So… About ABA…Confessions from an SLP
As far as overall treatment philosophies go, I’ve always considered myself more in the “Floortime” camp than an ABA (Applied Behavioral Analysis) person.
To me, the Floortime approach means doing what a kid likes and having as much fun as possible connecting with the child – all while teaching him or her to understand and use words. I must say, this has worked pretty darn well for me!
I’ve viewed ABA as a much more formal, abrasive approach. Truthfully, my perception of ABA therapy was more like this:
A child and a person are locked in a little room with nothing but a table, two chairs, and a bunch of black and white picture cards. No fun is allowed. Ever. Do the pictures. Occasionally give the child a goldfish for compliance. End the session. Repeat.
I’ve not shared that particular interpretation of ABA as I teach continuing education courses around the country for pediatric speech-language pathologists (SLP) and other therapists who work with very young children, but I’ve not exactly held back when someone has asked my opinion about ABA for toddlers, either. While I was teaching a course a few years ago, an SLP approached me at the end of the day and told me, “You’re doing more ABA than you realize.”
I laughed it off, but the comment stuck with me. Then it happened again.
A few weeks later, I was speaking to another group of SLPs in a different state and included a slightly snarky comment about ABA during my presentation. An SLP who is also a BCBA (that’s a Board Certified Behavior Analyst, which is a certified therapist who specializes in Applied Behavioral Analysis, in case you don’t know the lingo) purposefully followed me in to the ladies’ room.
As I was trying to politely end the conversation so I could proceed with my business, she took a deep breath and blurted out, “Laura… I know you say you don’t recommend ABA. You say you don’t like ABA. But I just have to tell you, your treatment methods are very ABA.”
I looked at her in disbelief and said, “Seriously? How?”
She couldn’t articulate anything specific, which made me want to shrug off her comment altogether, but she left me with: “Do some more research on your own. I think you’ll be surprised.”
Now I have to admit, I didn’t rush to do that research, but I did begin to think about what she’d said, especially since I’d heard it before.
I began to read a little here and browse an internet site there. I bought a couple of books and flipped through them, familiarizing myself with the terminology. I wasn’t sold, but I also began to realize that I wasn’t adamantly opposed to what I was reading because frankly, I did start to recognize similarities, particularly when I branched out beyond Discrete Trial Training.
Occasionally, I’d run across a therapist on Twitter or Facebook who was clearly “ABA All- the- Way!” As a discussion would unfold, usually in response to another SLP’s questions, the ABA person would reply with things like:
“I saw what you wrote about the importance of motor imitation in teaching a nonverbal toddler to talk. SLPs don’t always know to include that piece in speech therapy. You must have studied ABA or VB too.”
(If you were wondering, “VB” is Verbal Behavior, which is a form of ABA.) Eventually, it didn’t irk me anymore when someone would make a comment like that. That was a good thing, because it happened over and over again.
Hmmmm…What did they know about me that I didn’t?
Over the past couple of years, I have decided that I do use – even wholeheartedly embrace – many of the same beliefs about working with young children with developmental delays as our colleagues who use ABA. As I type that, it feels like I’m making a huge confession…
“Hello. My name is Laura. And apparently… I like ABA.”
Two weeks ago, I took a huge plunge and went to an ABA conference to hear a couple of renowned ABA experts. After sitting through two days of courses (one EXCELLENT day and one “eh” day) let me just say…
I think all of those ladies were right about me!
I don’t use the same terms, and my sessions look different than someone who’s been formally trained in ABA, but many of the underlying premises are the same. I want to share those similarities with you in case you, too, have been “in the closet” when it comes to ABA.
Over the next few days, I’ll be posting what I’ve learned that tells me I’ve been adapting ABA all along (without thinking I was remotely close!)
Today’s lesson is:
1. Go FAST!
A comment I hear often – mostly from parents but sometimes from therapists – is, “You keep a pretty fast pace with her!” or “Why do you talk so fast?”
