Today, we received the first question below from a parent in Saudi Arabia. We hope this Q&A helps!
Q: My child is 10+ years old and can speak only two to three words. Can you share your experience or advice about how to develop speech?
A: Have you tried Applied Behavior Analysis (ABA)?
There are a lot of treatment alternatives out there. So, it should not be surprising that many parents receive a lot of advice regarding developmental delays that is not consistent. It can be very difficult to choose the treatment alternative(s) that will work best for your child. What is common, and very surprising, in situations like yours is that parents receive little or no advice regarding ABA therapy.
ABA is the only treatment for autism whose benefits have been consistently validated by independent scientific research (http://bit.ly/qlkq0Q). ABA has been endorsed as an effective intervention for autism by the American Academy of Pediatrics (http://bit.ly/p8gJau), the United States Surgeon General (http://1.usa.gov/nqoQwB) and the National Institute of Mental Health (http://1.usa.gov/qEBlju).
Q: Who provides ABA therapy? Are there service providers in Saudi Arabia?
A: We are not familiar with ABA services outside of the United States – perhaps others will share their knowledge regarding Saudi Arabia.
In the US, there are many ABA alternatives available, depending on the family budget, including local ABA service providers supervised by BCBAs (Board Certified Behavior Analysts). There are also web-based solutions like Rethink Autism (http://bit.ly/6DILxq), which may be useful for those outside the US.
One-size-fits-all approaches typically do not work. All of your child’s therapies, including speech and language services, should be coordinated with the child’s ABA therapy. Parents should be as heavily involved in the process as they can. Also, to ensure effectiveness, programs should be updated as often as possible (based on the data from the therapy and on parent input). If the budget is limited, parents can learn how to provide some or all of the therapy themselves (for example, http://bit.ly/fYenWe).
Q: Isn’t ABA only for children with autism?
A: ABA therapy is most often associated with behavioral issues related to autism spectrum disorders (ASDs). But, ABA can also be used for children, whether or not they are on the spectrum, to address many other behavioral issues, including speech:
“[D]espite more than 40 years of applied behavior analytic research there continues to be misperceptions about ABA. One misperception is that ABA is a standardized treatment program that is used for a specific type of problem and with specific types of individuals. For example, some incorrectly believe that ABA is a type of therapy or a specific procedure for teaching children with autism, and that it is synonymous with “Lovaas Therapy” or “discrete trial training.” Although discrete trial training represents one type of ABA-based approach, the field of ABA is much broader and includes a range of tactics, methods, and procedures that have been shown to be effective for many different types of problems. Features common to all ABA-based approaches are the objective measurement of behavior, precise control of the environment, and use of procedures based on scientifically established principles of behavior. Any clinical procedure or research investigation adhering to these basic criteria can be considered to be an ABA-based procedure. This includes “functional behavioral assessment,” and approaches such as “Positive Behavioral Support,” and forms of “Behavior Therapy” that rely on direct observation of behavior and analysis of behavior-environment relations.”
If your child has a speech delay, you should consider the possibility that your child’s inability to speak could be associated with an autism spectrum disorder. Please ask a professional to screen your child for autism.
These general answers may or may not apply to your specific circumstances. You should consult a specialist to address your child’s specific needs. Behavioral Lifeboat can help you do that.
If you have questions, please comment in the Behavioral Lifeboat blog.
 Applied Behavior Analysis and Neurodevelopmental Disorders: Overview and Summary of Scientific Support, Authors: Louis P. Hagopian & Eric W. Boelter, The Kennedy Krieger Institute and Johns Hopkins University School of Medicine (2005)