Big Argument with the ABA therapist..
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Hi all, Just need your advice/inpute on this particularly testy situation I have got myself into! It all started with the whole "ttantrumming- calming down" issue which has been ongoing. My daughter is 2 and the therapist wants her to calm down completely before reinforcing her with a hug/squeeze/whatever when tantrumming. I completely agree...and my daughter is nmaking it a habit to whine which I totally agree has to stop!!! BUT.. and pardon me getting a little too statistical here but if u graph the tantrums on a bell curve, the last month has been pretty good with very few outliers meaning dd has had the typciall OUT of control meltdowsn rather infrequently. I understand we can't giv into the tantrum bu picking her up but I DO think that a 2 yr old (autistic or not) needs to understand what "calming down" is before opushing her away when she is crying and asking for a hug!!!! I know that my dd may use hugs as an escape - and I am not someone who is advocating whining/crying BUT I just think that the therapists are beeing unreasobanle at times..... call it a mommy instinct.... Anyway this has led to an argument and I dont want my dd's therapy to be affected... any advice? thanks a lot!
Bump - Someone plz advice. Just FYI - my daughter also gets OT and speech and the two therapists have completely different approached for the tantrumming and they work!!!!! I really like the ABA therapists but I am not able to see eye to eye on this one.. With Payne hugging (tightly) actually HELPS his calming down. We haven't had this issue in our youngest's VB/ABA sessions, but he's older. We do use hugging to help calm him. They even hug him tightly at school when he requests it. He often craves proprioceptive input when he's upset, and hugging is a quick and easy way to get it.I cannot imagine it making any sense to not hug a child under any circumstances Rejecting an autistic child when they are crying and asking for a hug seems really really wrong Just want to add that the therapists do hug her...but when they hug they expct her to calm down rightaway and NOT complain...With my daughter she will start "moaning" bec maybe she needs an additonal 30 secomds of hugging?? Kajoli - its like this - J will cary/tantrum and ask for a hug- they will push her away before picking her up! bec they dont want a hug to be a form of escape. I understand (sometiems!). BUT there are times they do hug her and she is not calm rightaway - they will push her back.. this I don't undertsand. I don't understand it either. I couldn't imagine pushing my child away during a hug, and I would be upset if I saw any of my son's therapists doing it.Hmm don't think you are overreacting, especially since she is 2 As long as hugging calms the child I see no problem with it. Of course, it just made my child more irritated. That's the only sense I can see that she may be saying, to see if the hugging makes her more irritable or not? Just a stab in the dark lol
She's only 2, i could see maybe if she was 7 and still tantruming and whining, using this type of unemotional approach . I think the therapist is using an application meant for older children. JMO I would ask the therapist if she has another effective approach that doens't involve denying your daughter much needed physical affection from you. Tell her you are not comfortable with not being able to hug your child especially when she is in distress. she is only 2i agree the method the therapist is using seems more appropriate for an older child Thankyou so much for all the advice. You don't always agree with the therapists, and here's the thing-therapy is therapy and home/family is home/family. If it works during therapy, it doesn't mean you have to do it during family time. The issue for therapy is she has limited time, and you don't want her to learn to escape it by hugging, but at home, mommies have more time to hug! Do what works for you, and as long as you are comfortable, let them do what works for them. Mimom3 - I se eur point but I don't want my daughter to have inconsistencies in behavior... I undetstand where she can be a little more pampered at home but I think with this disability, she is not at the level where she is using differential behavior consciously.With inconsistent approcahes, I don;t want her to be just confused. My dd is 2 and is at n 8 month level! Plus I am trying to follow thru with all that the therapist do in the day - but discipline during tantrumming is somethign we just don't agree on!! If their worry is her escaping the task, well, hug her for a reasonable period,setting a timer if need be, and then just make sure she still follows through on the task that set her off? That's what would make sense to me. She's not going to do the work if she's upset. And hugging, if she still has to do the work eventually, will not be inadvertently reinforced. The only thing reinforcing about the hugging will be that it will help her calm quicker so she can complete her task. JMO Rita, I had many of these gut wrenching moments you are describing when Sarah was in ABA and it was very hard to do as they (therapists)wanted during therapy especially when my child never noticed me much before therapy and then as soon as they started working with her she wanted me and was crying for me... It totally went against my mother instinct too...you are not alone in this area:) It was so difficult that I would have go into our bedroom and just cry because it was too hard for me to watch her. I am sure they wanted to shoot me many times for breaking their mode of doing things.. We see it as our child wanting us and they see it as an escape technique and your heart feels your doing horrible harm emotionally and psychologically by not responding especially when your child has autism All I can say is that both me and Sarah survived