I do. It’s true.
Here’s why: I learned a long time ago that when you keep things moving along pretty quickly, most young children – even those with delays – rise to the occasion and perform. The faster pace keeps them excited. When a child is revved-up, so to speak, he processes what’s going on better, understands more, and eventually begins to pop out those words. In my mind, it’s because he’s now “ON.” His system is in-gear and he stays right with me because it’s fun and, at times, even exhilarating.
My experience with thousands of busy toddlers has proven that fast always, always, always beats slow (a/k/a B-O-R-I-N-G!)
I also learned a long time ago that when a toddler is engaged, it reduces the opportunities for undesirable things to happen during therapy… things like being aggressive, refusing to do what I ask, running away, crying, and all other sorts of “bad” behavior.
When you’re having fun, who wants to ruin it? Who wants it to stop?
Being upbeat and playful is part of that fast-paced approach, and it’s good for me in sessions, too. It lets me see a kid’s best and, truth be told, it brings out the best in me, too. There’s no time for distractions for anyone who’s there… not the kid, not his mom, and not me!
It’s very important to note that one kid’s “fast” may be over-stimulating for another. Watch a child closely to determine what’s *just right* and when it’s too fast. When a child’s eyes begin to glaze over, when he starts to rub his face or disengage in any way, or (Heaven forbid!) if a child wants to LEAVE me, then I know I’ve pushed it too far and we slow it down a bit.
We also have to exercise caution with children who are hypersensitive to input – meaning they overreact or respond poorly to “too much” of anything. This especially applies to auditory stimulation, which in everyday terms means talking TOO MUCH and TOO LOUDLY!
Let’s discuss both of these common problems when adults are tweaking their approach with young children.
Sometimes people confuse the words “fun” and “fast” with being loud. I’ll admit to sporadically over-stimulating a new client who I’m just getting to know, but I am living proof that you can be learn to be super-fun and engaging without being so over-the-top that you scare the poor child! With a child who has a delicate sensory system, you must follow his lead to decide what speed and volume is *just right* for him.
I also want to caution you about talking too much. Many adults who are fabulous with children (SLPs included!) can be guilty of OVER-TALKING. Going fast doesn’t mean that you talk non-stop in paragraphs to a child who doesn’t understand very much. There are many toddlers who become overwhelmed by too much talking and then they block you out – either by subtly shutting down so that they look like they aren’t interested in an activity, by misbehaving so that you will SHUT UP and move on, or by physically moving on themselves so that they bolt and run away from you.
These kinds of children usually have some difficulty with receptive language too. They don’t follow directions. They look like they’re ignoring you, or at times seem like they can’t hear you. It’s not that. They don’t understand what you’re saying, and you’re not helping by over-stimulating them with language that’s too complex. With these kids, you should talk in single words and short phrases, but keep your turns fast. Don’t ask them “Can you say…?” seventeen times or take three whole minutes to explain something before you do what they want. Keep the activity MOVING!
This faster pace can be adapted by professionals during a therapy session, or even at home with a child. The next time you feel like you’re losing a kid’s attention, speed it up until it feels like both of you are into whatever you’re doing.
Fast = Fun for Toddlers
Until tomorrow –
Look for the next post in this series…Time Matters
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First, I would like to thank you for all you do for us moms who are lacking support in the autism community, and thank you for providing tons of information and resources to help our bright children. I myself benefited so much from watching your videos and reading your daily emails. I cannot stress enough how much all this information helped my toddler. Of course, getting an autism diagnosis for your child is extremely scary (she was diagnosed at 2 years old) and I was depressed and did not know what autism was, how it affected children, and how to teach children struggling with this condition. However, your videos helped me to find light in my child and now I am your biggest fan! I rewatch your videos over and over again to make sure I didn't miss anything that can help my daughter. I even purchase two books- Autism workbook and Teach me to Play. My toddler was completely non-verbal, she didn't know how to imitate, no eye contact, no pointing.. you name it she didn't have any skills and I didn't know how to teach her! And that is until I discover ed You- my toddlers (Fairy: smiling_face_with_3_hearts:)!
