ABA Programs for Kids with Autism – Dr. Gary Brown
This was the book that started this blog, and if you’ve read the first post from this blog then you already know that this is not going to be a positive review. I promise that there are some very good books out there that I’ve read, it just seems that all the books at the beginning of my library have been ones I have less than favourable opinions about.
I have yet to read a book as bad as this one.
Before I even start on the content, I estimate that about 30 – 40% of this book is the same few sections copied and pasted over and over again. There is a section in the book about what Time-Out is and how to do it and it is repeated at least 5 times (copy-paste so identical) throughout the book. Possibly more. So there’s that before you even start getting into the content.
I honestly believe that the person who wrote this book should not be working with autistic children, and the fact that he has spent 30 years working in the field concerns me. The very first program he describes is how to get eye contact from children because, “Obviously, a child has to make eye contact with caregivers, as well as peers, in order to learn.” Do you know what? My eye contact is, and always has been, at best infrequent and at worst non-existent and I had no trouble learning. In fact, if I’m making eye contact then I’m probably not listening or learning because I’m expending so much energy trying to make my eye contact look ‘normal’. The whole eye contact obsession is incredibly frustrating, especially when it has little impact on actual learning or bonding. Anyway, near the end of the section on eye contact we get this gem:
Some children start making eye contact, then go through periods of refusing to make eye contact on command even though eye contact has been established. When this happens, put the child in time out and sit beside the child. Tell the child that he/she cannot get out of time out until they make eye contact. When the child makes eye contact, they get out of time out, but do not get a reinforcer.
Brown advocates putting a child in time-out for not making eye contact on command. Do you know what makes my eye-contact drop from infrequent to non-existent? When people start demanding that I make eye contact. Who is it hurting if an autistic child doesn’t make eye contact? This is just one of many examples throughout the book of Brown stating that a child should be put in time-out for ridiculous reasons. He states that a child should be put in time-out for not following an instruction:
Of course the child will not always comply and follow the direction. Whenever this happens, do not say anything, but immediately go get the child, tell the child that he or she is going to time out for not minding, and put the child in time out.
Other times you should put a child in time out include if they tantrum (including if the ‘tantrum’ is as a result of sensory problems), if they child exhibits self-injurious behaviour, if your child ‘misbehaves’ in public (bearing in mind that supermarkets are some of the most sensory overloading places to be in), for repeated vomiting (he just assumes that any child that does this is doing it as avoidance or as a means of gaining control), if the child ever says “no” to a request, if a child doesn’t “hurry up” and complete a direction quickly enough, and if a child is aggressive (this last one is probably the only one of these situations where I might consider using time-out).
Time out is generally not effective for autistic children, and even if it were there is absolutely no reason to use time-out in most of these scenarios. To put a child in time-out for responding negatively to sensory overload is horrible. All these repetitions of time-out teach a child is that they get no say in their life and that their feelings do not matter because an adult is going to make them behave in a way the adult wants whether the child wants it or not. By putting a child on time out for ‘non compliance’ or saying “no”, it teaches them that they have no power and no right to say no to anything.
Speaking of which, the whole book is basically filled with the idea of forcing compliance in all situations from your child. Here’s part of the section on “Increasing Compliance in Children”.
Stand the child up with his/her back against the wall. Hold them by their shirt and say the child’s name followed by “come here”. Gently pull the child to you. When the child gets to you, praise them and then push them back against the wall and repeat 10 times.
He calls it error-less teaching. I would argue it’s just another way of showing a child that an adult can always make them do what the adult wants.
Basically the whole book is filled with everything that makes people (both some parents and autistic people) hate ABA with a passion. Brown says that children should be given “treats” for successfully completing the tasks put to them. Even in the above “error-less teaching” you hand over a sweet or “treat” each time the child is pulled towards you. If this sounds a lot like dog-training to you, well then you’ve just seen a lot of people’s problem with traditional ABA.
Then comes the section on “Eliminating Self-Stimulatory Behavior”. Here’s the thing, stimming is by and large a functional means of self-regulation in a chaotic and confusing world. I would only advocate intervening in trying to redirect a stim, if the stim were in some way harmful to the child or to another person, or I would relocate a child if the behavior were completely inappropriate (such as when autistic children exhibit mastubatory behaviors in anywhere but their bedroom). If a child stims by pulling out their own hair or by pinching themselves, then I would attempt to carry out a Functional Behavior Analysis or Sensory Analysis to find another behavior that might be able to replace the harmful one. All the other stims that aren’t harmful I would never even consider trying to eliminate, because they are not hurting anyone and they provide a function to the child. Brown advocates the use of overcorrection to elimate stimming:
In overcorrection, clap your hands together loudly and tell the child “no” in a firm tone whenever he or she self-stims. Then the child is told or made to practice a correct or incompatible behavior to the self-stim behavior. The goal is to “overcorrect” the environmental effects of the inappropriate behavior and require the child to “overly” practice appropriate behavior.
So per Brown’s examples: if a child licks an object or puts it in their mouth you should make the child brush their teeth, tongue and clean their face; for hand flapping you should hold their hands stationary; for head weaving you should hold their head stationary. Failing all that he suggests parents look into drugs.
I could carry on but I’ve probably made my point. This is, to date, the worst book on autism I have read. If it were neurotypical children Brown were saying should be restrained and held in time out for not making eye contact or for not responding quickly enough to a direction then very few people would be willing to follow his advice; but because it’s autistic children it has received 5 star reviews on Amazon. There is very little positive to be found in the book – what little is there certainly does not justify going through the rest of the book to find. In my opinion, the information in this book is at best horribly misinformed and at worst borderline abusive.