It was a rainy Tuesday morning in East Honolulu. Charlie’s mom turned the windshield wipers on, pulled out of the driveway after buckling her seatbelt, and drove her red Volvo sedan to Charlie’s preschool to pick him up for his yearly doctor’s checkup. The worry was written all over her face as she was driving down the street. His mother had suspected for months that her youngest child, her sweet, and loving 3 year old Charlie might have autism. As his mother learned from her Google search, autism is a developmental disorder, characterized by persistent deficits in social communication and social interaction. This was definitely not the surprise his mother had planned for his 3rd birthday.
Family relatives had made mention several times to his mother since about 17 months of age, that Charlie should be talking, saying words, and pointing with his index finger, and he just wasn’t. Charlie was not pointing to balloons in the sky, or construction zones, nor was he commenting on his environment by saying “Look mommy, airplane!” when he saw an airplane in the sky.
Charlie did not meet the 2-year old or 3-year old developmental milestones as his older cousins and brother had done so effortlessly. Charlie was now 3, and still mostly non-verbal. He doesn’t use words to ask for the things he wants, and he tantrums often when he is told “no” or when his routine is interrupted, he likes to line up his Legos in colorful rows, rather than building cars with them, and he enjoys spinning the wheels of his trains and cars instead of playing with them constructively like other little 3 year old boys his age do. And today, the doctor will likely give Charlie the diagnosis that will forever change his family’s life. Charlie has autism.
Fast forward 6 months……….and Charlie’s mom Mary and his father Sam have grabbed the bull by the horns and looked Autism straight in the eyes. They researched scientifically supported interventions, and found Applied Behavior Analysis, also referred to as ABA treatment. ABA treatment is the application of basic behavioral practices (use of behavior analytic principles, positive reinforcement, teaching in small steps, prompting, and repeated practice) to facilitate the development of language, social interactions, independent living skills, and other skill sets. Originated by the scientific principles outlined by Dr. B.F. Skinner in the 1960s, ABA methods gained popularity treating children with autism in the 1980s. ABA is scientifically proven to be the most effective method to teach children and adolescents with Autism Spectrum Disorder (ASD) and other developmental disabilities. ABA procedures have been endorsed by the Surgeon General, the National Institute of Health (NIH), and the Association for Science in Autism Research. ABA can be used to teach a variety of skills and positive behaviors, including:
- Communication/Language
- Positive peer interactions/social skills
- Self-Help Skills (toileting, dressing, bathing, etc.)
- Academics (teaching tolerance, or teaching the missing component/composite skills to fluency)
- Fine and Gross Motor Skills
- Play and Leisure Skills
- Life Skills
- Vocational Skills
ABA methodology is also effective in decreasing challenging behaviors such as noncompliance, tantrums, bed-wetting, feeding/eating problems, aggression, and self-injury.
Research shows that with intensive and early ABA, almost 50% of children receiving this important and life changing treatment delivered with fidelity, will be able to transition to general education kindergarten or grade 1 without any specialized supports (Lovaas, 1987).
Charlie’s parents have prioritized his ABA treatment, and he now receives medically necessary ABA treatment for 40 hours per week rather than attending preschool. After just 4 weeks of treatment, Charlie was beginning to use words to request for things that he wants, and his family has recently heard Charlie’s voice for the very first time! His mother cried when she recalled the first time Charlie said, “cacker” to ask for a cracker from the cabinet. “I couldn’t believe it” his mom exclaimed, I gave him about 1/8 of a cracker, waited, and then he said it again, ‘cacker’, so I gave him another little piece of it, just like his therapists taught me to do to.” At ABC Group, parents take part in parent training sessions with the Board Certified Behavior Analyst (BCBA), and learn the same techniques used by Registered Behavior Technicians (RBTs) who are the therapists who deliver the ABA treatment. These RBTs are supervised frequently by Board Certified Behavior Analysts (BCBAs).
Charlie is able to access his prescribed 40 hours of ABA treatment funded by his health insurance, because Hawaii was the 42nd state to pass health insurance legislation which went into effect January 1, 2016. This law, called Luke’s Law, mandated private health insurers like HMSA, Kaiser, UHA, and HMAA to cover ABA treatment to kids with Autism. Medicaid (MedQuest) also covers this medically necessary and life altering treatment to children in Hawaii. Prior to January 1, 2016, ABA was only available to those military dependents (active duty, retirees and reservists) with TRICARE insurance, and those families who were able to fund their ABA program privately.
ABA treatment looks different at every age and ability level, so for kids with more mild deficits, like social skills or higher level language deficits, they may only need 15-20 hours/week of intensity. ABA treatment should be fun. Your child should be running to, not away from the ABA therapist working with your child!
Because of this life changing treatment, Charlie’s mom is confident that he will attend regular kindergarten in 2-3 years without any special education support, and join the soccer team with his older brother! Charlie’s life trajectory has changed because of ABA treatment.
For more information on ABC Group or ABA treatment, please visit www.AutismBehaviorConsulting.com. ABC Group is a clinic-based ABA program in Halawa Valley, in Aiea.
Resources on ABA and Autism:
Research on ABA
http://www.lovaas.com/research.php
Behavior Analyst Certification Board
www.bacb.com
Autism Behavior Consulting Group (ABC Group)
www.ABCGroupHawaii.com
Autism Speaks, M-Chat R Online Autism Screening Tool
https://www.autismspeaks.org/what-autism/diagnosis/screen-your-child
