Autism: Challenging Behaviour

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0:00:11 > 0:00:15This is where it is frustrating,

0:00:15 > 0:00:18because I really, really want to know what he's trying to tell me.

0:00:18 > 0:00:20Because he's very intelligent.

0:00:20 > 0:00:23And I just think "Oh, I wish I could understand."

0:00:34 > 0:00:38He doesn't know that he's going to school for the first time.

0:00:38 > 0:00:43He's always seemed to be in his own world.

0:00:47 > 0:00:51Jeremiah and Jack have both been diagnosed with autism,

0:00:51 > 0:00:53a lifelong developmental disorder

0:00:53 > 0:00:55which affects 1% of the population.

0:00:58 > 0:01:00They're about to start at a school which uses ABA,

0:01:00 > 0:01:05an intensive intervention which aims to change autistic behaviour.

0:01:09 > 0:01:12We didn't know anything about ABA.

0:01:12 > 0:01:17But we found out that parents are moving from Belfast, Liverpool,

0:01:17 > 0:01:21Manchester, to this area, to put their children into this school.

0:01:27 > 0:01:29We're hoping there will be

0:01:29 > 0:01:31a lot of changes in him.

0:01:31 > 0:01:33I like to think that he doesn't have autism.

0:01:35 > 0:01:39He goes to Treetop and two years down the line he'll be OK.

0:01:41 > 0:01:44My job as a professional is to choose the method

0:01:44 > 0:01:49that has proven to have the best effect, and ABA is that method.

0:01:51 > 0:01:55'Oh, it's so exciting because I've been waiting for this place so long.

0:01:55 > 0:01:57'I just know it's going to work.'

0:02:00 > 0:02:03I can see from a parent's perspective

0:02:03 > 0:02:04that ABA might be attractive.

0:02:04 > 0:02:07But when people devise interventions

0:02:07 > 0:02:10I don't think they really think about the potential harm.

0:02:10 > 0:02:12Bye-bye, Jack.

0:02:19 > 0:02:24Try this, copy me. We shuffle the cards! Yeah, buddy.

0:02:24 > 0:02:25You can have a crisp, there we go.

0:02:25 > 0:02:29So we build a Lego, we build the Lego. Fantastic, try this one.

0:02:29 > 0:02:33Copy me. Can we build a Lego? Fantastic, dude.

0:02:33 > 0:02:35You can have a sweet. Well done.

0:02:38 > 0:02:40Applied Behaviour Analysis, or ABA,

0:02:40 > 0:02:45uses a system of rewards and consequences to modify behaviour.

0:02:45 > 0:02:48It is based on the discoveries of psychologist BF Skinner

0:02:48 > 0:02:52and his experiments with rats and pigeons at Harvard University.

0:02:54 > 0:02:58Touch white. No.

0:02:58 > 0:03:03ABA was first applied to children with autism in California

0:03:03 > 0:03:04in the 1960s and '70s.

0:03:04 > 0:03:09What do you want? No.

0:03:09 > 0:03:11Right. Go to the corner.

0:03:11 > 0:03:15Ever since it first appeared, it has raised questions

0:03:15 > 0:03:17about the rights of children with autism.

0:03:17 > 0:03:20Naughty, look at me. Naughty, naughty.

0:03:20 > 0:03:22If I had a child who was three years old

0:03:22 > 0:03:25and appeared to be a violin prodigy and I thought,

0:03:25 > 0:03:28"OK, we're going to do 40 hours a week of violin drills,"

0:03:28 > 0:03:29social services would be

0:03:29 > 0:03:31knocking my door.

0:03:31 > 0:03:33But if I have a child with autism,

0:03:33 > 0:03:34it's OK.

0:03:34 > 0:03:39- What do you want? - I want cookie.- Good!

0:03:39 > 0:03:42When I first knew of ABA, I remember thinking,

0:03:42 > 0:03:45"Oh, I don't really like it. It's like dog training."

0:03:45 > 0:03:49Having seen it now and seen how you motivate children

0:03:49 > 0:03:53and the kind of results you can get if a child's well motivated,

0:03:53 > 0:03:55to if the child isn't motivated at all,

0:03:55 > 0:03:58now I'm the opposite, and I think anything goes.

0:03:58 > 0:04:02Use what they love to get them doing what you want them to do.

0:04:07 > 0:04:09Tickle, tickle, tickle! Ready?

0:04:09 > 0:04:13ABA has changed radically since its early experiments,

0:04:13 > 0:04:15and is now used widely in the US.

0:04:15 > 0:04:17But not here.

0:04:17 > 0:04:20Jack and Jeremiah are starting their first term at Treetops,

0:04:20 > 0:04:25which is the only state school offering a full ABA programme.

0:04:25 > 0:04:27When the children first start with us,

0:04:27 > 0:04:29we find all of the things they like,

0:04:29 > 0:04:32to get them to want to come to school, to enjoy being here.

0:04:32 > 0:04:34You know, it's all based around fun.

0:04:34 > 0:04:38It's autism heaven, because they're getting everything that they love.

0:04:42 > 0:04:43It's impossible to know

0:04:43 > 0:04:47how Jack and Jeremiah will be affected by autism as they grow up.

0:04:47 > 0:04:50The condition develops differently in every child.

0:04:50 > 0:04:53During this time we do an assessment of the children.

0:04:53 > 0:04:57Eventually they will start actively teaching them new skills.

0:04:58 > 0:05:01I mean, a lot of people would look at this child

0:05:01 > 0:05:05and not really be able to see that much trace of autism in this child.

0:05:05 > 0:05:07But he has got some.

0:05:09 > 0:05:11There's your fishy.

0:05:11 > 0:05:14I actually thought my son hated me,

0:05:14 > 0:05:17because the way he was lashing out,

0:05:17 > 0:05:18I couldn't comfort him.

0:05:18 > 0:05:22It was awful, and that's what nearly

0:05:22 > 0:05:24just brought me to breakdown.

0:05:24 > 0:05:27I would say I was very close, very close,

0:05:27 > 0:05:31during his biting period, very close to breakdown.

0:05:35 > 0:05:38The kind of child that you say is engaged in their own world,

0:05:38 > 0:05:41nobody can really get in on the fun or interact with them,

0:05:41 > 0:05:44because they haven't been taught any other skills.

0:05:44 > 0:05:46Sometimes you have to block that self-stimulative behaviour

0:05:46 > 0:05:49otherwise you can't engage them in anything else.

0:05:49 > 0:05:51They won't be able to learn anything new.

0:05:56 > 0:05:58I'm not very good at looking after him.

0:05:58 > 0:06:00Five minutes is enough for me.

0:06:00 > 0:06:01You know, I get

0:06:01 > 0:06:03really, really stressed.

0:06:03 > 0:06:06There's no speech, no eye contact.

0:06:06 > 0:06:09He doesn't follow any instructions at all.

0:06:09 > 0:06:11And he doesn't know when he's hungry,

0:06:11 > 0:06:16when he wants a glass of water, or anything like that.

0:06:16 > 0:06:20What, for you, is the thing that you find most stressful?

0:06:20 > 0:06:23It's very difficult to say.

