I am a behaviour therapist for children who have autism. This is how I introduce my job title when people ask me what I do for a living, and the description usually elicits one of two responses:
- Good for you! Sounds very rewarding!
- What does that mean?
More often than not, I am asked to explain what Applied Behaviour Analysis (ABA) means, and what behaviour therapy is. Over time, through describing my job to friends, family members and strangers, I have come to realize that most people outside of the autism community have no idea what ABA therapy is, what children on the spectrum are capable of or how rigorously our clients work to gain verbal and developmental skills.
Unfortunately, not everyone gets to experience autism the way I do every day, and see what happens in a session of ABA therapy. I feel so blessed to work with and learn from a handful of the one in 66 Canadians on the spectrum, and I think we could all learn from the determination these children project in behaviour therapy sessions.
I’d like to reveal my account of autism to anyone who’s curious about Autism Spectrum Disorder, and speak specifically about the lesson in determination I’ve learned as a behaviour therapist.
The reality of Autism Spectrum Disorder
Many people have a very basic, simplified view of autism. Before I began working as a behaviour therapist, I thought autism was the boy in my elementary school who flapped his hands when he was happy, and who screamed, cried and covered his eyes when we went into the gym because the lights were too bright.
Autism Spectrum Disorder actually encapsulates a range of people with drastic differences in both their abilities and their challenges. Essentially, to receive a diagnosis of autism, an individual must have impairments in communication and imagination, as well as fixated, repetitive interests or patterns of behaviour.
I work with a boy who loves watching all modes of transportation in videos and in real life. He can tell you the name of every station situated on Toronto’s Lakeshore rail line. He can recite all the stops the GO bus makes on its way from Whitby to Yorkdale.
Transportation is one of the narrow interests he focuses on and converses about. While adults are willing to talk to him about Rouge Hill station at length, his peers normally want to change the topic after a while. Yet, he is unable to change his perspective within social situations. He can’t tell that his peer may be bored with the topic of conversation.
When his peer tries to ask him about something else, he will answer politely and then return to talking about buses, trains and planes, because those topics are interesting and important to him. This client doesn’t engage in self-stimulatory behaviour (or stimming), but a lot of my clients do, to an extent that makes it impossible for them to interact with the world.
Another little boy I work with engages in vocal self-stimulation, as well as echolalia (repetition of another person’s spoken words). He has a fantastic vocabulary, but sometimes has trouble conversing. He repeats words and phrases he’s heard throughout our sessions, such as “reinforcement,” “Time to do your independent work,” and “I can’t find my table targets!”
At his own leisure, he recites his favourite rhymes, lines from TV shows and songs from the radio to completion. Sometimes, his vocal stereotypy is similar to that of a child humming his favourite song, and is very sweet to listen to. However, at times, the verbal regurgitation is constant and impossible to break—you can’t speak to him over the sound of his own brain and mouth.
His engagement in self-stimulatory behavior is incompatible with learning about objective reality. Learning necessitates interaction with objective reality in a meaningful way. Therefore, it’s my job to engage him not just with himself, but with the world around him, in a way that is as reinforcing as his stimming.
These boys are among my higher-functioning clients.
What most people believe to be ‘autism’
I also work with children who display motor stereotypy—the superficial representation of what most people believe to be ‘autism’—a flapping of the hands or arms, hitting fists together, putting hands up to the face, rocking, spinning and pacing. Again, I work around motor self-stimulation to help the client function in the world, and allow them to stim to help self-regulate their emotions when they’re sad, anxious, happy, excited or angry.
While some of my clients are verbal, many of them are non-verbal or have limited speech. Through ABA therapy, they have learned to elaborate and use more words when they speak. We also teach our clients to communicate via an iPad or a PECS (Picture Exchange Communication System).
The following phrase definitely holds true: “When you’ve met one person with autism, you’ve met one person with autism.”
In this way, children who have difficulty communicating verbally learn how to use a different kind of voice in order to express needs to caregivers and educators. As you can see, the following phrase definitely holds true: “When you’ve met one person with autism, you’ve met one person with autism.”
As a behaviour therapist, I look at each client individually and work through the challenging behaviours that compete with their potential for growth and learning. I systematically teach each client to behave in ways that optimize, rather than impede, learning.
Every client presents challenging behaviours differently, and every individual has hurdles they must overcome to functionally experience the world around them. A non-verbal child who engages in problematic behaviour to signify wants and desires must learn how to effectively communicate in order to reduce such behaviours.
I work with children who can’t speak but cry, hit, bite, throw items or engage in other attention-function behaviours to alert their caregiver to a current desire. But by teaching an early learner how to simply point to an object they want, the frustration due to an inability to communicate never even needs to occur. As therapists, we analyze situations such as these to show children on the spectrum that there are more appropriate ways to respond.