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Marni Goltsman, whose son is autistic, says she and her husband have pushed the boy to take part in activities against his wishes because over time, he has come to enjoy and learn a lot from those experiences. But now that he’s five, she asks, should they begin respecting his preferences?

[T]here are two problems with this approach. The first is a new problem: Brooks is getting older. It’s one thing to ignore a toddler’s protests—it’s quite another when a increasingly verbal 5-year-old describes to you exactly what he doesn’t like, and asks you point-blank why he has to do it. And the second is a an old problem that’s been around ever since he was diagnosed: How far can we push him without sacrificing his self-esteem? If this is simply too challenging for him at the moment, which may very well be the case, then why are we torturing him by having him face his deficits in front of us and his peers week after week? Should we instead be taking a break from soccer and working on something else? Or should we design a more appropriate intervention, like having his physical therapist work on ball skills with him one-on-one?

A week ago, I linked to a parent who explained why she prefers one educational method (Floortime) over another (Applied Behavior Analysis, or ABA) for her autistic son. This week, as promised, she describes her family’s experiences with each of the two techniques.

ABA:

Although I can’t say that my son enjoyed the sessions (do you enjoy being forced to stretch yourself and perform outside of your comfort level?), this gifted therapist gave him so much support that it was almost impossible for him NOT to respond favorably. Every tiny success brought choruses of congratulations, and testimonials like “Wow, you are doing such an incredible job—I am sooooo proud of you!” I imagined that the 20^th congratulatory chorus might not have the oomph of the first. But remarkably, each endorsement was even more heartfelt and genuine than the last; undimmed enthusiasm, thus no diminishing returns.

Floortime:

I learned that sometimes, it’s therapeutic NOT to intervene; that my son needed to know that we loved and accepted him and all the things that made him happy, regardless of whether they were socially acceptable or if they contributed to his cognitive development. Gradually, this therapist introduced toys that would help my son learn, like animal flashcards. Her slow and gentle pace yielded incredible results. Within 3 months, my son, who was previously unable to identify a single animal, could recognize animals and animal sounds, with an ease that was slightly above average for his age level. Honestly, this slow-and-steady pace is much easier to endorse after the fact. When we were living it, many sessions prompted me to second-guess my confidence in this approach and wonder, is this therapist actually doing anything?

For those who read the recent New York Times magazine article about Floortime, an educational method for students with autism, here’s one New York City parent’s explanation of why she prefers it over Applied Behavior Analysis for her son:

Yes, we wanted our son to be able to do a 4-piece puzzle, but we wanted him to do it because he enjoyed it, not for the cookie. Those in the ABA camp say the technique is simply a door into the parts of the brain that need to be switched “on.” Once the door opens, advocates say, the kids do start to enjoy the ‘games’ of therapy, as much as any typically developing child. I have to say, I’ve seen ABA work in exactly that way, but I’m still uncomfortable with the overall approach. At its core, it still seems to me a mechanical and lifeless teaching method, and one that would not address one of our top priorities: to instill in our son a love of learning; to show him that it can be interesting and fun and exciting.

As it turns out, my son’s ABA therapists have been some of his best, and he’s made multi-faceted gains as a result of their efforts. But I’m still a huge Floortime fan. It’s complicated, like everything else about autism.