Madore Family's Autism Resource Site 

OUR HOME PROGRAM

CONTENTS OF THIS PAGE:
FUNDING
ABA LINKS
HELP WITH ACTIVITIES AND LESSONS
PICTURES OF MY THERAPY AREA
BOOKS
ARTICLES
ABA PROVIDERS IN THE U.S.
Computer Software
Videos & DVDs
Games
STORYBOOKS WITH AUTISTIC-LIKE CHARACTERS

Update 7-2007: Our home program at age nine looks mostly like tutoring. He must still learn everything at home 1:1 because he can't concentrate like a regular third grader can. Things go too fast for him in his regular class. In 1st and 2nd grade he was in a regular class all day that had his main regular ed teacher and then a special ed teacher would assist with lessons and pull Andrew and a couple of others out when things became too much. He does have an aid during PE and music. It is so wonderful that Andrew's 2 main therapists that have been with him all along are still with him at least 4 days a week. We were recently approved for CLASS so when those therapies finally arrive, we will encorporate them into his program and "train them in the language of Andrew". Update 8-2004: We are still using a home program with Andrew. He just turned six but he still needs help--time doesn't stand still. Other 6 year olds can read and write and socialize so we have to try and keep up with them. He has at least 1 session everyday after school. Therapists are here 6-7 days a week. We still do a combination approach with mostly AVB DI mixing, NET, speech practice and academics. He is reading beginner books and beginning to write spontaneous sentences about topics. He is doing addition and subtraction of single numbers and likes to draw and color (a big change). Jesse Franco from the Capital School has been great with helping us perfect his speech program. She even identified an adnoid problem that was keeping him from breathing properly and giving him a nasal tone. He is doing a second year in kinder to help him catch up with his peers--he is a summer baby so he was young for his grade anyways. We do RDI lessons to help with social skills and the NET activities help generalize things. We still have Jaye, who has worked with him for about 4 years, and Trish and Traci have been with him for about 2 1/2 years. We are lucky to have a good team. NEISD has been working with us but all parents know this is hard...we keep going and they are trying. He has a good monitoring teacher. We stay optimistic about things, but Andrew will always be different and I can respect that. He has a couple of good friends and a family who loves him. He endures a lot everyday and is very opinionated. I can respect that too. Mostly I just love him. I love him for making my life real. He tries my patience and pushes my buttons but he makes me smile and giddy with his progress. I am very lucky to have him in my life and a part of my family. Please keep him in your thoughts and prayer.

The rest of this page is from the past (I think most of this is from 200-2002 with some 2003 items) but is still helpful for beginners:
Our home program consists of a lot of different therapies: ABA for curriculum, AVB for language, floortime for play, etc...  We began with only ABA and it truly helped begin the process of bringing him back to us.  The Developmental Pediatrician who diagnosed him at 28 months said she knew he was autistic within seconds of entering the room.  She would not recognize my child today.

Applied Behavior Analysis (ABA) or Discrete Trial Teaching (DTT) is based on the method used by O. Ivar Lovaas where he was able to "recover" 47% of the autistic children in his clinic, but ABA should not be mistaken as the exact same thing. B.F. Skinner used "operant conditioning" as far back as 1938 to help with a variety of disorders. Autism was first named and described by Leo Kanner in 1944 as "The mysterious disability of autism is characterized by a peculiar emotional and intellectual detachment from other people and the common human world."
ABA is a technique that is used to help overcome some of these problems.

ABA teaches tasks, however small or complex, by breaking them
into small steps that can be learned more easily.
For instance, unpacking a backpack when a child comes to school may seem simple to us, but to an Autistic child it requires about 12 steps that must be learned individually and then put together.

The best resources for setting up an ABA Program would be other families that have set up a therapy program and of course an experienced professional/consultant if you can find one.
Below you will find some links and books that may help.

During a therapy session, when a child gives a correct answer or completes a task correctly, they are given a reward or a "reinforcer." Inappropriate behaviors or responses are either corrected, ignored, or redirected. A reinforcer is anything the child wants and likes, such as: hugs, kisses, tickles, food, drinks, or a chance to play with their favorite toy. A desired behavior or response is always followed by this positive reinforcement. Andrew's best reinforcers are just a smile from you with a "You did it," or "Great Job," or just a hug. In the very beginning the therapists used a lot of food related reinforcers like goldfish or gummy bears.

The data on each learning trial is documented to help make adjustments in the child's program. Discrete Trial Teaching is really a subset of an ABA program.
We started with just trying to get Andrew to sit at a table and to look at the therapist (attending skills). We have moved away from pure ABA and are now trying to find fun ways of teaching self-help skills, social and play skills, which are also included in ABA curriculum and we use this as a guideline. Now the therapists spend a lot of time moving around the room using a variety of activities. 
When Andrew started this program on Halloween 2000, he had zero words. Now he has over 400 words and phrases, questions and sentences. He can answer questions like "What is your name?", "How old are you?", "What is your mother's name (dad, sis, dog, teacher, etc.)?", "Do you have a brother?"
He can ask for things - "Can I have .... please?"  He will ask "Where are you?"  When he can't find you.  He will ask ask "What is it?"  when you say "I have something for you?"
This home program started out as an ABA program and then grew from there as he progressed.  ABA helped give him his start.  He was non-verbal and could not even sit well in a chair before we began ABA.  He did not have his first words until 30 months old (he did have a few words before 12 months old and autism stole him away).  

The therapists incorporate speech into everything they do.
They also work on self-help skills, communication skills, how to play appropriately so that he may be able to socialize with his peers, and to basically reach a level where he may be undetectable from others his age. It was only 1 year ago when Andrew would not let anyone touch him
(except Mom & Dad), and he could not tolerate others anywhere near him.

ABA or AVB may not be appropriate for every child. As parents, we know our children the best. My son's behavior was getting in the way of everything else and ABA helped him to concentrate and control the negative things he did. We incorporated a lot of sensory and gross motor movements into the sessions and also allowed for fun yet structured breaks throughout his 2 hour sessions. We are trying to bring in a lot of Verbal Behavior (Carbone and Sundberg-using Mands) to help with speech. We still use ABA to help keep him focused and his behavior in check though. We did a parent training workshop with Vince Carbone to set up a personalized speech plan just for Andrew.  Counting us, there were only 5 families there so we were able to ask questions and show videos of our children.  We practiced AVB techniques and set goals for children for when we got home.

