Is An Autism School the Right Fit for Your Child or Client with Autism?

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.

Home ABA Program Versus School ABA Program

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.

Autism School Age

First of all, we have to look at the child’s age. In most states, in the United States, children birth to three years old are either at home or at daycare. But then, for funding reasons, that switches when they are three to center-based early intervention school programming. Very few places do quality ABA programming. All 50 states now mandate insurance carriers to cover ABA. So then we’ve got home ABA versus school ABA that’s not through the education system. 

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. 

Autism School Variables

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.

Autism Behaviors

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.

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Schools for Children with Autism

Autism school funding is another big variable. In my third podcast, I spoke with Kelsey who had funding to take her son, Brentley, an hour away to an ABA center run by a behavior analyst. But even though that was funded, that was not what her child needed. The behavior analyst was trying to teach him things beyond his ability level. And when my son, Lucas, was supposed to go to the three to five year old program that was recommended, we discovered it was not appropriate. Just because something’s funded doesn’t mean it’s right for your child. 

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.

Autism School Functioning Levels

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. 

ABA Therapy at Home

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. 

Deciding on an Autism School

No matter what you call it, whether you call it ABA, verbal behavior, non ABA, floortime, or a typical school, how do you tell if a school or a center is a good program? I mostly look at the big three concerns.

1. Is the child safe?

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.

2. Is the child able to be independent?

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.

3. Is the child happy?

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. 

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Transcript

This is a question I get a lot is which is better home ABA or school ABA center-based and or should I homeschool? And there’s so many variables, people from all over the world literally who have different circumstances, different funding streams, good options, bad options. I don’t care what you call it. So that’s why I decided this morning to write out some of the variables that can help us decide what the best situation is. Hi, I’m Dr. Mary Barbera, autism mom, Board Certified Behavior Analyst, online course creator and bestselling author of The Verbal Behavior Approach. Each week I provide you with some of my ideas about turning autism around so if you haven’t subscribed to my YouTube channel you can do that now. So Anna got me thinking this morning about home versus school programming and uh, Anna, I don’t know how old her son is now, but um, he is in an ABA program, uh, approved private school or private ABA program that’s funded by her district and she’s had involvement with a lawyer and she is trying to make a decision about a non ABA school versus home program. Um, she’s wondering about using a completely different approach maybe a good thing but maybe a disaster. And on Friday we have an IEP and the district told us, uh, that home-based instructions will be implemented if he’s not accepted to the new school.

And um, so she’s just really, it sounds like leaving him in the current ABA placement is not an issue. It sounds like now she has a potentially a choice between a non ABA school versus a home and I guessing the age is around 12. Okay. So this morning I started thinking about, and this is, this is a question I get a lot is which is better home ABA or school ABA center-based and or should I homeschool? And there’s so many variables, people from all over the world literally who have different circumstances, different funding streams, good options, bad options. I don’t care what you call it, whether you’re calling the center, this school, this program, ABA, non ABA. I don’t care what you call it, I don’t care if it’s called life skills or autistic support or uh, inclusion. I don’t, it doesn’t matter. Typical preschool. There are certain variables that make it so complicated for each individual.

So that’s why I decided this morning to write out some of the variables that can help us decide what the best situation is. Home versus center or school. First of all, we have to look at the child’s age. Um, in most states in the United States, children birth to 3 are in a serviced in their home or at daycares, wherever they are naturally going. But then for, for really for funding reasons that switches 3 to 5, they switch in the United States, the funding stream usually switches to center-based school programming. Very few places really do quality ABA programming. Um, and then you have in the United States, all 50 states now mandate insurance carriers to cover ABA. So then we got, you know, home ABA versus school ABA that’s not through the education system. So that muddies the water too. But we’re not gonna really talk about like ABA versus non ABA.

We’re just going to talk about programming in general in the home or at a center/school. We’ll kind of put those together. So it, if you think about typically developing kids, um, and we’re, we’re talking about the whole day, we’re talking about a 6 hour chunk, we’re not talking about, you know, if we talk about a 6 hour chunk of time, if you think about the age that the child is at, where would he be if he were typically developing? That’s, that’s is usually where I would start. So under age 5, under the age of kindergarten, a child would be mostly at home, um, or in daycare and or at home with, with preschool, 3 mornings a week, uh, 3 days a week, you know, very few, like full time, 6 hours a day, every single day preschools that, um, would be an option if they’re typically developing.

