ABA program in school
For the purpose of this research one set of questionnaires had been handed out to each family having a child attending the particular school, summing up to a total of fifteen questionnaires. At the intended end of the time period fixed to participate seven of the fifteen forms have been returned properly by the parents. As one of it was completely blank and therefore of no applicability it was removed and excluded from further processing. The six remaining questionnaires made up an answer rate of 40% in total, what seems more than reasonable for a study of this size and give a good research basis.
The first question which looked at the relation between the voluntary participant of the research study and the child attending the school revealed that all six individuals who choose to take part are the child's mothers. There was not one single father, legal guardian, foster carer or otherwise related person involved.
The different answers to question number two discloses that all six children of the participants are aged between 9 and 10 years, with the youngest being 9 years and 2 months old and the eldest 10 years and 8 months. No parents/carers of younger children choose to take part in the study, and those of older children are unlikely to be involved with the school as it is for primary students only.
Question three tried to find out if parents/carers with children attending the ABA lead school do have further children with additional needs to look after. Only one mother reports that her autistic child has a 13-year old brother also with autism and additionally severe learning difficulties as well as Attention-deficit hyperactivity disorder (ADHD). All other 5 women confirmed not having another child with special needs; one even mentioning to have a neurologically typical (NT) daughter aged 12.
The questions number four focused on how parents/carers found out or heard about the specific school providing an applied behaviour analysis approach. Two out of the six participants were advised by friends about the school, one mother states that it was her child's doctor/therapists suggestion and one parent refers back to the PEACH charity. Further two parents mention the World Wide Web as their source and one of them additionally heard from the school through another school offering the same approach.
Following up the last question, query number five further investigates why those parents finally chose this bespoken school. Parents responses do not yield apart very far from each other: either an ABA lead school was clearly the first choice of education for their autistic child or because an ABA approach is already established at a home programme and the benefits and advantages of carrying on the same approach is obvious. Further the participants highlight their strong believe and favour in such an individual educational plan and the given individual attention, no progress at other special educational institutions/with other interventions such as TEAACH or the Local Authority only willing to fund an ABA school programme (but not an ABA home programme as initial wished).
The time the children of the research attendants are already being educated in the chosen school varies between just under half a year (5 months) and 5 years (5 years and 4 months) as certified by point 6. The maximum time a child can follow the programme in this school is from age 4 to 11.
Starting with query seven, the focus shifted a bit more towards ABA in detail. First, the participants were asked to rate their own knowledge of this therapy form for their autistic children and therefore were given a scale covering different - from expert knowledge, over solid understanding to not familiar at all - levels of understanding. Expect one answer, all reflect an own evaluation of a very good understanding of the principals of ABA by the parents. One mother rates her knowledge lower than the other, stating she has only some knowledge.
An overview of previous experience and of what kind before the child started to attend the school offering an ABA programme was the aimed outcome of question number eight. In general, 5 out of the 6 carers confirm previous experience within the applied behaviour field; only one parent had his first engagement with ABA just with his child's entrance into school. Four of the already ABA experienced families gained their knowledge and skills through earlier established ABA home programs - following it between six years, four years, two years and six months. One of those families additionally applied different other, more specialized forms of ABA, such as "leap" led ABA, independent VB program and Lovaas. The sixth participating family had their child placed in another ABA lead school before and where therefore familiar with the principals.
The next two questions (ninth and tenth) in the form were asked to analyze any improvements and difficulties recognized by the parents in the children's development since they started to follow the ABA approach at the school. Improvements in communication (four times) including speech/language (twice), manding (once), signing (twice), understanding (once) and vocalization (twice), behaviour (three times) and self-help skills/self-dependence (three times) were noticed mostly by parents. Further, progress in social skills was mentioned by two mothers. Other positive appearances were reported by the carers in the field of reading/writing/mathematics, confidence and awareness.
Regarding difficulties that may arise, parents were directly asked what kind of problems they have experienced since sending their child to the particular school. Although one mother noticed a bad (new) behaviour - biting nails - with her child (she assumes triggered through frustration or imagination), all participants reported no (significant) developed mental issues with their children.
