Reply to 4 year old new autism diagnosis

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]OP here. My private insurance already covers unlimited sessions of speech therapies for my 4 year old WITHOUT autism diagnosis. He has been doing 7 sessions/week for speech therapies through EI (public) & private for his speech delay (apraxia of speech).

The ADOS doctors say that the autism diagnosis is not solely based on his limited speech, but it is more about his social behaviors. He is self-centered, imitate people conservation without understanding the meaning, not aware of the other's people emotion/reaction etc., and he has been followed by different developmental pediatricians from children hospital since he was 15 months old suspicious of spectrum but cannot get the conclusion. It is just now that it is the first time he did the ADOS test from children hospital time (almost 18 months waiting list) that they give him an autism diagnosis.

I will continue to do speech therapies through ST, and they recommend ABA therapies & OT for his social communication behaviors. They recommend 25-30 hours/week of ABA therapies, is it too many hours or standard for 4 year old that is in private full time daycare? What ABB therapist do actually? As a social behavioral therapist to model correct behavior? And, they recommend me to pull him out from private full time daycare (even he is happy & learning at his own pace there), but put him in special need public preschool program (I bet autism diagnosis make him definitely eligible for the program)? I don't know about that. [/quote]

There are lots of problems with ABA.  Evidence from research shows it can help with developing life skills and rote language responses, but in practice it doesn't always work.  It is a huge time commitment, 20 hours a week or more is common.  10 hours is the fewest I've heard of.   It can be very taxing on both parent and child.  Some autistic adults claim that the ABA they had as children did them more harm than good.

ASD kids often have a deficit in social learning.  They don't learn basic skills spontaneously by watching parents and other kids. ABA therapy uses a reward system to teach these skills explicitly.  So if you want the child to come when called, you show them what to do, and if they do it, give a reward.  This can take many trials, and there are a lot of skills to learn, so that's why there are so many hours involved.

Here is some more on ABA.
https://www.autismspeaks.org/applied-behavior-analysis-aba-0

It's hard to say if your kid would do better in a special needs preschool.  There is benefit to being with NT peers and there is also benefit to focused SN learning.  I'd visit at the SN program and see if it is right for your child.  Ask them lots of questions about what they do and how it will help your kid.

Every kid is different and you know your child best, so there is no one right way to go.  I think most of us go on a combination of professional advice and parent instincts.

Hope this helps. [/quote]

You are basing it off of what you don't know or tried.  We did 4 hours - 2 two hour sessions.  We were offered a lot more but no provider had the time nor was it necessary.

For Apraxia you want a prompt trained therapist 3-5 days a week.[/quote]
The ABA studies were done with many hours per week for years. There's a reason for that.  If you got everything you needed in 4 hours, more power to you.  But that's a  unusually short amount of time for any type of therapy - psychological, speech, OT, whatever.  So count yourself exceptionally lucky.  I don't think OP should expect.that going in, especially when the doctors who have actually seen her child suggest a lot more than that.[/quote]

Every child is different so their need is different.  Its easier for doctors to put in the high referral hours and let parents decide.  We didn't need the 4 hours and I dropped it after a few months as I didn't see the value.  I am not worried about what a study says as that is not specific to each individual child.  Those studies were also probably kids with behavioral issues, moderate or severe ASD not the "high functioning."  Most doctors see kids for an hour some less and are just throwing all supports at kids to see what helps trying to be helpful.  4 hours a week of one service when you combined with with others is not a minimal amount of time.  My child is doing very well so clearly what we choose worked for ours.  OP should try it and then decide what is best for hers.[/quote]
You said "4 hours" not ""4 hours per week."   Now it makes sense. Four hours per week is certainly possible.  But you also didn't see the value, which may either mean  more hours would have been helpful or it wasn't right for you anyway.

We did behavior therapy with about 6-8 hours a month.  But it wasn't traditional ABA, it was mostly parent training, where we implemented the program ourselves.  And it was very focused on executive functioning with an older child.  [/quote]

Behavioral therapy is different from ABA, so one would assume its 4 hours a week.  It was very different than yours but the woman basically just played and was very sweet so I don't get the entire its horrible as it wasn't, it just wasn't helpful either because of who my child was.  For behavioral issues, parent training and how you did it makes a lot of sense but ABA isn't really parent training depending on the therapist and they do most of it.[/quote]

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