Saturday, September 27, 2014

Today's ABA-Based Home Programme is Different from "Previous Generation's": A Family's Experience

A family in Kuala Lumpur shares what their family's therapy is like. Hopefully the info will help new families.


Dylan started play-based ABA in January 2014 when he had just turned 4. Prior to this, we have been using the flashcard method (rote learning way) to teach him which we found Dylan quickly grasping, but needed a lot of effort from us as parents to keep him motivated and focused on his tasks. In addition, he language skill is limited and we found it challenging to prompt him to request for anything around him when he seemed so aloof.

(Photo above: So interested at the pet store, during a supervised community trip to the shopping mall.)

Intan was truly a blessing to Dylan when she introduced play-based ABA. Dylan has since shown tremendous step-by-step improvement in the areas of cooperation, compliance, cognition, language and community skills. Play-based ABA offers a home-based therapy which has the fundamental ABA principles coupled with many funfilled activities and practical strategies which are tailored to Dylan's needs and interests. Typically for Dylan, his therapy covers table time, floor time activities (book reading, play dough, etc.), play time (Thomas train, bubbles, etc.) and physical activities (fitness ball, throwing beanbags into basket) and community trips. Overall, play-based ABA keeps Dylan well-engaged during therapy especially in the areas of eye contact and language content, and most importantly, builds his love for learning and interaction.

(Photo above: Practicing staying close to a family member in public, without needing to hold hands.)

As with any 4-year-old, Dylan loved the outdoors and enjoys going to the shopping malls, However, bringing him out was a challenging task for us as he used to dash about to anything and everything that interest him and occasionally wandered off from family members. Sometimes, there were also moments of meltdowns in the crowded places. The introduction of supervised community trips, such as to a shopping mall in Dylan's case, definitely plays a pivotal role in overcoming these problems. The community trips help groom Dylan to behave appropriately and eventually ensure safety in those environments. Moreover, the trips allow Dylan to apply functional skills beyond the comfort of his home. As a bonus, we get the chance to enjoy every minute of time spent with him in the outdoors.

Team meetings are held at least once a month between parents/carers, therapists, and Intan. The meetings provide in-depth communication about Dylan's progress and challenges. Any new problems, obstacle or resistance are discussed, In addition, the meetings allow feedback and ideas from parents' perspectives to be incorporated into the programs as such the ABA programs are individualised to suit Dylan in order to achieve the best outcomes.

In short, we are pleasantly grateful to be part of this play-based ABA therapy in helping Dylan in the journey of life-long learning,

-Parents in Kuala Lumpur, 2014

*****both photos published with parents' permission*****

Thursday, September 18, 2014

Relationship & Social Skills: Going Beyond "Turn-Taking" in Guided Peer Play Sessions

All photos used in this post have been approved by both boys' parents.

This is the glimpse of a month in the life of 2 boys: "Robert" and "Luke" (both pseudonyms), who needed help learning to play and work with others in a meaningful, interdependent way.

Because Luke was moving away, we had only 4 weeks to work on our goals, mid-July until mid-August, 2014. This ended up being a module of 6 sessions at 1.5 hours each time. In addition to this face-to-face time, therapists who worked with each boy also reinforced some of the goals about once or twice a week on other days, in a 1:1 setting (therapist and child).

Goals were listed as:

A. Physical Coordination

- matching/adjusting one's body movements (speed, direction) to that of another peer
-practising sustained attention to another peer
-practicing working towards a common goal with the peer (rather than parallel actions)

B. Being Flexible
(a huge indicator of ability and predictor of school/life success)

- flexible about whose turn it is in an activity
- flexible in choice of activity
- tolerating disliked activities
- living with the "unknown" (you can be OK not knowing what's coming up next)

C. Personal Space

- practicing adjusting "just right' distance between 2 people
- practicing that what is "just right" depends on the activity/context and is not fixed (static).

D. Losing Gracefully (at a game)

E. Reciprocating Statements

- Congrats / Thank you
-Thank you / You're welcome
- Sorry / It's OK

F. Conversation Skills (goal during snack time)
- Statement - Statement
( example: "I like juice." "Well, I like water.")
- Question - Response
(example: "Can you help me open this?" "Sure!")
*The goal was to encourage both responding to a statement/question from a peer, and also to initiate statements/questions spontaneously.

G. Interviewing Skills
-finding out about each other.

Above: Coordinating my actions to my friend's actions, so that we can reach a common goal (aligning and gluing the snake pieces.)

Whether it's carrying and putting away a heavy box of toys together.....

....or carrying chairs to set up the snack table, these activities help the boys learn to focus on the movements (speed, direction) of each other, and continuously adjust their own actions. Sustained attention to another person is a challenge for many children on the spectrum. Activities like the above can help. 

Finding Out About Each Other: A little was done at every session. Each boy learns that other person have realities and interests different from his own ("Oh, he has a sister, but I don't. And guess what, he doesn't have a brother, but I do." "He likes cars but I like animals." "His mum has a different name from my mum.") Many children on the autism spectrum have challenges with understanding/accepting Other People's Perspectives. This activity can nudge that awareness along.

At the end of the 6 sessions (across 4 weeks), we could see some progress (defined by the reduced need for scaffolding/prompting by adults) in most* of the areas. However, it is clear that a longer module would have helped even more!

All the best, "Robert" and "Luke"!

*we did not have time to work on the Personal Space goal at all.