The eleventh question directed to the parents/carers aimed to evaluate the usage of ABA outside of school hours. Although the major part (five of them) of the volunteers of the research study do follow an ABA program at home for their child, the intensity, chosen level of input and the applied principles vary greatly from family to family. The intensity of additional ABA principles outside of school hours chosen by the individual parents ranges from a broad coverage of around 80% of all the time the child is at home over to about 12 additional hours under the week to less intense evening and/or weekend top-ups only to some families using ABA only for some single principles such as toilet training or behaviour teaching. The parents who decided too also follow an ABA approach at home state do so mainly as they believe that this creates more routine and consistence and less confusion for their children and would lead to better outcomes in communication, homework, daily tasks and their general approach to the child. In overall they choose additional ABA hours at home as kind of a safety net and to generalize what is taught at school.
With the next question (twelve) parents/carers were confronted with the inquiry if and what could/would change their idea about using the amount of ABA outside school they are currently using. From the five families applying ABA at home as well, one family thinks that ABA could be helpful during holidays, especially useful with social skills and behaviour issues, but although they would like to increase their current ABA usage they also feel that their child needs proper holidays and therefore they simple lack enough amount of time for more hours of the home programme. Another parent would also be open to increase the outside of school hours with ABA, but clearly says that they need more training and proper support to realise this step. A further family is happy with their arrangement at the moment, but if a new behaviour would emerge or a particular task to tackle they might consider additional hours of ABA outside school, although they are aware that it would be very difficult to find the necessary time for doing so. One party would not change their current input at all and the only family not using ABA at home at all is also confident with their choice, not planning any implementation of ABA outside of school so far. One parent did choose not to reply to this point.
The thirteenth and last question directed to the parents/carers of the autistic children attending the school offering an ABA approach summarizes that four out of the six parents have tried other intervention than ABA at home, including gluten casein free diet and OT sensory diet, the son rise program and Relationship Development Intervention (RDI by Gutstein).
Two mothers made usage of the provided space for personal comments, suggestions or individual opinions. Both of them particularly highlight the progress done by their children by being in an stable ABA program in school as well as at home, and they also refer back to their children's education before they came to the specific school and their negative experiences with the local special needs schools. One of the respondents mentions that one big issue for parents not being more involved in their children's ABA program might be their unavailability and possibility to bring and pick up their children to and from school, and thus not being able to communicate to the school's ABA team, ask for advice or work closer together.
Questionnaires have not only been distributed to parents/carers of children attending the particular school, but as well too in total 23 teachers/therapists/otherwise specified school staff. After the previously agreed time for responding of four to six weeks thirteen out of the 23 school's employees had opted-in for the research study and handed in a completed form. This respectful return rate (56.52 %) well exceeds the 50 percent mark.
The first question on this questionnaire which aimed to figure out how long and in what position the participants have been and are involved with the ABA program, presents that nearly all of them are teachers (twelve out of thirteen) and only one participant falls into the category of "otherwise specified staff". Their involvement covers a range from as short as ten months to the longest period of eleven years (an average of ...).
Question number two leaded directly to ABA and reveals that the 13 participants do see a quite huge variety of limitations and risk associated with the applied behaviour analysis approach. The main concern seems to lie in the very rigid way such an approach is conducted and in the many existent misconceptions, and that, if not applied properly ABA could rather be detrimental to a child's progress than adjuvant. Further, some teachers express their fear that an autistic child could easily become prompt dependent on one-to-one support, which in turn might restrict his social skills development. Other points mentioned are the strength put on families due to the high intensity of such a program, the lack of secondary provision when children leave the primary only ABA lead school, the difficulties in the consistency with highly specific procedures and to follow through consequences and reinforcement. Additionally one teacher highlights the fact that ABA is not suitable for all autistic children of all levels.
The participants' answers to query number three seems quite concordant, with most of them agreeing that the knowledge of parents do vary immensely. While some parents do have a good to high understanding of the ABA philosophy in general and the principles in particular, others do not have it at all - the point done by some of the teachers at this stage is that the more parents are interested and thus also involved in their child's ABA program, the higher is their knowledge in turn. The answers also emphasise that although some parents are (very) knowledgeable, they find it difficult to apply principles properly everyday, need more training to continue the program outside school and often struggle with English as a second language barrier. One of the teachers/school staff rate the parents' knowledge as being 25 % present and 60 % non-present, while three out of the thirteen feel parental interest in ABA as hardly to none existent.
