Why a special program for a child with autism? Why can’t they just go to school like everyone else?

Most children spend their infancy and toddler years learning the skills they will need to be successful in school. Parents provide their children with stimulation and experiences and the child learns how to talk, to play with toys, to imitate others, and to behave in a socially acceptable manner. They then go to school and the teachers join the parents in teaching them academics and continuing their socialization. When they misbehave they are punished and they learn not to misbehave. The entire learning process requires that the child be interactive with their changing environment.

Children with autism have trouble interacting with their environment in a constructive manner. Parents struggle with trying to teach a child who can’t seem to focus on a person or activity long enough to learn. A child who can’t seem to sit still or keep their body from constant movement. A child who never seems to learn to change their behavior based on routine family rewards/punishment. A child who doesn’t seem to be able to understand language and can’t talk, or just says nonsensical things.

They struggle with teaching these children because people teach in the ways that they learned and they saw their teachers and parents teach. It has been demonstrated repeatedly that a child with autism will not learn very much using the structured experiences approach that most children learn through.

Even though children with autism do not start out their lives interacting with and learning from their environment in the same way that other children do, well-controlled scientific studies have shown that they can be taught the skills necessary to do so, through specific training techniques based on the principles of applied behavior analysis, the scientific study of behavior.

Through the methods of scientific study of behavior, an individual’s behavior can be analyzed to determine why behaviors are or are not being emitted. After individual assessment, contingencies can be arranged to teach the individual the desired behaviors or skills.

Studies have shown that by teaching young children with autism using these ABA procedures, many can learn enough basic skills to then be able to successfully learn in a more natural learning environment which teaches through instruction, imitation, and experiences. Until a child has the basic learning skills however, to continue to try to teach them through traditional environments such as the family, friends, school, is going to be frustrating for everyone involved and the child will not learn sufficiently to be able to function within their environment.

A child who will not sit in a chair, look at a speaker, follow directions, imitate, or manipulate toys correctly, is going to have a hard time learning. But that child can learn if tasks are broken down into very small steps and they are prompted through repeated practice trials. Most children will learn new skills after seeing someone else do them 1-3 times, but a child with autism may have to be physically assisted in doing the activity thousands of times before they appear to have learned how to do the task. It takes a skilled instructor with a lot of one on one time to teach most children with autism, but once they have learned the basic learning skills then they can start to learn from less structured sessions. The intense initial training time is well worth it as the child starts to learn to talk, to learn through imitation, and to respond to their environment in a meaningful way.

Center Based Day Treatment Program or In-Home Program?

Both the BTTC Community Programs Manager and the Day Treatment Lead Clinical BCBA have experience in both center based and in-home programs. The BTTC Outreach Program continues to provide BCBA consultation for in-home programs.  The advantages of a center based program is the opportunities to practice group activities, the opportunities to practice generalization across adults, and the opportunities to practice accepting change and disruption of routines. These are important skills for success in a school setting.

Another critical advantage of the center based program is the ability for a BCBA to provide close daily supervision of the program implementation by therapists.  A well-meaning therapist can get confused and implement thousands of trials incorrectly between consultation visits to the home by the BCBA.

Younger Children and the full-day program.

Many parents are concerned their 2 or 3 year old is too young to be required to attend a structured day treatment program 6.5 hours every day. Typically developing children at that age do spend a lot of time in unstructured activities. However during their unstructured time a typically developing child will be exploring the environment, manipulating toys, and learning from their experiences. With children with autism unstructured time is often wasted time. The child does not explore their environment or play appropriately with toys or attend to environmental activities. Often the child spends the time engaged in inappropriate behaviors such as self-stimulatory behaviors or aggression.

Several children have started the BTTC Day Treatment program with instructions from the parents that they need a nap. It has been our experience that within 2-3 days the nap is no longer necessary. The child doesn’t want to take a nap because they have too many other stimulating things to do at the BTTC and as a result they sleep better at night.

For children who truly need a nap during the day, the BTTC recommends the child participate in the program part-time, either 8:30-11:30 or 1-4 daily so they can take full advantage of the 1:1 treatment while in attendance.