(This will be part one of an ongoing series that I will
update as I continue my research into this important topic)
So you’ve decided to heed the concerns of the Actually
Autistic community and part ways with ABA. Perhaps you spoke to an adult friend
or family member who is autistic and has formal or informal experience with it?
Maybe you saw how your child’s therapist behaved and spoke and found yourself
sickened as comparisons to canine behaviour training flooded your mind? Whatever
the case may be, good on you! Welcome to the wider world! It can be scary to
make that step – after all, ABA is considered the ‘gold standard’, and from the
moment an ASD diagnosis is handed down, advocates for its success are right
there to offset the scary fearmongering about how awful Autism is – a seeming
light in the darkness, reassuring parents that their children will be okay if
they act quickly and put them in intensive ABA treatments. It’s so deeply
enshrined as part of Autism supports that are offered by many governments and
organizations that often no one stops to question the quality of the support or
if there are in fact other options. I have good news on that front – there are
MOST DEFINITELY other options, though they aren’t usually as spoken about. Having
seen the fierce debates that rage online about this topic, I decided to put
together a very special installment of Differently Wired in order to outline a
few for you here. Please note; this is a constantly evolving subject, and as
such this won’t be comprehensive. I fully intend to follow up on this list with
new discoveries in future blog posts. With that out of the way, let’s begin!
Occupational Therapy:
This is one that a lot of people aren’t even aware has
applications when it comes to Autism, but it absolutely does. The goal of OT is
to identify areas of a child’s life that cause them difficulty and to develop a
plan that helps address each one in an ad-hoc individualized way. It can
encompass many strategies (such as physical activities to assist with fine
motor skill development, play to encourage communication, assistance with
learning basic life skills such as brushing teeth, tools for coping with
transitions, etc.), but is generally focussed on helping the child in question
develop skills that work best for them. By taking such an approach,
Occupational Therapy can greatly assist Autistic children to develop essential
life skills while not focusing too greatly on conditioning and compliance…two
areas that make ABA problematic.
Sensory Integration Therapy:
Sensory processing issues are among the most common ways
that those of us on the spectrum are impacted by our ASD diagnoses. Simply put,
the Autistic brain and nervous system interpret sensory input differently than those
of our Neurotypical peers. Quite often, it feels as though our senses are
either dialed up to 11, or else almost entirely muted (we in the community
often refer to ourselves as either ‘HYPERsensitive’ or ‘HYPOsensitive’ in this
way, and it can vary from stimuli to stimuli). Sensory Integration Therapy
focuses again on alleviating one specific aspect of Autism that may be unpleasant
instead of changing the entire person to fit a socially prescribed norm – in this
case, by helping children adapt to and become okay with certain sensory input
patterns. Sensory integration can include wearing a weighted vest (because
weighted clothing and blankets tend to have a soothing effect on some Autistic
people), slowly being introduced to a food whose smell or texture can be
intensely off-putting in order to help a person adapt to it, or embracing stims
like spinning or swinging. As with most things involving comfort zones, its important
to always take the consent of the child going through this into account…so this
one can be iffy. Still, as an alternative to ABA that focuses on assisting with
specific areas of difficulty, it has definite merit.
Relationship Development Intervention (RDI):
A relative newcomer to the field of alternative Autism treatments,
RDI focuses on encouraging the development of a supportive relationship between
parents and children wherein parents and caregivers work in the role of facilitator
to guide and assist their child’s development in various ways. This
relationship is referred to as ‘guided participation’ and allows children to
ask questions, seek guidance, and learn from their parents, while also allowing
parents to teach kids strategies for dealing with their emotions,
self-regulation, and other needed life skills. Because it functions as a partnership
between parent and child, it results in more validation, self-empowerment, and self-love
for the child involved. They feel self-actualized and take ownership over their
own learning and development, which is crucial!
