Aidan was just two years old when his home-based ABA program started. He had only just dropped his naps, and had been spending happy days playing at home, in the garden, visiting parks, and attending a small number of toddler classes we’d enrolled him in. He’d had relative freedoms, little structure, and was a little boy used to getting his own way at home. To say that it was a big shock to his system to go into a 9am – 4pm intensive program of early intervention therapy, is a huge understatement!
Aidan’s comprehensive ABA program had five main objectives, and a single therapist would work with him building skills and tolerance incrementally, in all of these areas:
To catch him up with his peers academically
To advance his gross and fine motor skills
To tackle his sensory issues and his rigidities
To manage his adverse behaviours
To provide us with parent training
An incredible amount of data was taken each day to track his general health, mood, cooperation or reactivity, behaviours, and the very specific way in which he best learned new skills. At first his therapist just played all sorts of games with him. They introduced him to exciting new toys and activities, and took note of any he particularly loved. We soon discovered that he preferred any that ticked his sensory boxes: Cause & Effect toys, toys that moved, toys that lit up, toys that played music, cars and trains, bubbles, stickers, magnets, colouring, swinging, and water play. But by far, his greatest passion was for devices of any kind!
This was all really important information for Aidan’s team, because ABA uses an initial “reward system” to help build cooperation and compliance with new students. These prompts and rewards are faded out over time, and by the time he ages out of ABA, and goes to school, his skills will be generalised and he’ll be fully self-motivated! But first the team needed to establish a relationship with Aidan and encourage him through his “Learn to Learn” foundation phase of his program.
Aidan was preverbal and had little to no receptive language, so his therapist couldn’t explain to him verbally that if he first did X, he would get Y. But she demonstrated this using consistent and predictable actions to very good effect. She soon had Aidan’s understanding that if he just finished a very quick and easy puzzle or stacking game, he could play with something fun! And he was incredibly motivated to listen to and comply with instructions, because all of his rewards were so fabulous! He was a kid in toy heaven!
These daily tasks were only incrementally increased in difficulty, always giving Aidan the best possible chance of completing them with relative ease. By setting him up for success each time, they ensured an activity would hold his attention for significant stretches of time. This system also enabled his therapist to build different levels of difficulty into a task with a single objective, for example: Learning his colours. Level one would be identifying colours, level two would be matching those colours, and level three would be the retrieval of coloured objects from different rooms in the house. Whatever the task set for him, fun and play were always kept at the heart of his learning!
ABA therapists call preferred toys “reinforcers” because they become so desired, that they act as great motivators to complete many different types of activities, or develop important skills, or even get him through tricky transitions and care routines. These reinforcers had to be locked away in the built-in cupboards so that access to them was controlled by his therapist, they retained their special value as teaching tools, and they were only available to Aidan at the end of certain tasks. Once his interest in a particular reinforcer faded, we were supplied with a list of new toys which would be introduced periodically over the months, to keep Aidan’s interest, attention, and engagement high with his studies.
When not engaged with the program, our cub had a ton of other fun toys to play with in his family time with us! With our boy being so busy and needing a lot of stimulation and input, we had an arsenal of games for every type of weather.
But implementing this program was not easy, because Aidan had never experienced this level of structure at home before. He had spent his days freely, doing whatever he wanted, with very few demands placed on him by us parents. Aidan had little receptive language and absolutely no expressive language, so whenever he didn’t understand an expectation in therapy, or didn’t want to complete an activity, or got frustrated by needing to wait for a reinforcer, Aidan cried. He cried a lot. Honestly, I don’t think even these well-experienced therapists, who had worked hundreds of cases with students of all levels and abilities, expected quite as much pushback as there was in the early weeks! Our son is so singleminded and so strong willed, that he fought his new routine with everything in him. It was emotionally, very hard going – for him and for us. There were many days when all I wanted was to go into the therapy room and rescue him from his apparent misery. But what I couldn’t see, and the therapist could, was that it was mostly a sassy attitude, and not trauma. Our stubborn little cub was determined not to be told what to do, or how to do it!
It was around this time, that Aidan began to be triggered by opening and closing doors. He had always been so free range through our house, that he hugely objected to the therapy room door being closed for periods. Just the act of closing the door behind him as he went into class, could set off a pretty epic meltdown. His therapist wasn’t overly concerned about it at first, but it soon evolved to us not being able to open or close any doors in our house in front of him. It was such a huge trigger for him, that it persisted for a year or more, and made life at home very difficult indeed. What we soon discovered, was that starting ABA also kicked off a number of other triggers and rigidities we never would have expected. And by choosing to continue his amazing progress on the program, there were a lot of extra behaviours us parents had to manage off it. I am going to be very transparent in coming blogs about what some of these adverse behaviours were, because I was quite upset that we weren’t warned about them during the organisation’s sales pitch and discussions about what we could expect. I feel very strongly that other parents starting down this path, should be made more aware of them. In a nutshell, a ton of behaviours got a lot worse, before they got better.
But I have to say that the academic progress our little man made on his program was absolutely extraordinary! Within three months his receptive language was developed enough for him to take verbal instructions from his therapist in three parts: “GO to KITCHEN and GET PLATE.” He caught on so quickly, that he was soon going to multiple different rooms to get multiple different objects at one time. And we discovered too that by allowing Aidan to move around the house while he learned, instead of restricting him to a closed-door classroom, he was a far happier chappie and much more cooperative with his therapist.
