Conducted by Mi Trinh, BA and David Celiberti, PhD, BCBA-D

We recently had the pleasure of interviewing Thuong Ho, MA, BCBA, to learn about her unique journey and her extensive work and efforts in introducing and integrating applied behavior analysis in the treatment for autism in Vietnam. Readers will gain insights into the reality of autism treatment in a Southeast Asian country as well as the challenges to be overcome to disseminate science and provide better access to evidence-based treatment internationally.

Mi and David: Could you share with our readers a little bit about your career path and what led you to the field of autism treatment and applied behavior analysis?

Interview with Thuong Ho

Thuong Ho, MA, BCBA

Thuong: I was born and raised in Vietnam. I graduated from Hanoi College of Pharmacy, and upon graduation, took a position with an American non-governmental organization (NGO) then called HAIVN – Harvard Medical School AIDS Initiative in Vietnam (now changed to The Partnership for Health Advancement in Vietnam). HAIVN is a leading NGO that specializes in building the capacity of doctors, nurses and healthcare workers for HIV patients in Vietnam through technical assistance, training, coaching, and other supports.

Back in 2010, the health care system for HIV in my country was already well established, but not the one for autism. I saw similarities between HIV and autism, including: (1) both are life-long conditions; (2) the earlier the identification and treatment, the better the outcomes; and (3) both need a multidisciplinary team to support the individuals with the condition. I had hoped to gain expertise in autism and use the capacity building models learned from HAIVN to help children reach their full potential, empower parents with the skills and knowledge to facilitate that progress, and to reduce the barriers and discrimination that dampen outcomes.

In order to pursue advanced training in autism treatment, I applied for the Fulbright scholarship offered by the United States State Department. Trained as a pharmacist, I first searched for evidence-based treatments for autism, and ABA came up as the first result. Completing the ABA master’s degree under the Fulbright scholarship at the Florida Institute of Technology has been one of the most wonderful experiences of my life so far.

Mi and David: What an interesting journey and we appreciate how you drew parallels between HIV and autism. There are certainly many. Could you tell our readers about your current position and what you do now?

Thuong: I currently hold several positions. First, I am the Clinical Director of MOSAIC Social Enterprise for Autism Training and Communication. At MOSAIC, we have established a center to provide ABA services for children with autism. The center is also where we provide hands-on training and coaching for caregivers and teachers. This is a much-needed service in Vietnam where training usually focuses more on theory than on practice. I have collected data and introduced ABA treatment at many scientific conferences here in Vietnam, with different topics, such as parent coaching using Behavioral Skills Training, desensitization in feeding intervention, behavior management, etc. In my work, I have provided more than 100 training courses on ABA to teachers across the country following my return in 2016 and offered online courses to 400 parents including those in remote areas through an app and website with online feedback during the recent pandemic.

I have also been involved in several national projects, such as Ability A365 funded by Grand Challenges Canada, creating a free website with hundreds of videos modeling ABA techniques for parents. I am the Chief Technical Officer of Project I-thrive, funded by USAID. In I-thrive, we have worked with the World Health Organization and Autism Speaks to bring Caregiver Skills Training (CST) to Vietnam. As a master trainer of CST here, I have helped build a system of training for caregivers to two provinces. This project also aims at advocating for a multidisciplinary team model to work in the public hospital system, which is under consideration by the Vietnam Ministry of Health.

Together with a few other professionals, I have co-authored three textbooks written in Vietnamese on ABA therapy for professionals and parents: Raising A Child with Autism in the Family, Rehabilitation Support for Children with Autism in Vietnam for Parents and Caregivers, and Rehabilitation Support for Children with Autism in Vietnam for Professionals and Paraprofessionals.

I also pursued the JASPER (Joint-attention, Symbolic Play, Engagement, and Regulation) training. JASPER is an evidence-based treatment based on ABA that focuses on early core deficits of autism. With JASPER, I have helped children with autism learn how to play with toys and have fun playing toys with parents and friends, and in doing so, develop their language.

These are just to name some of my work. Since I am the only Vietnamese BCBA currently living in Vietnam, I think there are tons of things to keep working on, and I hope more Vietnamese behavior analysts will be trained and come back to our home country.

Mi and David: To say you have been busy would be an understatement. Your list of achievements and accomplishments are incredibly impressive. How are individuals with autism viewed in Vietnam? What are the challenges that they face?

Thuong: Autism was only recently recognized as a disability in Vietnam. In the past several years, free treatment at public hospitals has become available. Yet, the treatment is limited in time and quality. At some hospitals, only two to three sessions of 35 minutes each are allowed per week. In almost all cases, parents must pay out of their own pockets, and they can only afford one hour per day, which is not intensive enough to help the children to improve their skills. Not to mention, teachers at public schools are not equipped with the knowledge and skills needed, so many children do not have a chance to access mainstream education during their whole lives.

