ABA or DIR/Floortime?
Choosing the "right" therapy for your child
ABA (Applied Behavioral Analysis) is commonly prescribed as the main treatment for autism spectrum disorders. Doctors frequently tell parents that they "need" to enroll their child in 40 hours per week of ABA therapy. But what is ABA and why does your child need it?
The fact is, they don't.
Focus on Function strongly believes in listening to and believing autistic adults regarding their childhood experiences with ABA. The majority of autistics (and yes, identity-first language is also what they want to hear!) tell us that ABA was extremely traumatic for them. As trauma-informed individuals and therapists it is essential that we avoid causing more harm than good to the children in our care.
What is ABA, anyway, and why is it so traumatizing? Click the links below to find out more.
A study published in 2018 in the journal Advances in Autism found that nearly half of children and adults exposed to ABA had post-traumatic stress disorder (PTSD) and were 86 percent more likely to experience it than their unexposed peers. According to the study, trauma sets in soon after treatment begins. (Today's Parent)
The DIR/Floortime model was developed by Dr. Stanley Greenspan over the course of his thirty-plus years as a child psychiatrist. In his own words:
"Floortime focuses on foundation-building, rather than concrete tasks of the sort that are often used in therapies. We use the child's natural emotional interactions as an entry point into the child's world, rather than trying to get the child to do what we want.
The idea is to get a continuous flow of back-and-forth interaction going between the child and parent or therapist, using gestures, perhaps, or facial expressions. Therapists often pursue cognitive tasks such as matching shapes, but you need to move that from sensory to cognitive. They become wedded to the task rather than the process. It's subtle, but so pivotal.
[The therapy is] profound in the effect it has on children and their relationships with therapists and their parents, and the effect it has on their growth. "
One of many important books that Dr. Greenspan wrote is The Child with Special Needs. The book is divided into three parts: Part One: Discovering Each Child's Unique Strengths, Developmental Capacities, and Challenges; Part Two: Encouraging Emotional and Intellectual Growth; and Part Three: Family, Therapy, and School.
Part One: Discovering Each Child's Unique Strengths, Developmental Capacities, and Challenges
"During the past 20 years, [the authors] have created a developmental approach that engages a child at his current level of functioning, works with the unique features of his nervous system, and utilizes intensive interactive experiences to enable her to master new capacities." (p.1)
The Six Emotional Milestones
Greenspan describes six emotional milestones or stages of development that form a developmental ladder. "Children achieve these milestones at different ages - there is wide variation even among children without challenges. What is important is not so much the age at which a child master each skill, but that each one is mastered, for each skill forms a foundation for the next" (p.89).
"Once a child has mastered all six milestones, he has critical basic tools for communication, thinking, and emotional coping. He has a positive sense of self. He is capable of warm and loving relationships. He is able to relate logically to the outside world. He can express in words a wide range of emotions (including love, happiness, anger, frustration, fear, anxiety, jealousy, and others) and is able to recover from strong emotions without losing control. He can use his imagination to create new ideas. He is flexible in his dealings with people and situations, able to tolerate changes and even some disappointments and bounce back. Obviously not all children do all these things equally well, but a child who has mastered the milestones will have important foundations for loving and learning" (pp.89-90).
This is just the tip of the iceberg. Creating connection with our kids creates connections in their brain. All "behaviors" can be managed in a way that makes our children feel safe, sound, and seen - and isn't that what we all want, in the end?
Q: What does Jenna think about ABA?
A: "As someone who used to be a behavior tech and worked under many different BCBA's, I believe we should listen to autistic children and adults - they are the experts! Making sure that our children feel safe, sound, and secure is my priority. At Focus on Function, we believe that behavior is communication, that kids do well when they can, and we always value connection over correction. We encourage all parents to keep asking questions and trust their child to show them what they need."