Despite the title of this post, I'm not writing about a fear that Billy will run off to Vegas and marry a showgirl.

No, it's just the running that scares me -- and with good reason. The behavior therapist who's working with him at school says this running -- as far and as fast as possible at the drop of a hat -- is called "elopement."

Yes, I said "behavior therapist." As much as I am a proponent of Floortime therapy and the developmental approach, I do believe that behavior therapy is effective on behavior problems.

For those of you aren't familiar with the "civil war" going on in the autism world, there seem to be two camps, with parents either choosing sides or vascillating between the two, pitching their tents a little closer to one side or the other.

For a few years now, behavior therapy has been publicized as the only successful treatment for autism. That is hogwash (in that it is the ONLY successful approach, not that it has been successful, which is undisputed), but it is a position widely adopted by the media, in part because of the successful lobbying/press efforts by ABA therapists. They are organized, well-funded and they get things done. (Just as an aside, I would like to know what happened to turn the TV show "Parenthood" into a VERY successful Public Service Announcement about behavior therapy.)

Applied Behavioral Analysis "is a system of autism treatment based on behaviorist theories which, simply put, state that behaviors can be taught through a system of rewards and consequences," according to About.com. (I used their definition because it's simpler and easier to understand than that on the Association for Behavior Analysis International page.)

In the past, I have heard some occupational therapists and developmental therapy devotees describe ABA as "dog training" because of its emphasis on repetition and reward to alter surface behaviors. For instance, behavioral therapists might focus on getting the child to sit for longer periods in class or eliminating stimulating behavior like hand-flapping or spinning. To some degree, all parents naturally use behavioral principles to reinforce good behavior and eliminate negative behaviors.

That dog training image, though, is the image I had in my head less than a year ago when we wholeheartedly adopted Floortime, a strongly developmental approach, as our philosophy of therapy -- a philosophy and outlook we still consider our guiding principle.

Often seen as the opposite pole to the ABA approach, developmental-based therapies follow the child's lead, de-emphasize routine and repetition over following the child's "joy" and trying to create desire for communication. But to compare apples to apples, let me go back to About.com for their definition: "Developmental therapies are intended to directly addresses autism's core deficits. To achieve this goal, they recommend that therapists and parents work with the child's own interests or actions to slowly build engagement, interaction, communication, affection, and then specific skills such as logical reasoning, symbolic thinking and more."

Strengthening Billy's ability to communicate is our primary goal. Everything will get easier once he can successful describe what he wants, what he feels and what he needs. We have seen amazing gains on this front since we adopted a Floortime approach and enrolled him in occupational and speech therapy with professionals who also believe in a more developmental approach.

All that being said, it's hard to communicate with a child who's half a mile away from you and increasing the gap with every stride of his long legs.

Last week after occupational therapy, as we were going through our getting-into-the-car routine, he suddenly slipped past me and bolted. It happened in an instant and was seemingly unprovoked (I say "seemingly" because I don't know what provokes him sometimes; he might have been hot and wanted fresh air).

Within seconds, he was around the side of the therapy building and there I still stood, with Willow still in the stroller and Billy on the run. I was terrified, frozen, unprepared.

I pushed her as best I could as far and fast as I could until I could make eye contact with him. He had cornered a nearby nightclub and was standing on a rickety deck, a few feet from stairs that went down towards ... what I don't know. And he was grinning at me.

I screamed to him, begged him to him to come back. "Willow is scared," I said. "She's by herself (she was a few feet behind me) and she wants Billy to come back."

He seemed to consider for a few moments. It could have gone either way. But slowly, he shuffled back toward me, until he was within my grasp.

I admit it: I yelled him then. I yelled at him that he had scared me and he was never to run off. And of course, then he got upset and tried to pull away again. It just went from bad to worse until I was able to bundle everyone back in the car.

Then I cranked up the air conditioner and the Kindermusik CD on the stereo until I could barely hear the screaming in the backseat and lowered my head to the steering wheel and finally let myself start shaking.

He could have run directly into traffic, I told myself. He could have fallen off that deck. A hundred nightmare scenarios went through my head, none of which were productive. But I told myself one thing: I would not be unprepared for this particular scenario again.

My solution is not elegant: I attach him to me with a strap locked on to his belt loop the second we leave therapy. He might get away but he's not going too far too fast if he has to drag me and Willow behind him. And I reward him for getting into the car and waiting patiently for his car seat strap to be attached. Good behavior = treat.

The point of this long story is this: Sometimes there's a place even for dog training. It's not pretty but this particular behavior is an absolute no-go.

Do I think that behavior therapy can cure every autistic deficit? I'm certainly no expert, but I think pure repetition and reward is unlikely to create a desire for more rich communication.

That being said, I've learned enough about actual behavior therapy to realize that very few of them actually practice in this manner. Practical behavior therapists are adopting developmental principles, particularly with younger children. And many developmental enthusiasts are finding a place for the principles of behavior analysis.

Parents should weigh every bit of advice they get better than I did in the beginning. See for yourself before making a judgment. And see more than one therapist.

Also, realize that your child is going to require a unique recipe that only you can write. After watching your child over a long period of time in a variety of situations, you will be the best judge of what is a behavior problem and what is an autistic deficit. And when you try one therapy combination, it may not work, and the recipe will require some tweaking. And it may work for a little while and then your child's behavior or progress will require something a little different.

That's OK. We're parents. The only place we're required to set up camp permanently is in a place that makes our child happy.

Are any of you engaged in behavior therapy? If so, what behaviors are you targeting? How successful has it been? If you're adamantly opposed to this form of therapy, I'd love to hear from you too.