One of our Autism ABA Help members got me thinking this morning about home versus autism school programming. Her son is in an ABA program – an approved private school or private ABA program. But he hasn’t been making much progress. So today’s all about whether an autism school or home ABA program is right for your child or client with autism.
This is a question I get a lot: “which is better, home ABA or school ABA-based programs? The truth is, there are so many variables. People from all over the world have different circumstances, different funding streams, and different options.
Whether you’re calling it the center, school, program, ABA, non-ABA, life skills, autistic support, inclusion, or typical preschool it doesn’t matter. There are certain variables that make it so complicated for each individual.
That’s why I decided to write out some of the variables that can help us decide what the best situation is for each child or client.
But in this blog we’re not going to really talk about ABA versus non-ABA. We’re just going to talk about programming in the home versus at a center/school.
Ask yourself where your child or client would be if they were typically developing. Under age five a child would be mostly at home, or in daycare, or at home with preschool about three days a week. For kids over five (the age of kindergarten), school is where neurotypical kids would be placed.
In addition to the age of the child, we also have to think about the work status of parents, grandparents, and other care providers. If a parent works full time and if the child were typical, they’d be a daycare or preschool. Or maybe the grandparents watch the kids.
It’s really important to figure out if there is one parent or caregiver in a home situation that has the time but also the interest in learning to deliver therapy.
With some of my former clients, both moms and dads worked full time and between the commute and everything they were gone like nine hours a day. In one case, the child was being watched by the grandmother and I trained the grandmother to deliver the therapy and to be the center of the child’s programming. I also trained mom to do it in the evenings when the grandmother wasn’t there. In another case, the child was being watched by a relative, but they were not into doing anything extra for the child in terms of therapy. So in that case, mom decided to pull the child back to her home, stay working nine hours a day, but hire a nanny to be the center and to have the speech therapist and behavioral therapists come in to run the programs.
The little boy that was being watched by a relative was banging his head on soft and hard objects three hours a day. When I started observing him, he had an open lesion on his head that we had to fix. As I was interviewing and assessing, I asked the parents and relatives, when was he banging? How hard was he banging?
He banged on the high chair. So I asked if they could get a shorter chair with a booster seat. He was banging in the pack and play in the crib because he was expected to take two naps a day. He was banging before he fell asleep and banging when he woke up. I suggested he take one short nap a day and as soon as he was awake he should be picked up and engaged. The boy needed a caregiver that was going to implement these changes and keep him safe.
Then there are other factors such as siblings, functioning level, and other diagnoses. I had a client once with autism, he was two. He also had a severe diabetes with a pump. I’ve had kids with severe anaphylaxis. I’ve had kids with other syndromes that needed a nurse. These are all factors that could make center-based programming not in the cards.
I do think that functioning level is something that I would consider as well. I remember when I was in my second due process case when Lucas was like nine or 10 years of age, he transitioned back from an approved private school to our public school and the teacher went out on her second pregnancy leave. Nobody knew what they were doing. I remember another behavior analyst that knew me pretty well and was working with me in a verbal behavior project. She said, “you know what to do, why don’t you just homeschool Lucas?”
And I was adamant, I was already working as a behavior analyst. I was like, no, I do not want to homeschool. I’m already working. I’m already becoming a leader in the field. There’s a lot of kids to help. And I need Lucas to go somewhere for six hours a day so that I can do my life and have goals. It’s a lot of time to have a child home.
Now, if it meant Lucas would be very high functioning and it would mean the difference between him going to college or being very disabled, I would have thought differently. And I knew it was a shorter term thing where I could fix it and then I could get him somewhere else. I knew by age 10 that Lucas had moderate to severe autism, and had a mild intellectual disability. He was not going to progress to college and be fully conversational.
If I had a kid who I thought that I could really make progress conversationally, you know, under age eight, I would try as hard as possible, especially if the child is making pretty good gains. When Lucas was under eight, I blasted full tilt.
For me, though, I always wanted somewhere for Lucas to go for six hours a day.
So, those are the factors: age, work status of parents and caregivers, funding streams, functioning level, and so on. Parents should really be thinking, “is this going to be pivotal in changing the trajectory of where my child’s going to be?”
For instance with Lucas at age 10, is that really me homeschooling? Is that going to change his trajectory of where he’s going to be at 12 or 18 or 25? I didn’t think it would.
When Lucas was three, right when he got his diagnosis and right when he was ready to go to the three to five programming, the program that was recommended was in the middle of the city. Lucas had just finished a year of two-year-old preschool that had an excellent reputation. I had developed a home program in my house, in the suburbs, and the three to five year old program that was recommended was in the middle of the city – in a gun zone. They could not do any outside playground time because it was in a gun zone.
I would’ve had to drive him, but I also had Spencer who was 18 months younger. I would’ve had to take my 18 month old and my three year old essentially nonverbal child and drive both of them into this gun zone in the middle of the city. At the center, I think there was 15 minutes a week of one to one time. Studies show kids needed 40 hours a week of one to one time and this place was only going to give him 15 minutes a week. Plus, every six weeks, because of funding, they would take like a two week break. So they didn’t take summers off, but they had this scattered schedule.
Or Lucas could stay at my home with his 40 hour per week program, which was proven. We had a yard with a fence. He could go outside, he could return to his typical preschool with one of his behavioral therapists. One option was much safer.
In Kelsey’s situation in podcast three, as she was driving him he was banging his head on hard surfaces a hundred times a day. He would run out of the door and three blocks away when Kelsey was trying to drop him off. Safety is a big issue.
In addition to the center or school having safety, you also want to make sure that the time during the school day is appropriate. They should be working on skills that your child or client needs, not skills they already have or skills that are too hard. These skills should be functional. This will depend on the age and ability level of the child or client. As your child or client gets older, say 10 or 12 or 14, start to think, no matter what the functioning level is, of where they are headed. What skills are really going to be appropriate for them to learn?
We hired Au Pairs for a good 10 years of Lucas and Spencer’s lives. I remember one of our old au pairs coming back after not seeing us for three or four years. And Lucas was probably eight when she was there and 12 when she came back. She said his independence skills with chores and showering and all that stuff had really improved. But she didn’t see a ton of gains with language. And it wasn’t because we weren’t trying and we weren’t working on that. Just recently Lucas answered his first “why” question spontaneously. We were walking in a parking lot of a restaurant after we ate. I work with him a little bit on why questions like, why is the pool closed? And he knows to say “because.”
So I go, “Oh, Oh, be careful. It’s slippery.” It had snowed a little bit. I said, be careful. I asked him, “why is it slippery?” And he said, “because it snows.” He could see the snow, but it still was his first spontaneous answer to a “why” question.
Lastly, is your child happy to go to a center or a school? Or if they haven’t gone yet, do you think they would be happy? See what the school knows about autism and autism therapy. Do they know about pairing? Do they know about the power of manding or requesting?
For instance, if I were picking a daycare for a typically developing kid and I went to a daycare and the teacher was like, “Johnny, stop that.” And “all right, the jump rope is going away because you guys can’t share.” Then I went into another daycare and the teacher said “I like the way you’re sharing. That’s so awesome.” I would pick the positive environment over the negative environment for my child.
When you’re assessing potential places for your child to be, whether that’s a center or a school or a classroom, look for people that are positive. Look for people that know enough to talk to you about how they program for happiness, how they keep the child safe, and what kind of skills they work on. See if they are in line with what you think your child needs.
My mission is to provide practical autism ABA strategies to both parents and professionals so they can help children with autism reach their fullest potential.
