ABA for high functioning and high IQ autistic 3 year old?

Hello, I have a 3 year old son who was recently diagnosed as being on the autistic spectrum. He is high functioning and high IQ (at 133). He is reading and writing at a 6 or 7 year old level, and seems to display an affinity for languages.

However, he is lacking eye contact, and his social skills are at half of his age, like those of a 1.5 year old. He often replies with scripts from books or YouTube videos. We have noticed improvements already with some of the basic work that we have been doing (like encouraging imaginative play with his stuffed animals, and encouraging him to provide context about the book or video he is scripting from) but we think he will still benefit from some type of intervention. 

The Regional Center suggested ABA therapy as one potential option, as well as the local school district in Oakland. I've read a lot of polarizing positions on ABA therapy, and would be interested in hearing about others' experiences with ABA, both positive and negative.

What do you wish you knew before you began working with an ABA therapist?

What questions should someone like me be asking while searching for a therapist?

What questions should I be asking when interviewing a potential therapist?

Any suggestions for this newbie to the ASD world will be greatly appreciated.

-Dan

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Hello! I would highly recommend the book "Uniquely Human" by Dr. Barry Prizant. It is a beautiful book that looks to the positives of neurodiversity instead of the common view that there is something that needs fixing/changing. I would also highly recommend looking up Greg Santucci, OT on Facebook, as he also has a beautiful and positive take on working with neurodiverse kiddos.  I follow the hashtag #actuallyautistic on Instagram, for some reallllly great (and often difficult) personal views of how ABA was perceived by autistic individuals in the community. (It's rarely positive, I'm afraid.) Here are a few great websites: https://www.theexpertally.com/https://www.nicolefilipponeauthor.com/ , & https://autismsupermomsmagazine.com/blog/ . Lastly, I discovered a wonderful advocate in the Bay Area named Maisie Soetantyo who has a lot of information on both Instagram/Facebook, as well as a organization that she runs to help young autistic adults with finding meaningful work, called Autism Career Pathways. She's super responsive to questions from parents! I'm am a mom to a recently diagnosed 7 yr old son, and would be more than happy to talk with you about my own experience (navigating OT/PT/Talk therapy/Kaiser/schooling, etc., if you're interested. Every kid and path is unique. The most important advice I can give is to trust your parenting instincts. YOU are the expert, and true support works with the knowledge that parents know their kids better than anyone. Best of luck. :)

Hi Dan, 

Your child has some great strengths and it's good to be mindful about services would best benefit his needs. My child was very similar to yours at that age. Social skills and adaptability were our challenges. The path we chose was a combination of ABA and social skills groups. There is a lot of data and opinions about ABA. It's best to see for yourself and your son if it'll be a good fit for him and your family. I found that the application of ABA from providers worked best for us if it was more naturalistic in style.

You'll find that ABA companies are different - the turnover rates for direct staff are high. Most likely there'll be a clinical supervisor (BCBA) who will oversee a behavioral technician (this person will work the most with your child). Look for someone who is able to engage well with your child, in a style that is comfortable for him and your family. Communication is key - know what your boundaries are, but try to keep an open mind to potential interventions. I've found most staff were willing to work with me about suggestions for my child. We had sessions not only at our home but outside in the community (parks, play-dates) to promote skills. There will always be staff that you like more and some you don't. It's not uncommon to request for another staff for a better fit (just know, it might be a wait).

You mentioned your school district may have options. That's also a good place to start. My kid did a combination of school services (preschool/ABA) and private ABA, and eventually social skills groups. It made for long days, but we saw much growth. You can always ask to tour the potential classroom to see what it is like (this was certainly available pre-Covid). Join your local SELPA - there should be special education resources for your district. Get to know other families at your school and/or in your area. They are always the best to get local information from - classrooms, ABA companies, special needs friendly places, etc.

All the best to you - our kids will make progress in their own time and it's amazing to see.

I am a parent and a school psychologist.  I always recommend that parents access ABA Therapy as early as they can.  It is most effective early and it does really seem to help.  I can't think of a downside.  I believe it can be hard to find ABA therapists.  You may not have so many choices.

As for suggestions for ASD newbies, I would start by limiting screen time and playing 1:1 with your child.  Do all the usual fun stuff with them.  If he is rigid, prep him ahead of time for what is likely to happen.  He is likely to ask you a lot of questions, answer as best you can.  You can write your own social stories for him, or find relevant ones online.  Social stories help explain social expectations in a kid-friendly way.

Typically kids like this do very well in school because they like the structure and rules.  Learning comes easily to them.  The real challenge is with social functioning.  I would try to encourage him to socialize with peers around shared interests.  He won't have many peers who will be able to read, of course, but maybe he enjoys trucks, dinosaurs, or playing in the mud?  As much as you can, treat him as a regular kid.

--Silvia

I’m not sure if it is available here, but my sister is a speech therapist who works withASD children using play therapy (in NJ. )

Hi Dan,

I'm an adult who learned I am autistic as an adult, so I haven't been through ABA myself. 

But, what I can say is, the best advice is to listen to autistic adults talk about their experiences. There are some good books on this (this is the recommendations list from an online book club for autistic people that I'm in List) and social media is great (#actuallyautistic, Ask Autistic Adults on Facebook, etc). https://www.auteach.com is run by autistic adults with professional backgrounds in helping autistic kids, and has a great tiktok, YouTube, and some consulting services on finding the right therapies and help for your kid. Also, I have learned a TON supporting my probably autistic toddler and myself from following pediatric OT's on social media. They have great advice on sensory stuff, and how to help autistic kids learn to regulate.

I beleive, strongly, from listening to other autistic adults who went through ABA, that it is harmful. Looking or acting not-autistic is a soul crushing goal for autistic people. Your kid can have an awesome life. The most important thing is to support them for who they are, and knowing and loving that who they are is autistic. They will never be "cured" or "normal again". Being autistic is just being a person with a different kind of brain.

We have been very pleased with our ABA experience for my son. He began working with a BCBA and Behavior Tech from Kadiant ( https://kadiant.com/) when he had just turned 3 years old and is fading out ABA services as he has improved his skills so much that he doesn't need it now at 5 years old. The ABA sessions are fun and my son looks forward to seeing his BT and BCBA, who are a big part of his (and our) support system for his parenting. When they work with my son at home, they'll play games or take turns choosing different activities together, but all along, they are working on different skills with him like taking turns, expressing his needs, or recognizing when he is in the "red zone" so he can practice regulation skills. Once a month or more, we meet with them to go over his progress in specific skills and come up with new goals together so we can be working with him at home, too. His BT attended preschool with my son for half days and while there, she prompted him about various social skills while on the playground or gently supported him when he had a meltdown. I had the same concerns as you, but once I was able to observe ABA for myself, my fears were alleviated. I think it is important to ask how much experience the Behavior Tech and the BCBA that will be assigned to your child has. Other than that, we found that the most helpful thing to do was to observe any BT the company sent out to us and see if they were a good fit and we liked the way they interacted with our son. We observed two that were not so great but were assigned to one that is wonderful and we have been lucky enough that she has stayed with my son for the past two years. Feel free to contact me if you have any questions.