what she is today. When you read her books she is also clear that what she received was "Early Intevention." And, you know what? It was. She got EI before it's time. Her fate could have been a lot different.

Overall, Temple is a big advocate of kids channeling obsessions into something constructive. She doesn't want people to eliminate someone's obsession. Neither do I. But, my point is that in order to do that, you need to get the kid to a level where they can manage the obsession and learn other things in the process that will allow the obsession to be beneficial in their lives. That's where behav mod helps.