0:06:23 > 0:06:28When you think about it, he hasn't called me Dada, you know.

0:06:28 > 0:06:30Erm...

0:06:30 > 0:06:33He hasn't said Mama.

0:06:44 > 0:06:48One of the features of Jeremiah's autism is that he finds it difficult

0:06:48 > 0:06:51when asked to move from one activity to another.

0:06:51 > 0:06:55What's happened is, he's got used to people following him around

0:06:55 > 0:06:57and people not really knowing the skills that you need

0:06:57 > 0:07:00in order to be able to engage a child.

0:07:06 > 0:07:08All you need to do to change behaviours

0:07:08 > 0:07:10is to reward the behaviours that you want to see

0:07:10 > 0:07:13and don't reward the behaviours that you don't want to see.

0:07:13 > 0:07:15If you ask a child to do something

0:07:15 > 0:07:16and they cry to get out of doing it,

0:07:16 > 0:07:18make sure the crying or the biting

0:07:18 > 0:07:21doesn't get them out of doing the task.

0:07:24 > 0:07:28In a demand situation, the demand just stays on the child.

0:07:28 > 0:07:32Nothing else happens in your world, nothing else fun's going to happen

0:07:32 > 0:07:36until you follow through with my request.

0:07:36 > 0:07:38Sometimes that may take five minutes,

0:07:38 > 0:07:40sometimes it might take three hours.

0:07:40 > 0:07:42It might take three hours on one day,

0:07:42 > 0:07:44the next time it'll be less time,

0:07:44 > 0:07:48and then soon you get a child that's complying with all your demands.

0:07:55 > 0:07:59Before coming to Treetops, Jeremiah was at a mainstream nursery,

0:07:59 > 0:08:01where he made very little progress.

0:08:01 > 0:08:0570% of children who have autism

0:08:05 > 0:08:07are able to go to mainstream schools.

0:08:07 > 0:08:11Only those that are more severely affected attend special schools.

0:08:13 > 0:08:16- # Hello, hello - Say hello

0:08:16 > 0:08:18# Hello... #

0:08:18 > 0:08:2015 miles from Treetops,

0:08:20 > 0:08:25St Christopher's also has a large percentage of children with autism.

0:08:25 > 0:08:28Like the overwhelming majority of special schools in the UK,

0:08:28 > 0:08:31it has rejected ABA.

0:08:31 > 0:08:34I think it's the rigidity that perhaps ABA offers

0:08:34 > 0:08:38over other approaches that maybe we sort of avoid.

0:08:38 > 0:08:42# How do you do? How do you do? #

0:08:42 > 0:08:45All our children are individual, like we're all individual,

0:08:45 > 0:08:48and it's about educating those people around them,

0:08:48 > 0:08:51whether that's in school or in home, in society.

0:08:51 > 0:08:53I think it's important about learning to accept people

0:08:53 > 0:08:55that are a bit different.

0:08:55 > 0:09:00The fundamental question about the education of children with autism

0:09:00 > 0:09:02is whether to accept these autistic differences

0:09:02 > 0:09:05or try to push children to learn new skills.

0:09:05 > 0:09:07There's a huge clash of ideologies.

0:09:07 > 0:09:11Many people believe that autism

0:09:11 > 0:09:15is a different way of perceiving the world,

0:09:15 > 0:09:18and that we shouldn't necessarily believe

0:09:18 > 0:09:21that there is one normal development trajectory

0:09:21 > 0:09:22that people should be following.

0:09:22 > 0:09:26And on that view, you understand

0:09:26 > 0:09:30that the child has differences and that's OK.

0:09:30 > 0:09:34The aim then is to support that child in negotiating the world

0:09:34 > 0:09:38without trying to fundamentally take the autism out of them.

0:09:39 > 0:09:43No, Ricky, put it on top of the dresser.

0:09:43 > 0:09:47Ricky! That's inside, put it on top. Good boy.

0:09:47 > 0:09:51In ABA, at least historically, one of the main aims

0:09:51 > 0:09:56was to make autistic children indistinguishable from their peers.

0:09:56 > 0:10:00And so if that's your perception of what autism is,

0:10:00 > 0:10:03something that needs to be fixed or something that needs to be cured,

0:10:03 > 0:10:08or made normal, then ABA would be the route to go down.

0:10:13 > 0:10:17Gunnar Frederickson is an independent ABA practitioner

0:10:17 > 0:10:19who works with families all over Europe.

0:10:24 > 0:10:27He believes it is possible for some children with autism

0:10:27 > 0:10:29to be brought out of the condition.

0:10:31 > 0:10:33I don't appreciate autism.

0:10:33 > 0:10:35I cannot see anything good about it, to be honest.

0:10:35 > 0:10:40I think we should fight against it, by all means,

0:10:40 > 0:10:44as early as possible and as intensively as possible.

0:10:45 > 0:10:48SPEAKS OWN LANGUAGE

0:10:55 > 0:10:57OK, clap.

0:10:57 > 0:10:59Tobias has no language

0:10:59 > 0:11:02and finds it difficult to engage with the world around him.

0:11:02 > 0:11:05Gunnar has been working with him for four months.

0:11:05 > 0:11:08Clap! Clap!

0:11:10 > 0:11:12TOBIAS CRIES

0:11:19 > 0:11:23What kind of changes have you seen over the last few months?

0:11:23 > 0:11:25He has opened his eyes

0:11:25 > 0:11:27and he has opened his ears.

0:11:29 > 0:11:33It's easier to give him short messages,

0:11:33 > 0:11:36like "come here", "sit down",

0:11:36 > 0:11:39"give me that" - stuff like that.

0:11:39 > 0:11:41And he is a lot better with the eye contact.

0:11:43 > 0:11:45Tobias? Tobias?

0:11:45 > 0:11:48TOBIAS SCREAMS

0:11:54 > 0:11:58There's a lot out there in the autism industry

0:11:58 > 0:12:00trying to sell to parents that

0:12:00 > 0:12:01you can change your child,

0:12:01 > 0:12:04that the autism is a kind of

0:12:04 > 0:12:06medical, separable appendage.

0:12:06 > 0:12:11But autism is the way your brain's wired,

0:12:11 > 0:12:13the way your brain has developed.

0:12:13 > 0:12:18You can't remove the autism without removing the person altogether.

0:12:18 > 0:12:22He seemed to be angry at me when I offered him sugar milk.

0:12:22 > 0:12:24OK.

0:12:24 > 0:12:25And that's quite unreasonable.

0:12:25 > 0:12:27When a nice man offers you sugar milk

0:12:27 > 0:12:30you shouldn't start to cry or be angry, you should be happy.

0:12:30 > 0:12:31But he wasn't.

0:12:31 > 0:12:35But I enjoy that because I want him to be more angry.

0:12:35 > 0:12:39I want him to show his temper more.

0:12:39 > 0:12:42- Because he will use that to learn and pick up new things.- Yeah.

0:12:42 > 0:12:45We work with children with autism,

0:12:45 > 0:12:48which have a very, very serious problem

0:12:48 > 0:12:50with a very, very bad prognosis.

0:12:50 > 0:12:52You cannot be afraid of conflicts.