this intact:) It was sooo hard for me to have them tell me how not to respond to my child...I found out though that she was a very smart & resilient child and I had to learn the hard way that by going against them in how they worked with her took days for them to get her on track again... We also had to have many meetings with my dh so that all of us was on the same page..he had a habit of messing up what took days to implement. I totally agree with you in this area but I feel you are going to have a hard time making the therapists agree..they are looking at a much bigger picture than us...mine were very good at explaining things to me and I hope yours will too so it isnt so painful to bear:) There's a mean to the madness of ABA...it is hard to understand when your in the thick of it like you are right now but when she is older and doing very well you will be so happy you stuck it out:) Sarah had over 3 years of ABA and she is very well adjusted both mentally and emotionally...no scars that I can see:) Hang in there! (((HUGS!!))) She is going to have to learn to behave differently in different places and with different people. The bottom line is the therapist works for you, so she should do what you want her to. You have to be able to carry skills she is learning to home life. Good luck! I have always hugged through tantrums, including when the therapists were there. If I did not the tantrum would escalate until they vomitted, they can not calm down until they get that reassuarance, and actually I think its the pressure points that help them calm down. The therapists would actually tell me to hug them to calm them down. After the hug and the calm down it was and is back to work. In my boys case I am sure they weren't using it as an escape mechanism, they were just too stimulated and really couldn't help their behavior. But the therapists would often do things other than hugs to get them to calm down, "wrestling" and tickling, redirecting, squish with the pillows, and having a very heavy turtle for them to hold. Alot of this stuff was directed at applying pressure to their bodies, especially the torso, and it did help them calm down. I guess I would look at what is causing the tantrum, and if she really is trying to use it as an escape mechanism or not, I can understand what the therapist is trying to do, she is trying to not reward her for negative behavior (screaming) and reward her with a hug for positive behavior, calming down. If its working and you can keep that in mind then it might be the best thing for dd. Has the improvement happened since you've started withholding the hugs or was it happening before that and is it getting worse since the hugs have been withheld until the screaming stops? That method would never have worked for my boys, the tantrums would have escalated, but that is them. ABA is usually my way or the highway. That being said, you have to ameeting with the BCBA to make sure everyone is consistant in their approach. My old agency actually sent out a letter which stated that Sensory Intergration Therapy was in direct conflict with the implementation of ABA within their agency. The guys that ran my old agency were very reknown in the field and lectured all over the world. I have struggled with some of the approaches myself. My son has some behaviors and for him I have to be firm. It really does work but in the short term, it is so hard to do. One of the things which do concern me is the quality of the ABA, Therapist and Program. If you do not have good quality ABA, and the child does not respond positively, this may be looked upon as non compliance versus a poorly run ABA program. THANKYOU SO MUCH U GUYS! Kathy - very interesting point u make.. I am on my part going to request a pvt session by one of the pvt ABA agencies (typcially charge $70/hr for therapy) and just do a couple of sessions. I want to see the efficacy of their programs. Also my daughter is not so phobic with "instructors" - I guess she knows it is battle lost!! :) I want to see what is different - if anything. Hi Rita,I agree with everyone else. A hug is a technique we use to calm any 2 year old, NT or not. It is soothing, and may just have the effect that the ABA therapist is trying to achieve!! My son's therapist had the same idea, but my son was 3 at the time. She would say things like, "he was a moosh today, and wanted hugs, but we worked through it without the hugs". Although I understood what she was trying to convey, what harm did a little hug do here and there? It's not the same as a kid screaming in the store for a candy bar. I agree with you 100%. nakama I agree too. She is only 2 and if she is asking for a hug give it to her! I know with DD who is 3 1/2 yrs old she will ask for a hug and the therapist will say, ok, go hug mama and come back. If maybe the child is older than 7/8yrs old then I can see her point but it depends on what level the child is at more than chronological age too so maybe it would not apply to older children even. I would find a new therapist if she is not willing to change. Go with your mommy instincts too. I believe it all depends on if the person has defensiveness issues or not. The brushing/joint compresses work on Daniel well. When he still got private St she this every session on him first. it worked. haven't read all the posts, but have you gotten Sensory Integration Therapy for your daughter? She seems to CLEARLY need physcial input. Have you actually done an FBA so you KNOW her needing a hug is for escape? If it is, give her the hug the INSTANT she does anything positive. That way, she'll get the idea that her hugs can come as soon as she complies. You can collect data for a week using the ABA therapists' techniques. Then collect data for a week using YOUR techniques (plan this first with the therapist). Then look at the data from both "experiments." You should get some valuable insight this way.