So my thought, um, is for kids under 5, that’s usually home and kids over 5, it’s usually school is where normal neuro typical kids, uh, would be, would, would be placed. So the other variables, and there’s, there’s several variables. And then we’re going to talk about, after we talk about home versus school, we’re going to talk about how to tell if a center or a school is appropriate. But in addition to the age of the child, we also have to think about the work status of parents, uh, grandparents and other care providers. Uh, so if a parent works full time, um, and there, if the child were typical, he’d be at daycare or maybe they have siblings and the siblings are in daycare or preschool then, or maybe the grandparent watches the kids, the parents work and the grandparents, watch the kids. So like what options are there?

Um, I know a couple of my, um, clients’ moms, their dads worked  full time and then their moms also worked, you know, between the commute and everything, like9 hours a day. And so, um, in one case, uh, the, the child was being watched, in both cases, the child was being watched by a relative when I first started.  In one of the cases I trained the grandmother, Jacob’s grandmother, to deliver the therapy and to be the center of the child’s programming. And I also trained mom to do it in the evenings and everything. And the other situation, the relative that was watching the child, uh, not that they were a bad person or abusive or anything, but they just, uh, were not into anything extra that they would have to be delivering. So in that case, mom decided to pull the child back to her home, stay working 9 hours a day, but hire a nanny to be the center and to, you know, uh, have the speech therapist come in and have the therapy, behavioral therapists come in and have me come in to run the program. So I think that’s a really important variable is, is, is there 1 parent or caregiver in a home situation that has the time, but also has the interest, um, in learning and being open and being, um, the little boy that was being watched by a relative, this little boy was banging his head on soft and hard, uh, things 3 hours out of the 9 hours a day. We didn’t know that, but we did know that when I started, he had an open lesion on his head that we had to fix. Um, and so when I was, uh, interviewing and assessing, when was he banging? How hard was he banging and what, you know. Okay. He’s in a high chair. He’s banging on the high chair. Okay. Can we get a shorter chair with a booster seat? Okay, we can do that. He was banging in the pack and play in the crib because he was expected to take 2 naps a day and he was banging before he fell asleep, banging when he woke up. Okay. We need to switch that. We can’t have this child banging his head. Like he can’t have 2 naps. He needs 1 nap. It needs to be short. No banging. As soon as he’s awake, he needs to be picked up and engaged. Um, so those are, those are 2 big things. Uh, funding is another big, big variable, but just because something’s funded, like in Kelsey’s situation on podcast number 3, marybarbera.com/3, um, Kelsey had funding to take her son Brentley an hour away driving him an hour away to a center, an ABA center run by a behavior analyst, but that even though that was funded, that was not what her child needed.

So just because it’s funded, like when Lucas was supposed to go to the 3 to 5 program, um, that whatever was recommended was not appropriate. And we’re going to talk about why that wasn’t appropriate. So I’ll save that. But just because something’s funded doesn’t mean it’s right for your child. Um, and then there’s other factors.  Are there siblings? Um, you know, what’s the functioning level? What are the other diagnoses? I had a client once with autism, he was 2. He also had a severe, uh, diabetes with a pump.

I’ve had kids with severe anaphylactic, uh, allergies. I’ve had kids with other syndromes that they need a nurse. Um, these are all factors that could make center-based programming or something, um not in the cards. I do think that functioning level is something that I would consider as well. Um, so because if it’s a matter of, I remember when Lucas, when I was in my second due process case when Lucas was like 9 or 10 years of age, um, he had transitioned back from a approved private school to our public school and the teacher went out on her second pregnancy and nobody knew what they were doing. And like I wasn’t gunning for perfection. It was just like a disaster, like all of a sudden. And of course they didn’t want me to see the disaster, so they like didn’t let me in the classroom and were rude.

