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I Worked at an ABA Clinic. It was Abuse.9 min read

Applied behavior analysis (ABA) can mean a lot of things, and there’s not a stan­dard­ized def­i­n­i­tion for it. Essentially, it’s looking at what causes a behavior and then mod­i­fying con­di­tions to modify the envi­ron­ment. Sometimes, ther­a­pies are called ABA in order to be bill­able for insur­ance, and some other types of providers, like speech or occu­pa­tional ther­a­pists, use ABA prin­ci­ples.

If you’re con­fused about whether or not your child has a good– or bad– ther­a­pist, you can use this guide with a print­able check­list to help you figure it out.

ABA is a type of therapy that involves as much as 40 hours per week of one-on-one therapy with a cer­ti­fied tech­ni­cian. Certified tech­ni­cians dis­tribute or over­look the pro­gram­ming pro­ce­dure, orga­nized around the child’s spe­cific goals.

The goals are assigned by a board-certified behavior ana­lyst (BCBA)—like devel­oping social skills, for instance, or learning to make eye con­tact. ABA breaks down “desir­able” behav­iors into steps and then rewards the child for com­pleting each step along the way via pos­i­tive rein­force­ment.

But most autis­tics object to ABA on the grounds that it is pro­gram­ming chil­dren to ignore their basic needs, to blindly accept authority, to for­feit con­sent to their bodily autonomy, and to not be able to set bound­aries. It makes their innate autistic traits into “behav­iors” and attempts to train those behav­iors out of chil­dren.

Dr. Ivar Lovaas con­sid­ered the goal of ABA to make autistic people ‘indis­tin­guish­able from their peers.’ This goal puts all the respon­si­bility for change on autistic people. Autistic people try so hard to sur­vive in this world and often that means we com­pro­mise our­selves to ‘fit in’ with non-autistics. We force our­selves to do things that hurt us or make us uncom­fort­able, which par­tially explains the high rates of mental health prob­lems and sui­cide in our com­mu­nity. Despite all this effort, we often still stand out as dif­ferent and so still get judged and crit­i­cized. This aim of ‘indis­tin­guish­able’ still gets cited by ABA providers. While society strives for this goal – the goal of making us ‘normal’ – our human rights will be vio­lated. Aiming for ‘normal’ is uneth­ical, often unachiev­able, and many first-hand accounts sug­gest it comes at too high a cost to the autistic person.

-Shona Davis on Autistic UK

Giving Back to the Autistic Community

I was an employee at an ABA clinic for only a few months. I don’t know the exact span of time any­more as it all seemed to blend together. I got into the ABA field just after grad­u­ating from col­lege.

I was only just starting to be openly autistic with myself and society. While in col­lege, I resolved that I was going to give back to the autistic com­mu­nity in some way, shape, or form.

I remember going on job search web­sites typing: “Autism Employment Near Me.” The only results that came up were var­ious ABA clinics. Unbeknownst to me was the con­tro­versy sur­rounding ABA. I knew very little about ABA going in, such as they used the pos­i­tive and neg­a­tive rein­force­ment models.

In fact, that’s all I knew about it before entering the field.

I resigned my posi­tion as an employee at an ABA clinic less than six months after starting there. A lot of people have requested of me that I talk about my point of view and expe­ri­ences being at the ABA clinic and being openly autistic. To sum­ma­rize it all in a few short sen­tences: 1. I’m still pro­cessing it all with my ther­a­pist 8 months later. 2. Every day I worked there I could count mul­tiple occa­sions when I ques­tioned the system.

It’s for their own good…

Whenever I had doubts, I was always imme­di­ately reas­sured that [insert uncom­fort­able sit­u­a­tion I was in] was helping the autistic child overall. I was told that the autistic child would grow with better, more “appro­priate” behav­iors as they learn from the pro­gram­ming, which in turn will help them socialize and be a proud member of society once they are older.

Before I go any fur­ther, let me inform readers that I am not a parent. I never had expe­ri­ence babysit­ting, and I was never in a direct mentor posi­tion for chil­dren or par­ents– so it’s also hard for me to judge any­thing about what was really hap­pening. I had no prece­dent or barom­eter for “normal” when it came to working with kids.

I can just say, I ques­tioned the processes and system of ABA while at the clinic, but again I was told numerous times I was really helping. I never saw how; I just saw chil­dren being uncom­fort­able often, and I, myself, feeling the same sen­ti­ments in exchange.

Is that what being a parent is like? Is that what it’s like to be a teacher? I was in com­plete misery and so was the child as we both tried to mask our misery during break times by doing enjoy­able activ­i­ties as mere dis­trac­tions– or what ABA refers to as “rewards”– before going back to pro­gram­ming or “work.”

Joe

I recall one time working with a child whom I will refer to as “Joe.” Joe was a 4‑year-old boy, and he was bois­terous and excitable all the time, run­ning around just every­where. He was a child with so much energy that he didn’t know how to handle it all.