In the beginning we started with only 8-12 hours a week. We have been having a hard time even getting that lately. I would love to have closer to 20 hours a week but that does not seem possible at this time (2 hours in the morning, eat lunch, nap, 2 hours late afternoon). With adding PPCD at his public school, it is hard to get in a lot of hours. No matter what, in the evenings we do family things that keep him focused and verbal. 
We already have spent over $30,000's a year out of our pocket on this technique and you know that teachers and firefighters, as we are, do not make much money so we try to be inventive.

Andrew is really in therapy 24 hours a day 7 days a week because everyone in his life knows how to work with him and we try to incorporate it into his everyday life. He has to use words to request something (we have to prompt a lot) or he has to point to what he wants and say please and thank you. Of course this didn't happen right away because he had no language until he was about 29 months old. Now he can spontaneously request things he wants; "I want a cookie, I want bear movie, I want computer, I want go outside back yard, Can I have the red ball please." This has been a huge accomplishment. It is well worth the expense and sacrifices we have had to make. I cannot stress to other parents and caregivers the importance of working with your child. Having a therapist is great, but unless we do our part, our children's progress will be much slower and less meaningful. Parents are key to the therapy team.
We are the directors and evaluators. We are the ones to guarantee that what the child learns during sessions is generalized into the "real world." I think our work with Andrew is helping to re-wire his brain but I still urge all of you to pursue medical testing and treatment.

We did ABA with my son and it helped him A LOT!  It only took us so far because my son was so bored of the repetitious things.  We had to adapt or go insane. We still use the curriculum. In the beginning during his sessions, he had behavior problems that were horrible, now he does not (knock on wood).  He still can be a terrible two (although he 3) out of "class" but we attribute that to the communication problems and being a 3 yr old boy (he will be 4 May 31st). 

When we started try to get words out my son, we made him work for everything (was hard for me at first because he would cry).  At first we only required eye contact or the sign, then the first syllable, then the full word, then want ...... ,  then want more ....., then I want ...., then I want ..... please.  We had this in October 2001 when we went to the Carbone workshop so this was not from AVB.  I did not know at the time how key this was and luckily we tapped into it.  So we basically picked up all his favorite things and denied access to everything he would want and then made him work for it.  I remember even taking away his Buzz Lightyear and not giving it back to him until he ask for it again or said more or whatever.  This was very time consuming and frustrating for all of us.  I wanted him to have everything and to be happy but the other won out (the necessity for language).  

For pretend play I have a tea set that I keep on the table and we "work" while we are eating.  Pour tea for mommy.  Sister needs more tea.  Can Buzz pour mommy some tea in the pink cup?  Starting out basic and then getting complicated.  I had to start with hand-over-hand to show him what I wanted.  We use the doctor kit and take turns doing exams.  Constructions kit to "pretend" to build things and to actually build things.  We dress up as characters and pretend --- this is a real grey area. He can repeat parts of movies so when we dress up like Buzz and Woody I have to make him go beyond the lines from the movie (he did NOT like this in the beginning).  The bean/block technique (negative reinforcer/third lever of BF Skinners book) can MAKE him participate correctly but it was hard for me to do because I don't like to be negative with him.  

Andrew loves counting out dollars when playing store.  He did NOT want me to intrude with this one at first.  He was acting out the Blues 1-2-3 Activities computer game and repeating Cash Register's lines from the Present Store.  I decided this was too close to a stim after he did it the same way 10 times.  So "pain in the butt" mom came and ruined it and made him give me the "blue dollars" and I would buy things.  Now I will hold up an item and he will tact/label it and tell me how much it is: "That'll be 5 blue dollars please" (this is from the video but he is substituting this situation so I go with it since last summer 2001 we were lucky to get 1-2-3 word combinations together). I will count out the dollars and then he will hit the number 5 on the register and total/open drawer and re-count the money in .  I repeat, this is very close to a stim activity for him but I try to use those needs and mold them into useable life moments.  I pull up those phrases from movies and put them in real life.

I pretend play everything I can think of:  Barbies in the rooms of their house acting out and conversing with one another, car races and crashes, puppet plays, stuff animal parties, cooking and eating in the play kitchen and the real kitchen, pretend cleaning the house.  I keep some things on shelves mostly because he does not play appropriately all of the time with certain things (those become selective shelf items).  I tell him it is play time and give him a choice of activities (I used to have to use PECs for this but I faded those ASAP).  If he is not cooperative I give him the choice of doing an activity or picking up the beans. I know this sounds mean but Skinner/AVB hit the nail on the head with this one - at least for my son.  If he had his way, he would stim, play on the computer or watch the same videos all day (although his stimming is mostly gone now).

He now has to get out his own bowl, fork, plate, - pour his own juice, cereal, chips - clean up etc..  This gets frustrating for me because it takes so long.  It is SOOOOO much easier for me to do it.

We don't use cards anymore except for initialing introducing a new word along with the object and for review in the fast AVB way.  We go on field trips (last week was to the airport and was that ever an eventful time with security - 4 preschoolers holding hands and loud planes!!!). While we are out in the community we label things and talk about their features, functions and class. 

Don't get the wrong idea.  I don't spend enough time doing this.  There are too many other things to do.  It is that juggling act - especially with having more than one child.

 Language and behavior have been the biggest hurdles. We give him choices for mostly everything. "Do you want a cookie or a cracker?" He says, "I want cracker." We make vocabulary boxes and work on about 10 new words at a time. In the box we place a picture of the object and a couple of examples of the object. When he is not in session we make sure to use these words and point out any example of this object. For example a bed. We have a picture of a bed, a Barbie bed, and a Little People's bed. The therapist will phrase the questions in many ways: "What is this?" "Hand me the bed." "Give me bed" "Point to the bed" etc.. . We then point out his bed, sister's bed, Mom & Dad's bed, and any other beds we encounter (including a trip to the mattress store). After 8 months of therapy he had over 80 words and about 15 phrases that consist of 3-6 words each plus the "I want ... " phrases. He also understands a lot more. At 1 year of therapy he had over 200 words and he speaking a lot more spontaneously.  At night I will say, "Night, Night, Andrew." He says, "Nigh, Nigh, Mama." I say "I love you." He says, "I love you too, Mama." He is interchanging the correct names along with these phrases, e.g.. "Nigh, Nigh, Daddy." "I love you too, Grandma." He is even starting to shake people's hands (this is huge for us because he never liked people to touch him). Applied Verbal Behavior is helping him to conversationalize and learn to ask questions.  Now at 1 1/2 years of therapy he has over 400 words, can ask a few Where and What questions and is very spontaneous. Every day is getting better but many things are still a struggle.