0:12:52 > 0:12:57You cannot be afraid of crying, unhappy children,

0:12:57 > 0:13:00resistance towards demands.

0:13:00 > 0:13:02Then I suggest that you do something else.

0:13:04 > 0:13:07The use of punishment by early practitioners

0:13:07 > 0:13:11gave ABA a reputation for harshness that has been hard to shake off.

0:13:11 > 0:13:13SCREAMING

0:13:13 > 0:13:16But while punishment is no longer used,

0:13:16 > 0:13:18many in the autistic community

0:13:18 > 0:13:21continue to question ABA's basic principles.

0:13:22 > 0:13:28'The science it's based on is the increase or decrease

0:13:28 > 0:13:34'in a behaviour deemed appropriate, or not, by non-autistic people.'

0:13:34 > 0:13:41It can teach the child that it's not OK for them to be as they are,

0:13:41 > 0:13:45and that they have to act differently,

0:13:45 > 0:13:47not like themselves, not naturally,

0:13:47 > 0:13:51in order to be loved and rewarded

0:13:51 > 0:13:53from the people around them.

0:14:00 > 0:14:02Good boy, well done.

0:14:02 > 0:14:05Jeremiah, can you match?

0:14:05 > 0:14:08Jeremiah, can you match?

0:14:08 > 0:14:13See this? See this?

0:14:14 > 0:14:17Good boy. Copy me.

0:14:17 > 0:14:20Excellent, well done, Jeremiah, good boy.

0:14:20 > 0:14:21You can have a raisin.

0:14:21 > 0:14:24Jeremiah, can you match?

0:14:24 > 0:14:27Match, good boy, well done, Jeremiah.

0:14:27 > 0:14:29Can you match?

0:14:29 > 0:14:33Match! Clever boy, well done, Jeremiah.

0:14:33 > 0:14:36There we go, you can have these and you can have your raisin.

0:14:36 > 0:14:38Clever boy. Jeremiah, can you match?

0:14:41 > 0:14:44Yeah, clever boy, Jeremiah.

0:14:44 > 0:14:47You matched. Excellent. Here we go.

0:14:47 > 0:14:50You can have the beads, you can have the bells and you can have a sweet.

0:14:50 > 0:14:52Good boy, Jeremiah. Excellent.

0:14:52 > 0:14:56I think my mum brought me up behaviourally without knowing it.

0:14:56 > 0:14:58If she asked me to do something, I had to do it,

0:14:58 > 0:15:02there was no choice about that. If I was good, I got things.

0:15:02 > 0:15:05COMPUTER VOICE: P-U-M-P-K-I-N.

0:15:07 > 0:15:10Pumpkin. Give me ten, pal. Spud me.

0:15:10 > 0:15:14Whoo! Right, you can have your 14th tick.

0:15:14 > 0:15:17Shall we have some mushrooms? Yeah, we can have some mushrooms.

0:15:17 > 0:15:18There you go, pal.

0:15:18 > 0:15:22It's a very scientific approach, but when it's all broken down,

0:15:22 > 0:15:25to me it just makes sense.

0:15:25 > 0:15:28It's just, you know, it is just good parenting, it's good teaching,

0:15:28 > 0:15:30it's teaching children to gain skills

0:15:30 > 0:15:34and to be free of some of those behaviours that are enslaving them.

0:15:35 > 0:15:37Tuck in your feet and hands.

0:15:37 > 0:15:40- Ouch.- That's it. Fold your hands. Good boy.

0:15:40 > 0:15:46Jack, touch your hands. Copy me. Copy me.

0:15:46 > 0:15:50Good boy, well done, Jack. Good boy.

0:15:50 > 0:15:52There's your lion.

0:15:52 > 0:15:56Although Jack has good social skills, like many children

0:15:56 > 0:16:00with autism he struggles with routine and has problems with food.

0:16:02 > 0:16:05That is Jack's diet for two weeks.

0:16:05 > 0:16:07That's all I can get into him.

0:16:11 > 0:16:14Yes. Are you going to do it, Jack?

0:16:14 > 0:16:16Will you do it for Mummy?

0:16:16 > 0:16:19Good boy, well done.

0:16:19 > 0:16:24What would happen if you fed Jack anything other than that now?

0:16:24 > 0:16:29He would projectile vomit. Definitely. It would just come out.

0:16:29 > 0:16:33I have tried so many different things. Grinding food up.

0:16:34 > 0:16:39Just trying him with, like, a bit of egg on toast,

0:16:39 > 0:16:42cutting it really small.

0:16:42 > 0:16:44There's just no end of things I've tried.

0:16:44 > 0:16:48He just gags, and that's it. He's just sick.

0:16:50 > 0:16:53I just want to see Jack eating foods that children his age

0:16:53 > 0:16:56would be eating.

0:16:56 > 0:17:00He can't be on this jar food, like, when he's 16.

0:17:00 > 0:17:01Do you know what I mean?

0:17:01 > 0:17:03It's just going to go on and on and on.

0:17:03 > 0:17:06And do you feel it's better for the school to tackle this than for you?

0:17:06 > 0:17:08Definitely.

0:17:08 > 0:17:10I've dealt with many things with Jack,

0:17:10 > 0:17:14but the food situation is a very, very difficult one.

0:17:16 > 0:17:19I'd like to be able to take my son to a restaurant, which is

0:17:19 > 0:17:21just not possible at this stage.

0:17:24 > 0:17:25Look at you.

0:17:30 > 0:17:34Lesley started using ABA at Treetops 11 years ago.

0:17:34 > 0:17:37To make it possible on a state school budget,

0:17:37 > 0:17:42she recruits unqualified tutors who she trains and supervises herself.

0:17:42 > 0:17:45The people that we've got working with the kids,

0:17:45 > 0:17:47they're not super highly-trained people. I think

0:17:47 > 0:17:50you can teach the science to almost anyone if they're intelligent

0:17:50 > 0:17:53enough, but you can't teach people to be around kids and like kids.

0:17:53 > 0:17:56So I try and find people that are naturally good with kids.

0:17:58 > 0:18:04Push! Good boy, ready? OK. Push, good boy.

0:18:04 > 0:18:07The school now has 70 pupils on

0:18:07 > 0:18:08one-to-one programmes.

0:18:08 > 0:18:11I do show parents when they come round that not

0:18:11 > 0:18:13all of the children are going to speak, we're not going to

0:18:13 > 0:18:16cure your children, but I do think everyone's reaching their full

0:18:16 > 0:18:19potential, and that's the important thing.

0:18:19 > 0:18:21Know what this sound is, this is...?

0:18:21 > 0:18:23N.

0:18:23 > 0:18:26Excellent, well done, everyone have a token, brilliant.

0:18:26 > 0:18:28- And this sound is?- M!- Brilliant.

0:18:28 > 0:18:32One, two, three, four, five.

0:18:32 > 0:18:35Right, that's five, Joe.

0:18:35 > 0:18:40There is sometimes a really visceral response when you say ABA.

0:18:40 > 0:18:44Some people just really hate it, and others obviously don't.

0:18:44 > 0:18:46Others think it's been highly effective with their child.