Now she is little sweet 2.5 years old and she says "mama" (I cried when she said that magic word), she waves bye bye or hi, she points, she gives "high 5", her joint attention is great and overall she is doing so much better! And that's all because I have been doing everything you described in your books and videos! I. My mind I always play "repetition, repetition and repetition", teaching her everything through play that she so much enjoys!!! I can write forever explaining how much I taught her through yr videos and books! And the most amazing thing is that her speech therapist is a big fan of yours as well so it worked out perfectly since we understand each other and work based on your teachings! The therapist even owns the same books I own ...I am so grateful that my toddler has such an amazing therapist; especially the one that understands autism and is ready for a real challenge! God bless you for all you do and I cannot wait for my toddler blossom.. you gave me hope and lit the light inside me. And I'm determined to work with my girl :)"
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Thank you so much for all your hard work and publishing books! Our 17-month-old toddler suddenly exploded into speaking and imitating everybody's gestures and sounds, just a week or two after we 'completed' all activities that are listed under 11 pre-linguistic skills! Your method really works!"
I absolutely LOVE all of your workbooks, especially your Autism Workbook. Starting with Social Games has been a game changer for many of my littles with ASD and their families. It's been the best way for them to finally connect and sustain shared attention and engagement, leading to longer social interactions, through play!"
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Thank you so much for the videos you have posted on your youtube channel. They are so direct, informative, and helpful. Thank you for being a resource for me to become a better therapist."
"Hi Laura - I just wanted to say I received my copies of the Apraxia workbooks yesterday and I LOVED workbook 1 (not ready for 2). I'm on chapter 8 and going through the questions carefully so I'm prepared to help my son. I knew it was a great book when you acknowledged the fact that sometimes therapists and doctors don't bring a positive and supportive vibe when diagnosing. I remember being terrified at the mention of apraxia and ASD by both because they had these very concerned looks and made it seem like it was a death sentence. I know now (in LARGE PART, THANKS TO YOU AND YOUR VIDEOS) that it doesn't have to be!! I see a future for him now. You SINGLE-HANDEDLY, through your books and videos have empowered me to help my son after the doctors and therapists have gone home. You've given me strategies, play ideas, plans on how to keep moving forward. I don't always do things right, but I know I'm on the right track and I love that I can reference, and re-reference your books to help me keep going. As I was reading the book, I was so proud of myself because I've used strategies from your previous books and it felt good because I could check off a lot of the skills that you discuss. So, thank you for all your previous books as well!!"
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Thank you for systematically organizing and explaining essential steps for young children to learn and develop. You are having a great impact on our profession, the ECE profession and families!"
If this is Laura herself reading this email let me take this opportunity to thank you from the bottom of my heart for all that you have put forth for us professionals. I own every manual (except the autism manual) and have watched every course on DVD. I have listened to countless podcasts. All of what I’ve come to be as an Early Intervention speech therapist was absolutely to your credit. With your resources at my side I have never needed to scramble for answers and strategies and above all the clear language I use when communicating with parents. My fun, animated affect and key phrases I use have been learned through watching your example. So….thank you! May you be blessed."
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Thank you for helping me be a better Developmental Therapist. I often listen to your podcasts which help me help families.
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the sheer volume of information is so great.
You are part of my team.
I just wanted you to know I appreciate you."
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As a retired audiologist with a fabulous and language delayed grandson, I used your podcasts and outstanding publication, The Autism Workbook, to inspire and guide me over the past year.
It works!! He went from barely verbal, no gestures, didn't respond to his name etc etc to a verbal, social, curious, ready to imitate anything, fill in the blanks on familiar "set" speech, generate his own totally appropriate and mostly understandable sentences...not just short phrases anymore... full little paragraphs...about imaginary things, what he did during the day, what he wants. True communication!