I use our digital camera a lot to take pictures of people, places, and things he needs to know. We put Velcro on the back of the pictures and stick them onto a felt board-homemade-I used a cheap blank picture canvas and then glued down the corners of the felt I bought at the hobby shop or even better buy the material that is used for headliners in vehicles at upholstery stores-attaching this to part of a
cardboard box would work as good. Andrew mastered his people program and can identify others great (used the digital camera) so one of the therapists suggested we cross programs. We took pictures of the people in his life doing verb activities such as: Mom cooking, Dad throwing a ball, sister pushing a wheelbarrow, our dog running, Grandma walking, Granddad kicking a ball, therapist sleeping, therapist brushing their teeth, etc... . The verb program can be hard and we are always looking for ways to spice up the sessions (by the way he has learned about 40 verbs this summer). Our computer software programs add a lot to his language skills too. I use the Laureatte Software. A hint that I got at the Texas Autism Conference is to add words to all of these pictures (sort of like the PECS). To be able to read and write, he needs the concept that these things are words that contain letters that we can read and write. Turn on the closed caption on your TV's, label things around the house with spelled out words. Encourage them to draw and pretend writing things. You may want to find out what style of writing your child's school district uses to print so that you are teaching them the correct way from the beginning. You can use sentence strips and hand print on them or just take regular paper, print and then use a tape to attach that will come off clean.
Most of our children are very visual and this can really help.
Dollar Stores are great resources for books, party blowers, art supplies,
and more (and they are cheap).

One of Andrew's therapists has a preschool "class" once or twice a week here. She brings 2 non-autistic girls that are Andrew's and Kristen's age and includes Andrew and Kristen. In this 2 hour class, Andrew has 3 girls to model appropriate play, social skills, and proper conduct in school settings. This has been a real bonus to our in-home program. When watching a video of this session from a few weeks ago I could not believe what he is doing. He holds hands to walk places, gets his carpet square, participates in circle time, does hand motions to songs, and so much more. Our therapist introduces a new piece to a program every week such as "learning shapes." "Today our new shape is a triangle." They then do activities during class that will help reinforce this new concept. If anyone can do something like this, I would highly suggest it. Our therapist has a way of helping Andrew want to be with and like the other kids. There is a new awareness since we have started this weekly "class." One week I was hearing a lot of crying from the "classroom" during this group sessions. After class was over, the therapist said she had added sharing to the program. Andrew does not like to share and will take toys from others if he wants them. To help with this, she sat the kids in a circle and pulled out some of Andrew's favorite toys. Each child took a toy and she set the timer. When the timer goes off, each child then passes that toy to the right. This was huge for Andrew. They were all touching his favorite toys and then he had to give up the one he had and move on to what was passed to him. This is the child that a year ago could play with the same toy for days at a time doing the same motion over and over again.  We are also starting to bring in just one other NT child to work with in a different session - also good for sharing taking turns and modeling.  We go to the park and and I look for a child that seems very nice and patient and make friends with that child by giving compliments.  "Wow you slide great, You run so fast, etc..  If they respond warmly I introduce them to my son and try to make it a play session.  Usually the parents of NT kids are sitting on a bench relaxing or talking to other parents since they don't require what our kids do.  I find the children wanting of attention so this works well.

One thing that really helped with Andrew's babbling was to teach him some children's songs. Many autistic children love music (especially those sing-a-long videos). So instead of repetitive sounds like "Dicka Dicka Dicka" that he went around saying all day, he would now sing "Row Row Your Boat" and other songs. A lot of his repetitive taking things off and on were helped by teaching him how to play appropriately with those toys. One of our therapists is an ex-special needs teacher who is a natural with pretend play. When I watch her, she resembles techniques of floor-time, son-rise, play therapy with a dash of ABA, into her own special therapy. Both of our in-home therapists are wonderful. One has a psychology degree and is working on her masters, the other is an ex-special ed elementary teacher, both with a lot of training in ABA, AVB, and have been working with special needs children for a while (with an emphasis on autistic children). The most important quality that they both possess is that they love Andrew and want him to achieve the most he can. They set high goals and work endlessly to overcome all of his issues. I don't get upset when I hear Andrew crying or tantruming (although I did in the beginning) because I know they are working through these hurdles and Andrew will come out better than before.

Below you can look at pictures of our "classroom," "sensory room," "playroom" and field trips. When we started our program on Halloween 2000 we were in Andrew's very small bedroom with the smallest Little Tikes table and 2 very small chairs. After about 4 months we were able to redesign the house to allow more room for his therapy (his sister really liked the changes too). Now my husband and I have a small bedroom for us to live out of. Our reasoning was that we have spent A LOT of money on therapy, so let's set it up the best we can.

There have been some set backs. Right now Andrew is really testing his boundaries and saying no to things. We just try to work as a team and redirect him. We have also used the AVB block/bean technique to extinguish things.  We have finished the first step in toilet training and it is an interesting experience. He stays in underwear all day except when he is sleeping. He has even gone on the toilet at McDonalds!! This is only for urinating though. He still requests a diaper to "Go Poop, Please."

We also like to play games. This can be very tough for Andrew because he has to wait for his turn, follow directions, hand-eye coordination, counting, colors, shapes and more. We don't always follow the directions because they are not always on our level-so be creative. 

We have started a reading program to coordinate with the lessons of the day and problems he is having such as: sharing, controlling anger, manners, holidays, numbers, alphabet, etc.. It can be hard for an autistic child to sit and attend while someone is reading a book out loud to them. I have been doing a lot of research into good books for our kids. The best ones to begin with will have limited words and contain a phrase that is repetitive throughout the book so the kids can anticipate this line and be more actively involved. The illustrations should be eye catching. Consider making props to go along with the book. Check back for a list of great books and ideas for props!

My suggestion is to try to build a team of people you trust and who love your child and want the best for them. Surround yourself with positive people that can understand what you are going through. Stay focused on what you have accomplished and not how far you have to go. Take care of yourself and the others in your family during the therapy sessions because the rest of the time is pretty much devoted to your special child or children. Good Luck and check back for more ideas and links.