I dont want to pick a fight especially bec I really like this therapist and she has been WONDERFUL to my dd - and I know what she is doing is NOT out of some personal vendetta to prove her point against the OTs/mine but bec she truly believes in this!! WHat are my choices? I can't take this sobbing and gasping that my dd does when she wants the hugs and gets rejected! I agree with Tzoya. I know I haven't been around much, but my first thought was that your child needs sensory input = sensory integration therapy. I was amazed how well "pillow squishing" or joint compression, or a tight squeeze worked for Andrew when he was 2. PS We do not do ABA at home. What about suggesting pillow squishing in place of the hug if she is so deadset against the hug? It is essentially the same sensory input. What about brushing? Has the OT suggested a sensory diet? And the brushing can be done by you right before the ABA therapist even gets there. I brush every 2 hours when they aren't in school, and it has helped alot. The weighted vest, joint compressions, all of that would probably help. I think I would do the pillow squish though cause you said she seeks confinement, rolling in a blanket something like that. That will sort of cocoon her. Also maybe you can schedule hugs. Every half hour she gets a 2 minute break and gets a hug. So she gets the sensory input she needs but it can be done before she hits full meltdown mode. Or maybe a hug as a reward. Then she can be getting that sensory input as a reinforcer and it might just prevent the meltdown. I personally don't really agree with the rocking to calm down. Nikolas is a rocker, it is his self-regulation mechanism and it does calm him, but not when he is in full meltdown mode, that is not the sensory input they are seeking, she needs to be squished. And not when the meltdown is in full swing but before it gets there. Brushing might really help her, it is essentially a deep massage followed by joint compressions and it takes about 3 mintues. Talk to her OT about it. The effects are suppose to last 45 minutes and give it 2 weeks before you decide you see no difference. I did it a couple of years ago and thought I saw no benefits but I didn't give it 2 weeks, this OT told me to try a solid diet of it for 2 weeks before I gave up. It has helped them. And you know, I just realized today that almost all the stimming is gone. Don't know if that is a coincidence or not. I am trying to find a way you can compromise with the ABA therapist since you don't want to lose her but still get DD the sensory input she is obviously seeking. Personally I would use hugs and pillow squishing outside of ABA everytime she asked. Also my boys will bring me the brush to brush them.
Maybe you could suggest to the therapist to set a timer when your daughter is wanting a hug and they could let her know that she gets hugs for a certain amount of time and when the timer goes beep beep the hug is over for then, just a suggestion, I am no therapist. I agree with always hugging, especially when they seek it. Hey Rita, I have to go with Shelley and the therapist on this one. I am all for the "sensory" issues that our kiddos have, but now that they found out that mommy will give in or let me stop what I am "supposed" to do when I ask for a hug, they are escaping the task. It is heart wrenching and I agree, but because she wants it sooo much. it has to be a reward/ reinforcer.. It is really hard to find stuff that reinforce my ds and if it is as easy as a hug so ne it... I have to agree that hugs from the therapist should be used as a REWARD. If your dd gets them for sensory input and as a reward (the natural use of a hug), it will be confusing. I'd keep hugs for rewards (cooperation) and use some other sensory thing for sensory input. Even if it takes a LONG time. Consistency is key, so using hugs as sensory input when other things can be substituted will only mix up the message of rewarding positive behavior and ignoring negative behavior. However, ignoring sensory needs makes no sense, either. Ask the OT to consult with the ABA therapist about how to give sensory input without inadvertantly rewarding negative behavior. Then take data on how it works.I have to agree with the therapist here. Having been through this with my own child, I know it can be hard. But no one said this was going to be easy.Our children are very good at escape and avoidance and we have to let them know at a very young age that this is not ok. It will be so easier to nip this in the bud NOW when she is young. If you don't think about how hard school will be. And...hugs for avoidance won't be so cool come 5th, 6th, 7th grade. Good luck, Cecelia |
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