In big cities, people are informed about autism through social media and communication projects. However, in mountainous or remote areas, families of children with autism still blame the condition on witchcraft, spirits, and the children are considered as having no hope for development. Some mothers are encouraged or even forced to give birth to other children with a better chance of becoming the family breadwinner in the future.

I have been appearing on television shows, building the A365 website, and managing my own Youtube channel and the MOSAIC Facebook page, providing information on early identification and treatment and showing how intervention can help change the future of children with autism. Also, A365 has been working on projects with the Vietnam Ministry of Health to develop community health centers at villages to screen children for autism and educate parents and people in remote areas to help improve knowledge on autism.

Mi and David: What are the challenges for parents, caregivers, and teachers in Vietnam regarding resources and treatments? What are some initiatives to address those challenges?

Thuong: Upon my return from the US in 2016, there were misunderstandings such as autism was caused by the parents’ karma. Also, pseudoscience practices could be seen everywhere, such as coin rubbing, Catgut embedding therapy, acupuncture, or spiritual actions like name changing sacrifices, etc., which cost families not only money, time, and resources but also raise false hopes.

Many parents suffer from learned helplessness, and believe that they could not help their children, and intervention is just a professional’s job. Through communication and training to teachers and parents as well as weekly educational livestreams, etc., the awareness of the community as well as the knowledge and skills of parents and professionals have been improved greatly.

With the help of technology, my 3-month online course “Joyful and Effective Treatment” has reached parents in the mountainous areas as well as Vietnamese parents living in the US, Australia, Korea, and Poland during the Covid-19 shutdown. The course includes weekly recorded and animated lessons, requires homework assignments, and offers individualized feedback to parents and weekly interactive zoom sessions.

Mi and David: Can you please describe the efforts to disseminate science-based treatments for autism in Vietnam? Where are some areas for improvement?

Thuong: To disseminate science-based treatments for autism in Vietnam, I have been using two approaches. On the one hand, I have worked with other professionals on multidisciplinary teams to write textbooks, as well as to train teachers and healthcare professionals on ABA. I also published and presented on Vietnamese scientific journals on topics such as feeding intervention, Behavior Skills Training, etc. On the other hand, I have offered weekly videos and notes on my Youtube channel called ThuongHoMOSAIC (with more than 6,000 subscribers up to date), and my Facebook page (around 10,000 followers). These videos and notes feature simple and fun examples of ABA principles so that they are easy to understand and follow and offer free to access to parents.

At MOSAIC, I have trained more than 20 ABA technicians. They are capable of not only providing direct services for families who can pay the treatment fee, but also coaching parents. We also established a scholarship fund for parents with financial difficulties. The need for treatment is huge; therefore, MOSAIC’s waiting list is years long. One of the important areas for MOSAIC to improve, for sure, is to increase the number of trained therapists in the coming time.

Mi and David: Are you able to connect with other BCBAs in Vietnam? What does that look like?

Thuong: As the only Vietnamese BCBA currently living in Vietnam, I work with other professionals such as OTs, SLPs, and special educators more often. But I have several opportunities to work with BCBAs in the US through ECHO Autism and will run a free project for Vietnamese parents soon using the Echo model™. Different from a telehealth model, Echo model™ is a hub-and-spoke knowledge-sharing network, which helps develop the capacities of hub (in my projects, this will be caregivers) by real cases on common topics, with me leading with main treatment strategies, and then fade out for caregivers to support and lead new caregivers with similar cases in a parents-to-parents support model. This model, for me, is more sustainable, by providing the parents with the fishing rod rather than just the fish.

Mi and David: How can an internationally based organization like ASAT help you in your mission? What can we do to contribute to your dissemination efforts?

Thuong: My first time learning about ASAT was when my professor at FIT introduced me to the organization. Since then, I have visited the ASAT website from time to time to look for information needed for my work. ASAT is a credible and useful source of information and knowledge. I am so impressed that the ASAT website is available in more than 100 languages, including Vietnamese.

Since I can read English, I did not notice that ASAT’s content is also available in Vietnamese using the Google translation feature on the home page. Thanks so much for this effort, I will share the website with my community. I believe that this will be very helpful, especially the Treatment and Lifespan sections on the Parents and Educators part of the website. Sharing this source to my community is a great way for me to disseminate evidence-based autism treatment so that I don’t have to “reinvent the wheel.” I believe many parents will find this knowledge important and useful, and many professionals will find the website inspiring. I also hope to network with more professionals through ASAT and create a better impact and value on families with autism. I also hope to connect with more experienced BCBAs to bring ABA into formal training in colleges in Vietnam.

Thank you so much for sharing your perspectives, journey, and insight about the state of autism treatment in Vietnam with our readers. What you have shared has been nothing short of inspiring as you are bringing needed awareness of evidence-based treatment to families and practitioners in your native country. 

Citation for this article:

Trinh, M., & Celiberti, D. (2021). An interview with Thuong Ho, MA, BCBA (Vietnam). Science in Autism Treatment, 18(8).

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