What is AVB?  Here is some information that may help:

For the record, I think that there are a lot of therapies that can help our kids.   I will also be talking about OUR therapy for our son and our positive results with ABA, AVB and Sensory Integration.  I will not be addressing the medical end which I feel is very important-please pursue the medical issues ASAP.  I am not pushing AVB but offering suggestions on how to teach language to a speech delayed child.  I am just a mom.  I don’t think anyone needs to run out and buy a book or attend a conference because it has helped my son, but if one hint will help one child, then my tired fingers are worth it.  I know others out their have other great ideas and may want to correct something here and that is great.  When someone asks a question like “What kind of therapy do you suggest?”  I can only answer what has worked for our son but every child is different.  Try different ones, find good people to support you and listen to what your child’s behavior and progress is telling you.  We never go exactly “BY THE BOOK” on any therapy.  We customize it to fit Andrew’s needs and take a little from many therapies.  If your child is non-verbal, Vince Carbone suggests using sign language first and then add words/sounds to the signs and then fade out the signs.   Since the AVB is less known, I will focus my details on that (mind you without any notes so forgive mistakes), so here goes.

Just some background, my son was diagnosed September 2000 (almost 28 months old) as autistic.  He was awful - Non-verbal, and VERY aggressive (threw chairs at people and would physically abuse everyone – only his father stood a chance at protecting himself).  He could not match or sort, for all purposes acted deaf, and did not seem to understand anything (no receptive language).  Overall I was at the end of my rope.  Forget bathing, brushing teeth, clipping nails, etc..  He would eat grazing and standing up because we could not get him to sit in a chair. 

Our life changed when we meet some great trainers (not certified therapists) that worked with behavior modification and ABA (Applied Behavior Analysis).  It resembled the “Miracle Worker” movie about Helen Keller.  They came in and took control.  We set up a home program on October 31, 2000 with 2 therapists and only 10-16 hours a week to work one-on-one.  We had a consultant to help us with the behavior problems. We were in the ECI program but that was a waste of time because Andrew so out of control all the therapist would do was run after him or defend their bodies from him. 

I don’t think anyone has every earned their money more than these 2 young ladies (one had a psychology degree and had been trained by some of the best ABA people in the US and the other an ex-special ed/PPCD teacher with some ABA training).  By Thanksgiving he was sitting in a chair and was starting to match and sort.  At Christmas 2000 he was still non-verbal but could echo “moo” when prompted.  The biggest change at that time was his aggression.  It was waaaay down and he no longer was hitting us (I could still see that he wanted to though). 

At Easter he had about 20 words and was echoing much better.  We were starting to make changes about this time because he was getting bored.  We tried to change things up, add in sensory things and would move the therapy around the house and to the outside.  We added on to our house and made our master bedroom into the “classroom” and the living room into a sensory-motor room and the playroom into a pretend room that also housed their TV and computers.   By his 3^rd birthday (May 31^st) he was up to 80 words and would say the word spontaneously to request something along with the phrase “I want …….please.  This was a big turning point since he found the power of language.  The only medical intervention we had done at this point was removing milk from his diet (began this when he was diagnosed and I believe was a huge factor in “waking him up”).  This Christmas 2001 he has over 400 words-we just stopped being able to count, sentences and phrases.  He has a couple of questions like “What is it?”  “Where are you or Where is it?”.  I mentioned in an earlier post that this Christmas in no way resembled last years when he was still aggressive and non-verbal.  He opened presents like a pro, except that he got carried away and opened a couple of his sisters (boy she puts up with a lot).

I digress; Andrew’s 2 therapists went to a Mark Sundberg conference in the Winter of 2000-2001 and came back energized to make additions to his program that were more verbal oriented.  Don’t get me wrong, the ABA techniques can bring language, but some children may do better without the Discrete Trials of some things (eg. The use of 10 trials).  In my experience, most ABA programs have a lot of adaptive techniques to better fit the child (if the therapists are good).  To this day e were and still are using the curriculum from the BEHAVIOR INTERVENTION FOR YOUNG CHILDREN WITH AUTISM: A Manual for Parents and Professionals
Edited by: Catherine Maurice Coedited by Gina Green & Stephen C. Luce.  

Before watching AVB techniques (our old style), we would show a flashcard of a new word, eg. Bird.  I would even have bird type objects so that my son could relate better to fake birds than a picture.  We would say “This is a bird.”  Then we would ask “What is this?” and would point to the bird.  We would hope for an echo response.  Praise.  We would do this multiple times and include a point to bird with a few other cards out.  AVB looks more like this (note after trying more AVB techniques we would go outside and observe birds, bird nests, visit the zoo and visit the bird section and talk about what they do, how they fly, and their attributes – feathers, etc.):  Put 3 cards on the table – 2 that he knows, 1 the new word-bird.  Ask him to point to one or both of the others and then ask him to point to bird.  You point if he does not get it (may repeat but move quickly if it works best – especially for those that get bored).  Pick up the 3 cards and ask what each one is one at a time, “What is this? He answers correctly with the old vocabulary word-dog.  Repeat next old word.  Now comes the new word:  What is this?  If no response after about 2 seconds, give them the answer – it’s a bird (there is not a “No –wrong answer or a Try Again” you give the correction or the answer {errorless learning}.  Now change up the cards and add in another 2 old words and repeat the “What is it?”  This time when bird comes up hopefully there is correct answer, if not, cue with the first sound “buh” and still if no word then give the correct answer (trying to get them to echo).  You transfer the knowledge and then try to fade the verbal prompts.  When bird is mastered make sure and mix it in later and reinforce in the next session.  You also teach “Feature, function and class of objects while introducing the words, eg-“which one do you drive?”  “who flies in the sky?” etc… 

My son’s therapist and I attended a Vince Carbone workshop on AVB where there were only 5 children and their therapist and 1 parent (the children did not actually attend-just parent and therapist).  We had videos of our children in therapy and around the house.  We watched videos of each child (just bits of them) and then went over the ABLLS (Assessment of Basic Language and Learning Skills) that we had done ahead of time to show where we are now.  They grouped us with one other family/therapist group (that was close to our child’s level) and gave us an AVB therapist to practice techniques and answer questions.  Vince Carbone said my son would be asking questions and participating in conversations soon if we used these techniques.  And well, he has.  I thought he was crazy and selling snake oil and probably really high on himself, but now I know he really understands language (or actually BF Skinner did).

In AVB - note a “mand” is a demand/command, "tact" is a label/name, "EO" is a reinforcer, 

(1)-taken from the DTT-NET yahoo list:
note a “mand” is a demand/command, "tact" is a label/name, "EO" is a reinforcer, 

TEACHING YOUR CHILD TO ASK QUESTIONS

TEACHING WHAT

The teacher will bring in a paper bag with things ANDREW likes inside the bag (i.e. little toys, gummies, books).The teacher will look in the bag and say “WOW, look at this” while keeping the bag closed. 
Prompt ANDREW to say "what is it?" or "what is in there?".
Teacher then removes item from the bag and says it is a book and delivers the book to the child.

