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The Verbal Behavior Approach

The Verbal Behavior Approach

How to Teach Children with Autism and Related Disorders

Mary Lynch Barbera
With Tracy Rasmussen
Foreword by Mark L. Sundberg, Ph.D., BCBA

Paperback: £13.99 / $19.95

2007, 234mm x 156mm / 9.25in x 6in, 200pp
ISBN: 978-1-84310-852-8, BIC 2: JNS MMJ

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Introduction

I was a registered nurse with more than a decade of experience, but when my physician husband first mentioned the possibility that my then 21-month-old son Lucas might have autism, I was as bewildered and angry as any parent.

To be honest, I had very little experience with autism and it simply never crossed my mind that my first-born was anything less than perfect.

So what made my husband think that my son had autism?

He pointed out that Lucas wanted to watch television too much and didn't play with toys, and that, at times, Lucas simply appeared to be in his own world. At that time I wasn't willing to look at the possibility. I argued that Lucas had language, a good ten words, which wasn't that unusual for a child under two, and that he was a warm and cuddly baby.

He didn't look like he had autism, since he didn't fit the picture I had in my mind of what autism was supposed to look like. He wasn't banging his head. He wasn't rocking. He wasn't doing anything that I considered to be autistic.

I told my husband on that day that he was crazy for bringing up autism. I told him that Lucas didn't have it and that I never, never wanted to hear the word "autism" again.

Little did I know that a little over a year later autism and its various treatments would begin to take over my life.

Soon after my husband used the "A" word, I reluctantly had to admit to myself that I didn't really know what autism looked like in a baby. I had to tell myself that, as a physician, my husband might have a better ability than I to gauge Lucas's behaviors against other kids his age.

So my husband's comment did plant a seed as I began to carefully watch Lucas interact (or fail to interact) with the world around him. I thought about autism every time Lucas did something odd. If he took toys and methodically moved them from one basket to another I wondered, maybe…

If he played with a piece of string hanging from a chair for more than a few seconds I worried, maybe…

The word autism, autism, autism would spin around my brain only to be explained away by my desire to have a typical child, not a child with autism. But, Lucas did have autism. And the fact that I stuck my head in the sand and was in denial about it didn't help Lucas get better.

In fact, it made him worse.

Lucas got further and further behind his peers in language until it was undeniable that he wasn't keeping up. By the time he was two-and-a-half, the other children from his preschool were running out to their parents and asking if they could go over to a friend's house, speaking in full, animated sentences. Lucas's peers were speaking in sentences and developing relationships with other children, while my goal at the time was to teach Lucas to say the word, "ball." At that moment, I started to realize that I had no choice but to get out of denial and into the reality of my son's life.

From that point forward, I was in my son's corner as his coach and advocate, as well as his mother.

The Importance of Early Diagnosis and Treatment

Once I got out of denial in 1999 it took several months before a diagnosis was obtained and treatment could be started. In retrospect those were precious months of learning lost to the slow-moving protocol of the system of diagnosing autism. Today it is not unheard of for some children to receive the diagnosis of autism at 18 months or two years of age, but back in the mid to late 1990s, very few specialists were willing or able to diagnose a child under the age of three. All research completed in recent years supports a previous belief that children who receive an early diagnosis and early and intensive intervention have the best long-term outcomes.

Even today with research proving that early detection and intervention is key, the majority of children continue to receive the diagnosis much later than two, mostly because pediatricians and parents are still not aware of the early warning signs of autism (see www.firstsigns.org for typical milestones and red flags for autism). To confound the problem, the specialists who are qualified and comfortable in making the diagnosis of autism in a toddler often have year-long waiting lists.

Had Lucas been diagnosed and treated sooner, the strides that he has made over the past seven years would have been accelerated and I would have learned about the best treatments sooner, implementing them more quickly.

But much of the research and materials have come out only within the last few years and these include the important work of Dr. Catherine Lord and Dr. Rebecca Landa to discern the qualities for early detection. Nancy Wiseman's book Could It Be Autism? A Parent's Guide to First Signs and Next Steps was also published in 2006, getting important information into parents' hands.

So instead of being diagnosed and into therapy when he was 21 months of age, Lucas finally got his diagnosis and began treatment in 1999 when he was three years, three months old.

And that began my single-minded pursuit of the best possible therapy for my child and how I came to understand and eventually consult about the Verbal Behavior approach.

From Parent to Parent/Professional

I have since learned that there was some treatment information available in the late 1990s, but I didn't know where to begin. I became the "gung-ho" parent sitting in the front row of every conference I could fit into my schedule. I began to read every book that I could on the subject and depended on the knowledge of the parents who had gone before me to help my son.

I found that I was learning so much that I wanted to help others. I became the founding president of the Autism Society of Berks County in 2000; parents came to me for help and support continuously. I didn't want to leave even one parent in the dark about the facts or the different types of treatment. For me, the best way to help Lucas and others was to educate myself. In 2003, I became a Board Certified Behavior Analyst (BCBA) and began to work in the field of autism, specifically using a Verbal Behavior approach. As the lead behavior analyst for the Pennsylvania Verbal Behavior Project since 2003, I've trained hundreds of people and have had the privilege of working with many children on the autism spectrum as well as some students with Down Syndrome, and other developmental disorders.

Parents come up to me frequently and ask me one simple question: Where do we begin? They tell me that their child is falling further and further behind. He or she is throwing tantrums, has no language, is obsessive about different things. Like me seven years ago, they don't know where to begin.

So, I devised a simple way to get them started. This book offers a simplified version of some very complex treatments that I believe both parents and professionals need now. I will give you the information that I give to parents and professionals every day, the same information that I would give to my sister or best friend if they had a newly diagnosed child with autism or some other disorder involving a language impairment. I will walk you through the information you need and give you my perspective not only as a parent but as a professional.

This book will offer a simple explanation of how to use the principles of Applied Behavior Analysis and the Verbal Behavior approach to help children with a myriad of issues, including autism, Down Syndrome, developmental disorders, or even simple language delays. Drs Drash and Tudor have also recently completed some preliminary studies suggesting that the Verbal Behavior approach might even prevent autism in at-risk infants and toddlers (2006).

Using the Verbal Behavior approach has become my answer when parents ask me, "Where do we begin?"

This book will answer that question with simple, clear instructions for you, too.

Everything in this book is compiled from information I've learned along the way from internationally recognized professionals such as Dr. Jack Michael, Dr. Mark Sundberg, Dr. Vincent Carbone, Ms. Holly Kibbe, Dr. Brian Iwata, Dr. Glen Latham, Dr. Ivar Lovaas, Dr. Richard Foxx, Dr. Bridget Taylor, Mr. Michael Miklos and Dr. Rick Kubina among many others. I've learned much from colleagues and parents of other children on the spectrum too, as we muddled through cases and tried to find a way to help each individual student. I've probably learned the most, however, from my son with autism, who continues to teach me each and every day.