Why ABA Is Mostly Unsuccessful without Neurological Organization
About 1 in 54 children has been identified with autism spectrum disorder (ASD) according to estimates from the CDC Autism and Developmental Disabilities Monitoring Network.
With the pure volume of families now experiencing ABA methods in managing and treating ASD, many families are questioning the efficacy of the therapy. Applied Behavioral Analysis (ABA) continues to be the dominant treatment method, with dismal results and sometimes devastating long-term impacts.
In this article, you'll learn:
What is ABA?
What is ABA missing?
How vagal regulation and neurological organization are key to treating ASD
How Brain Harmony can help
Neurological organization for ASD success stories
What is Applied Behavior Analysis (ABA)?
With a general search on the internet, Applied Behavior Analysis (ABA) appears to be a logical choice as your search will tell you it is one of the most common treatments offered to people with Autism (ASD). Common explanations for ABA involves targeting specific behaviors by applying psychological principles of learning in a way that ultimately aims to modify behavior. In terms of ASD, behavior refers to reasoning skills, emotional regulation, verbal behaviors, and social skills. Put simply, the goal of ABA is to decrease the negative behaviors associated with ASD[*].
So far so good. What’s the problem?
According to ABA basic principles:
Antecedent - what comes before the behavior
Behavior - the response/behavior
Consequences - caregiver provides positive reinforcement with external cues like praise, touch, or sugar.
Let’s see what an application of ABA principles looks like for a child on the spectrum with low verbal skills & poor fine motor skills, who wants to open snack container but cannot.
Caregiver sees he is struggling so she provides an ABA prompt or antecedent:
Antecedent- “Do you need help?”
Behavior- Child hands container to mom.
Consequence- Because he handed the container to mom, mom reinforces this positive behavior by opening the container for him and handing him a container without a top so he can grab the gummy bears.
By doing this over and over, the intent is to train the child with a positive behavior to this situation.
Did having mom open the container for him help him build the manual dexterity & frustration tolerance required to open container independently?
So when does she get to stop opening his containers?
Do all the caregivers need to be trained to provide the same response to keep it consistent for the child?
Are we keeping the caregiver and child addicted to external rewards and the process?
ABA is a behavior-reward process meant to motivate the individual to increase their good behaviors and reduce so-called "bad behaviors." While ABA may sound like a well-thought-out strategy for behavior change on the surface, there are rising concerns around this approach.
And despite the fact that it's the most common therapy prescribed for those with ASD, research shows that 76% of families report no lasting change. And perhaps even more disturbing, some report PTSD from the ABA process[*].
Why would a treatment that's so widely prescribed be failing so miserably?
Why ABA alone Doesn't Work
By targeting specific behaviors, there is no appreciation for the root cause, the reason people are behaving the way they are.
ASD is a complex condition that requires a comprehensive approach to address personalized needs and root causes (including the need for a biomedical cellular perspective) behind their behaviors, sensitivities, and emotions.
ABA not only overlooks the root cause of these behaviors, but through the behavior-reward process, it forces the participant to push through the noxious responses of their bodies and follow the command, come snow or high water. How about we instead provide soothing input to the nervous system of this child so they know and feel safe, then build the connections in the brain so they can open the container themselves.
Individuals with ASD tend to be highly reactive to sensory input, and present with symptoms of disorganized brains and nervous systems. Through working with thousands of friends on the spectrum, Brain Harmony therapists have emerged to give a different perspective on ASD. With the understanding that these individuals have a unique way of seeing and experiencing the world, we first provide vagal regulation so that we can access and build higher cognitive centers of the brain where the function is!
Now, let's look at what the research says:
In an article published in 2019, researchers examined the impact of ABA on participants with autism's behaviors and emotional status. The study concluded that ABA creates a dependence on prompts (rewards) for good behavior and can lead to unintended but damaging consequences. In conclusion, the researchers state that the ABA process may be defined as psychological abuse[*].