Teacher presents a field of three or more cards and objects both mastered and target items.  
Present cards and say "tell me what is on the table", 
Prompt “What is it?” when the child comes to unknown item. 
Teacher will tact item and give reinforcement. 
Teacher says "I have a surprise for you".
Prompt "What?”,  “What is it?" or "what do you have?".
Tell the child what it is while you deliver item.

Teacher says "I want to play".
Prompt "what do you want to play?” 
Teacher says " reinforcing game or toy"

TEACHING WHERE

Present ANDREW with a closed box with that has a reinforcer (candy works best) in it and say "this is for you". 
Present the box two times with the reinforcer in it.  On the third time the box will be empty.
Prompt  “Where?” or "Where is my candy?”
Deliver the reinforcer while saying “Oh, here it is” 

While doing an activity the teacher will abruptly end the activity with no warning and say "come on".
The teacher should prompt "Where are we going?".  The teacher will then say to play on the computer or any item that is more reinforcing then the item they are leaving .
The teacher should say "get the ____" or "give me the ______", requiring the child to find an item necessary for a reinforcing task (e.g. "go get your shoes so we can go outside") 

The necessary item will not be available or missing from its normal place. Prompt ANDREW to say “Where are my shoes?".  The teacher should then say it is on the table, in the drawer, in my pocket, etc 

Have ANDREW come to sit, but have no chair for him.
Prompt "Where is my chair?" 

Have ANDREW sitting and suddenly get up and say "I'll be right back".
Prompt "Where are you going?"

Teacher should say “to get a gummy (or other reinforcing item) for you”.

Teacher will deliver lunch with no utensils.
Prompt "Where is my spoon?" or "Where is my fork?"

Teacher will present crafts with one necessary item missing
i.e. glue and say "Okay put some glue on it". 
Prompt "Where is the glue?"

Have ANDREW come to the table for preferred activity (e.g. Lego’s but have only one piece on the table). 
Prompt "Where are the rest?".

TEACHING WHY

Teacher will put a chair on the table while ANDREW is engaged in another activity.  Then tell the child “Let’s go sit down.”
When ANDREW returns to the table the teacher should Prompt "Why is the chair there?"
Teacher can answer with something like “I was cleaning the floor and look what I found under your chair” while handing the child a reinforcer.

Teacher says "I am going outside to play".
Prompt  "Why can't I go?"
Teacher should say "You can, follow me!”     

At mealtime the teacher should put a NON-food item on ANDREW’s plate
and give the plate the to the child.
Prompt ANDREW to say "Why did you do that?"
Teacher should act as if they got it mixed up and present ANDREW with the correct plate.

ANDREW is doing a reinforcing activity e.g. watching TV and teacher turns it off with no warning.
Prompt "Why did you do that?" or  "Why did you turn it off?"
Teacher should say, “So we can go to the playground”. 
(Remember the teacher must pick an activity that is MORE reinforcing to ANDREW then what he was just doing)

Change things in the house (hang Pooh from the fan) 
and prompt “Why is pooh there?”

TEACHING HOW

Teacher will have see through jar of desired items and the child will mand for the items. 
After manding, the teacher should acknowledge the mand by saying 
"Oh, sure you can have it” and at same time hand the tightly closed jar to the child.
The teacher will prompt "How do I open the jar?" or "How do I open this?". The teacher will then show the child how to open the jar. 

Teacher will say “Lets go outside and play” and take child to a locked door and say “Okay ANDREW open the door, lets go".
The teacher will prompt "How do I open the door?" when you see the child seems puzzled as to how to open the door.
Teacher will say "oh, like this” while using a key.

Teacher will present ANDREW with task e.g. (Lego’s , train set
 Wooden log builders) and say “Let’s make a bulldozer.”
Prompt "How do I build a bulldozer?" or “How do I built that?”.
Teacher will respond "Oh here, let me show you". 
(Remember to always select an activity that can not be done by the child and an activity the child would want to participate in completion of)
Play with a toy that the child cannot operate by themselves.  Make the toy do something (such a play music). 
Prompt the child to ask “How did you do that?”  

TEACHING WHICH

Teacher will set up a situation where two similar reinforcers are on the table and say "Give me a gummy” (one is red and one is blue)
Prompt "Which gummy?" 
Teacher says “the red one”.
The student should hand the red one to the teacher and the teacher should  give other item to the child.

Teacher should put a reinforcer in their hand and switch it back and forth, hiding the location.
With hands extended out prompt "Which hand?".
Say “This one” and deliver reinforcer from hand to child.

Teacher will put out 3 containers that are the same and move then around with a reinforcing item under them (like the shell game). 
Tell the child “you can have the cookie.”
Prompt the child to ask “Which one is it under?”

Teacher should offer the child 2 cookies and say “You can only have one”. 
Prompt Which one can I have?

TEACHING WHO

Have three people in the room and say "Someone has a gummy for you" (or other desired item).
Prompt "Who?” or  "Who does?"
Then give the name of the person and child walks to person and gets reinforcer.

Teacher presents pictures of known people e.g. mom, dad, grandparents and unknown professionals. 
The teacher holds up one picture and says Who is it? (only ask who is it? one time when starting the game).
When an unknown person is held up,
Prompt "Who is that?" and tell the child who it is.

Using toys that are reinforcing to ANDREW the teacher will hide a toy character (Buzz Light-year) behind a barrier and say "Guess who is behind here".
Prompt "who?".
Show the item and say it is Buzz Light-Year and let the child have it.

TEACHING WHEN

Place highly desired item on the table when the child mands for it, the teacher should say "Not right now" and prompt "When can I have it?".
Teacher says "After you …………..". 
Child does the activity and then gets the item

Give a peer a desired reinforcer and prompt "When can I have it?" or "When is it my turn?". 
The teacher should say "After ANDREW is done with it".
Prompt peer to put it down (Reinforce peer for doing so) and teacher tells child "Now you can have it"

Help Introduce Conversation

Turn on one of your child’s videos and have the remote in hand to pause.  Play the video for a while and then pause, “What is Barney doing?”  give the answer “Barney is dancing.” Or just “dancing.”  Push play for a couple of moments then pause again, “What is Barney doing?”  if no answer give the answer or the “Du” for dancing.  Continue this back and forth “conversing”.  The first couple of times that I did it with my son it only lasted a couple of pauses and then he got agitated that I was stopping his video.  After a couple of weeks of this he started to look forward to our conversations about Barney.  We then tried it outside talking about cars, the wind, clouds, etc.  We now can talk about his toys and favorite things to do.  Don’t get me wrong, this is not normal conversation.  He can’t just go up to people and ask “How are you doing?”  “What do you think of the Cowboy’s game?” but I never dreamed that we could get this in just a couple of months!!  I know many kids are not ready for this because they cannot speak or do not have echo skills but start with sign language.  Over time add in the words along with the signs and then fade the signs.  This is a lot harder than it sounds but so is Autism.

