Hi Marti, from cochlear implant, children have to start speaking well before the 2nd birthday. I don’t think ABA can be effective in the early 2nd year of life. From our genetics results, “mutism” is caused by “stranger anxiety” triggering (abdominal?) migraines. Hence, we may need to prevent those migraines so that children learn enough language during that window-of-opportunity to benefit later (from ~3 years of age?) from ABA.
Hi Knut, I’m going to speculate here, as I really don’t know. However, if one were to engage in a type of ABA (that is a kind of contingency teaching) with a child as young as 13-23 months, it would have to be so modified as to hardly look like ABA, as we know it. I’d have to know exactly what the next step in development should look like and become an expert at that very moment in my child’s life. We started at age 3 and two months. To be honest, the ABA we used for Nick was so natural in its approach, it would be difficult for a layperson watching to pick out the contingency. For example, let’s say I am trying to get him to respond to me in a room–that’s all. So, I get a terrifically motivating (for him!) activity like blowing bubbles through a wand (I’m hoping you know what I’m talking about). So, I dip the wand in the holder, prepare to blow a bubble, Nick looks my direction or comes up to me or does anything to show he’s engaged, and the bubble is blown. He then enjoys the reward (bubbles!) and we start again. I then up the stakes. Maybe I try saying his name. I say, “Nick!”, he looks around, and the bubbles are blown. I can move any direction–and if I am a good therapist I am aware of this. I can continue with the receptive language, or go for a non-verbal communication. In the latter case, I’d say, “Nick!” (he turns toward me). “Want bubbles?” I now nod my head vigorously, hoping he does anything like nodding his head. If he shows even the slightest movement toward nodding, I blow the bubbles. I can now increase the nodding (shaping the response until he’s giving a proper nod and not just the suggestion for one), or I could decide to move to another desired response (saying “yes!”). That’s a bit of a leap, but I’d get there eventually….I could, of course, decide to get a cookie and say, “Nick!” and he turns around. “Want this!?” and hold up the cookie. He then nods. So I work on nodding to different things he might want….and so it goes…..
One more point: In a condition as diverse as autism, exceptions are the rule. For some children, like Nick, age 3 may not yet be too late. Some may have talked, but only with sheep, dogs, and horses. Whatever it was, I’m happy that Nick became “high functional”, after very intensive behavioral intervention. Still, identifying risk factors earlier, in the US from the 9-month well-child visit, and protecting language development from 12 months would likely also help with development of social skills.
He had no verbal language at all and apparently very little (maybe no) receptive language and began therapy at about 38 months. We weren’t even good at it. Nick didn’t talk to anything…people or otherwise.