ADOS. is flawed

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't even understand this debate. Autism isn't a disease or disorder with a specific known cause, like tuberculosis or Down's. It's a word doctors have decided to use to describe people who present with a particular set of characteristics and limitations. If objective observers perceive those characteristics and limitations then you "have" autism, by definition, no matter how or why you got there. And because there are different underlying mechanisms causing different people to fit that profile, there will be some people who meet the autism criteria today and do not a year from now, and others who will meet them forever. The ADOS can't be "flawed" because there isn't some other, more objective or accurate perspective to critique it from. If the medical powers that be want to declare that test the definitive measure of whether you have "autism" or not, then the word just has no meaning apart from the results of that test.

Autism is thought to be a lifelong condition. Early intervention is also thought to result in better functioning later in life. So there is a push to diagnose autism early, and immediately begin treatment. The debate exists because some parents were told their kids had autism and were pushed into expensive, time-consuming treatments, but it later turned out they had a language delay or a language disorder. This raises the questions as to whether the ADOS is really the best we can do.

If there's a "push" for early intervention for kids with speech or communication delays not for diagnosing autism. Early intervention methods are often the same because many kids don't have a diagnosis.

Mom of a language child - of course there is a push for early intervention. Speech therapy will not cure a child with a langage disorder. Nor should one go in expecting it. Nor will it make a child higher functioning like ABA is supposed to do for a child with autism. BUT, it will give your child the tools they need so when they are ready, they will be successful, especially with receptive language. The language comes in its own time but the stuff they work on is important so your child has it in their memory bank to draw from when they are ready to talk. I don't think speech therapy was helpful before age 3-3.5 but it was helpful in getting my child ready and understanding the routine and expectations.

You basically only have ABA, Speech, OT, PT (and depending on if you want to include art, horse and other therapies most of us don't have financial access to). So, in that sense they are the same, but how they are used is different. ABA was a huge waste of time for my child. He loved the provider but she didn't really understand language development and we didn't have any other issues outside speech so it wasn't helpful. But, I know other kids who do have autism and it was extremely helpful.

I am baffled by the bolded.

What do you think the term "higher functioning" means other than having more of the skills you need so you are more successful?

I'm not the PP, but as the mom of a child with severe receptive language issues, I know exactly what she means.

ABA for autism teaches compliance and skills. So kids learn to follow simple directions. Fill out the worksheets. Sit quietly at your desk. Tie your shoes. Button your shirt. Respond rotely when people say, "Hi, how are you?" Yes a child becomes "higher functioning" but it's often pretty limited.

Speech therapy for a child with a receptive language issue like for my child initially just got him to associate spoken words with items, like book, or ball, or car. Those single words he could hold onto and his vocabulary from ages 2 to 3 exploded with probably 100 words, almost all common nouns. If he could see a picture of something tangible, he could hold on to the idea and know what it was. We thought we were all set. But then his progress stalled dramatically.

It took us a long time to realize that he couldn't understand words put together. He couldn't blend sounds. He couldn't process what you were saying at all beyond single words -- but sometimes he could fake it, if he could pick out a few nouns and used contextual cues. This isn't anything that could be remediated with ABA, because it wasn't compliance oriented, or skill oriented; it was the fact that his brain couldn't process language.

And there's no fixing that, unfortunately. You can lay in a foundation with speech therapy so they have the most basic speech building blocks their brain can process, but you can't build beyond there for true speech until their brain is ready to move on.

So people need to understand the difference between the two therapies. My child didn't really need ABA because he readily imitated and eager to please, if only he knew what you wanted, so paying astronomical ABA prices was a waste for us.

Private speech therapy after about 5 years old also didn't do much. Instead, using Hanen methods at home and getting him into a language rich school environment were the most beneficial. The most important thing, though was just time. Time was the biggest "speech therapist" for us.

Hanen IS speech therapy, only it trains the parents to act as a therapist. This is effective because the parents spends way more time with a kid than any SLP could.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't even understand this debate. Autism isn't a disease or disorder with a specific known cause, like tuberculosis or Down's. It's a word doctors have decided to use to describe people who present with a particular set of characteristics and limitations. If objective observers perceive those characteristics and limitations then you "have" autism, by definition, no matter how or why you got there. And because there are different underlying mechanisms causing different people to fit that profile, there will be some people who meet the autism criteria today and do not a year from now, and others who will meet them forever. The ADOS can't be "flawed" because there isn't some other, more objective or accurate perspective to critique it from. If the medical powers that be want to declare that test the definitive measure of whether you have "autism" or not, then the word just has no meaning apart from the results of that test.