0:18:46 > 0:18:50But because ABA is so intensive, you often have to work

0:18:50 > 0:18:54one-to-one with a therapist and child, it's therefore expensive.

0:18:54 > 0:18:58So it costs, either parents if they go privately,

0:18:58 > 0:19:01or local authorities, so taxpayers' money, a lot of money,

0:19:01 > 0:19:06in order to deliver ABA to autistic children.

0:19:07 > 0:19:09- And what did you do yesterday? - Yesterday.

0:19:09 > 0:19:12Where did you go yesterday with Daddy?

0:19:14 > 0:19:15Where did I go?

0:19:15 > 0:19:18- It starts with A.- A.- Aah.

0:19:18 > 0:19:21- Aah.- What did you see? Tell me.

0:19:21 > 0:19:24- You went to see some fish, where did you go?- Aquarium.

0:19:27 > 0:19:30We're trying to teach him recall, which is quite hard.

0:19:30 > 0:19:33It's like a new concept.

0:19:33 > 0:19:39He's 13 and he has the functional age of a seven-year-old,

0:19:39 > 0:19:40so we have quite a way.

0:19:40 > 0:19:43But as you know, we have all the time, don't we, Reuben?

0:19:45 > 0:19:49For parents like June, who don't live near Treetops and want ABA

0:19:49 > 0:19:54for their child, the only options are to set up a home programme

0:19:54 > 0:19:58or fight to get funding to attend one of the few ABA private schools.

0:19:58 > 0:20:02My son went to a local authority special school.

0:20:02 > 0:20:04He was failed very badly.

0:20:04 > 0:20:08I got him out of there and started on an ABA programme

0:20:08 > 0:20:09and he started talking.

0:20:09 > 0:20:13So, you know, I mean, since he's been there now for

0:20:13 > 0:20:16many, many years and he's doing very well, as you can see.

0:20:16 > 0:20:18He's doing a lot of writing.

0:20:18 > 0:20:22But I know a lot parents who didn't have...who don't have

0:20:22 > 0:20:27the resources to either run the home programme, to get the evidence

0:20:27 > 0:20:31that the ABA works, and then to mount a tribunal appeal

0:20:31 > 0:20:36to move their child into a specialist ABA school.

0:20:36 > 0:20:38I know a boy called Matthew,

0:20:38 > 0:20:42he was at the same school that my son was at, and he was there

0:20:42 > 0:20:45for six years and he made absolutely no progress at all.

0:20:45 > 0:20:47Actually, in fact, he regressed,

0:20:47 > 0:20:52and his mother wanted ABA but didn't have the resources to make it

0:20:52 > 0:20:56happen, and now she's taken him out of that school

0:20:56 > 0:21:01and she's home-teaching him and trying the best that she can.

0:21:01 > 0:21:02Go on.

0:21:05 > 0:21:06Go on.

0:21:08 > 0:21:09Go on.

0:21:13 > 0:21:15Go on, hold it.

0:21:19 > 0:21:20Well done.

0:21:26 > 0:21:30Do you feel that Matthew's been let down?

0:21:30 > 0:21:35Yes. He's been in that school six years with no progress.

0:21:35 > 0:21:41The school have spent six years - almost nothing. Yeah. You want soup?

0:21:41 > 0:21:43OK.

0:21:43 > 0:21:48So I have to give up everything at my end to look after my son.

0:21:53 > 0:21:57More bread. Here.

0:22:00 > 0:22:02What has happened?

0:22:02 > 0:22:05Since 2005 he's been in that school - what have they done?

0:22:08 > 0:22:11A child who was able to count up to 17

0:22:11 > 0:22:16now only can count up to ten independently.

0:22:16 > 0:22:18That's not progress.

0:22:18 > 0:22:21By now Matthew should be able to count up to 100,

0:22:21 > 0:22:25but Matthew cannot - only one to ten, a 14-year-old.

0:22:25 > 0:22:28What are you hoping for now?

0:22:28 > 0:22:34Well, I just want a full ABA programme for my son.

0:22:34 > 0:22:37You know, I need funding, which I haven't got.

0:22:37 > 0:22:42I'm just trying here and there to get some funding, which is

0:22:42 > 0:22:44not coming through.

0:22:44 > 0:22:49I want him to be independent and be able to pay back the society.

0:22:49 > 0:22:56That's what my aim is, to be fully part of the society, not excluded.

0:22:59 > 0:23:02- Look.- Frog.

0:23:02 > 0:23:07Frog, well done. Look, Um...

0:23:07 > 0:23:09- Umbrella. - Umbrella, well done.

0:23:11 > 0:23:14I'm the mouthpiece for him.

0:23:14 > 0:23:18He didn't ask for this disability to come. It just happened.

0:23:19 > 0:23:22So then the least you could do is help him.

0:23:24 > 0:23:27If you talk to people with autism, or

0:23:27 > 0:23:30if you, for those who can't speak, if you spend your time observing

0:23:30 > 0:23:34them, what you'll see is a different cognitive style, a different way

0:23:34 > 0:23:39of learning, which is overlaying a different sensory perceptual system.

0:23:41 > 0:23:44It's not wrong, it's just different.

0:23:47 > 0:23:50These differences can vary dramatically over a wide

0:23:50 > 0:23:51autistic spectrum.

0:23:51 > 0:23:54Are you going to wear your scarf today?

0:23:54 > 0:23:58You should, with that. You had a sore throat yesterday.

0:23:58 > 0:23:59OK, I'll put it on.

0:23:59 > 0:24:01It was only when he started

0:24:01 > 0:24:02going to nursery school that

0:24:02 > 0:24:04I really noticed it.

0:24:04 > 0:24:06He was crying, he was rolling about the floor,

0:24:06 > 0:24:08he was climbing under desks...

0:24:08 > 0:24:10He would get very upset.

0:24:10 > 0:24:12He would have meltdowns.

0:24:12 > 0:24:13He used to lash out.

0:24:15 > 0:24:18'I'd been called into the school lots and lots cos of the problems,

0:24:18 > 0:24:20'and the speech and language therapist sat down,

0:24:20 > 0:24:25'and she said Joss probably has something called Asperger's.'

0:24:25 > 0:24:28And she said, "Well, you'll know because you're autistic as well."

0:24:28 > 0:24:33And I was like, "No, no, I'm not. I'm not autistic."

0:24:35 > 0:24:38She said, "You are autistic and you need to get checked now."

0:24:40 > 0:24:43I had no idea what autism was.

0:24:43 > 0:24:47For me, when I got the diagnosis, it made everything make sense.

0:24:49 > 0:24:52With Joss, it made things easier.

0:24:56 > 0:24:59All I knew was he was going to grow up knowing that he was just

0:24:59 > 0:25:02great who he was and he was his own wee person.

0:25:02 > 0:25:04I wasn't going to change him.

0:25:04 > 0:25:08I wasn't going to force him to be something or someone he wasn't.

0:25:11 > 0:25:13You experience the world differently.

0:25:16 > 0:25:19I'm being social right now.

0:25:19 > 0:25:21I'm conforming right now.

0:25:21 > 0:25:23If you see me...

