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For many parents, when their toddler first gets diagnosed with autism, they’re scared and overwhelmed. The idea of treating their child and sending them to therapy sounds foreign and daunting. At Circle Care, we’ve found that many parents coming into the clinic don’t actually know what it is they’re signing their toddler up for! ABA therapy may be new to some parents, but it’s hardly something to fear. Hopefully this will help shed some light on what the goal is of ABA therapy, and how it can help your toddler.
Once Upon a Time: The History of Autism Treatment
Early Autism Treatment Approaches
The earliest published studies about autism date back to the early 1900s. A Swiss psychologist by the name of Eugene Bleuler first used the term autism in his description of the symptoms of schizophrenia. Until autism was classified as its own distinct disorder, there was a lot of crossover and speculation about the characteristics and symptoms between autism and schizophrenia. This came about because the term autism was used to describe the extreme social withdrawal that often accompanied psychiatric conditions that presented with psychosis*.
Attempts to Physically Alter Brain Chemistry
One of the first types of treatment that was delivered for autism was electroconvulsive therapy (ECT). ECT was delivered by administering small electrical currents through the brain to cause changes in brain chemistry by triggering small seizures. Scientists who used this type of therapy (and some still do) believe that the change in brain chemistry reduces self destructive behaviors and agitation. Thankfully, the use of ECT is rare due to the evidence based effectiveness of behavioral therapies such as ABA.
Attempts to Alter Nutrition as Treatment
Another approach to treating the symptoms of autism that emerged in the 1920s was the restriction of certain foods in a child’s diet. The nutritional approach is still being explored today as research continues to explore the effects of gluten, food colorings, and other ingredients that could affect a child’s behavior. To date, there have been many theories but no direct connections made to any particular ingredients. Obviously, the dietary approach is much easier and less controversial to try than electroconvulsive therapies. It is a harmless way to observe any noticeable changes at home by eliminating certain foods or ingredients.
Current Therapies for Managing Behaviors
Since those early days of classifying autism, there has been a steady progression of research and therapies that have been tested along the way. What we know about autism now took years of trial and error to understand.
Thankfully, we now live in an era that has a much clearer understanding of the characteristics of autism. We also have years of implementing behavior modification therapy, such as applied behavior analysis, to show the positive outcomes for children with autism.
Here is what we know about autism treatments today. We know that early behavior intervention for children with autism is the best approach to treating the symptoms of autism. Plus, we know that teaching these skills in a natural environment using the “work” of “play” is a direct and efficient way to teach young children with autism.
How Toddlers Learn
All children learn best by observing, listening, imitating, and acting out the things that they see, hear, and feel. Think about a young baby playing peek-a-boo. They watch mom or dad as they cover their eyes and ask “where are you?” in a sing-songy voice and they suddenly remove their hands from their eyes and say “PEEK-A-BOO”. At first, the baby might startle, then laugh, and inevitably they repeat the behavior back to mom or dad.
The same applies to speaking and communicating. Even in infancy, a parent who is speaking to a tiny baby can see the intense gaze from the infant as their baby listens and watches mom or dad’s mouth move as they speak to them. Before long, the infant is moving their mouth and attempting to push sounds out of their mouth that sounds like mom or dad.
Observation and imitation are the primary tools for babies and toddlers to start learning about their world and how to navigate their way through it. At each new milestone, the reactions that small children receive from those around them will shape their behavior. They encounter positive reinforcement for appropriate behavior and negative reactions for behaviors that are not so welcome.
When a toddler has autism, sometimes the ability to observe and imitate is hindered. When this happens, the characteristics of autism become evident. The lack of eye contact, the apparent disinterest in speaking, the lack of imitating sounds and motions, and perhaps the hyper (oversensitivity) or hypo (under sensitivity) to sights, sounds, smells, and touch.
How Play Helps Development
The educator Maria Montessori once said, “play is the work of children”.
Fred Rogers who we lovingly remember as Mr. Rogers from Mr. Rogers Neighborhood said: “Play is often talked about as if it were a relief from serious learning. But for children, play is serious learning. Play is really the work of childhood.”
