"40 hours a week?" "100's and 100's of trials a day?" "It doesn't matter how many hours?"
There are so many Autism consultants out there telling us what to do ....IT IS SO CONFUSING! Especially for new parents. After eight years in this, here is my take…
- ABA is 24/7. This is a fact. Whether structured or not, a parent committed to Applied Behavior Analysis is on it 24 hours a day, 7 days a week. That's from me.
- Dr. Mark Sundberg said in his last Dallas conference that he tells parents the child must be engaged 90% of the waking day and have 100's and 100's of trials a day. My Comment: This sounds harder than 40 hours a week but I know it is true. My son is up from 6am- 9pm. Wow!
- Dr. Ivar Lovaas said for the fourth time that I"ve heard him (this time in Austin) that his research indicates an average of 40 hours direct therapy a week for best outcome. My Comment: Read the research in detail...not just a glance...all the studies and followups. Don't make emotional evaluations. Be a scientist. Note: Don't judge based on what your ABA friends are doing. Look at your data on your child.
- Those I've talked to who worked under Dr. Lovaas for years say that for 2 year olds, that therapy is 20 hours play, 20 hours or so table. They increase this direct time as need indicates as they are between 3 and 4 years. My Comment: This is so reasonable. Young children play, but they've got lots of catching up to do on their other skills. This is a good balance.
- Dr. John McEachin (part of the original Lovaas study) says as time goes by, you see by your data if the child needs 40 hours of structured time, 50 hours, or 30 or even 20...this is as time goes by. My Comment: don't take chances at first. Make these decisions carefully with data as part of your decision making.
- I've heard some consultants and therapists say "quality, not quantity". I say "quality AND quantity". We've had to have both 24/7 for my son since this happened.
Every child is different. I don't assume every child needs what my son has had, I don't assume every child doesn't need more (if that is possible, like if there were 36 hours in a day!). But the decisions regarding this have to be made intellectually, not out of desire for this to be easy. It's not easy. It will never be easy.
Whatever is done, you have have to have a plan you stick with, a framework for your therapy and committment to it. We are human. We will never stick to something this hard unless we plan too.
Dear friend, I know this is hard truth so please know I give it in love. I want the best out come for your child. Some times a well meaning Autism consultant or friend will say what you want to hear to help you relax or feel better. I want you to feel better too...and I know over time the best way for that to happen is for you to be able to make informed decisions for your child.
(Note: the professionals cited in this editorial article were seen in person by the writer. However, the information recorded is her recall of their input. She has talked directly to some of them about this subject. They gave their data much more artfully and specifically than this writer ever could.)
My heart is with you,
Katherine Lee