Here is an explanation of Applied Verbal Behavior taken from www.ChristinaBurkABA.com

“ In 1957 B.F. Skinner published a book called Verbal Behavior, outlining his analysis of VB, which describes a group of verbal operants, or functional units of language. Skinner explained that language could be analyzed into a set of functional units, with each type of operant serving a different function. He coined terms that didn't exist (to separate these operants from anything described by traditional linguistics) for these operants. Applied Verbal Behavior (AVB) is teaching based on Skinner's analysis of verbal behavior; it is the application of the science of verbal behavior. The primary verbal operants, which are most often initially discussed in relation to teaching children with autism, are echoics, mands, tacts, and intraverbals. Here I will briefly explain the functions of these operants and how they may be taught. I also want to touch on the establishing operation as the foundation of AVB and how it relates to teaching language.

In order to learn any skill, a child must have an imitation repertoire. Without imitation it is nearly impossible to teach anything. This is especially true for teaching language. To learn to sign, for example, a child needs to develop a good motor imitation (mimetic) repertoire; to learn to speak, the child needs a strong vocal imitation (echoic) repertoire. The echoic is the verbal operant that relates to vocal imitation. An echoic is verbal behavior whose form is controlled by someone else's verbal behavior with point-to-point (1:1) correspondence. What this means is that the child echoes exactly the speech of the teacher. For example, the teacher says, "Cookie" and the child says, "Cookie." The echoic is often discussed as verbal imitation in other systems, such as DTT, and is taught very differently than in AVB programs. In order for speech to be reinforced, it must occur. The echoic provides us with a mechanism for evoking speech such that we may reinforce it. If, for example, we wish to teach the child to say, "Mommy," but there is no echoic repertoire, we would have to wait until the child said, "Mommy" on his own and then reinforce it strongly. If instead we teach the child to develop a strong echoic repertoire, we can repeatedly say, "Mommy," the child can echo, "Mommy," and we can reinforce it many times, thus increasing the probability of the behavior (the word Mommy) in the future. Thus, you can see how a strong echoic repertoire is critical in teaching new language, since the child's ability to imitate vocally allows the teacher to create many opportunities for the child to use and be reinforced for speech. Echoics are key in teaching the other verbal operants as well.

 The mand is verbal behavior whose form is controlled by states of deprivation and aversion; it is often said to "specify its own reinforcer." What this means loosely is that the function of a mand is to request or to obtain what is wanted. So if a child says "Cookie," and it is functioning as a mand, that means the child is requesting the cookie. Think of mand as short for "demand" or "command." The way to reinforce a mand is to deliver the item manded for. So if a child says "Cookie," you'd give him a cookie. This positive consequence (reinforcement) of the mand will make it more likely that the behavior will occur in the future, i.e., that the next time the child wants a cookie, he will say cookie. So you can equate a mand with a request. We mand for a great many things every day without really thinking of them as mands: Desired items ("I want pizza for dinner"); information ("What time is it?"); assistance ("Can you help me"); missing items (given a bowl filled with cereal and milk, the child says "I need a spoon"); actions ("Play with me"); attention ("Mommy, look what I did"); negative reinforcement (removing something undesired/aversive) ("Turn off that loud music!"), etc., etc., etc. Manding is typically a first step in teaching language because it's based in the child's motivation. Manding typically increases language in general because, through the positive reinforcement delivered as a consequence for the mand, the child comes to associate the sound of his/her own voice with positive consequences.

Tied inextricably to the mand is the establishing operation (EO). Technically, the EO (as per Jack Michael, 1982) is a set of environmental events that temporarily alter the value of other stimuli/events as reinforcers and therefore evoke all behaviors that have produced these events in the past. The EO relates to conditions of deprivation and aversion. When the child is deprived of something, the EO for the item is high because the "not having" makes the item more attractive. However, once the child has access to the item, he becomes satiated and the EO is low. For example, if a child who loves cookies has not had any for weeks, the EO (desire) for cookies is probably very high. If you take a platter of cookies and offer one to the child, you could likely teach the mand for cookie fairly easily. You would hold up a cookie and say, "Cookie." If the child has a strong echoic repertoire, he will probably echo, "Cookie," which you then reinforce by giving the child the cookie. Once this has transpired several times, the child will begin to mand "Cookie" in the presence of the cookie when the EO for it is strong because saying, "Cookie" has historically led to access to cookies. However, after the child has eaten the platter of cookies, the EO is gone and the mand will probably not occur. Thus, as you can see, EOs are dynamic, not static, and are temporary. When teaching mands, you want to teach in a condition of deprivation, when the EO for the stimulus is high. In mand training, there is an EO for the target stimulus, which is also the reinforcer that will be delivered. The EO is probably the single most important motivative variable in teaching children language, although it is typically not discussed outside the circles of verbal behavior.

Once the child has an echoic repertoire and has acquired a number of consistent mands, you can begin to teach the tact. The tact is verbal behavior that is under the control of the nonverbal environment and includes nouns, actions, adjectives, pronouns, relations, and others. This one you can think of as a label of something in the environment or vocabulary. The word tact, another of Skinner's intentionally "nonsense" words, comes from the notion of the child's making "conTACT" with the nonverbal environment. Tacting is functionally very different from manding. If a child sees a cookie and says "Cookie," but maybe has just had dinner or a bunch of cookies and is satiated (there is no or a weak EO), his saying, "Cookie" is not functioning as a mand, but as a tact. He could just as easily say "Hey, there's a cookie." We also do this all the time, in so many ways it's hard to enumerate, but think of it essentially as labeling. The way to reinforce a tact is NOT by delivery of the item named, because a tact does NOT specify its own reinforcer, as a mand does. You reinforce tacts with generalized reinforcers, essentially anything other than the item named. Naturally, praise or confirmation are typical means of reinforcement (i.e., to the child labeling "Airplane!" the mother says "You're right, it IS an airplane" and maybe ruffles the kid's hair). You can also reinforce with a primary/tangible reinforcer: "You're right, it's an airplane. Here's a cookie." Tacting is, in a way, most of vocabulary and makes up a huge portion of everyday language. It is usually the focus of many DTT programs, although echoics and mands are arguably far more important, especially when first teaching language. When teaching tacts, you want to teach in a condition of satiation, when the EO for the stimulus is low. This is the exact opposite of mand teaching. To teach a tact, you would choose a stimulus for which there is no or a weak EO and give the echoic, "Cookie" (after he's had his fill). When the child echoes, "Cookie," you could say, "Right, it's a cookie!" and reinforce with chips, or something else for which there's an EO. In tact training, there is no EO for the target stimulus, but there still must be a strong EO for the reinforcer that will be delivered. Thus, the EO is still critical in tact training, although it relates to the reinforcer that is now different from the target stimulus.

