The Lowell Sun reports that the bill shown below is being discussed in Massachusetts.
I have worked in schools where students with autism are provided a 1:1 ABA therapist hired by the school. The therapist provided both support to prevent maladaptive behaviors such as stripping or eloping and activities to promote learning by using positive reinforcement (aka rewards). Common reinforcers include:
- watching a video
- food
- stickers
- praise/hugs
- time spent in a sensory area
Applied Behavioral Analysis is controversial and has been described by some individuals as aversive because the person loses their autonomy. According to, Autism Today : “Not all ABA therapists have the same education and initiative for their career. A qualified and empathetic therapist can prevent trauma and help children with autism progress in life”.”
Occupational Therapists may use “sensory reinforcement”
Individuals on the autism spectrum may seek out sensory-based rewards such as
- holding a vibrating object
- sifting fingers through a bowl of rice
- pressing a switch to activate a fan
- being offered time using a trampoline
- or making a horse start walking again
What is positive and negative reinforcement?
I frequently used strategy #5 when treating children during hippotherapy because they were motivated to wave, point, pat the pony or say “go” in order to make the horse move. Sensory reinforcers can be very effective because they are designed to provide the sensory input that meet a child’s needs.
What I am describing is “positive reinforcement”- providing a reward for performing a desirable action. On the other hand, “negative reinforcement” involves a punishment after a maladaptive behavior. One of the most controversial uses has been electric shock and is largely opposed.
Below are posts about sensory reinforcement to motivate and develop skills….
So, what does this proposed bill mean?
Parents are naturally eager to see their children learn functional skills and be safe with a 1:1 ABA therapist. If the therapists are qualified and the child is progressing- it sounds good to me!
But outside ABA providers do the hiring and dictate what $ to charge. The expense may place an undue burden on schools already struggling with state and federal funding cuts.
What happens when the outside ABA therapist has a different approach from the classroom teacher?
Will the student be isolated from peers or will the therapist promote classroom involvement with peers and classroom learning? …
…and who determines whether the child is no longer benefitting from the service?
Occupational therapists assess, report gains and give recommendations on whether or not a service is effective. Sometimes there is a plateau where a student has not nor is likely to make gains from a particular treatment.
Sometimes, parents want OT or ABA forever, thinking that any help is better than none- regardless of efficacy or lack of progress. How will this work when an outside provider is foremost eager to generate an agency’s income?
These are just a few of my thoughts… I would love to hear yours!