The things that children do might look nonsensical or random. But, there really is a purpose to everything that a child does when they are young and learning. When children play they are learning and developing in various areas:
- Fine Motor Skills
- Problem Solving Skills
- Spatial Awareness
- Negotiating Social Situation
- Practicing Conflict Resolution
- Self Confidence
- Speech and communication skills
- Making sense of their world- their bodies, the environment, and the people and animals around them
For example, the simple act of playing in the sand at the park with other children is developing fine motor skills as they pour sand from a shovel into a bucket. They develop their social skills as other children join them in play. Conflict resolution is developed when one child wants an item and another child is using it. Communication is developed as children negotiate who gets the shovel, who gets the bucket, and who gets to be the instigator of the next activity.
Play is the most natural form of learning. Children don’t really need to think about play- they just do it because they are naturally driven to this type of interaction. During play, children will observe, investigate, and attempt to imitate the things that they see and hear.
Psychologists, child development experts, and therapists know this about children. Play is heavily utilized in speech therapy, physical therapy, occupational therapy, cognitive therapy, and even in academics.
Play is so prevalent in the development and education of a child that it is commonly known as Natural Environment Teaching or NET. Just as its name implies, NET is a type of therapy that is conducted in a more natural setting or “real life” setting. NET teaches skills but it also focuses on the generalization of skills from one environment to another. For example, a child learns how to sit appropriately in a school setting but they also need to learn how to sit appropriately in a waiting room at a doctor’s office or at the dinner table at home. NET helps a child with autism to learn these skills in a natural and playful way.
ABA Utilizes Play in Delivering Therapy
ABA therapy uses many forms of therapy to help a child with autism. ABA uses:
Discrete Trial Training
This breaks skills down into steps; correct responses are reinforced and incorrect responses are not. This kind of training is often used to help kids with autism learn potty training.
Early Intensive Behavioral Intervention
This method teaches social, communication, and functional skills in an intensive individualized manner.
Pivotal Response Training
This training is a social development teaching that helps to motivate a child with autism to interact with others and care for themselves.
Verbal Behavior Intervention
This kind of intervention helps teach toddlers and other kids with autism better communication skills.
The play-based therapies are:
Early Start Denver Model
This model is primarily used with toddlers who have autism. It is used to teach cognitive, social, and language skills.
Natural Environment Teaching
The natural environment is used to practice the pivotal skills that are learned in discrete trial training. The focus is to use skills across environments and social settings that the child is normally exposed to. For example, many children with autism experience sensory issues, and have great difficulty in common experiences. Natural Environment Teaching helps toddlers with autism to use the skills they’re learning in ABA therapy across many environments, such as getting a haircut or going on an airplane for the holiday.
ABA is comprehensive, so there are a variety of therapies that a behavior analyst might use when developing a treatment plan for a child with autism. It all depends on the needs of the child and the family’s goals for the child.
Older children and teens also benefit from this type of therapy. Depending on the cognitive level of the child, therapy can remain very elementary and playful or it may develop into a more focused type of play therapy if the child has a specific interest.
For example, if a child enjoys cooking, a therapist might use cooking to teach several skills. Academic skills can be developed by researching, reading, and following recipes. Measuring can help with cognitive skills. Cutting, stirring, and prepping foods develop fine motor skills. Working in collaboration with a partner in the kitchen helps communication skills and so on.
ABA therapists know how effective this type of therapy is and use it frequently during ABA therapy sessions.
Find an ABA Agency That Understands the Importance of Play
When you are seeking services for your child with autism, it is important to find an agency that understands the principles of play and natural environment training. Your child will interact with therapists anywhere from ten to forty hours each week when you consider time with ABA, speech therapy, occupational therapy, and teachers.
Working with professionals who realize how important it is to engage the senses, keep a child happily playing, learning how to communicate and interact are all essential parts of helping your child with autism.
Circle Care Services in New Jersey is an ABA Agency that understands these things well. Our therapists are trained to motivate children to interact with others and instigate play with others. We realize how important it is to develop good communication skills and the ability to navigate conversations and play with their peers, their family, and the adults that they are in contact with each day.
Circle Care offers social skills groups, preschool readiness programs, and individualized therapy for every child- and we keep it fun and playful.
Call us for a consultation and help your child to learn the skills that they need in a fun and engaging way.
*Psychosis: conditions that affect the mind, where there has been some loss of contact with reality.