Question four was directly related to the above question, and so are the different answers. Again there is a consensus between the participants of this research study that parental involvement with the ABA school program depends mostly on their interest in general; the more interest they show, they more they are likely to get involved. Additionally researcher particularly highlight that the school constantly keeps the families up to date regarding their children's behaviour plan and individual ABA plan, but not all choose to follow through it and even the more interested parents need lots to encouragement to involve themselves in their child's program. The degree of parental involvement in the eyes of the school's employees varies greatly from 60 % involved to one third are involved over to "as much as they can be involved" to "not that involved" or "little to none involved" and even "majority not involved".
Within query five teachers were asked to rate the importance of the parent's involvement in ABA outside school hours from their point of view as professionals. Eleven of them declare additional ABA hours at home as quite, very and even highly important for a success as this approach only works effectively when done consistently over a child's day/week. As parents know their children best, with an extra ABA home program they can provide not only this consistency, but also continuity and generalization of skills taught in school. One person mentions the specific importance of ABA in the initially stages of implementation (first 2 years) and also states that the need to carry on ABA out of school hours may depend on the individual needs of the child. Another individual notes that although a general understanding of ABA principals may well be of advantage, a solid comprehension of the child's behaviour and skills it much more relevant.
The following two questions (number six and seven) focused on the teachers/school staff perception of advantages/opportunities as well as disadvantages/risks for the autistic children to be exposed to ABA not only in school but also in additional home programs. Extracted from the given answers the clearly advantages mostly referred to are the higher consistency across school and home and the generalization of social, language and independent skills and behaviour. The teachers see the benefits of additional ABA hours at home not only in the reinforcement what a child learned at school, but also in the possibility of a better structure to establish routines. Those in turn are beneficial for the autistic children to better understand and know what is expected from them and what behaviour is acceptable. Further, advantages in the reduction of unpleasant behavior and reinforcement of desired behaviour as well as developed independent skills and socialization show up on the replies to the question. Opportunities for practice and parental training are mentioned as well.
The main risks in parents following an ABA home program identified by this group of participants are the consequences of the lack of correct training, missing supervision by qualified professionals, inconsistency as well as misunderstood/misapplied/misused principles and procedures. All this can confuse children as they have to deal with inconsistent approach, hindering advancement and successfulness, undesired behaviour might be instilled and earlier learned skills unlearnt. The schools' employees also mention the very rigid and restrictive traces of ABA and the possible interlinked side effects of missing time to focus on socialization and overburden for the children. Further they point out that ABA is a highly structured approach not treating children in a neutral, normal way and creating an "unrealistic" world for them. Thus it becomes very difficult to them to develop flexibility and dangerous to become easily prompt and one-to-one dependant. Only two respondents do not see any disadvantages/risks in ABA.
With answers to question number eight, teachers/school employees try to list up reasons why they think that parents/carers do not follow the ABA program at home. The main barriers, mentioned from over half of the participants, include time constraints/busy lifestyles and the lack of knowledge/resources: parents too often simple do not fully understand the supporting principles of ABA and do not know the correct procedures to deal with it. Further counting to the top problems of such a rigid approach is the obvious non-practicality of such a program, the complication of family life and having other children (not following ABA) to look after - it is very difficult to set and follow one set of rules for on child and another set for another child. Two teachers touch the point that families sometimes just do not follow the ABA approach at home as they simply disagree with it or do not fully belief and trust it - the example is given that it is very hard for parents to cope with tantrums/negative behaviour and parents do not always appreciate that ignoring an undesirable behaviour will eventually lead to its extinction/replace it with more acceptable/sociable behaviour. This is due the natural of parent to wish to discipline their children. Not enough school-parental relationship/communication, lack of awareness, information and understanding of the importance of consistency and missing interest in additional work at home are other points referred to in the questionnaire. One answer simple says: "With proper support there is no reason not to implement an ABA home program".
With the last question (ninth) the researcher tried to find out what the school staff would recommend as a better support and encouragement for parents in behavioural management of their autistic children at home. The responses are clear and mainly contain the suggestion of regular training classes/workshops/lectures for the parents, repetitive meetings in school and opportunities of school-based observation and enforced home visits/home intervention programs by teachers and ABA consultants. The participating teachers also clearly say that a much better relationship between school and families is needed as well as a more open communication so that parents can ask for help, are given constant advice and are more confident with home visits - those are already offered by the school, but not all parents make usage of it or do allow it.
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