Another study published in 2019 highlights the detrimental impact that ABA can have on a child's emotional process. ABA denies a child's reality and overlooks the very real emotional struggles that are causing their behavioral outbursts by only focusing on behavior and not looking at the core issue. This, in turn, only leads to more frustration and shame and self-denial [*].
With research and wary clinicians showing such justified concern around ABA, why would a strategy that's so ineffective continue to be the leading treatment for autism? Perhaps its potential market size of $17 billion annually plays a role in the pervasiveness of this treatment.
In addition to dismal and sometimes devastating results, ABA can be incredibly expensive, costing up to $60,000 a year in some cases. Some families find us after they have spent their life savings on ABA to treat a child with ASD. This adds layers of suffering to an already devastating situation.
Neurological Organization and Autism
If ABA alone doesn't work for autism, then what does work?
When your brain is organized, you're better able to access emotional regulation, manage incoming sensory input, and access learning and developmental skills.
The image of the pyramid below outlines the foundational benefits of neurological organization and how the upstream neurological processes build on one another. Without a strong neurological foundation, behavior change becomes almost impossible.
ABA by itself, does not address this foundation and aims to interject task demands near the top of the pyramid without addressing the very basic needs of the central nervous system.
In addition to neurological organization, taking a cellular approach to healing is required for comprehensive healing with ASD. Understanding your child's biology and any factors that may be contributing to symptoms can open the door to healing the body, while neurological organization can help heal the brain and nervous system. For more information on the cellular approach to healing, seek out the care of a functional medicine practitioner.
Brain Harmony's 5-Step Plan Of Care
At Brain Harmony, our goal is to get to the deepest root of the behavior and developmental issues and create balance and harmony at every layer of the nervous system. With programs and tools that help build neurological organization, friends with ASD get an opportunity to build the neuron connections so they can access better function, more independence and a better quality of life.
Step One: Vagal Regulation
In step one, we work on vagal regulation. This provides a sense of safety and calm that many friends with ASD have never experienced before due to the disorganized states of their nervous systems. We use a couple of programs during this phase which can bring about feelings of safety and calm. The Safe and Sound Protocol (SSP) enhances vagal tone and helps to bring the nervous system into a parasympathetic mode and out of sympathetic (fight or flight) activation.
Another tool used to achieve vagal regulation is with the Alpha Stim. The alpha Stim is used to feed the brain alpha waves which reduce anxiety and depression, and enhance your ability to focus and learn. Depending on the individual, we may use one or both of these options to bring the brain into a state of calm.
This is a crucial step in neurological organization, as your brain must be relaxed enough to allow for deeper changes to occur. Being stuck in sympathetic mode is one of the key signs of a disorganized brain.
Instead of training an individual to behave with an external reinforcer, vagal regulation awakens the innate ability to connect socially. This genuine human interaction stems from a true sense of safety and openness.
Step Two: Neurological Organization
In step two, your occupational therapist develops a unique plan with specifically chosen interventions to allow for holistic rehabilitation of the human system.
This step involves sensory integration, which is only accessible once vagal regulation is awakened. At this point, our friend is feeling safe and ready to open up to deeper skills and developmental processes.
We often see shifts in IQ points and gains in year's worth of language and math skills during step two. Friends access their ability to communicate verbally and non-verbally and show greater self-confidence and emotional control. It's not only the interventions themselves but also the order in which they're given that allows our clients to build neurological organization daily -- right at home.
Step Three: Therapeutic Activities
In step three, we provide therapeutic activities that tune the input to the nervous system through fun and targeted play or work.
We layer these activities into the program, which can further strengthen the nervous system outside of modalities based upon neurological indicators measured in the program. The experience of your therapist will allow you to bring the most powerful and effective activities known to balance your nervous system on a regular basis.
