The following is a detailed analysis of the responses to the two different questionnaires. The full questionnaires and answers are summarized in tables in the appendix (please see appendix E and appendix F).
The response rates to both questionnaires were relatively good. From the parents, 6 out of 15 returned a completed questionnaire, giving a response rate of 40%. From the teachers, therapists and other school staff 13 out of 23 returned a completed questionnaire, giving a response rate of 56%
Background of parents and children
All 6 respondents to the parents' questionnaire were the respective mothers of the children with autism; no fathers, carers or other relatives responded directly. The ages of their children ranged between 9.2 and 10.7 years (median = 9.9) and all except for one had only one child with special needs. This particular mother reported to have another son (aged 13 years) with autism and additionally severe learning difficulties as well as Attention Deficit Hyperactivity Disorder (ADHD).
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The parents heard about the school with an ABA programme from different sources. Two of them were referred by friends; two found out about it on the World Wide Web, one was referred by a doctor and one by a charity called PEACH (Parents for the early intervention of autism in children). The motivations of the parents to send their child to the school were also different: for four parents it was particularly because of the school-based ABA programme - one of these four even followed an ABA-program at home before while another one wanted to switch to an Applied Behaviour Analysis-based intervention as she didn't feel that her autistic child was making any noticeable progress at the Local Education Authority (LEA) school. Another parent had trouble getting funding for the desired home-based ABA program from her local council and so opted for a school-based approach (which the local council agreed to fund), while the last respondent merely indicated that the school was "what she wanted".
The duration of those 6 children at school ranged from only half a year to over 5 years, giving an average of 3.5 years and a median of 3.8 years.
Teachers' experience with and views of ABA
The 13 teachers/school staff who participated in the questionnaire had very different levels of experience. Experience levels measured in years ranged from just under 1 year to 11 years with a median of 3 years showing a very wide dispersion of the results. The average experience of teachers' was 4.3 years. 12 out of the 13 school staff were real teachers, 1 indicated to be "other school staff".
Asked about the limitations and risks of Applied Behaviour Analysis, teachers replied that ABA might not be suitable to all children with autism and that the main risk is that children can become "prompt dependant" or dependant on one-on-one support, which may restrict their social skills development in the future. Teachers also noted that Applied Behaviour Analysis is a very rigid and intensive way of teaching which can be hard to follow, putting a lot of stress on the families, and if not applied properly it could be detrimental to a child's progress. Other teachers / therapists also mentioned the lack of secondary provision after the child leaves the particular school (which is primary only) and that the program is very expensive. Unfortunately, only 11 of the 13 teachers replied to this question.
Parents' knowledge of, experience and involvement with ABA
From the six parents responding the questionnaire, 5 described their knowledge as "very good", while one felt that she had "some knowledge". Also, 5 out of 6 had some previous experience with Applied Behaviour Analysis principles, either through a home-based program or another ABA-lead school. One parent also applied different, more specialized forms of ABA before, such as "leap led" Applied Behaviour Analysis approach, independent Verbal Behaviour (VB) programme and Lovaas.
Interestingly, the teachers' responses to the question regarding parents' knowledge and experience is very different: teachers find that the knowledge level of parents varies a lot and on the margin, parents have far too little understanding of the ABA-approach. They see a direct relationship between the level of interest a parent shows to his or her level of knowledge and stress that the school is already offering a lot of information to parents in order to keep them up to date about their autistic child's behaviour programme. Teachers believe that the involvement of parents in their child's Applied Behaviour Analysis program is very important. The main benefits in the eyes of the school staff are consistency and continuity in the way the child is worked with, especially in the initial stages of the ABA-program implementation. However, teachers complain that most parents are not involved enough in their child's ABA program. Most suspect that the reasons for this are simply a lack of time, interest, knowledge and in some cases also their bad commandment of English. Some also say that parents simply need much more support.
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All of the parents have seen improvements in their autistic child's behaviour since following the Applied Behaviour Analysis programme at school. Most parents saw improvements in the communication of their child, some additionally noted improvements in skills, behaviour and confidence. No difficulties have been reported except for nail-biting in 2 out of the 6 cases.
Usage of ABA at home
Teachers believe that using Applied Behaviour Analysis outside of school (e.g. at home) has a number of advantages for a child with autism. Mainly it reinforces what the child has earned at school but more importantly it provides consistency to the child, allows him to generalize behaviours and potentially learn more behaviours and skills. One teacher thought that it is not possible to generalize the advantages for all children, another one thought that its good to follow ABA principles when dealing with behaviours of the child, but not useful to use in all situations at home.
However, the 11 out of 13 teachers also identified a number of risks with using ABA outside school - 2 of the teachers thought there were no risks at all. The main risk identified was that parents would need to be properly trained in order to apply ABA correctly and consistently with the way it is done at school. Otherwise, children could get confused, maybe unlearn some of the good behaviours and skills that they have acquired at school and possibly even get frustrated. Teachers also mentioned that children could become easily "prompt-dependant", that Applied Behaviour Analysis is not a natural way to educate or treat children and if applied throughout would create an unrealistically structured world for the child with autism. One teacher also mentioned that using ABA both inside and outside school could be too much for children, as the program is very intensive.
Of the six parents participating in the questionnaire, 5 currently use ABA principles at home. However the intensity varies a lot between the families. One mother indicated she used it 80% of the time, two moths use it in the evenings or on Saturday morning, one mainly for toilet training and the fifth mother gave no clear indication of how much she used it but said that she would use it "to generalize what is taught at school". Asked about whether they would consider using ABA more at home, parents' opinions seem to be divided: three replied that they would not use it more, or only if a new problematic behavior would emerge, while two said that they would like to use it more, e.g. during school holidays. One of these two said that she would need more support and training. The sixth mother gave no response at all to this question.
Teachers and therapists believe that the main reasons why parents do not use Applied Behaviour Analysis at home are linked to a lack of the necessary time and knowledge. Some teachers also believe that other family commitments, e.g. other children and partner, and a lack of support play a role in it. One teacher suspects that some parents may disagree with ABA and that there might not be enough communication and trust between the parents and the school.
Asked about how parents could be encouraged to use ABA more at home, teachers believe that both training and home visits would be most important. Two teachers also think that a better communication between the school and the parents would help, while some suggest that parents should visit the school more often and, for example, attend workshops or just observe their child in classroom. One teacher also believes that more funding is needed to get parents more involved in Applied Behaviour Analysis programmes at home.
Finally, parents were asked about any other intervention techniques they used to treat their autistic children. Two of them answered that they were using the Relationship Development Intervention (RDI), one tried the Son-Rise Programme and yet another mother uses a gluten casein free and OT free diet. The two remaining parents indicated that they were not using any other interventions.