Real Housewife of NJ Reveals Son Has Autism - Part 2

As we revealed in Part 1 of this story, Real Housewife of New Jersey Jacqueline Laurita recently told People magazine that her 3-yr-old son Nicholas has been diagnosed with autism.

In Part 1, we talked about what autism is and about a new study linking paternal age to autism. Researchers found that the older the father, the greater the chance that autism can occur.

Laurita talked about how her son is currently being treated with Applied Behavior Analysis (ABA).

In Part 2, we explain what ABA is with the help of guest blogger, Alison Boguski, a teacher at a residential and day school for children with autism. She has been teaching students using Applied Behavior Analysis for the past 3 years.

What is Applied Behavior Analysis?

Behaviorism in general is very focused on reinforcement, positive or negative, and the idea that every behavior has a consequence.

Many behaviors are exhibited because of a cue which happened right before it. For instance, when a phone rings, this is your cue to pick it up because you have learned in the past that there might be someone you want to talk to (unless you decide not to pick up the phone because it is likely a telemarketer, which is also a learned behavior).

Another example is if you take a child into a supermarket and they begin to whine and throw a tantrum because they want a treat, by giving in to that request and allowing them to get that treat, you are REINFORCING that behavior. In other words, teaching them that “when I cry and scream I get what I want,” which will likely mean they will do it again the next time they go to store because past experience tells them they will get a treat.

There are several components of ABA therapy. Key components include:

  • Treating behaviors that are significant to the individual and society (applied),
  • Treating behaviors that can be observed rather than guessing at what someone is feeling or thinking (behavior)
  • Using methods of scientific inquiry to test whether changes in behavior are a result of the behavioral intervention introduced (analysis).

How does this work with autism?

Behavioral interventions for symptoms of autism are typically determined by first finding the function of the behavior you wish to change. A function is defined as what effect the student hopes to achieve by acting in a particular way: “Why do I want to do this”, or “What will it get me?” There may be one or several functions of a behavior.

Some common functions include:

  • Seeking attention from others
  • Escaping a demanding situation
  • Being denied access to preferred items
  • The behavior itself is automatically reinforcing, that is, there is something rewarding about the sensation that the behavior provides either through touch, sight or sound.

Once the function of that behavior is determined, one can treat that behavior by introducing interventions that serve to increase appropriate behavior and/or decrease and replace problem behaviors. For example, if Johnny hits his teachers in order to gain their attention, one way to decrease this behavior is to simply ignore it (also known as extinction) and train him to ask for attention appropriately (e.g., “Excuse me”). One could also provide lots of praise and attention whenever Johnny acts in an appropriate way.

Repetitive behaviors often exhibited by individuals with autism are often found to be automatically reinforcing. Although this makes them difficult to treat, they can be replaced with more socially acceptable behaviors.

Sometimes the function of tantrums or self injurious behavior is to receive social attention even if that attention is negative. This is why traditional methods of scolding a child for having a tantrum do not necessarily decrease (and may even increase) this troublesome behavior.

Because children and adults with autism have difficulty communicating, they may act out or act aggressively. Teaching them to ask for help or for a break when they wish to temporarily escape a demand gives them a better way to communicate than becoming aggressive.

ABA is not only used to treat problem behaviors but also to help students with autism to learn new skills. Finding out what motivates a particular child allows you to use it (favorite food or toy/activity) to reward them for correct responses.

Many more school systems are taking advantage of these types of therapies for the treatment of autism based on the large body of research that supports its effectiveness and practicality in treating symptoms of autism.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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