THE BENEFITS OF APPLIED BEHAVIOR ANALYSIS (Cognitive Behavioral Therapy) FOR AUTISM
The majority of children with autism and related disorders exhibit unwanted behaviors such as hitting others, aggression, poor attention, impaired learning or self injury. For parents, stopping this kind of behavior is often frustrating and unsuccessful. In fact, in most cases, trying to discourage often makes the behaviors worse in the child. One way to deal with such behavior problems is application of Cognitive Behavioral Therapy training or applied behavior analysis. Cognitive Behavioral Therapy is now an accepted therapy for autism treatment in the US and most health insurance plans to cover the treatment.
Cognitive Behavioral Therapy usually is offered by a team of healthcare professionals who are trained to deliver Cognitive Behavioral Therapy. The team usually involves a speech therapist, psychologist, the primary care giver, social worker, behavior therapist, pediatrician and a mental health counselor. Cognitive Behavioral Therapy is very labor intensive and requires countless hours of therapy on a daily basis to achieve success. In some cases, the parent may be involved in the therapy so as to maintain a structured working relationship to ensure consistent delivery of the treatment.
How Cognitive Behavioral Therapy Helps Autistic Children
The principle behind Cognitive Behavioral Therapy is that children are more likely to perform repeated behaviors that are rewarded than behaviors that are ignored or not recognized. Cognitive Behavioral Therapy was first developed in the 60s and researchers noted that it was helping some children with autism. Cognitive Behavioral Therapy helps autistic children by teaching them new skills while at the same time decreasing the probability that they will engage in problematic or negative behaviors. Cognitive Behavioral Therapy is recognized as a bona fide treatment for autism by a number of leading health organizations. Over the years, many studies have shown that Cognitive Behavioral Therapy is an extremely useful intervention for children with pervasive developmental disorders.
How Cognitive Behavioral Therapy Works
Cognitive Behavioral Therapy training of autistic children is conducted by a trained behavior therapist. In most cases, the therapist will spend 30-40 hours a week working one on one with the child. Frequently the therapist will use “modified Cognitive Behavioral Therapy” which means the therapist will spend about 10-15 hours a week with the child. The rest of the time will be spent on other therapies like occupational and speech therapy. Use of combination therapies allows the child to spend adequate time in a social environment that is realistic and therapeutic. However, since the needs of each autistic and ADHD child are different, the type and intensity of therapy will also vary. In most cases, the therapist will formulate an individualized Cognitive Behavioral Therapy program that meet the needs of the child.
The Steps for Cognitive Behavioral Therapy
At the initial consult, the child is assessed by the behavior therapist to determine which skills he/she possess and what deficits the child lacks. The Cognitive Behavioral Therapy program is aimed at improving the child’s skill in many areas. In general, the aim of the Cognitive Behavioral Therapy program is to 1) increase communication skills 2) academic maturity 3) social skills and 4) overall interaction with the existing environment.
How Cognitive Behavioral Therapy is Performed
Once the goals of treatment are identified, the therapist will create a series of programs to help the child achieve them. The therapist may use a variety of approaches to teach the autistic child a given skill. A commonly used technique is discrete trial training, where the therapist starts by providing a cue to the child. If the child responds in an appropriate manner, the behavior is rewarded. The reward is something that the child likes so that he or she will be motivated to repeat the desired behavior again. However, discrete training trial is much more complex and so are autistic children. Thus, the therapist will continue to use a variety of other training programs to engage the child. Each program is designed to teach the child a new skill that can be applied to several settings. As the child progresses, other techniques may include incidental teaching of skills and analysis of tasks. With these techniques, the autistic child learns to perform multiple steps to carry out a particular task.
Starting Cognitive Behavioral Therapy Training
Experts recommend that Cognitive Behavioral Therapy is most successful when started at a young age. Therapy should begin before age 5, though some older autistic children can also benefit. One thing parents have to know is that Cognitive Behavioral Therapy is not a one shot deal and requires extensive time with the child. This is not a cheap undertaking either and can easily cost thousands of dollars. The benefit of Cognitive Behavioral Therapy therapy is that it will reinforce positive behaviors and teach the child new skills. The therapy will also decrease the probability that the autistic child will engage in negative or unhealthy behaviors.
The first thing to know is that Cognitive Behavioral Therapy is an expensive form of therapy. It is labor intensive and often requires 30-40 hours a week for many months. Often the parent will be left out and feel neglected because so much time is spent with the behavior therapist. Some experts argue that Cognitive Behavioral Therapy is very regimental/stern and uses some type of punishment to deter negative behaviors.
It is important to understand that Cognitive Behavioral Therapy does not cure the disorder and does not work in all autistic children. Older autistic children tend to have a less favorable response, compared to younger children.
Selecting an Cognitive Behavioral Therapy Therapist
Cognitive Behavioral Therapy therapy is relatively new and there are simply not enough therapists. There is a huge demand for therapists and this has led to many inexperienced people offering Cognitive Behavioral Therapy programs. Thus, the parent should always ask for credentials and get second opinions about the therapist, preferable from other parents. Further, there are some therapists who are too aggressive and others who use questionable methods. Use of such professionals leads to poor outcomes. Always check with the state licensing board about the status of behavior therapists before employing them.
The Importance of Parents and Caregivers Learning Cognitive Behavioral Therapy
There is no reason why a parent or caregiver cannot learn some aspects of Cognitive Behavioral Therapy therapy. Unfortunately, programs are not always available in most cities or towns and it require time, effort and money to learn the therapy. Additionally, one needs to develop skills to ensure that it works and is delivered appropriately. There are some websites that do offer the basic Cognitive Behavioral Therapy programs online. One can even buy books which are easy to read and learn.
Today, there are a number of family run Cognitive Behavioral Therapy programs in the country. When done the right way, there is no difference in outcome between the therapy delivered by healthcare professionals or the parent. There are many resources for parents who want to know more about Cognitive Behavioral Therapy.
The parent is a crucial part of the team. The therapist will communicate with the parent at all times about the progress of the child. In addition, the therapist will also teach the parent some basic techniques that can be used to enhance learning in the autistic child.
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