0:25:25 > 0:25:29..at home or things like that, I might not look at you.

0:25:29 > 0:25:31I might rock more.

0:25:31 > 0:25:32Hand flapping, I still do,

0:25:32 > 0:25:36or I walk round in tiny circles or my hands'll go...

0:25:37 > 0:25:40Is that stress? Does it relieve the stress?

0:25:40 > 0:25:43I think so. It seems to happen when I'm under stress,

0:25:43 > 0:25:46so it must be doing something or my body wouldn't

0:25:46 > 0:25:48naturally do it.

0:25:52 > 0:25:56Repetitive and self-stimulatory behaviours are defining

0:25:56 > 0:25:57characteristics of autism.

0:25:59 > 0:26:03Whenever you look at what the goals of an ABA programme are, you'll see

0:26:03 > 0:26:07things on there about lessening or eliminating repetitive behaviours.

0:26:08 > 0:26:12These are things like hand flapping and watching your fingers -

0:26:12 > 0:26:15the things that mark someone out and parents find them

0:26:15 > 0:26:17embarrassing or strange.

0:26:17 > 0:26:20And that's considered a perfectly good thing to use

0:26:20 > 0:26:21ABA to get rid of.

0:26:23 > 0:26:25On the other hand, if you talk to people with autism

0:26:25 > 0:26:28you find out that these behaviours are actually functional.

0:26:28 > 0:26:29They're things that allow them

0:26:29 > 0:26:33to cope with sensory perceptual difficulties that they're having.

0:26:33 > 0:26:36They allow them to cope with stress. The behaviours work.

0:26:40 > 0:26:44Gunnar has now been working with Tobias for six months.

0:26:44 > 0:26:45Hi, Tobias.

0:26:45 > 0:26:47HE SPEAKS OWN LANGUAGE

0:26:54 > 0:26:59This is an activity he doesn't learn anything from,

0:26:59 > 0:27:05just the self-entertainment without any progress or development.

0:27:05 > 0:27:09Other people might think that this is a necessary activity for a child,

0:27:09 > 0:27:12so they leave them doing it.

0:27:12 > 0:27:14The point is, having worked with a lot of kids,

0:27:14 > 0:27:16I can't see it makes them happy.

0:27:16 > 0:27:19I can't see it causes development,

0:27:19 > 0:27:26and I see lots of motivation problems and learning problems.

0:27:26 > 0:27:28SHE SPEAKS OWN LANGUAGE

0:27:35 > 0:27:37Gunnar has trained the parents

0:27:37 > 0:27:41so that they can work intensively with Tobias as his tutors.

0:27:41 > 0:27:43SHE SPEAKS OWN LANGUAGE

0:27:51 > 0:27:53Fantastic.

0:27:56 > 0:27:59HE SPEAKS OWN LANGUAGE

0:27:59 > 0:28:01It was fantastic.

0:28:01 > 0:28:04He is receivable, for your instruction.

0:28:04 > 0:28:08And your influence. He'll watch you, he watches you a lot.

0:28:08 > 0:28:12Just a few times you say, "Look at me," and he looks at me immediately.

0:28:12 > 0:28:15HE SPEAKS OWN LANGUAGE

0:28:21 > 0:28:25You are not a happy parent of a child doing...all the day.

0:28:27 > 0:28:31So, er, it's much better to work and see the progress.

0:28:31 > 0:28:36Some days you go back, and I don't think that I smile every day,

0:28:36 > 0:28:40but it's much better when we see we help him,

0:28:40 > 0:28:44than see him being worse every day.

0:28:50 > 0:28:55I try to learn parents to be focused on defining the behaviour as I do -

0:28:55 > 0:28:56reasonable or unreasonable -

0:28:56 > 0:29:00and if it's unreasonable behaviour, you should demand some other

0:29:00 > 0:29:01behaviour from the child.

0:29:01 > 0:29:05Some people might think that you're being unreasonable.

0:29:05 > 0:29:09I don't think so. I think I'm quite reasonable.

0:29:09 > 0:29:14The point is, he has to perform, he has to...

0:29:14 > 0:29:17do something to gain,

0:29:17 > 0:29:20to reinforce the wanted object.

0:29:20 > 0:29:23And I don't care if that stresses him today,

0:29:23 > 0:29:27because the goal is not today, the goal is many years ahead.

0:29:29 > 0:29:34And if he cried towards me at the age of three-and-a-half year,

0:29:34 > 0:29:41when he's six, that doesn't matter - he would never remember it even.

0:29:41 > 0:29:44So, I don't really see the dilemma.

0:29:47 > 0:29:49Look, we've got the snake.

0:29:49 > 0:29:52Halfway through Jack's first term,

0:29:52 > 0:29:55Lesley is ready to start tackling his food issues.

0:29:56 > 0:29:59The whole food thing is a really difficult issue.

0:29:59 > 0:30:02You can't force children to eat food against their will.

0:30:02 > 0:30:04We wouldn't want to do that.

0:30:04 > 0:30:06But sometimes you have to encourage children to do things

0:30:06 > 0:30:09they don't want to do, in order to be able to move them on.

0:30:09 > 0:30:10Here comes dinner.

0:30:14 > 0:30:16It's a big, red lorry.

0:30:22 > 0:30:24The first thing that we're doing is getting Jack used to

0:30:24 > 0:30:27sitting at the table with food in front of him.

0:30:27 > 0:30:32He needs to be able to tolerate the food being there without panicking.

0:31:06 > 0:31:08Don't do that.

0:31:14 > 0:31:17We have seen quite a few cases where children would only eat

0:31:17 > 0:31:20orange food or only eat baby food.

0:31:20 > 0:31:25I've left that there thinking he may have gone for that.

0:31:25 > 0:31:29That's not going to happen in a month of Sundays.

0:31:32 > 0:31:35You do have to consider he's a little child

0:31:35 > 0:31:38and it's a person who doesn't want to do something.

0:31:38 > 0:31:40They're not just being difficult.

0:31:40 > 0:31:43They may have sensitivities or feel or think things differently

0:31:43 > 0:31:45to how you do.

0:31:45 > 0:31:48But I don't think you can let that stop you trying to teach them

0:31:48 > 0:31:49new skills.

0:31:49 > 0:31:52I think you just have to be careful how you introduce it.

0:31:54 > 0:31:56# Put your coat on

0:31:56 > 0:31:57# Put your coat on

0:31:57 > 0:32:00# And come along out to play

0:32:01 > 0:32:03# Put your scarf on

0:32:03 > 0:32:05# Put your scarf on

0:32:05 > 0:32:08# Make yourself nice and cosy

0:32:08 > 0:32:10# Put your boots on

0:32:10 > 0:32:12# Put your boots on

0:32:12 > 0:32:15# Now come along out to play. #

0:32:16 > 0:32:19St Christopher's take a different approach to

0:32:19 > 0:32:21children's issues with food.

0:32:21 > 0:32:29Cameron is one of the few that refuses to eat anything.

0:32:29 > 0:32:32He's never eaten a solid thing in his whole entire life.

0:32:32 > 0:32:35So he has six milkshakes a day that bulk him up.

