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Monday, November 9, 2009

Conventional Wisdom

Yeah, I'm a slacker. I learned more at the autism conference I recently attended than what testing goes on inside a DAN! office.

ABA is on the decline.  Several speakers with a background and education in ABA spoke of the shortcomings, including a certified and practicing behaviorist. Mainly that while it's effective in some cases, it's often pushed as a panacea and the only therapy anyone should use. One professor said that kids who had the sometimes recommended level of 40 hours a week of intensive ABA were simply overwhelmed by it.

I tend to agree. I have concerns about the true effectiveness of ABA beyond teaching a discrete behavior. Yet I, like many others, tend to hold it up as an example of an evidence based practice, because it's certainly better than admitting that there's very little evidence based practice in the education system, period. This would certainly be a better place to throw research money than disproving the vaccine-autism connection again.

The problem is that many states are starting to role out mandated autism coverage laws. What gets covered? ABA. Speech therapy, occupational therapy, and ABA. That means there are situations where a family would be told that they can get ABA or nothing. Let's hear it for teenagers that demand a reward for every action. Let's hear it for kids being taught that food is a reward. ABA in theory isn't that, but in practice it quite often is.

That said, we're in the process of hiring a behaviorist for potty training. Using the toilet seems like a behavior where rewards and positive supports would be effective. I really hope it works. He's going to kindergarten next year. And while it's not surprising that he's not potty trained, he's got enough social barriers as it is. He doesn't need a poopy diaper incident to follow him around his school career.

Another point:

The phrase "genetics loads the gun and environment pulls the trigger" is in some ways an invocation of Bettelheim. We didn't cause autism in our genetically predisposed children, though sometimes prenatal stress seems to make the difference. And that's an environment we already do our best to control.


  1. Well said..Yes, theory and practice are two very different things. The idea of rewarding with food has always rubbed me wrong-I mean, thats how I train my dogs.
    Good luck with the potty training..One of my boys completely finished with it-the day before kindergarten started! :)

  2. He must have heard me mention ABA, because he's nearly trained himself. He hasn't figured out how to get pee into the toilet, but he likes to sit on it, and he's suddenly fascinated when we go.