First Days: Summer & ABA

Tomorrow Oliver and I will meet a woman named Kristin. She is an Applied Behavioral Analysis therapist with The May Institute and she is going to become a very important part of our lives. To begin with, she will only work with Oliver two days a week, for 2 hours each time, in our home. In a couple of weeks, a second therapist, Jamie, will join us. She will do six hours to start. Within the next month, Oliver will be up to 10 hours of Specialty Services a week. Once I know how he handles that, the pace at which we increase to 20-25 hours per week will be determined.

When a child is diagnosed with Autsim, they become eligible for "Specialty Services." Essentially, these specialty services are supplemental to the Early Intervention Program and provide intensive 1:1 therapy, typically at the child's home, focusing on the key characteristics of Autsim. The most popular therapy used is Applied Behavior Analysis, or ABA. Rather than try to define ABA for you, I have copied the following from the Autsim Speaks website. I think it gives a thorough picture of what ABA therapy involves, on the part of the therapist, the child and the parent.

Done correctly, ABA intervention for autism is not a "one size fits all" approach consisting of a "canned" set of programs or drills. On the contrary, every aspect of intervention is customized to each learner's skills, needs, interests, preferences, and family situation. For those reasons, an ABA program for one learner might look somewhat different than a program for another learner. But genuine, comprehensive ABA programs for learners with autism have certain things in common:

•Intervention designed and overseen directly by qualified, well-trained professional behavior analysts
•Detailed assessment of each learner's skills as well as learner and family preferences to determine initial treatment goals
•Selection of goals that are meaningful for the learner and the family
•Ongoing objective measurement of learner progress
•Frequent review of progress data by the behavior analyst so that goals and procedures can be "fine tuned" as needed
•Instruction on developmentally appropriate goals in skill areas (e.g. communication, social, self-care, play and leisure, motor, and academic skills)
•Skills broken down into small parts or steps that are manageable for the learner, and taught from simple (such as imitating single sounds) to complex (e.g. carrying on conversations)
•An emphasis on skills that will enable learners to be independent and successful in both the short and the long run
•Use of multiple behavior analytic procedures - both adult-directed and learner-initiated - to promote learning in a variety of ways
•Many opportunities - specifically planned and naturally occurring - for each learner to acquire and practice skills every day, in structured and unstructured situations
•Intervention provided consistently for many hours each week
•Abundant positive reinforcement for useful skills and socially appropriate behaviors
•An emphasis on positive social interactions, and on making learning fun!
•No reinforcement for behaviors that are harmful or prevent learning
•Use of techniques to help trained skills carry over to various places, people, and times, and to enable learners to acquire new skills in a variety of settings
•Parent training so family members can teach and support skills during typical family activities
•Regular meetings between family members and program staff to plan, review progress, and make adjustments

Despite all of the information I can read about what ABA therapy is supposed to be, I still have no idea what to expect. There are a lot of videos of ABA sessions on Youtube, but none really with a child as young as Oliver. I feel like I've been waiting an eternity for tomorrow, and now that it's nearly upon me, I am scared to death. The first two weeks of services will be used for the therapist to get to know Oliver, and to get Oliver to like and trust her. The third week is when my anxiety will really soar. That is when the actual therapy, and work will begin. And then, the pressure is on, and all of my what ifs will be answered.

What if Oliver cries because I'm not with him?
What if Oliver throws a tantrum because he doesn't want to do a task?
What if nothing is motivating enough to make Oliver perform a task?
What if they can never teach him to imitate?
What if he never talks?
What if he never says mama?
What if I can never potty train him?
What if he throws things on the floor forever?
What if he never wants friends?
What if he can't go to college, or have a job?
What if I lose my mind wondering "What if...?"

Ok. So the first two what ifs will probably get answered in that third week, but the others? Let's just pretend I didn't worry about those for now, ok?