Autism is thought to be a lifelong condition. Early intervention is also thought to result in better functioning later in life. So there is a push to diagnose autism early, and immediately begin treatment. The debate exists because some parents were told their kids had autism and were pushed into expensive, time-consuming treatments, but it later turned out they had a language delay or a language disorder. This raises the questions as to whether the ADOS is really the best we can do.

If there's a "push" for early intervention for kids with speech or communication delays not for diagnosing autism. Early intervention methods are often the same because many kids don't have a diagnosis.

Mom of a language child - of course there is a push for early intervention. Speech therapy will not cure a child with a langage disorder. Nor should one go in expecting it. Nor will it make a child higher functioning like ABA is supposed to do for a child with autism. BUT, it will give your child the tools they need so when they are ready, they will be successful, especially with receptive language. The language comes in its own time but the stuff they work on is important so your child has it in their memory bank to draw from when they are ready to talk. I don't think speech therapy was helpful before age 3-3.5 but it was helpful in getting my child ready and understanding the routine and expectations.

You basically only have ABA, Speech, OT, PT (and depending on if you want to include art, horse and other therapies most of us don't have financial access to). So, in that sense they are the same, but how they are used is different. ABA was a huge waste of time for my child. He loved the provider but she didn't really understand language development and we didn't have any other issues outside speech so it wasn't helpful. But, I know other kids who do have autism and it was extremely helpful.

I am baffled by the bolded.

What do you think the term "higher functioning" means other than having more of the skills you need so you are more successful?

I'm not the PP, but as the mom of a child with severe receptive language issues, I know exactly what she means.

ABA for autism teaches compliance and skills. So kids learn to follow simple directions. Fill out the worksheets. Sit quietly at your desk. Tie your shoes. Button your shirt. Respond rotely when people say, "Hi, how are you?" Yes a child becomes "higher functioning" but it's often pretty limited.

Speech therapy for a child with a receptive language issue like for my child initially just got him to associate spoken words with items, like book, or ball, or car. Those single words he could hold onto and his vocabulary from ages 2 to 3 exploded with probably 100 words, almost all common nouns. If he could see a picture of something tangible, he could hold on to the idea and know what it was. We thought we were all set. But then his progress stalled dramatically.

It took us a long time to realize that he couldn't understand words put together. He couldn't blend sounds. He couldn't process what you were saying at all beyond single words -- but sometimes he could fake it, if he could pick out a few nouns and used contextual cues. This isn't anything that could be remediated with ABA, because it wasn't compliance oriented, or skill oriented; it was the fact that his brain couldn't process language.

And there's no fixing that, unfortunately. You can lay in a foundation with speech therapy so they have the most basic speech building blocks their brain can process, but you can't build beyond there for true speech until their brain is ready to move on.

So people need to understand the difference between the two therapies. My child didn't really need ABA because he readily imitated and eager to please, if only he knew what you wanted, so paying astronomical ABA prices was a waste for us.

Private speech therapy after about 5 years old also didn't do much. Instead, using Hanen methods at home and getting him into a language rich school environment were the most beneficial. The most important thing, though was just time. Time was the biggest "speech therapist" for us.

Yes, the best thing for development is development. But the skills that you dismiss as being "rote" are actually important and can be built upon. Barring expense, I still don't think you have made a case for why children with severe receptive issues would not benefit from ABA.

Well, besides the 50 grand, it's a huge time sink. 3 to 5 hours a day, and a parent has to be home. So kiss your job goodbye! And for what? It wouldn't bring in my child's receptive language any sooner.

And my child rebelled against anything that wasn't child-led. No way would he have tolerated ABA. As it was I wasted a lot of time on a speech therapist who wasn't child led. Once I told her she need to switch to the Hanen method, she couldn't believe how much better the therapy sessions went. A lot of "professionals" out there really don't know what they are doing.

That may be true, but it has nothing to do with ADOS .

[Anonymous]

Anonymous wrote:

Bouncing this back up; sick of all the posters saying "Get the ADOS" for a language-impaired child. DO YOUR HOMEWORK on the ADOS. Read the research on it - it has sensitivity but not specificity. It routinely overidentifies kids as autistic.

Autism diagnoses don't happen in isolation of just the ADOS. The diagnosis happens with a host of testing and input from related providers. Get a life. Geez. An autism diagnosis is not the problem; it's paranoid blowhards like you.