Although Applied Behaviour Analysis (ABA) is a much more appropriate and dynamic form of therapy for autistic children, many medical professionals and parents remain unaware of ABA’s potential of benefiting and improving their child’s condition.[Note: We have provided a detailed analysis and comparison between ABA and speech therapy on another page.]
Some parents think that Occupational Therapy (OT) can benefit their child who has autism by helping him learn self-help skills that allow him to attain a degree of independence. The child is trained in basic self-care tasks such as dressing, eating, and using the bathroom, which are known as Activities of Living (ADLs).
Occupational therapists do this by observing and evaluating the child, and then recommending and training the child in the most suitable way to perform such routine tasks.
For example, a child with writing difficulties can learn the hand movements necessary for holding a pencil in a correct position so as to be able to write.
Nonetheless, however well-intentioned the training and the principles behind OT, these intentions end up being misguided and limiting the potential of the child, and do nothing or very little in improving his condition.
Learning the perfect way to hold a pencil to be able to write does nothing much for the autistic child, who needs to be learn to talk and communicate his needs and wants.
While OT does help with improving and learning fine and gross motor movements involved in self-care tasks, such deficits in fine and gross motor movements are not the crux of the problem of autism.
Autism is a developmental disability and children with autism spectrum disorder or ASD, have social, communication and language problems.
Therefore, training in speech, language and behaviour is where the focus on any form of therapy for the child should lie as the child can derive direct benefits from these that help improve their condition.
In the teaching of skills to kids with developmental delays, what matters most is that the child is able to understand and use language for communication while the teaching of tasks such as holding a pencil, while valuable, is not a huge priority.
Learning to communicate their needs and wants and knowing how to interact with others in an appropriate way directly benefits the child when he can get what he wants and learn the value of communication.
This is where Applied Behaviour Analysis (ABA) therapy shines, in particular advanced ABA therapy with an emphasis on Verbal Behaviour (ABA-VB).
ABA is the only scientifically validated and proven approach for the treatment of autism and other developmental delays in children. Early and intensive intervention using ABA remains the most effective treatment for children with autism.
ABA specifically targets such deficits in speech, language and behaviour by teaching the child:
- Behavioral treatment to decrease problem behaviours and to increase functional alternative behaviours
- Joint attention intervention to teach a child to start or respond to the social requests of other people
- Modeling by adults or peers to demonstrate suitable behaviors to imitate.
- Self-management training for the child to regulate his behavior by recording and taking control of his own behaviors.
- Naturalistic teaching strategies to help a child learn functional skills in the environment that he frequently encounters.
- Story-based interventions to help a child learn suitable behaviors for different situations, and see other people’s perspectives.
ABA-VB goes a step further by emphasising the development of language skills, by demonstrating to the child the value of communicating in words. The child learns skills such as:
- Manding: requesting for desired items and activities
- Receptive repertoire: following instructions non-verbally
- Intraverbal: verbally responding to other people’s speech
- Tact: Describing, naming or labelling objects
- Echoic: Repeating other people’s speech
All of these invaluable skills form a foundation that enables the child to learn how to learn for himself and presents the child the opportunity to eventually overcome his condition.
This is infinitely far more valuable and empowering than learning just to cope with autism, using the self-care skills that are learned through OT.
Therefore, it is wiser for parents to focus on ABA as the primary form of therapy for their child with OT providing an ancillary function by teaching the child self-care skills used in daily living.
Occupational therapy by itself would never be enough to help children improve from their developmental delays because developing language is a key factor in overcoming these delays and OT does not target the development of language. Therefore, as a stand-alone treatment, OT is simply inadequate.
We believe that the purpose of investing in therapy services is to help the child with autism live an independent and meaningful life in adulthood. The focus is less on being able to write perfectly, having an enjoyable time or even learning advanced ADLs. Instead, the child should learn to speak, be motivated to make friends, channel his interests into useful skills and develop his talents for a future career. It is our view that ABA-VB provides the best chance for this outcome.