Friday, April 23, 2010

30-40 hours? REALLY?

Sometimes well-meaning individuals question why I would ever want to have Alanna in intensive therapy for 30 to 40 hours a week when she is currently receiving only 15.  I have heard comments like, "shouldn't she just play?", or "won't she get dependent on her instructors if they spend so much time with her?"

I think this stems from a misunderstanding of what autism is and how education treats it.  Individuals with autism are completely learning disabled.  Most of the time to get started you have to draw them out of their world long enough to even get them to interact with you - this often requires intervention from an occupational therapist to deal with sensory problems.  Once a child with autism has some sensory regulation (whether through providing needed stimulation or making an environment tolerable for an over-stimulated child), you have to get them to attend.  That is, be able to look at you and pay attention to you for more than 0.2 seconds.

Once a child with autism can attend a little, they can start to learn.  But they typically have zero imitation skills, receptive language, speech or expressive language.  They have motor impairments.  They can lack ability to process tasks cognitively.  An autistic child's ability to learn from their environment is essentially zero.  So any attempt to allow them to play is likely to result in non-productive self-stimulatory behaviours, like jumping, bouncing, running around, staring at lights, flowers, etc.

Alanna after six months of therapy still has the speech of a ten month old (she is almost two and a half) and the receptive language of perhaps a 13-14 month old child.  Socially, she is perhaps in the 16 month range.  She is catching up, but she is so far behind.  Kids with autism can't play.  They have to be taught how to play, just like everything else.  Most time on their own is dead time, wasted time.  As they acquire more skills and catch up, their "alone" time becomes more productive and the self-stimulatory behaviours can decrease.

Kids with autism need intensive intervention.  If they don't get it they may lose skills until they are so developmentally behind their chances at catching up are greatly diminished.  Sure, they need rest - time to not think and to relax like the rest of us.  But most of their waking hours, like most typical kids, need to be doing very specific educational activities designed to help them learn, because they just can't on their own.


  1. Dude dont go so much on the numbers - I know it sounds irnoic, but you can't count on 'em. Humans and autism is not an exact science. Autistic people are as vastly varied as all other people. I would look long and hard at how old my child is, what other kids his age are doing, what are his specific barriers, how much of it is the autism, and what exactly I want my child to learn in the first place.

    I have no interest in teaching him prepositions and colors and numbers - even though he is 4. I would much rather spend entire hours and days teaching him other things that help him cope with the barriers. ABA cannot teach those things unfortunatly so for my family, the 30-40 weeks of ABA sort of defies logic. BUT Khaled does need an intensive PROGRAM - what that is, depends on the kid I feel :)

  2. Stranded- I understand what you're saying but a good ABA program does not focus entirely on academics (prepositions, colours and numbers). A good ABA program is varied and includes play skills and social skills and other programs that help our kids cope with certain barriers. I do however, agree that treatment depends on the child. Our child rec'd a dx of mild autism and has made wonderful gains with far less than the recommended 30 hrs of ABA/week. Sadly, he is too high functioning to be eligible for public funding, but we are happy with the results of ABA.

  3. We have a great ABA program too. Several sessions a week. Can't do without it.

  4. The good news is that the brain is more plastic than ever imagined. Pamela is showing us that even a young adult (sh . . . don't tell her that . . . she accurately sees herself as a big girl) can make progress. The past three years has been so revealing to us, watching her slowly conquer infant and toddler milestones we were told back in the mid 1990s that autistic kids will never do.