0:32:37 > 0:32:40He will be given exactly the same as all the other children,

0:32:40 > 0:32:42and then it's down to him to then make those choices

0:32:42 > 0:32:44if he wants to put it to his mouth.

0:32:45 > 0:32:47If you try and push the children too much,

0:32:47 > 0:32:49you then lose that trust with them.

0:32:49 > 0:32:53So we try and take steady steps with them to build that

0:32:53 > 0:32:56trust and allow them to sort of make further progress like that.

0:32:56 > 0:32:59And what will happen with someone like Cameron,

0:32:59 > 0:33:00because I guess that can't carry on?

0:33:00 > 0:33:03No, I mean, he's 11 years old now

0:33:03 > 0:33:06and so Mum is discussing about medication,

0:33:06 > 0:33:10anxiety medication and trying to reduce the anxieties around food.

0:33:10 > 0:33:15Hopefully we'll be able to then take that window of opportunity to

0:33:15 > 0:33:18make him feel comfortable enough to then try and eat solid food,

0:33:18 > 0:33:22but it probably will end up being that he'll be tube-fed.

0:34:08 > 0:34:12Treetops have been working with Jack on his food issues for

0:34:12 > 0:34:15three weeks, but at home his eating has got worse.

0:34:15 > 0:34:17Bye-bye.

0:34:17 > 0:34:20He wouldn't even touch his custard last night.

0:34:21 > 0:34:25He just tipped it over the side, as if, so, you know,

0:34:25 > 0:34:27he couldn't then eat it.

0:34:29 > 0:34:32So, have you spoken to the school about it?

0:34:32 > 0:34:34Well, I didn't know what to do,

0:34:34 > 0:34:37and they said about coming out and showing me what to do at home.

0:34:37 > 0:34:39Because I did want to know.

0:34:39 > 0:34:43But I just didn't quite realise, he's got to sit there

0:34:43 > 0:34:45and he's not allowed to be sick,

0:34:45 > 0:34:50and then if he's sick he doesn't get his custard as a reward.

0:34:50 > 0:34:53- And what happened? Was he sick? - Yes.

0:34:54 > 0:35:00And the two times I tried to do it, he was just projectile vomiting.

0:35:01 > 0:35:07You know, it wasn't good. I just don't know the answer.

0:35:07 > 0:35:09There's no way you'd have dealt with it, Mum.

0:35:09 > 0:35:13No. Just don't know what to think,

0:35:13 > 0:35:17but he won't eat something so you'll give him, like,

0:35:17 > 0:35:22chocolate custard and he'll eat that, and then he'll decide what

0:35:22 > 0:35:25else he wants to eat and he's going, "Lovely, that's what I want."

0:35:25 > 0:35:30So then when you try him with ordinary food, he's not going to -

0:35:30 > 0:35:31he's trying you out.

0:35:31 > 0:35:34Well, they said he's doing OK at school,

0:35:34 > 0:35:37but I do need to go in and see that for myself to decide

0:35:37 > 0:35:40whether I will continue with the programme

0:35:40 > 0:35:44because I can't do it if it's the way it was here,

0:35:44 > 0:35:47Friday, I just can't do it.

0:35:48 > 0:35:49Come on!

0:35:51 > 0:35:54- Bye-bye.- Good boy!

0:35:55 > 0:35:57Say bye-bye, Nana.

0:35:59 > 0:36:01Bye-bye, Nana.

0:36:02 > 0:36:06Nan's gone. Going to come back in now?

0:36:06 > 0:36:13Going to come back in? With me. Going to come back in?

0:36:13 > 0:36:15Come in. Come in, Jack.

0:36:17 > 0:36:20Quickly. Quickly.

0:36:20 > 0:36:22Quickly!

0:36:33 > 0:36:35HE LAUGHS

0:36:35 > 0:36:36Come on.

0:36:36 > 0:36:37HE CRIES

0:36:41 > 0:36:42Oh!

0:36:42 > 0:36:45HE CRIES HARDER

0:36:56 > 0:36:58HE CRIES

0:37:05 > 0:37:07Where's your pass?

0:37:09 > 0:37:10OK, give us a cuddle.

0:37:12 > 0:37:14HE CRIES

0:37:21 > 0:37:23Oh!

0:37:24 > 0:37:27HE CRIES

0:37:32 > 0:37:35HE CRIES HARDER

0:37:51 > 0:37:54Woh-ah-ah.

0:37:56 > 0:38:00Ah, hey.

0:38:01 > 0:38:06- Hello, June. - Hi, Patience, how are you?

0:38:06 > 0:38:09June works as a volunteer adviser for parents of children with

0:38:09 > 0:38:11special educational needs.

0:38:11 > 0:38:14She has stayed in touch with Patience since Matthew

0:38:14 > 0:38:16and Reuben were at school together.

0:38:16 > 0:38:18Yes, you've grown.

0:38:18 > 0:38:20Wah, oh, ah, ha.

0:38:20 > 0:38:22Hello.

0:38:22 > 0:38:23Sorry.

0:38:23 > 0:38:25Hi.

0:38:27 > 0:38:29- Reuben is 13 now?- Yes.

0:38:29 > 0:38:33And Matthew's near to 15. So it's only a two years' gap.

0:38:33 > 0:38:37But you know, when Matthew started, as you say, he could count to 20.

0:38:37 > 0:38:42Reuben didn't, couldn't. He didn't know his numbers.

0:38:42 > 0:38:44Maybe one, two maybe.

0:38:44 > 0:38:46Matthew knew more than that when he started, yes.

0:38:46 > 0:38:49Yeah. Reuben hadn't. He had maybe five words.

0:38:49 > 0:38:52He'd learned fantastically.

0:38:52 > 0:38:55As you see, you know, he can read, he can write.

0:38:55 > 0:38:58You see, this is one of my worries why I don't want him

0:38:58 > 0:39:01to go to any more special schools, whereby he picks up more

0:39:01 > 0:39:08negative behaviour and then, you know, he will be very unmanageable.

0:39:08 > 0:39:10So that's why I said I feel a little bit...

0:39:10 > 0:39:13But you, no, you've got him at home, but he's not...

0:39:13 > 0:39:17because you don't have the money to have tutors in, he's doing nothing.

0:39:17 > 0:39:21He's un...you know, he is just bored!

0:39:21 > 0:39:25We do work. There are these two things. Some cutting.

0:39:25 > 0:39:27We do coupons.

0:39:27 > 0:39:30But, Patience, it's a lot of work because, you know,

0:39:30 > 0:39:33he needs to be stimulated six hours a day.

0:39:33 > 0:39:37If you imagine a child at school, you can't manage at home, because

0:39:37 > 0:39:41at the moment you don't have the funding, you need to push that side.

0:39:41 > 0:39:44You do.

0:39:44 > 0:39:46You obviously work with loads of parents,

0:39:46 > 0:39:50and I wonder how unusual Patience's experience is?

0:39:50 > 0:39:58It's not unusual at all. It's becoming more frequent.

0:39:58 > 0:40:01And there are lots of families around the country doing home

0:40:01 > 0:40:03programmes and funding it themselves,

0:40:03 > 0:40:05so you don't hear of them at all,

0:40:05 > 0:40:07but they are, they're there.

