Friday, November 4, 2011

Colton's Autism Therapy Part 2

So, now that you understand basics on why we are doing therapy for Colton, what areas we are trying to help, and what we hope to achieve (see last post)... is an overview of ABA, the main therapy we use for Colton.
(In my final post, I will talk about his other therapies)

ABA (Applied Behavior Analysis)
Colton is involved in Nationwide Children's EIBI (Early Intensive Behavioral Intervention) program. Hours recommended are 25-40 hours a week, and Colton is currently around 25 hours. He has a psychologist, a case manager as a day to day contact, and 3 aides that work daily with him at home, school (in a few months), and in the community.

Applied Behavior Analysis is a scientific approach to understanding behavior and how it is affected by the environment. The science of behavior analysis focuses on principles about how behavior works, or how learning takes place. Through research, behavior analysis has developing techniques for increasing useful behaviors and reducing negative behaviors. It is used to help skills in all areas including basic skills like looking, listening, imitating, as well as complex skills like reading, conversing, and taking the perspective of others.

Basically, it's looking at things from a behavior perspective, and breaking things down to the smallest/lowest level...seeing where Colton is successful...and then building on it.

What does research say about ABA?
Although unfamiliar to a lot of people, ABA is widely recognized as an effective treatment for Autism and endorsed by many state and federal agencies. Studies show that children with Autism show great improvements in their cognitive, communication and adaptive skills. And, (since Colton falls in this category), these studies also show that many children that participate in early intensive ABA for at least 2 years acquired enough skills to participate in regular classrooms with little or no ongoing help.

What does ABA therapy look like for Colton?
We have aides come to our house around 5 hours a day (2 2.5 hour shifts), 6 days a week to work on programs outlined by our case manager and psychologist. I am very involved in the whole process and have received training in all the ABA areas as well. Everything is fun, with a lot of positive reinforcement, breaks, and play time. They do the programs at a little table we have for him, or wherever it makes sense. Each time they bring him over to the table, they do 4-8 trials of a program (ex. trials means saying "do this" 4 to 8 times with putting the block in the bucket, or imitating an action), and having Colton respond each time...either on his own, or having them take his hand and help him do it, if he is not doing it.) There are also reinforcements involved like verbal praise, food, high fives etc.

Here are just a few of the basic programs Colton is working on now. They sound a little dumb and simple, but I assure you it is NOT so simple for Colton and all very important things for all future learning and success.

Imitation- this is basically Colton learning to imitate things that people are doing. Right now we are on a basic level where the aide says "do this" for the prompt and then does some action (bang a drum, put a block in the box, push a car, clap hands, touch nose), and then Colton is supposed to do the action. This basic act of imitating is usually just instinct in kids, but Colton lacks it. Imitating is the basis for all learning, because you look to others to see what they are doing, and then copy them to learn. It also teaches Colton basic compliance, which he had none of.
Matching- Matching is another basic skill of learning. Colton first matched objects, then flash cards, then 2D to 3D, then similar objects, and how he is sorting. Matching leads into sorting, and grouping, and recognizing patterns, and all sorts of learning skills.
Puzzles- Learning problem solving skills. Colton started with just a 3 piece puzzle and is now doing 8 pieces of a 12 piece puzzle on his own.
Fine Motor- Using utencils, finger strength, pencil grasps etc. Colton works on coloring, playing with playdoh, putting coins in a bank (help his grasp), putting clothespins on a lid (strength and grasp)
Toy Play- Playing properly and functionally with toys. Colton tends to narrow his interests, become ritualistc, and rigid with his toy play. As in, if left up to him...he would play with the SAME toy in the SAME way every time and not vary from it. You can't be successful playing WITH other kids, until you know how to properly play with toys on your own.
Receptive Commands- Following simple commands like "clap hands" or "touch table". Colton used to ignore all commands, and only act on them if he wanted to. He needs to be able to follow commands from others, and in a variety of circumstances.
Receptive Object Labels- Learning basic vocabulary.
"Hi" "Bye" program- Learning to say Hi when people come in a room, and Bye when they leave. That involves looking up at them, saying Hi, and sometimes saying their name.
"Come here" program- Learning to come in the general area of the person asking you to "Come here."

Where Colton Was
When we first started ABA, Colton cried the second he would see any therapist, minimally interact, and bury his head in the ground every time anyone asked him to do anything. He never would respond to what I'd tell or ask him, and only performed tasks on his own terms. I once tried for 30 mins to get him to put in one puzzle piece at an evaluation while he screamed the entire time not complying. He did not eat with utencils, look to me for reactions, or come to me to involve me in activities and throws major tantrums multiple times a day... and on and on...

Where he is just 3-4 months later
Colton now loves all his therapists. He goes downstairs happily with them, pushes me out and says "bye mommy" while closing the door. He interacts, plays games, laughs, and talks to the therapists. He comes over to the table and participates in all programs. He quickly learns programs, because he is paying attention and being reinforced positively. He engages with me so much more, looks to me for my reactions, imitates my facial expressions, handles demands being placed on him, and only throws tantrums about once every week.

Night and day difference. He is improving so much. I work constantly, but it's all worth it...because his life is improving and he is happy. And that is what it is all about. I love ABA.

Ugh, wow. I'm sure no one read all that. :) I'M tired just re-reading it!


Cummards said...

I am short on time, but I wanted to leave you a comment really fast! You are doing so good with him. And, WOW he is improving so much! So happy for him, and you guys!

Ben N Nessa said...

Well I read the whole post and I am so proud of you and colton...what hard work, but what great payoff!! We still think of you often and are happy to read this update :) you make me want to be a better mommy and give Chloe more time and attention...loves to you guys!

McGiven Family.... said...

You are a rockstar! It sounds like Colton is doing great and making huge improvements! What a great reward for all of your hard work!

Chrissi said...

You are an amazing mom with an amazing little boy! Thank you for posting all of this!

Hannah said...

I read all of it! And, enjoyed it! Wow, it's pretty remarkable to think just how far he's come with 3-4 months of ABA. God really does work miracles!

You're amazing, and so is Colton!

Brooke said...

I read the whole thing and loved every second of it. I am so impressed with Colton's improvement. Sounds like you are on the right track! It must be so motivating to see what can happen in 3-4 months! Go Angela! Go! You are doing it! You are amazing. We miss you guys so much and I wish I could see Colton in action. He sounds like a different boy from when we last saw him. Love you guys!

Kennedy said...

What an awesome thing to read!! I am so glad that things are going so well and that you have seen that much improvement in such a short amount of time! Go Colton!

You know he wouldn't be doing so well if it weren't for great parents like you and Mike. :o)

Heidi, Greg, and Jackson said...

I loved reading this! It's great to get a feel for what you encounter each day and great to to see Colton progressing so well! He is such a sweet boy and I am amazed by your persistence! He is lucky to have you for a mom and I can't think of anyone more capable!

sam and brittney said...

I'm impressed by both your and Colton's hard work! He has made so much progress!

The Maughans said...

I read every word and am so amazed at this wonderful program. Thinking aobut Chris Jens makes me appreciate all you are doing and the sacrifices made for the future success of this little man. He looks so much more bright eyed. What growth. Hang in there but be sure to take breaks for yourselves too, Yes?

becca said...

Ang, I love the progress of 3-4 months ago to now. I love thinking of Colton happily interacting in such a positive way with his therapists. And I give you credit for all the time and coordination and commitment that it takes to properly implement ABA! And I LOVE Colton!