Speech Language Pathology:
Speech Language Pathology is another one of those ‘I had no
idea that helps with Autism!’ entries on this list, and once again it definitely
does have applications in the field of Autism support. SLP focuses on assisting
Autistic individuals with some of the most common communication issues that
come with the Autistic neurotype. Some specific areas where it can be helpful
are: understanding body language, knowing how to match emotions with facial
expressions, making clearer speech sounds, and being better able to understand
conversational norms such as knowing when to speak and when not to, modulating tone
of voice, and so on. All of us on the spectrum have some communication issues –
I myself often slur or improperly pronounce words when I’m excited and
passionate, and often find that I communicate far more effectively using the
written word than verbally. SLP can help kids work on these deficits in order
to better help them speak and learn. It is therefore invaluable in assisting
many autistic people shine!
Honourable Mentions:
Sometimes you come across something that might help autistic
kids and those with other Neurodivergences maximize their potential but that don’t
necessarily take the form of traditional therapies. In this next section, I’ll
be outlining a few of those, with one in particular being really cool and I’ve become
a huge fan of it!
‘Mightier!’ Bioresponsive Feedback Games (by Neuromotion
Labs):
This is one that a friend of mine recently turned me on to,
and I couldn’t have been more impressed! While officially designed for kids with
ADD and ADHD, many of us on the spectrum have similar emotional dysregulation issues
and this is extremely helpful for those. Essentially, Mightier is an
interactive game experience that uses a heart rate monitor to allow the child
playing to control the game by regulating their stress levels. This teaches
self-regulation and is bolstered by a program that involves partnership between
parent and child to co-develop calming and emotional control techniques while
also allowing the child to have and express agency and guide the process. As a
child-centered approach with a video game basis, how could anyone NOT think
this one is awesome?
Giant Steps!
This one is complicated for me in that, as an organization,
Giant Steps DOES have an ABA therapist on staff, but after speaking with my
cousin who is a graduate of the program, I’ve opted to include it here anyway
because of all the other things he says the program gets right. Based out of
Montreal, though with operations in Toronto and York Region as well, Giant
Steps is a comprehensive, multi-disciplinary approach to Autism support that is
focused on developing individualized therapy approaches for each child. It encompasses
more or less every approach previously discussed in this blog post – OT, SLP, Sensory
Integration Therapy and so on – and combines them in a unique, child-focused
way. Unfortunately, as I mentioned they do employ ABA therapists among the specialists they
keep on staff, however once again, from what my cousin has described of his own
experiences, the presence of the other alternative treatments on this list and the unique curriculum
developed by the program serves to mitigate the more deleterious issues with
ABA in this exact case. I can’t verify this, as I have only one Actually
Autistic voice to testify to the program’s success…and as always when ABA is involved
caution should be warranted…but I’m including this one as an honourable mention
because while more investigation is needed, I find it tentatively promising in
its focus on the whole child.
So that’s about it for now, though as mentioned I do plan to
update this going forward as new information is presented to me. If there’s
one thing I think anyone reading this list should take away from it its this:
alternative Autism support programs by and large target specific areas of actual
need, rather than attempting to condition autistic behaviour out of a person.
They take into account the mental state, struggles, challenges, and even skills
of the autistic person in question while developing a therapy program that
meets their individual needs, and in the most ideal cases, is child-guided. But
what can you do if your child is already in ABA and would struggle with the
transition to something else? What if you’re living in a jurisdiction where
Autism funding is scarce enough for ABA, to say nothing about any other types
of therapy that might be more ethical? Well in such cases and others, I would
offer the same advice I have before: develop a rapport with your child’s
therapist, be clear that they are to focus on life skills, not on curbing
autistic traits and forcing eye contact, and insist that your child’s mental
and physical well-being is always taken into account. Their ability to consent
must always be respected and encouraged as well.
Finally, and most importantly, the biggest step you can take
to mitigate any deleterious effects you child may experience from any therapy
(because none is perfect, even if some are better than others) is this; treat
your child like a complete human, not a burden. Value their opinions and their
insights, teach them that Autism is their superpower not their curse, and meet
them where they’re at, instead of trying to change them to be where everyone
else is. They are who they are, and you are who you are. You’re partners on
this journey, and neither of you will ever find a better guide to how the other’s
mind works than each other.
So buckle up friends – you’re in for a wild and awesome ride
down the Neurodiversity tunnel!
Yours in diversity,
Adam Michael
Links to websites used in the writing of this article in
case you want to learn more:
https://www.autismspeaks.org/speech-therapy
(I know...I know...Autism Speaks is gross…but this was a useful article at
least…)