And so we ended up, you know, in due process anyway. But, um, when I was in my due process when he was about 9 or 10, I remember another behavior analysts that knew me pretty well and was working with me in the verbal behavior project, said, why you know what to do, why don’t you just homeschool Lucas? And I was adamant, I was already working as a behavior analyst. And 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 6 hours a day so that I can do my life and have my goals and have, um, you know, it’s a lot of time to have a child home. Now, if, if it was, if it meant Lucas was, you know, very high functioning and, and this, when he was 10, it would mean the difference between him going to college or being, you know, very disabled.

And, and I knew it was like a shorter term thing where I could fix it and then I could get him somewhere else. Like I would’ve, I would’ve, uh, probably considered it, but I knew by age 10 that Lucas had moderate, severe autism, had a mild intellectual disability. He was not going to progress to college to be fully conversational, most likely to, you know. So if you’ve taken my intermediate learner course in module 1, I talk about the three profiles of intermediate learners. And for me, I’m not saying like I gave up on Lucas or anything, it’s just a factor. If I had a profile A kid who I, if I think that I could really, you know, under age 8, I would last as hard as possible. Um, especially if you have a child that’s making pretty good gains. And I did when Lucas was under 8, I blasted full, full tilt.

Um, but when children get older, um, you know, so, so that, that was kind my experience, it’s that I wanted, I always wanted somewhere for Lucas to go for 6 hours a day. And it didn’t have to be perfect, but it had to be, um, it had to be appropriate. So, so those are the factors, age, the work status of parents and caregivers, the funding streams or whether parents are, you know, independently wealthy and can do whatever they want, hire nannies, hire round the clock care, you know, like, um, there are differences between, you know, even hiring a lawyer, which, you know, um, I went through, many of our, our parents have gone through and then, um, really thinking about, you know, is, is this going to be pivotal in changing the trajectory of where my child is going to be? So, um, for Lucas at age 10, is this really, me homeschooling, is that going to change his trajectory of where he’s going to be at 12 or 18 or 25? And I didn’t think it would.

Um, and now he’s 23 and again, he goes to a center 6 hours a day. And I have friends who don’t have that. Um, for whatever reason, their kid, their adult kids can’t go to this center based program. And so you end up, I think, in a difficult situation where, um, you know, your kids at home all day. It’s a lot of hours to fill with meaningful activities. Okay. So let’s switch gears pretty quickly and then I’m going to get to the rest of the questions. I know this is kind of long. Um, let’s switch gears to how to tell if a center or school, um, is appropriate no matter what you call it, whether you call it ABA, verbal behavior, non ABA, floortime, whatever, a typical school, how do you tell if a school or a center is appropriate?

Those variables that I talk to about home versus center still absolutely apply the age, the, you know, the age, the funding, all that stuff. However, when I’m really looking at a school or a center, I am mostly looking at my big 3. Is the child safe? Um, so let’s talk about safety first. Um, as I say in podcast, uh, 1 with my journey, um, and I have a whole podcast episode on my legal battles over the years. And I have a, an interview with Gary Mayerson as one of my podcasts interviews, both, you know, excellent podcasts interviews, um, and episodes. But when Lucas was, uh, when he turned 3, that’s right when he get the diagnosis and right when he was ready to go to the 3 to 5 programming, um, the program that was recommended was in the middle of the city. Um, Lucas had just finished a year of 2-year-old preschool at our, um, you know, neighborhood preschool that was, you know, had an excellent reputation.

Um, so he already had that. He already, um, got the diagnosis of autism. I was developing, I had developed a home program in my house, in the suburbs and the program that was recommended with the 3 to 5 year old program was in the middle of the city in a gun zone. So they could not do any outside play ground time because it was in a gun zone. And then I had a choice to get him to this center. It was either, um, I would drive him, but I also had Spencer who was 18 months younger. So I would have take my 18 month old and my 3 year old, essentially nonverbal child drive both of them into this gun zone, middle of the city, park or I don’t know what I would do. Maybe they would come and get Lucas out of the car and swiftly move him into the building.

