So… About ABA…Confessions from an SLP

confessions

confessions

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.

Remember…

Fast = Fun for Toddlers

Until tomorrow –

Laura

———————————————————————————————————

Look for the next post in this series…Time Matters

Need some help with your own late talker? Teach Me To Talk the DVD

Need some help with your whole caseload of late talkers? Recommendations

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