0:40:07 > 0:40:12It's this kind of hidden community of parents doing ABA at home.

0:40:18 > 0:40:21Gunnar considers one of his most successful home programmes to

0:40:21 > 0:40:25have been with a family who live in Stockholm.

0:40:25 > 0:40:30We're going to say hello to Richard, a Swedish boy, he's 16.

0:40:30 > 0:40:35He got an autism diagnosis at around age three.

0:40:35 > 0:40:39The official system told the mum and dad not to be too optimistic,

0:40:39 > 0:40:43and they should prepare themselves for sending Richard

0:40:43 > 0:40:45to a special school,

0:40:45 > 0:40:47but the parents thought otherwise.

0:41:03 > 0:41:07Richard plays badminton for the Swedish national junior team.

0:41:18 > 0:41:20The parents contacted me

0:41:20 > 0:41:23and we started development training when he was three and a half.

0:41:23 > 0:41:25It was a struggle.

0:41:25 > 0:41:28Most of all, it was a struggle for the parents,

0:41:28 > 0:41:32not always agreeing on how to do things.

0:41:37 > 0:41:40THEY SPEAK IN SWEDISH

0:43:39 > 0:43:40THEY LAUGH

0:43:49 > 0:43:51So this is his birthday, is it?

0:43:51 > 0:43:54This is his two-year birthday.

0:44:09 > 0:44:11HE LAUGHS

0:44:13 > 0:44:15THEY LAUGH

0:44:38 > 0:44:41This is in November, he was born in April... Three and a half.

0:44:41 > 0:44:45So at this point speech hadn't really started?

0:44:45 > 0:44:47No, no, no, not at all.

0:44:48 > 0:44:52OK, OK... Shh!

0:45:00 > 0:45:02SHE SPEAKS IN SWEDISH

0:45:17 > 0:45:19HE CRIES

0:45:42 > 0:45:44THEY SPEAK IN SWEDISH

0:45:47 > 0:45:49He doesn't want to watch more.

0:45:51 > 0:45:54He's a really happy child right now,

0:45:54 > 0:45:56and it's great that you have done this,

0:45:56 > 0:45:59but it's, yeah, hard to see.

0:45:59 > 0:46:01Yeah, it is very surprising.

0:46:02 > 0:46:06And I never think it was so hard.

0:46:06 > 0:46:11And I think I was just sick, but not so sick.

0:46:14 > 0:46:22He had a condition that tells him to try to avoid demanding situations.

0:46:22 > 0:46:26It was very difficult to find anything you could use

0:46:26 > 0:46:28as a proper reinforcement.

0:46:28 > 0:46:30There was a couple of things he could like,

0:46:30 > 0:46:35but nothing he was willing to climb Mount Everest to get.

0:46:35 > 0:46:38You see what I mean? So we had to be firm.

0:46:38 > 0:46:40If not, he wouldn't take us seriously.

0:46:40 > 0:46:42And seeing the result today,

0:46:42 > 0:46:44I don't personally feel very, very bad about it.

0:46:44 > 0:46:47Listening to Richard telling that he really doesn't recall

0:46:47 > 0:46:50anything from that period.

0:46:50 > 0:46:54So it's a little bit... In a hospital, when we get hurt,

0:46:54 > 0:46:56it looks like a mess.

0:46:56 > 0:46:58There's blood all over,

0:46:58 > 0:47:01it's sweat and tears, it's sadness,

0:47:01 > 0:47:03and then they fix you.

0:47:27 > 0:47:30- Where's it gone?- Have we got our bus with the doors today?

0:47:30 > 0:47:33Shall we shut them?

0:47:33 > 0:47:37I can't believe him. Why did he give me all that grief?

0:47:37 > 0:47:41- Yes, good boy.- Clever boy.

0:47:41 > 0:47:44You know, I've been reading in the book that he's not

0:47:44 > 0:47:47been sick for the past two days,

0:47:47 > 0:47:51so obviously it is me.

0:47:51 > 0:47:52It's got to be me, ain't it?

0:47:52 > 0:47:55It's going to be a long process,

0:47:55 > 0:47:58and that emotional attachment makes it so much harder,

0:47:58 > 0:48:02cos you don't want to see him upset and distressed, you know,

0:48:02 > 0:48:06and he's not used to you doing things like that with him.

0:48:06 > 0:48:09So it's almost he's got a whole new learning process.

0:48:09 > 0:48:12Where's that truck? Who's that?

0:48:12 > 0:48:14SHE LAUGHS Hello!

0:48:14 > 0:48:18"What are you doing here, Mummy? What's Mummy doing here?"

0:48:19 > 0:48:25- What's she doing? Did you come to speak to Michaela? Wow!- Mummy!

0:48:27 > 0:48:31Have you been eating food? You been eating food?

0:48:31 > 0:48:33I think we might get tears.

0:48:33 > 0:48:36Yeah. Just go and sit over there with Michaela.

0:48:36 > 0:48:39We're nearly finished now, ain't we? Where's the last one?

0:48:39 > 0:48:42Where's the truck gone?

0:48:44 > 0:48:46Where's the truck gone?

0:48:48 > 0:48:52People have to think very carefully about exactly what compliance

0:48:52 > 0:48:54is teaching their children,

0:48:54 > 0:48:58because you're giving way to an adult.

0:48:58 > 0:49:00You are complying with an adult, all the time,

0:49:00 > 0:49:04and that can leave you extremely vulnerable, extremely vulnerable.

0:49:04 > 0:49:06Yeah, we're done for today.

0:49:06 > 0:49:12So he's tried two bits of everything and no...no gag at all.

0:49:12 > 0:49:14Come here, you cuddle Mummy.

0:49:14 > 0:49:17Aw!

0:49:17 > 0:49:21I think the argument is, it's the child's right to say no.

0:49:21 > 0:49:24But we believe that it's the child's right to be able to experience

0:49:24 > 0:49:27other things, and they don't really know what they're saying no to

0:49:27 > 0:49:29because they've got a barrier

0:49:29 > 0:49:33so it's about removing those barriers and retraining their brain

0:49:33 > 0:49:36so that actually they can access a whole lot of other things

0:49:36 > 0:49:38and enjoy a much fuller life.

0:49:54 > 0:49:58Although I wasn't diagnosed as a child,

0:49:58 > 0:50:01it was obvious that I was different.

0:50:04 > 0:50:09You know, there's no blame, there's no hard feelings,

0:50:09 > 0:50:14but this drive to make me

0:50:14 > 0:50:17look, appear, behave, think, feel...

0:50:19 > 0:50:25..experience everything in a normal way

0:50:25 > 0:50:26was...

0:50:26 > 0:50:30it-it broke me inside.

0:50:32 > 0:50:36It is a form of cruelty to deny a person who they are.

0:50:36 > 0:50:38Erm...

0:50:38 > 0:50:42There was no cruel intent there, the best interest was

0:50:42 > 0:50:49always there, but it wasn't right for me, and I couldn't put

0:50:49 > 0:50:54Joss into a system or a programme

0:50:54 > 0:50:56that wasn't designed for him.