Um, and then at the center, uh, that was proposed, I think it was 15 minutes a week of 1 to 1 time. I mean we were talking about studies showing kids needed 40 hours a week of 1 to 1 time and this was given to give him 15 minutes a week in uh, uh, classroom where he couldn’t even go out to recess. And then every 6 weeks because of funding, they would take like a 2 week break so they didn’t take summers off, but they had this scattered schedule. Um, so right there it wasn’t a safe situation or he could stay at my home with this 40 hour week program, which was proven. We had a yard with a fence. He could go outside, he could return to his typical preschool with it, with 1 of his behavioral therapists, like, which part of this would even make sense for him to go to this other option.

So safety’s huge in Kelsey situation podcast 3, she was driving him, he was banging his head on hard surfaces a hundred times a day. He was eloping  from the center, running out of the door 3 blocks away when Kelsey was trying to drop him off. Um, it’s just not safe. So if it’s a safety issue, um, then it’s, it’s, it’s not appropriate. Um, in addition to the center or school having safety and, and it doesn’t, you know, you might have to put things in the IEP to make it safe for your child, a 1-to-1, a 1-to-1 during recess time, which with the 1-to-1 being within arms distance of your child the entire time because there’s no fence, um, you may need, you know, whatever you need, but you have to make sure that the center or the school has enough, uh, safety considerations to make your child safe.

Um, you also want to make sure that the time during the school day is, is appropriate. They’re going to be working on skills that your child needs, not skills he already has, not skills that are too hard, uh, skills that are functional. And this is again depending on the age and the ability level. And I think as your child gets to be 10 or 12 or 14, we have to be thinking no matter what the functioning level is, where are they headed? What will, what skills are really going to be appropriate? I remember one, we had au pairs, which is how we kept Lucas safe and uh, I got to work and earn a PhD and travel, um, was we hired au pairs for a good 10 years of our, of Lucas and Spencer’s lives. And um, I remember one of our au pairs coming back after not seeing us for 3 or 4 years.

And Lucas was probably 8 when she was here and 12 when she came back. And, and she said like his independent skills with like chores and showering and all that stuff just really improved. 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. It’s just, um, and like the other last week, Lucas answered his first why question spontaneously. We were walking, um, in a parking lot, uh, at a restaurant after we ate. And I had been trying, I work with him a little bit on why questions like, why is the pool closed? And he knows to say because, but he has. And so I go, oh, oh, be careful. It’s slippery. It had snowed a little bit. I said, be careful. It’s slippery. And I go, why is it slippery? And he’s like, because it snows and you know, because he could see the snow, but it still was his first spontaneous answering why questions.

I don’t want you to think like, I’m not working on language. We teach him new people that he comes in contact with new tests at work and all that stuff. But, um, I, I think at this point, you know, his language, he’s not fully conversational. I think it would. Um, but we can work more and more on independence. Keeping him safe, working on independence with everything and working on keeping him happy. So that’s the other thing is, is is your child happy to go to a center or a school or do you think they’d be happy? If it’s just a possible, uh, possible. Um, what kind of things do they know? Do they know about pairing? Do they know about the power of manding or requesting? Is it set up so that the kids look happy? Like if I were picking a daycare just for a typically developing kid and I went in, um, to daycare A, and this teacher was like, Johnny stopp that.

All right, the jump rope is going away because you guys can’t share and blah, blah, blah, blah, blah. If, if that was the, you know, stop, keep your hands to yourself. I told you, you know, sit criss cross applesauce like nobody’s listening today or, and then I went into daycare B and it was like, I like the way you’re shearing. That’s so awesome. You know, give me a high five. If it was like all these 8 positives to every negative, I don’t care what you call it, I would pick the positive environment. So when you’re assessing potential, uh, places for your child to be, whether that’s a, a center or a school or a classroom, um, look for people that are positive. Look for people that, um, know enough to, uh, talk to you about how they program for happiness, how they keep the child safe, and what kind of skills they work on and see if they are in line with what you think your child needs. Wherever you’re watching this, I’d love it if you would leave me a comment, give me a thumbs up, share this video with others who may benefit. And for more information, you can attend a free online workshop at marybarbera.com/workshop and I’ll see you right here next week.

 

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