START TREATMENT EARLY - BY AGE THREE!
The six-year-old boy who walks through the door
is exceptionally cute but his protective helmet warns me that something
is amiss here. It takes only my hello to start him screaming and
hitting his head - for the next fifteen minutes! He does not want
to be here. At the Judevine Autism Program at East Central Regional
Hospital (ECRH) we train parents to use Applied
Behavior Analysis (ABA) methods to bring their child's behavior
under control and to get them ready to learn. This boy, we could
already see, would be a challenge.
six years old is 'middle age' for autism interventions
But, if truth be told, we knew that before the
boy walked through the door. He was six - that's young for most
things but it is "middle age" in the world of autism
treatment. If a child with autism
has not had some basic behavior training by age six, he may well
have learned behaviors that will be disturbing and difficult to
change. This is said to encourage those parents of young children
diagnosed with autism to get help by age three. It is not said to
discourage those parents whose children have already passed that
For them, let me say, it is never too late to
start treating a child with autism - much can still be accomplished
- but it will be much harder! My favorite Bible verse is "Love
covers a multitude of sins" (1 Peter 4:8). This gives me hope
as a parent because I have made many mistakes with my kids - it's
never too late to start over. We have worked with children and adults
with autism of all ages. We have yet to have one that did not benefit
in some way - for some it may only have been that the person with
autism sat down when we said, "Sit down."
Our goal is to teach the parents of persons with
autism how to apply the ABA techniques in their daily lives and
in training sessions. In our workshops we always tell parents that
having a child of three slap you in the face is not pleasant but
much easier to deal with than a young man of twenty-three doing
the same thing! It is so important to start early - when the child
is pliable, has not learned so many inappropriate behaviors, and
is small enough to physically manipulate, if necessary. With that
said, let me explain the purpose of this story:
We have trained hundreds of children with autism.
The ones that are easier to train are always those who have been
taught some basic respect for others at an early age. It has nothing
to do with their level of autism or even their intellectual abilities.
It has nothing to do with the level of skill or intelligence of
the parents. It has everything to do with how early the parents
began to expect good behavior from their children and not to tolerate
a personal experience with behavioral issues
This was brought home to me with my eldest daughter
Charity. At age two, she defined the term "terrible twos".
She always did the opposite of what she was told, she was mean,
she hit others, she tantrummed, and she was just not a pleasant
child to take anywhere. She did not have autism but she had severe
behavior problems that were getting more and more out of control.
One night her mother had a dream. In the dream
she was calling for Charity to come to her and get away from the
road. Instead, Charity ran the other way - right into the path of
a big truck. We took this as a message from God that we had better
do something fast or we could lose our daughter. We started to expect
good behavior from her and gave her consequences for inappropriate
behavior. When we told her to do something, and she didn't do it,
we made her do it. We said what we meant and meant what we said.
It worked. She turned into a wonderful child who people actually
wanted to be around. This story is not meant to scare you - but
if that is necessary to motivate you to take action, maybe it's
not so bad to be scared. If your child is behaving inappropriately
- get help as early as you can.
In many ways a child with autism does not learn
the same way other children learn. For some children it seems as
if they grow up on "auto-pilot". We don't have lessons
on language, but they pick it up any way. We don't teach them to
walk or run or jump and play, but they do all these things. Kids
without autism are able to pay attention to the important things
and to shut out the unimportant things. They pick up the natural
cues around them to learn how to imitate and to create new behaviors.
Kids with autism have a difficult time focusing on what's important
and usually need specific training to teach specific skills.
children with autism do learn
Kids with autism do learn, however. They, like
all kids, want things and learn ways to get those things. In most
cases, kids without autism eventually learn to use language and
appropriate behavior to get the things they want. Kids with autism
may not learn these things so easily. Instead, they learn other
ways to get their needs met. They may scream or hit to get what
they want. Kids with autism are great independent problem-solvers
and they always take the easy way out. Sometimes what they want
is to be left alone.
So, like the little six year old you met at the
top of this web page, they may learn that their behavior can effectively
back people away and get them things they want. Tantrums are nothing
more than a learned response to get the child with autism something
he wants - either something he desires to have (like a cookie) or
something he desires to avoid (like work or physical contact).
All kids learn the wrong things sometimes. Children
without autism can often be turned around rather easily (like my
daughter was) but when kids with autism learn the wrong things,
for some reason these things stick with them - sometimes for years.
When a child of six has learned these wrong things for three to
four years, you may have a severe problem on your hands. Getting
him to learn a new way to get what he wants, will take a lot of
time because first you must teach him that the old way no longer
works. That means ignoring the tantrums (which can be very hard
to do) and giving a consequence for aggressive behaviors (which
can be even harder to do). Depending upon the age and size of the
child, these things can be next to impossible to accomplish. Like
I said earlier, though, if your kid is past age three, it can still
be done. It will just be harder.
suggestions for those who have just received a diagnosis of autism
So . . . start early. Please! As soon as you get
the diagnosis, do this:
1. Read Let Me Hear Your Voice by Catherine
Maurice (a great introduction to ABA).
2. Purchase an ABA manual (Behavior Interventions
for Young Children with Autism by Catherine Maurice or A
Work In Progress by Ron Leaf & John McEachin) and begin
working with your child.
3. Expect your child to behave. If you tell the
child to do something - make it happen even if you have to use hand-over-hand
assistance to make it happen. Teach your child an appropriate way
to get what he wants (e.g., ask or sign or point to pictures of
the things he wants in order to get them). See your child's speech
therapist for specific ways to improve communication.
4. Contact someone in your community who is trained
Behavior Analysis (ABA) to teach you how to work with your child.
If you have the money, you can hire an ABA consultant and ABA therapists
to work with your child. If you do not have the money, you may have
to sacrifice your career to work with your child from age three
to six to teach him what he needs to learn before he goes to school.
What he learns now will determine how independent he will be as
an adult. There is no guarantee that ABA will cure any child of
autism, but he or she will be better off for having learned some
important skills. You have a small window of opportunity to teach
him. Use it wisely and put everything else on hold. Your child is
the reason God brought you into this world at this moment - there
is nothing else more important!
5. Pray - the Lord knows autism and will always
Do not lose heart. If your child is already older
than three - start with what you have but begin to expect good behavior
from your child. Have a person trained in ABA methods observe your
interaction with your child and take their advice on how to change
your interaction patterns to improve your child's behavior. It can
happen! May God bless your journey with your child.
Click here to go to the
home page of this website: www.autism-help.org
to go to the Early Intervention page of the website
Click here to
read more personal stories from parents of children on the autism spectrum
Visit http://groups.msn.com/TheAutismHomePage/environmental.msnw which is the autism home page of Gary Heffner, the author of this
article. This personal story remains under his copyright and is
used with his permission. You are encouraged to visit his site as
it is one of the few autism websites offering free comprehensive