Autism Vox

Engaging Floortime (4): Where I’m coming from

by Kristina Chew, PhD on July 20th, 2006

Before continuing my examination of Dr. Stanley Greenspan’s new book Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate and Think, I wish to clarify “where I’m coming from” in regard to the educational and other approaches that have helped our son Charlie the most over these past nine years.

I am an ABA mother—-ABA being Applied Behavior Analysis. Charlie has done ABA since he was two years old. He has never done a Floortime program, though many of the exercises to evoke language and to develop play skills in Engaging Autism ring a familiar note to me, as Charlie’s ABA therapists, speech therapists, and teachers have always integrated similar techniques into their teaching, and my husband and I have used such techniques in our own interactions with Charlie (as an example, I note Greenspan’s description of how to interact with a child even while you are driving, “by having the child point out different license plates or speed limit signs and so forth” (p. 192) ).

I have written regularly about ABA and how Charlie has learned thanks to ABA on Autismland. If you go to the “Categories” section on the left, there is a link to the many posts in which I have written about ABA. And, from writing online about ABA and mentioning the Lovaas agency, whose model of ABA was created in the Psychology Department of UCLA under the direction of Dr. O. Ivar Lovaas, I have gotten numerous comments about “I hate ABA”; “ABA treats children like animals”; “ABA is the same as dog-training”; “Did you know Lovaas tried to cure homosexuality using ABA?”; “Lovaas used aversives including hitting”; “ABA is harsh, cruel, and inhumane”; “You have to live with your choices”; etc..

My position on ABA is summed up by something my husband, Jim Fisher, has written in a book review (February 2006) of the The Science and Fiction of Autism, which is by psychologist Laura Schreibman:

To her credit, Schreibman does acknowledge that claims of “scientific” validation for behavioral treatment rests on shakier ground than many ardent proponents will generally admit. She concedes both the flaws of a celebrated 1987 UCLA study that fueled claims of “recovery” from autism through the methods of applied behavior analysis, and the failure of subsequent efforts to replicate the original results. As an academic researcher (though hardly a scientist) I would not care to invest my reputation in a single study showing that 9 of 19 autistic children were “indistinguishable” from other children after receiving highly intensive behavioral interventions. As the parent of an autistic child, on the other hand, I would (and have) quit my job and moved halfway across the U.S. in search of an educational placement for my son grounded in these same behavioral principles, not so that he can become ‘indistinguishable’ from other children but so that he can be taught in the way he learns best.

Charlie did ABA intensively in a home program under the Lovaas agency when he was very young and—after a hiatus of a few years—-again has a home program overseen by the Lovaas agency. He has attended school programs that claimed they used ABA and DTT (discrete trial teaching) and did not really, with the result that Charlie’s academic and other learning did not progress and his behaviors became unmanageable and, indeed, dangerous to himself. He has attended, and is currently attending, a school program that not only says they use ABA, but that really puts its principles to work and not by teaching Charlie in a rote and rigid manner while he sits at a desk and does endless drills. This is the stereotypical view of an ABA program and, while it may be what is called an “ABA” in some programs, it is not what Charlie’s school or his home program does. It is thanks to Charlie’s current ABA school and teachers and to his ABA home program and therapists that he has been learning too read, to communicate and talk, to interact socially with his classmates, and much more, and that his self-injurious and aggressive behaviors are under control.

While Greenspan in Engaging Autism only refers specifically to Lovaas and ABA once (on pg. 252, where Lovaas’ model of ABA is described as working “on changing surface behaviors with structured tasks”), the entire book is an implicit critique of ABA. In chapter 1, “Redefining Autism and the Way We Treat It,” Greenspan notes that “for many years, the behavioral model—which did help some children fit into school and home life—was the only model” (p. 9), vs. his DIR approach which is presented as addressing a child’s “core deficits” and teaching “core abilities,” rather than just dealing with the “surface behaviors of tantrums, hand-flapping, humming, etc.. When words such as “limited” (p. 10), “idolated skills” (p. 10), “repetitive” (p. 18), “structured” (p. 252) appear in Engaging Autism, ABA is implicitly being referred to.

So, yes, I read Engaging Autism with a critical eye. I know parents who have done Floortime and seen their child do very well; I know that the kind of intensive ABA that has taught Charlie so much is not necessarily the best method to teach other autistic children. It is a truism in Autismland, but I will write it: When you’ve met one autistic person, you have met one autistic person, and the next person will be different.

Nonetheless, I have decided to devote a series of posts here on Autism Vox to Engaging Autism in part because of Greenspan’s views on how autism develops–on how the parents can contribute to putting their child “at risk for ASD.” These views are at the heart of his Floortime approach; these views implicitly resuscitate the refrigerator mother theory of autism. And while we say that “no one believes that any more,” I am not so sure.

I will consider Greenspan’s views on how to address behaviors from the self-stimulatory and “avoidant” to those that are dangerous and aggressive in my next post on Engaging Autism.

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