Case Study in Neurodiversity-Affirming Care: A Toddler with Childhood Apraxia of Speech

At the beginning of the evaluation, Adam appeared to enjoy playing with zoo animals with mom and the therapist. He laughed and smiled readily and paired gleeful, albeit, infrequent, babbling with gestures like pointing and guiding his mom’s hands to the toys he wanted her to play with. However, after a few misunderstandings in which neither mom nor the therapist could figure out what Adam was gesturing for them to do, Adam became highly frustrated and emotionally dysregulated. He threw himself to the floor and, in between sobs, began to bang his forehead on the floor repeatedly. His mother was worried that this self-injurious behavior had started happening more and more frequently in recent weeks.

A Parent’s Guide to Respectful Feeding Therapy: Part 2

ABA providers will tell you to break your child, to reward your child for eating food, to re-present food your child has spit out or vomited, to restrain your child in a chair and do not let them leave the chair. There are better ways.

ABA Call to Action!

Did you know that there is a Congressional Autism Caucus? This 141-member caucus includes members from both parties in the U.S. House of Representatives and in the U.S.
Now is the time to voice your opposition to ABA!
Contact your State Congressional Members of the Congressional Autism Caucus https://doyle.house.gov/issues/autism-caucus/autism-caucus-membership

Autism, language, and identity. Part 1.

I will raise my hand in shame. As a clinician, I have not always considered the effect that the words I choose. My reports were full of “impaired communication skills”, “limited ability”, “low-level skills”. And I felt quite free to use these labels because my clients would not be the ones to read my reports. If my report was directed to my client, the language would be different. So at least on some level, I recognised how negative these labels are. Yet I used them about people who as speech and language therapist I truly care for.

And then suddenly my world changed. And with my world my perception changed too.

Over the last year my family have all received the label of “Autistic Spectrum Disorder”…

ABA Therapy and PTSD

I was called “unethical” by a professional colleague today.
The reason may surprise you—I said “ABA is abuse”. My peer was naturally taken aback because they are an SLP-BCBA and “would never dream of abusing a child.” I always find this rebuttal interesting because we usually don’t hear about people walking around admitting to abusing people; even overt predators somehow convince themselves that they are helping their victim. The sanctimonious SLP-BCBA told me that it was the “old ABA” and not “new ABA” that was harmful, and then only a small fraction of the time. She accused me of “throwing the baby out with the bathwater” (I still don’t really understand how this idiomatic expression applies here) and she further went on to insist that there is “no way ABA could cause PTSD in people with Autism.” (She really meant “Autistic people,” I am sure.)

Rebuttal to critique of “ABA is NOT Effective: So says the Latest Report from the Department of Defense”

“The DoD/TRICARE report isn’t a study in any real sense of that word.” This is FALSE. In fact, they included 3794 participants who had received at least 18 months of ABA services; 2,183 from the eastern region of the United States, and a replication in the western region of the United States with 1,611 participants. As such it is not merely the largest study of the effectiveness of ABA, it is the only large-scale test of ABA . And they determined that ABA services do not meet the TRICARE hierarchy of evidence standard for medical and proven care..

Q&A with Faye Farhrenheit

“They used food deprivation in my program and they made us pair up and do it to each other. I feel incredible guilt over this.

Every morning I’d cut up a peanut butter and jelly sandwich into as many pieces as possible. Each piece was like a little bigger than an M&M.

Then I’d be told to force this non-verbal Autistic boy to do behaviors for each piece of the sandwich. He’d cry, hit his head in frustration, and say “hungry” which was one of like four words he could use.

I have no words to describe how bad I feel about being forced to do this as a child. If he didn’t “behave” he’d get no food and he’d go hungry.

He and the rest of us were expected to perform like trained circus animals for basic rights, like the ability to go to the bathroom.”

A British, Autistic SLT’s Pro-Neurodiversity Paradigm Shift

My journey to realising that I was autistic is similar to that of many women, in that I was placed in the mental health system as a child. For the next 15 years, I was given various diagnoses – one of these being Borderline Personality Disorder (BPD). My sensory and emotional difficulties were pathologised and misdiagnosed. What we know now is that there is a multitude of evidence showing how often autistic girls and women are misdiagnosed. But, that’s not what this blog is about.

An Autistic SLP’s Experiences with Social Communication

When I first considered the possibility that I may be autistic, I thought the only missing piece was difficulty with social communication. I understood topic maintenance, turn-taking, figurative language, sarcasm, small talk, and the fact that no one actually wants a real answer when they ask how you are doing. I also knew that I hated small talk, talked about things I had no interest in for the sake of being social and polite, practiced responses in my head before saying them out loud, and had more difficulty expressing ideas verbally than in writing.

AAC: The Big Myth

It is so important that we start with the presumption that the person is a learner! Learning takes time and sometimes a good amount of patience. Always presume they are on their way to developing competence in learning this new language.

Avoiding the “Good Job!” Habit

“Good job!” is a phrase used frequently during treatment sessions with autistic children. What message does a child receive from hearing, “Good Job!”? We hope they hear our interest, encouragement and approval. However, when “Good Job!” becomes a habit, is it still successful in conveying this meaning? Or, does it simply signal that the adult is in control, with specific goals in mind and is directing the child towards those behaviors, regardless of the child’s intention? Can frequent “Good Job!” responses undermine a child’s initiative, creativity and broader learning? Does it interfere with a more robust engagement?

May is Better Hearing and Speech Month: Building Trusting Relationships through Therapy

As a Speech-Language Pathologist (SLP), I often find myself trying to explain what I do. Our scope of practice is broad and not well understood by the general public. As an SLP specializing in feeding disorders, my work is even harder to explain! To educate the public about what SLPs (and Audiologists) do, the month of May has been designated as Better Hearing & Speech Month.

Letter to the ASHA Leader Editor

This letter to the ASHA Leader Editor is being circulated for signatures from speech-language pathologists who share the expressed concerns regarding the article “Building Working Relationships With Applied Behavior Analysts” that appeared in the April 2020 issue of the ASHA Leader. The letter is sponsored by the Speech-Language Pathology Neurodiversity Collective (SLPNDC) and authored by Therapy Chair Amy Lustig, PhD, CCC-SLP.

TBI in Service Members – Real-life effects & the need for Empathetic, Compassionate & Trauma-informed Care:

Beginning in around the year 2000, the field of Applied Behavior Analysis (ABA) has included Traumatic Brain Injury (TBI) among their ever-increasing scope of practice, claiming that ABA is “one of the most effective treatments for managing mood, behavioral and other mental disorders associated with brain damage”.3 ABA, in its simplest form, treats the behavior associated with TBI, rather than treating the underlying neurological reasons for that behavior.