You make a powerful difference in this world! ❤"
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I received your book (The Autism Workbook) yesterday and it is absolutely amazing! As I evaluate young children (0-3) for developmental delays and write plans for them with their parents, there are a ton of ideas that are ready to use. Others that reinforce what I have been doing, and saying, all along. Thank you so, so much for writing this incredible book and pulling everything together in one place!"
FRANCINE IN MICHIGAN
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I’m a parent who bought the autism workbook and it’s the only clear resource I found to make a change in my son. I’m really thankful to Ms. Laura for helping out people like us all over the world."
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Girl…my son is 3 years old, and he NEVER asks for something using words. We were playing “Get Your Belly” (from Teach Me to Play WITH You), and after several times, he laughed and screamed "BEWIEEE!!!" It was a hoot. And I can't believe he said it! I have played with him like this before, but this time I took your advice and acted CRAZY!! I will act like a total lunatic if it will get him to talk to me! Now I can give him "the look" from across the room, and he will say it. That manual is so amazingly practical, and it is a GODSEND right now! Thank you SO MUCH!”
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We still have so much work to do with our sweet boy, but I know in my heart he would not have succeeded without the education you provided. I will continue to read your emails & watch videos as we go along this journey and face challenges, but credit is due to you, Laura.
Thank you so much, endlessly."
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"I was very frustrated with how speech therapy was going for my child. I would take him and drop him off and not hear much of anything from his therapist and teachers other than, "He had a good (or a bad!) day." Your materials were invaluable for us because I learned how to work with him on his speech. I learned how to teach him to talk and play. I learned how to pay attention to his cues and work with him to teach him to communicate. Without it, I have no doubt he still wouldn’t talk."
"Hi! I just wanted to say (from an SLT perspective) how incredibly useful I am finding absolutely all of your articles, blogs and resources - I only discovered your site last month and have just received all your books which I feel I am learning more than on my entire university training course!! But also the way in which you give specific, realistic, fun, encouraging ideas for working with parents is really just fantastic, I only wish I have your site sooner! Thanks so much from the UK! Kind regards."
"I just wanted to reach out to say thank you for making things a little easier to manage for me this year. I made the transition from school SLP to private therapist about a year ago. While the change was welcome, it was a lot, and I was just getting my footing in the clinic when I began teletherapy full time. Your website has been a huge lifeline in helping me work with late talkers and coach their parents in an accessible but effective way, even remotely. I look forward to getting your emails each week. I am floored by the amount of valuable, free information that your website provides, and I’m looking forward to investing in your workbooks soon. A sincere thank you for all you do!"
"You are an inspiration! I am truly grateful for the way you put into words and writing how to do what we do as SLPs. At this time in my 13 years of practicing, I find your encouragement keeps me going. As a single mom, I find it a stretch to buy materials these days and I am so thankful for the freebies you so generously share that help me teach my families. I don’t have much time to put together lists or quick references for parents!! Much gratitude!!"
Laura thank you so much. Btw, you have transformed my therapy- I have become such a competent and strong therapist after watching probably like 350 of your videos and podcasts over the past few years. And I am a seasoned therapist with almost 25 years experience. (Yes prob 350 episodes ha!) But there was still a lot I learned from you. I have such a thorough understanding of birth to 3 development and how to properly incorporate appropriate therapeutic goals, techniques and strategies now, thanks to you. Kelly
Hi Laura,I want to thank you so much for the resources you provide, my daughter has delayed speech and though she qualifies for CDS. Honestly the most progress she has made in her speech/language development has been after I implemented your 5 top strategies for delayed talkers! She is now almost 2.5 and her vocabulary is well over 75 (I haven’t counted recently, could be over 100) words when at 2 she barely had four words. Honestly the last few months have been a transformation for her.