0:50:57 > 0:51:04I couldn't rob Joss of who he was, of his soul, of his essence.

0:51:04 > 0:51:09And if part of that was autistic, then fair enough.

0:51:09 > 0:51:13It's not necessarily a bad way of living.

0:51:13 > 0:51:18But there's other people who are profoundly autistic

0:51:18 > 0:51:21and I can't... I can't speak for them.

0:51:21 > 0:51:25# Happy birthday to you

0:51:25 > 0:51:29# Happy birthday to you

0:51:29 > 0:51:35# Happy birthday, dear Jeremiah

0:51:35 > 0:51:39# Happy birthday to you. #

0:51:39 > 0:51:42Ready, steady...

0:51:42 > 0:51:44THEY CHEER

0:51:45 > 0:51:50Some people suggest the goal of ABA is compliance with social norms,

0:51:50 > 0:51:54with rules, and that is in fact true.

0:51:54 > 0:51:58But everybody expects that from their children. Nobody wants chaos.

0:51:58 > 0:52:03We are who we are, due to some genetic endowment.

0:52:03 > 0:52:08But most of who we are is in fact the result of a set

0:52:08 > 0:52:11of environmental events completely out of our control

0:52:11 > 0:52:13and unwittingly applied by people around us.

0:52:13 > 0:52:16But the fact that we're unaware of it doesn't make it

0:52:16 > 0:52:18any less effective.

0:52:18 > 0:52:21Dr Vince Carbone is a leading ABA practitioner

0:52:21 > 0:52:23and researcher from New York.

0:52:23 > 0:52:26He constructed the programme that Treetops follows

0:52:26 > 0:52:28and visits the school twice a year.

0:52:28 > 0:52:31- Who's that?- This is Jack.

0:52:31 > 0:52:33Jack, huh?

0:52:35 > 0:52:37That was funny, huh, Jack?

0:52:37 > 0:52:41Look at him sign.

0:52:41 > 0:52:43In a book!

0:52:43 > 0:52:45Nice, Jack!

0:52:47 > 0:52:49That's great.

0:52:49 > 0:52:53I think it's important that people pay attention to what people

0:52:53 > 0:52:57with autism say about ABA therapy.

0:52:57 > 0:53:00But we're not trying to change the soul or...

0:53:00 > 0:53:03the essence of the person,

0:53:03 > 0:53:06what we're attempting to do is change their behaviour patterns so

0:53:06 > 0:53:09that they garner more reinforcement during their life than they do

0:53:09 > 0:53:12negative attention and punishment from the social community.

0:53:12 > 0:53:16And...a biscuit. Well done!

0:53:25 > 0:53:29Hey, do some exercise or else you'll freeze.

0:53:29 > 0:53:31Matt, go on, go on the bike.

0:53:34 > 0:53:37I'm not regretting what I did

0:53:37 > 0:53:40because any mother in my position would do the same.

0:53:53 > 0:53:58It breaks my heart to watch him growing up, you know,

0:53:58 > 0:54:00not getting any better.

0:54:10 > 0:54:12The love for my child, is it right?

0:54:12 > 0:54:17Nothing else. It's that love that I have for my son that drives me

0:54:17 > 0:54:20to do anything, anything that it takes.

0:54:23 > 0:54:26If I don't fight for him, nobody does.

0:54:34 > 0:54:37Thank you. Shall we go home?

0:54:42 > 0:54:44Matthew, come on.

0:54:44 > 0:54:48It's getting dark, look. Night-time.

0:54:48 > 0:54:49Night-time.

0:54:51 > 0:54:55Listen, five, four,

0:54:55 > 0:55:01three, two, one! Home time.

0:55:01 > 0:55:03Home time.

0:55:03 > 0:55:06Going home, going home...

0:55:06 > 0:55:08- You want me to leave you?- Yeah.

0:55:08 > 0:55:12I'm going now, Matt. I'm going. Bye-bye.

0:55:12 > 0:55:14OK, I'm going, bye-bye!

0:55:16 > 0:55:18I'm going, are you coming?

0:55:18 > 0:55:20Are you coming? Come on!

0:55:22 > 0:55:23Let's go.

0:55:24 > 0:55:25Come on.

0:55:43 > 0:55:45He never used to look at me.

0:55:45 > 0:55:48Even if you called for him, he never used to come.

0:55:49 > 0:55:50Things changed for me.

0:55:50 > 0:55:52He does come to me now.

0:55:52 > 0:55:56I'm much happier than what I was.

0:55:56 > 0:56:00That stress level is, you know, reduced enormously.

0:56:01 > 0:56:03BOY LAUGHS

0:56:06 > 0:56:07You can have it later, OK?

0:56:09 > 0:56:14The changes are always going to be slow. There is no quick fix.

0:56:14 > 0:56:17But the changes are very positive, and if he is going to

0:56:17 > 0:56:21a mainstream school, I don't think it would have happened.

0:56:22 > 0:56:28Do you feel that you're just able to communicate better with him?

0:56:28 > 0:56:29Yeah.

0:56:29 > 0:56:34Jeremiah, how do you say sweeties? How do you say crisps?

0:56:34 > 0:56:35Crisps, good boy.

0:56:35 > 0:56:37How you say raisins?

0:56:37 > 0:56:38Raisins.

0:56:38 > 0:56:41How do you say biscuits? Biscuits. How do you say bubbles?

0:56:41 > 0:56:45Bubbles. How do you say up? Up.

0:56:46 > 0:56:50Good boy. Show his nose, eyes.

0:56:50 > 0:56:53Touch your nose. Touch your nose.

0:56:53 > 0:56:55Touch your nose.

0:56:55 > 0:56:58Look. Touch your head. Head.

0:56:58 > 0:57:01Touch your head. Good! That's a good boy!

0:57:01 > 0:57:02Spin!

0:57:03 > 0:57:05Spin!

0:57:06 > 0:57:10There is this fine line about knowing when to allow children to,

0:57:10 > 0:57:13kind of, step out of their comfort zone and when not to.

0:57:13 > 0:57:16And this is, I think, the case for all children,

0:57:16 > 0:57:18but it's particularly difficult for children with autism,

0:57:18 > 0:57:21who are often very set in their ways.

0:57:21 > 0:57:24Can they be pushed at this moment in time in order to experience

0:57:24 > 0:57:27something new, or should we just, kind of, hold back?

0:57:27 > 0:57:30And parents and teachers are making these really quite subtle,

0:57:30 > 0:57:32ethical decisions all the time.

0:57:35 > 0:57:38Yeah, I know. It'll be here in a minute.

0:57:38 > 0:57:40Dinner come in a minute.

0:57:40 > 0:57:44We'll watch the children first. Yeah?

0:57:44 > 0:57:46Look. Look, Jack.

0:57:47 > 0:57:49Wow!

0:57:50 > 0:57:54Yeah, Mummy's going to cut it up for you.

0:57:54 > 0:57:55There you go.

0:58:05 > 0:58:08Look at him. I never thought this day would come.

0:58:08 > 0:58:11Never. Nothing makes him sick any more.

0:58:11 > 0:58:15Oh, it's just absolutely fantastic.