There are
many odd things in the world of autism. One is ABA
(Applied Behavioral Analysis), the gold standard therapy in North America,
where it is seen as evidence-based. In
the rest of the world there is very little ABA and that same “evidence” is not
seen as conclusive.
Raymond in Las Vegas with his “assistant”
Charlie
In the US, Federal
Government funded very early intensive intervention is available to anyone
under three years old with an autism diagnosis. The “evidence” shows that such
very early intervention can change the outcome.
But why stop at three years old? What is magical about 36 months of age? After this age some people continue to get intensive intervention and some do not; it all depends where you live and who wants to pay.
If the
evidence is so strong that very early intervention is so effective, why do rich
European countries leave it to far older than 36 months to even diagnose
autism?
Much does
not add up in the world of autism.
Personally,
I am a fan of ABA as a teaching method, but only when done in a fun way, which
is how our US-trained Behavioral Consultants practised it. Lots of high fives, “good
jobs”, smiling faces, tickling, dancing and generally a good time; no tears and
no stress.
I cannot see
why you would stop your intensive intervention so soon after starting it and I
really doubt you make a life-changing difference very often, by 36 months of
age.
One of our Behavioral
Consultants came from the New England Center for Children and I recall asking
her, “so when do you stop with your therapy?” She told me that they have people
in their 60s still in therapy and they might go on a trip with their assistant to
Las Vegas (yes, just like in Rain Man).
There are
many special schools in the US using techniques like ABA. Because of the high
ratio of staff to pupils, these schools are very expensive and somebody has to
pick up the bill.
In Europe
there are very few ABA schools, one of the first is called Tree House and was
established in London. It was set up by
a charity called Ambitious about Autism.
This school is very expensive and the idea is that the municipal
authority where you live is supposed to pay the fee for you. This would come
out of their budget for special needs kids, so the more money they spend on
such private schools the less money there is left over for the kids with less
demanding parents, who do not advocate for their kids.
Anyway, I recently
came across the fact that Ambitious about Autism has gone a step further and
now runs Ambitious College for people up to the age of 25.
This made me
wonder if you go to the ABA school from 4 to 18 years old and then go to the
ABA college until you are 25, when does it end? Perhaps with a trip to Las
Vegas?
ABA as a treatment or a teaching
method
While I see
ABA as a (highly effective, in the right hands) teaching method, the ABA specialists
put if forward as a proven treatment, meaning you should get better.
Ambitious or Realistic?
When
treating a three year old with autism I think you have to be ambitious,
optimistic and hopeful.
At some
point I think you need to be realistic.
Day care and
activities for young adults with severe autism is a great idea. Including them
in activities with non-autistic people would be even better.
With people
living longer there are many activities for retired older people, which are
entirely suitable for adults with (non-violent) severe autism, or indeed with
Down Syndrome. Why can’t the 25 year old
with severe autism play table tennis with the 70 year old retired teacher and
go to the same keep fit class? Last year Monty, aged 14 with ASD, was in Shanghai and when he saw a large group of older Chinese people doing their group exercises in a public park; he joined in. Everybody enjoyed it.
I am not
sure creating a “College” for people with severe autism is helpful. Helping people
with autism go to a regular college, by giving them an assistant, is a good
idea.
If it really
is day care, why not call it day care?
If it is about
preparing for life in the real world, what was happening at the ABA school from
4 to 18 years old?