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April 23, 2014 / 23 Nisan, 5774
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Life Lessons From Raising An Autistic Child (Part III) – Therapy


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After several years of not getting past stage one in DIR, of spending every therapy session unsuccessfully trying to regulate his hyperactivity, we finally decide it’s time for a switch.

The ABA (Applied Behavioral Analysis) Therapy Session

“Say ‘more’.”

Menachem looks at me briefly, then tries to grab the cookie on the table. I reach it first, and shake my head at him firmly. “No.”Arnold-053113-Train

I try again. “Say ‘more.’” I over-enunciate, so that he can observe the mouth movements.

Menachem wriggles and squirms, and makes another attempt for the cookie.

“Say ‘more.’”

“Mmmma.”

My eyes widen, and, exultant, I hand Menachem the cookie, which he gobbles up.

He reaches for another.

“Say ‘more.’”

We go through this routine for the prescribed amount of time, which isn’t a whole lot, when taking into account how long Menachem can reasonably be expected to sit. Later in the day, I’m still on a high from our victory, when Menachen begins pushing his little sister. She wails, and my insides tense up. But I know the ABA rules of behavior modification, and I’ve learned to plan before reacting.

“Menachem, no pushing,” I say, separating him from my daughter.

She edges away. Menachem eyes her, ready to pounce. Now is not the time for any rewards. I continue holding him, protecting my daughter from an attack. Slowly, I feel him slacken, feel his body relax, and I can tell the urge to hit has left him. Now I can present him with his reinforcement.

“Good job, Menachem! You aren’t pushing.” I hand him a candy.

No more spending countless hours making Menachem feel we understand his tantrums. In ABA therapy, they don’t stand for such nonsense. Child’s screaming on the floor? Then make him sit up. Not by force, but by behavioral reinforcement. In ABA, it doesn’t really matter what the child’s feeling; this is a scientific program aimed at teaching specific skills. And by acquiring those skills, be it learning colors or learning to dress himself, the child is gaining knowledge that helps him become a more integrated, connected member of society.

For me, this is a breath of fresh air. Finally, a therapy that makes sense! A system that is logical and measurable, that is designed to teach functional behaviors; I wish we’d heard of this option sooner. Perhaps, had Menachem not wasted his critical early years working on eye contact, he would be toilet trained by now.

To me, it seems like Menachem is taking to this approach. I can sense the tension drain from him, as his therapist shows him his daily pictorial schedule. First we say hello and take off our coats, then we sit and do work, then snack time…as each task is completed, each picture is removed from the board. There are no surprises; Menachem knows exactly what to expect. For children with autism, this is hugely comforting.

But there are expectations that go along with this therapy. Unlike DIR, where the focus is on understanding the child, and giving meaning to his world, in ABA the focus is on the child understanding what is expected of him, and complying. And my child, it turns out as time progresses, is not very compliant. After three years, he is thrown out of his school. The therapists say he’s too uncooperative to work with.

No one ever said raising a child such as Menachem was easy.

Will Menachem ultimately grow more using the holistic, child-centered DIR approach? I do know that, in our efforts to learn and use this therapy technique, we have gained something priceless: some wonderful moments of connection that we otherwise would not have known how to elicit. When I join Menachem in his races up and down the stairs, and he suddenly looks at me and smiles, or when he takes me by the hand and starts to jump, telling me in the way he knows how that he wants my company in this activity, I know that DIR has given me the gift of a loveable child.

Is the behavioral ABA the better approach for him? Though he had trouble cooperating with this approach in school, I do know that whatever skills he has managed to acquire over the past eight years have been thanks to the methodical system of teaching and reinforcing that we learned from ABA.

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