Step Four: Reflex Integration
In step four, we work on reflex integration. Friends with ASD require the integration of specific primitive reflex patterns that can restrict development in everything from eye movements to emotional regulation, turning off the fear/paralysis reflex, and bladder control at night.
For example, when friends are considered to be easily victimized or present with bullying types of behavior, we look to the nervous system to understand and address the root cause of the behavior. We identify if there are any infantile reflex patterns still present and teach you how to break apart these restrictions that contribute to the dysfunction. You can see how this is different from providing only a behavioral modification or punishment for these behaviors but instead freeing the nervous system from limitations that result in dysfunctional behaviors.
Our Brain Harmony therapists are trained in the Masgutova Neurosensorimotor and Reflex Integration developed by Svetlana Masgutova, considered the gold standard for reflex integration. Brain Harmony therapists add their touches to the protocols for a robust intervention, although not core certified. We train our caregivers like we would train a therapist in the clinic so that you can be empowered to continue to organize the nervous system with critical movement patterns at home.
Step Five: Self Care
One could say that independence is the primary goal of all parents for their children, and it's no different for families with ASD. Appropriate achievement of self-care includes everything from morning routines with teeth brushing, getting dressed to preparing meals, digital hygiene, and balancing a checkbook.
At Brain Harmony, this is not accomplished through route repetition of steps. Instead, we work on organizing the nervous system in a particular order and with accelerants to the process, so self-care skills percolate to the top when the foundation is built well.
Our program applies to non-verbal children and friends with astronomical IQ but limited social skills to high functioning adults and everything in between. It's not just for low or high-level friends; it will provide the greatest organization to the system no matter what level of care is needed. We frequently "hear" the smiles from a mom when she states that her child is consistently dry at night, is now speaking with complete sentences, is now able to sit for longer periods of time and read, able to self-initiate breakfast meal preparation, able to test better on assessments, able to communicate through the use of their eyes, and able to have a natural back and forth tone in conversation. From autistic adults, we hear reports of decreased anxiety and distracting stimming behaviors to just having a better quality of life.
That's real Brain Harmony.
Natalia's Brain Harmony Success Story
Natalia is on the severe end of the autism spectrum, suffering from high general and separation anxiety, communication issues, sleep problems, and more. Her mother was having her see a speech and occupational therapist, but she eventually hit a plateau and made no progress. After using Brain Harmony for a month, Natalia began having incredible improvements, becoming more independent, sleeping through the night, communicating clear thoughts, having considerably less overall anxiety.
"I used it for just a month or so, but I see stuff in my daughter I have never seen. The anxiety disappeared, the sleeping got better. She's more calm. She said, "Mommy you go to the store, I'll stay with Dad." She started to learn from other kids. She started to learn from her environment. She's starting to listen more. Some people told me that she will reach a cap and will never be able be conversational. My daughter now goes to the park and talks to the kids."
Griffin's Brain Harmony Success Story
Griffin's parents sought help when Griffin was two years old. He was sensitive to sound and had not started to speak like other children his age. He would spend hours playing alone and rarely engaging other children.
"When our son was diagnosed with autism, we were crushed. This program has been nothing short of miraculous for our family. It has returned our son to us and given him the ability to achieve his full human potential."
- Griffin's Dad
Takeaway
It's time for us to look at ASD as a reflection of the state of the brain and nervous system, which can be changed based upon the input that it is given.
Traditional treatments like ABA that do not change the brain or nervous system are essentially compensatory strategies. As a result, this type of therapy can go on for years with minimal lasting progress leaving the nervous system unchanged and remaining dependent on others to function.
Instead, Brain Harmony works with our autistic friends from a root-cause level. We begin by creating a sense of calm, then introducing neurological organization so their behavior change can come from a place of intrinsic growth and motivation. This foundation will allow a friend to achieve an even higher level of gains from your present manual therapies just by adding our home program component.
Let us help you take the next step with Brain Harmony and schedule a Free Consultation today.