Requests and vocabulary are obviously very important in language acquisition. Equally important is another operant, the intraverbal. The intraverbal is verbal behavior that is under the control of other verbal behavior and is strengthened by social reinforcement. Intraverbals are typically thought of in terms of conversational language because they are responses to the language of another person, usually answers to "wh-" questions. There are two classes of intraverbals, fill-ins and wh- questions. So if you say to the child "I'm baking..." and the child finishes the sentence with "Cookies," that's an intraverbal fill-in. Also, if you say, "What's something you bake?" (with no cookie present) and the child says, "Cookies," that's an intraverbal (wh- question). Intraverbals allow children to discuss stimuli that aren't present, which describes most conversation. With an intraverbal, what the child says in response to the adult's/peer's language does not match what the adult or peer originally said. Intraverbals can be reinforced in a number of ways, with praise, generalized reinforcers, or, naturally, with a continuation of the conversational exchange, i.e., "Wow, cookies! They smell great!" (to which the intraverbal response could be "Thanks" or "You can have some when they're done."). To teach an intraverbal, you would ask a question and prompt the response with an echoic, reinforcing based on the EO when the child echoed the correct response. Obviously, it's unnecessary to explain why teaching conversation is important.

Hopefully, it is clear how all of these verbal operants, along with the EO, come together in language teaching. Once the child has a strong echoic repertoire (or mimetic/motor imitation repertoire for sign) you can teach across all the functions of language by prompting echoically and reinforcing differently. AVB targets these operants and teaches them through errorless learning (prompting and immediately fading prompts/transfer trials), mixing and varying targets, interspersing easy and hard tasks, and teaching to fluency. This combination of curriculum and teaching procedures has led to great success for many children with autism."

End of quote.

Funding you may want to check into:

1. School District-check with other parents in your district. If you mention that you will bring a lawsuit against the school if they do not fund your program you will often hit a brick wall and not get much in the way of services. Many parents find this not to be worth the trouble as you will not get the money for years. There have been families that have won cases. We have pushed the district to pay for "home and parent training" and since one of our therapist is a Home Trainer for that district.  Because of that, we are helped with a few hours a week. Every little bit helps.

2. Medical Assistance-Some states have a MA card and will pay the wages of your therapist (not very common). We use our In-Home Family Support Services money towards some of the ABA therapy but of course it does not pay for all of it.

3.College Students and volunteers and you the parent-check with your local colleges (post a "college student-needed to work with my autistic child" sign in the speech therapy, psychology, teacher education areas). Some colleges offer course credit if they work with your child so that it would be free or inexpensive to you after training them. Family members and neighbors are great resources. As parents we probably have the most impact on our children. Even if we choose not to be a "therapist," we need to be trained for those non-therapy time. I know we work with Andrew 24-7 no matter what.

4. Grants-some companies and organizations offer grants to help pay for programs such as these.

5.Insurance-not very common especially if your therapists are not certified.

6. Tax Deductions-you will need a copy of your diagnosis and a prescription from your doctor for the amount of hours you are giving him in ABA. You will need 1099's for all therapists and a signed contract stating that they are responsible for their own taxes. You will only be able to deduct the amount that exceeds 7.5% of your gross income. Check with your accountant for all of the details.

7. Donated money from family or coworkers-instead of birthday gifts, ask that the money be given to your child for their therapy. I felt uncomfortable with this but I did suggest gifts that we could use in his therapy. If you choose to let others know your child is autistic perhaps they could contribute a little every year (your church or work). They probably give to charities anyway. There are some people well versed in setting up a fund for this-seek them out to help you.

8. We have been working with In-home Family Support Services for financial help. They are a program under the Texas Department of Human Services that provides financial assistance to families with a child who has autism/pdd, mental retardation and maybe other disabilities, I am not sure. They can give you up to $3,600's a year, depending on your income as to your co-pay, and is renewable every year. They also have a one-time grant of $3,000's if you are in dire need of something regarding medical or therapy problems. This money can be used for ABA, respite, and few other things. Even if you think you make too much, request the application and fill it out. Maybe another program may open up and you will be able to qualify under new changes.

9. The ARC can get you on special state and government assistance lists that may be of help somewhere down the line. If you don't use the ARC, find someone who can help you fill out form for these programs (SSI, CLASS, Medicaid, etc.).

10. Have your therapist apply to your school district to be a home-trainer.  Then work very hard getting your special education coordinator to give your child A LOT of home-training hours and/or parent training hours.

Even if you can't get funding and you must pay for it yourself, as I do, keep great records in case something comes up and we can be reimbursed. My therapists make about $30 s an hour.
For the 40 hour recommended therapy that would be over $60,000's a year
(see why we cannot afford the "PROVEN" amount of hours???)!!!!!
This does not include consultants and training. We have spent thousands of dollars on therapy equipment and supplies. We do need help funding this.
Keep involved with your legislators and your local Autism Society.

I know this is a hard thing for everyone.  Am I giving my child enough of what they need?  I even do this with my 5 yr old NT (Neuro-Typical non-autistic) daughter. 

I remember when beginning my research into autism I kept coming up with the ABA LOVAAS research.  It was stressed everywhere I went that ABA was the only way to give your child a chance.  There were no programs in San Antonio so we had to start one at our house.  The most hours we were ever able to get were around 18.  There were no schools for ABA and only one consultant in the area.  I stopped sleeping - all I could think about was my son and what were we going to do?.

