Autism

Autism defined:
Autism or Autism Spectrum Disorder (ASD) is defined as challenges with regards to social communication and social interaction. This includes deficits in social-emotional reciprocity, deficits in non-verbal communication and deficit in developing, maintaining and understanding relationships. It also includes restricted, repetitive patterns of behaviour and interests.

Autism hallmark signs typically appears during the first three years of life. Some children with autism do not reach the developmental milestones on par with their peers, other children develop typically at first, only to lose skills such as speech, eye contact, etc. This is commonly known as regressive autism.

The DSM-5 gives a comprehensive definition of what autism is. However, defining autism is just not enough to develop a treatment plan. Autism is a complex spectrum disorder. Each person with autism has unique strengths and challenges. Autism ranges in severity from needing substantial support in order to be functional in everyday life, to some limitations to an otherwise “normal” life.

Furthermore, an autism diagnosis now encompasses so much more than what we knew in the past to be an “Autistic disorder”. It now includes what was previously known as Asperger’s syndrome, pervasive developmental disorder and childhood disintegration disorder. In addition to this, there are many comorbid disorders to the autism spectrum such as; a Fragile X syndrome, Epilepsy, Sensory Disintegration Disorder, Down Syndrome and Attention Deficit Hyperactivity Disorder, to name a few. Some children with autism also have gastrointestinal symptoms.

This highlights the complexity of the autism spectrum and brings me to one of my favourite sayings: “Once you have met one person with autism, you have met just one person with autism.” This could not be more true. When looking at treatment for autism, this saying should be kept in mind at all times. In defining autism and taking the possible co-morbid disorders that each child with autism might present with into account, it is clear that an individualised treatment plan is the only way forward.

Below are common misconceptions of ABA:

1. Aba is experimental in the treatment of autism
This cannot be further from the truth. ABA is an evidenced based science with more research to support its effectiveness than any other therapy used for children with autism. Scientific, peer-reviewed studies on the practice and effects of ABA have been conducted. Data collection is a vital aspect of ABA. This data reveals the progressive effects of ABA.

2. Autism is treated through the use of punishment
True ABA is characterised by its use of positive reinforcement procedures. No aversive stimuli are used in the teaching process. One of the main objectives of ABA is to replace inappropriate behaviours with appropriate behaviours. This cannot be done through the use of punishment. Punishment teaches a child not to engage in a specific behaviour in the presence of the punishing stimuli. This does not teach the child how to engage in more appropriate behaviours as a replacement.

3. Using ABA as a treatment for autism causes children to behave like robots
When ABA is implemented correctly, this is impossible! ABA has many different teaching strategies used to teach children with autism. Some are more structured while others are embedded in play activities. One of these strategies is called Discrete Trial Training (DTT). This instructional technique involves frequent repetition of the targeted skills. It is also a very structured way of teaching. Some believe that this way of teaching, limits a child with autism in many ways. For example, not being able to think in an abstract way, not being able to ask questions such as “Why?” or “What?”, not being able to respond to a question in any way other than the way they were taught, and this list goes on. The truth is, DTT, and other instructional techniques used in ABA, are actually ways of teaching a child with autism to do and engage in exactly these behaviours that critics state they will not be able to. For some children on the autism spectrum, it might be needed to use a more structured teaching technique to lay the ground work for mastery of the above-mentioned skills. Although some instructional techniques are more structured, a well-designed programme incorporates strategies to prevent the creation of “little robots”.

Most children with autism do not learn like their peers in school, thus, it is up to us to find a way to teach them. In ABA, we do exactly this. If this results in the creation of “robots”, it is definitely not the application of good ABA.

4. ABA is only for children with autism:
ABA is very effective in the treatment of autism but, the magic does not stop there. Adolescents and adults can also benefit greatly from ABA. In addition, ABA can be used in the treatment of other disorders such as ADHD and Down Syndrome.

5. ABA is a technique used to train animals
As mentioned earlier, ABA is based on the principles of behaviour. These principles are used to teach new skills and to manage problematic behaviour. It is true some behaviourists use this in the training of animals. However, the use of ABA is not limited to one specific field of behaviour, neither is the success of it.

6. ABA uses food in the teaching process which makes children with autism dependent on edibles

The value of reinforcements in the teaching process cannot be emphasised enough. When a child is motivated to learn, successful skill building and behaviour management can be guaranteed. Depending on the child, food and drink are most often used as reinforcers to ensure motivation. Having said that, an effective ABA programme always encompasses strategies to fade this over time thus, the use of edible/tangible reinforcers is sometimes common in the initial stages of the program, but through pairing and detailed planning for the future, children are taught to find reinforcements in their natural environment.

These are just a couple of the misconceptions that exist about ABA.

Remember the following important facts when coming across misconceptions that might stand in the way of effective treatment of autism:

• ABA is an effective treatment plan for children with autism and related disorders. This can be backed up by years of scientific research.
• The objective of ABA is to build on a child’s skills and teach appropriate ways of communication with the aim to socialise children with autism in to the community. It further aims to equip those with autism with the necessary life skills to be productive and active members of society.
• ABA aims to liberate those with autism by giving them a way to communicate and the ability to learn. Therefore, access to “good” ABA should be a basic human right.