Thursday, 22 January 2015

ABA Strikes Again

This blog is mainly about clever pills and potions that may improve some people’s autism, but I do like to remind people of the power of behavioral interventions.

Monty, aged 11 with ASD, has had three behavioral consultants since we began his home ABA program when he was aged about four.  Since there are no ABA consultants in our part of the world, we have to fly them in.  We have our local therapists/assistants, who then work with some support from the foreign consultant.  The net result is a mixture of approaches, which admittedly becomes more “ABA” when the consultant comes to visit.  We now have a vast collection of ABA books, manuals and training materials.

Last week our excellent American-Greek behavioral consultant came for a two day visit and so it was a good opportunity to look at progress.

Monty went to the airport to wait for her and then we went home for some discussions and Monty showed off his piano playing.  Later everyone went out to a pizza restaurant; all went well and Monty quietly devoured his full-sized margarita pizza.

The next day the consultant went to school with Monty and his assistant, to see how things are handled there.  The last time she came, she pointed out that there was little interaction with the other kids.  Now things are much better in that area.  In class, she noted than he can now sit attentively and follow much of what the class teacher is saying/doing.

Then back home to see Monty’s afternoon home program with his other assistant.

Another school visit the next day and the visit was over.  Now we wait to find the suggested items to work on at home, as we work our way through one of the ABA bibles, which in our case is:-

We have lots of other material, but we still often use this book.

Academically and socially we have moved on a fair way since the last visit.  Back home our consultant runs more intensive clinic-based ABA programs and she was wondering out loud how come we are making all this progress.

“Our other kids have six times as much intervention”; I am not sure exactly how the six figure was picked, but I do get her point.

Near the end of the visit she did ask “are you giving him any drugs?”

The answer was “yes, but not any ones you will have heard of”.  I did then give a brief explanation of my "extra-curricular" activities.

I have learnt it is best not to mix messages with different audiences.  ABA people are great, but do tend to think nothing else can help.  Equally, people convinced that the problem is candida or vaccines, have also already made up their minds.

It is, of course, not a good idea to compare one child with ASD’s performance against another, but everybody still does it.

It looks like the kind of people our consultant works with now and encountered at a leading center in the US, where she trained until 10 years ago, are generally more affected by autism than Monty.  Most of the people I read about today with “autism” (mainly from the US) are clearly much less affected than Monty.  This does rather suggest that what passes for “autism” there has really changed a lot in 10 years.  Now that Asperger’s has ceased to exist in the US, under their latest DSM, this process will continue yet further.


My conclusion is that ABA works great and so does the Polypill.

Hopefully, next time we go to the airport to meet our ABA consultant, or even drop by her in Athens, we will again have moved forward nicely.

For now everyone is happy.


  1. Hi peter, Have you read "teach me language" by Sabrina freeman. It's one of the best books I've read about teaching higher skills using ABA therapy. I have been using this book for more than a year with great results.

  2. Yes, we started using that book several years ago. It is excellent. In case you have not seen the site below, they have a great selection of books and resources:-

    I never understand why more people do not use ABA at home. It can be highly effective and the books are not so expensive. You cannot entirely outsource this to therapists.

  3. Hi peter,We do have all the materials and books required for ABA therapy and speech therapy. Every day I work with my daughter one on one as many hours as possible. We never sent her to full day school knowing that she would not listen to her teacher in group setting or have meaningful conversation with her classmates. She keeps up with her peers as far as academics are concerned for now (1st grade) but we can foresee problems in the future. When she is with kids she just runs around and plays by herself without any focus on others. Do you have any tips to encourage back and forth conversation?

    1. I think you have the best book, but it really needs a great deal of time to do all those exercises.

      You just need hundreds (and really thousands) of hours of 1:1 work, like you are already doing.

      If your daughter responds to Bumetanide or other substances, you may find things go much faster. This was our experience.

  4. Hi peter, My daughter is doing very very well..thanks for all your work and thanks for your blog. She responded very well to Bumex, although I'm still a little bit concerned about the long term side effects. She also positively responded to NAC,sulforaphane, cocoa flavonols and B- vitamins. Her teachers, behaviour and speech therapists are also very impressed. My husband and I are feeling relaxed and happy for the first time in 7 years. Thanks again.. I know I have lot more work to do and a lot more to understand about Autism but for now I'm happy for my daughter.

    1. I am glad that your daughter responds so well.

      The side effects from Bumex really seem to be limited to low potassium and loss of fluids. You do have to drink more to compensate for the diuresis; most people do this automatically. Most people will replace the lost potassium by eating an extra banana a day and/or taking a potassium supplement. Many adults are on Bumex for years and so the side effects are well documented.

  5. Peter, I can see that my daughter is more aware of her soroundings after Bumex but her auditory processing is still weak. I tried reading her small stories/ paragraphs without visual cues and she couldn't follow after one minute. I give her auditory processing exercises from some workbooks I have ... I'm also planning to put her on ' forward forward' program that's popular here in USA. But she won't be able to go to regular school until I can fix this problem. What are the medical reasons behind this? And what else can we do about it?

    1. It is a slow process, you need to optimize functioning by correcting as many biological dysfunctions as possible and then provide a stimulating, supportive learning environment. Then you just keep going and gradually things will improve. You probably cannot fix everything, but can make things much better than they would otherwise have been.

  6. After reading an article about Optimal Outcomes (or kids who lost the ASD diagnostic) I decided to look for complementary therapies, more linked to neurologic rehabilitation then behaviour, as I feel ABA works but has its limitations.

    I've found Padovan Method (or Neurofunctional Reorganization), and one month into it I feel confident enough in the results I'm seen on my kid to recommend it.
    Here is a link to the method, it needs to be performed by physical or speech therapists, so its kind of expensive.

    And here the article that lead me to search therapies in this direction

    “For that study, researchers led by Dr. Inge-Marie Eigsti performed fMRI scans on three groups as they read short sentences and answered questions by pressing a button.12 They tested 16 people with "optimal outcomes" (OO), 23 with high-functioning autism, and 20 typically-developing peers, the controls. Would the scans of the OO group be identical to the control group?
    Surprisingly, the answer was no. Their scans resembled those of the autism group in some ways, but in others, they differed from both the control and the autism groups. The OO group appeared to be using different parts of their brains for the sentence comprehension tasks. Researchers say they may have learned to compensate for their early autism by using new pathways to process language.”




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