I wish I could go back and reassure myself that my son was going to get better without those 40 hours of ABA.  There are so many things to do to help your child.  These things will sometimes cost money and sometimes not.  Initially the only money you will probably have is out-of-pocket from credit cards (some families end up declaring bankruptcy over medical and therapy bills), home equity loans, retirement funds (we have borrowed against this since I can't fathom making it to retirement now-ha ha), loans from family members, garage sales, begging, and anything else we can think of.  Get on all the waiting lists, apply to In-home Family Support for the $3,600's a year, but don't count on it soon.  Once you get that available cash, find other families that have had success with their children.  You can try finding a child a lot like yours and having those parents share their experiences with you (medical, tests, therapy), but our kids are sooooo different that it is hard to find someone. 

When and if you are working outside the home yourself, it can be very hard finding the time to watch some else's program, but it is well worth it. If you are not working outside the home, you still have many other duties including other children, support groups, school problems, etc.. that keep you from being able to do this easily.  If you have to train therapists, you should go through the training yourself with them.  You will become The Specialist.  Make the most of every penny you send on therapy.  If you are paying co-pays for speech therapists and they are not that great, take that co-pay money and spend it on behavior or language therapy that is working - or even a recreational program for your child. 

Now that we have done ABA, AVB, Floortime, AIT, Professional Speech and Occupational Therapy, Sensory Integration, ECI, PPCD, Inclusion Pre-School and a ton of medical tests and interventions, I can see things more clearly.  I need to provide what Andrew needs, not what LOVAAS, Greenspan, Kauffman, Sundberg/Carbone, and all those other people say my son needs.  I need to take the best of them, try it and use what works.  Use a developmental chart to see where your child should be and find ways of helping them to get closer to age appropriate (I have the Brigance Developmental Guidelines and have placed them in the Files under “Brigance Developmental Chart).  This may mean buying the other Catherine Maurice book "Teaching Young Children With Autism" and starting with their curriculum-sitting in a chair, matching, echoing.  It may mean buying a Blue’s Clue’s Puppet and getting on the floor and trying to teach your child to make eye contact with Blue.  It may mean driving 30 minutes for therapy (which is a pain) or opening your home to therapists (which is harder than you may think).  The objective is to help your child overcome as many of the “problems” that autism inflicts, but to also help your child reach a point where they can be happy.  I see so many families home schooling because of that (and I greatly admire those parents).

Just for FYI, and I think I have posted this before but we do have new members from time-to-time, here is the study done by the Wisconsin Early Autism Project that did a study trying to replicate Lovaas’ study but with 2 other study groups (1 clinic 40 hour Lovaas style, 2 parent home program, 3 school-based only).  The web address is:

http://www.wiautism.com/prelimin.htm

They found that very involved parents with a home program of less than 40 hours could give as much of an increase in normal IQ as the 40 hour a week Lovaas clinic style.

Here are a couple of excerpts:

“Clinic Directed versus Parent Directed

Of the 24 children, 22 were matched pairs within our sample. The other two children were matched with children from other replication sites. Although it was anticipated that if given the choice parents would elect to offer a relatively low number of hours, upon being advised that children in Dr. Lovaas' 1987 study had received an average of 40 hours per week of therapy, many parents in the Parent Directed group chose to provide higher numbers of hours. Looking just at out eleven pairs of children, the hours of treatment averaged 39 per week for Clinic Directed children, and 29 per week for Parent Directed children. These figures do not include hours of therapy provided by parents which were substantial in some cases. Pre-treatment and first year scores are presented in Table 3. As can be seen, there was difference of four points in IQ at post treatment that favored the Parent Directed group.”

“In addition to having a higher pre-treatment non-verbal IQ, there may have been another reason the Parent Directed children did so well. In some cases there was a difference in how involved parents were in two groups. In the Parent Directed group, some parents became very involved, became quite skilled therapists, supervised their teams extensively, and carried out treatment and generalization activities many hours beyond the officially recorded time in therapy. Parent Directed families with other children often involved them as informal therapists. When asked to estimate the number of hours the family had provided outside those provided by the program, most were unable to do so, saying such things as "It was all the time. We had the other kids doing it too. When he was on the toilet, I was rehearsing maintenance items".

It is not because of this study that I feel the “down” time (out of therapy) is so important, but because I saw it with my own son.  I could get more eye contact and language out of him than anyone else (not in the beginning though – I was just trying to survive every day).  I controlled dinnertime, juice needs, toy distribution, food choices and such.  I could take those needs and desires he had and give him incentives to get them.  I guess I made my son “work” for everything he wanted.  You want some juice, then look at me, give me the sign, show me the PEC, echo the first sound, ANYTHING to start.  You thought bath time was for bathing – HA – we are working on language, signing, eye contact, songs and body parts.  

Autism took away my power, but I realized that I had my own powers to combat things.  I know a lot of parents that received NO training but naturally did this with their children.  Autism was waaaaay out of my league so I needed training and lots of reading and practice.  A parent’s will is incredible.  Finding those resources for training and teaching you skills can make things so much easier for you and make them happen so much faster.  If you are investing in your son’s therapy, allocate money to help you become the expert and give you power and control.  As I mentioned, other parents are the best resource for this because they usually will pass on techniques and hints for free and those tips are truly applicable skills – not like some of those “workshops” given by people that don’t know what living with autism is like.

Please don’t forget the medical part.  Invest money into good tests.  We need to come up with a FILE on tests that parents suggest and specific labs for them.  Find a good doctor that is knowledgeable about autism and that does not always mean they have to be DAN doctors.  I have two GREAT doctors and neither one is a DAN doctor because they don’t necessarily agree with everything that DAN recommends.  We are making FILES on doctors too.  Sometimes there are simple solutions to problems – serotonin levels might be off, zinc deficiency, yeast overgrowth, food sensitivities, etc… .   Sometimes, of course, the answers are not so easy or simple – heavy metal poisoning, spikes on EEGs or seizures, diabetes, etc… .

Hope this helps a little.  I know what you really need is to win a million dollars or better yet, have a cure for your child.  All this other stuff is hard.  Good luck!!

Links

ABA/VB e-groups
Connect with other therapist across the world.
You must join to read and post here. I really enjoy the ideas therapists post.
http://groups.yahoo.com/group/DTT-NET and
http://groups.yahoo.com/group/autismaba/ or
http://groups.yahoo.com/group/VerbalBehavior

The ME list database:
http://www2.addr.com/~me-list/databases/

Consulting Behavior Analyst (AVB specialization)
Has ideas and information on how to teach ABA or VB.
www.ChristinaBurkABA.com

Association for Behavior Analysis
http://www.wmich.edu/aba/

Dr. Vincent Carbone's Verbal Behavior Website
http://www.drcarbone.net

http://info.med.yale.edu/chldstdy/autism/