In the clinic, where we worked with the chil­dren, we each had rooms with a desk, 2 chairs, and a few dec­o­ra­tive and cliché moti­va­tional posters dis­played on the walls. Joe couldn’t sit still in his chair and would crawl under the desk and chairs or stand at the top of one or another.

He would lick, rub, tear, stare at, and smell the posters as if they were some mag­ical entryway into another realm. The clinic super­vi­sors sug­gested we remove every­thing from the room and strip it away bare. The room was com­pletely empty, just a small, blank room with no posters, no fur­ni­ture of any kind or any­thing: just four white walls and a dirty beige carpet.

Joe and I would just sit on the floor, and I was sup­posed to work with him on enun­ci­a­tion of words such as “Rocket.”

Joe still would do any­thing to find dis­trac­tions. He would play with his own foot or gaze at his moles while ignoring me com­pletely. It was my duty to corner Joe in the tiny room each time we entered the work room. We were to be knee-to-knee as we sat cross-legged across from one another.

This posi­tion was pre­scribed so that I could phys­i­cally hold him back or do any sort of hand-over-hand ges­tures if Joe would attempt to escape. I would hold up a card of a pic­ture of a rocket and demand, “Say Rocket.” I was told by my super­vi­sors that I couldn’t leave the room until Joe at least attempted to make a sound.

Ro-cket, Rock-et, Ro…

We sat there for what felt like an eter­nity in a life­less, joy­less room as we both avoided any sort of con­tact with one another. This was after I had already held up the rocket card and ordered him to say “Rocket.”

As I waited for Joe to show any sort of response, I kept thinking to myself: “He is 4 years old! How is he going to be able to handle reg­ular class­rooms or any­thing next year when he starts kinder­garten– when we are like this in this empty room knee-to-knee?

I felt slightly suf­fo­cated in that room, so I could only imagine how Joe felt as he fre­quented this room daily. I won­dered, Is this what being in a padded room feels like? Even prisons have more stuff than this!

Checking the Box

For the sake of both our sanity, I fudged the data saying he attempted to say “rocket,” and we both left the room after 5–8 min­utes. I tried to make it look like I really tried to wait it out so the super­vi­sors wouldn’t get sus­pi­cious of me.

If I’d admitted he didn’t try, they would have tried to shadow us the rest of my shift with Joe. If that were to happen, the misery would be a lot worse, and I would lose all power on making the rest of the time we shared less mis­er­able.

I tried to extend Joe’s breaks, or “reward times,” as long as I could, until a super­visor would tell me Joe and I needed to do more pro­gram­ming in their des­ig­nated work room. Trying to get Joe to his work room involved me chasing him as if I was a dog catcher and he was a noto­rious stray dog run­ning for his freedom.

Just every­thing about the whole sit­u­a­tion was awful, and I never felt right about any of it. I could see the pain in Joe’s eyes still to this day, looking back at me in panic as I finally caught him and had to drag him to the work room, then corner him into a knee-to-knee posi­tion.

After working with Joe for the first time, I had night­mares day in and day out. I think that was the final straw that made me realize I was in a ter­rible place no matter what anyone said to me. Less than a week later, I resigned.

Confirmation Bias

My boss didn’t under­stand why I left, and kept telling me I did every­thing right, and that I was over­re­acting. They begged me to stay because their com­pany looked great having an autistic person as an employee.

To this day, I wish I knew better alter­na­tives for working with Joe. I still ponder how he will be able to handle school once he is eli­gible for kinder­garten. All I can say is, the pro­grams at my clinic didn’t serve him like they were meant to serve him.

Even now, after my time working in the clinic, I still don’t have any­thing to offer up as a better method when it came to the pro­gram­ming with any of the chil­dren. I can just tell you what we did was always inef­fec­tive.

To this day, not being in that clinic for over 9 months, I am still ques­tioning every­thing around me like a mad woman hopped up on con­spir­a­cies. Part of me is ques­tioning every­thing because I am starting to see some level of tox­i­city traits in other edu­ca­tional sys­tems, and the other part me feels so guilty for being involved at such an abu­sive facility that I am ter­ri­fied of sug­gesting any alter­na­tives: what if they are just as dam­aging, if not worse, to the autistic com­mu­nity?

Modern ABA

Here’s what I can tell you, and I will let you decide for your­self: the his­tory of ABA is dark and paved with bad inten­tions. The only thing that has really changed is that there is more money poured into ABA now, and they have reframed their orig­inal goals to sound less ableist.

They may have changed some words, but they still have the same bad prac­tices with the same bad motives. They still don’t try to do research or seek input from autistic adults, and they still don’t do any research on how the autistic indi­vidual is doing over time in a span of years after ABA. How can one grow in quality of ser­vices if they are not asking input for the ones being served?

I’m Sorry

I myself am still trau­ma­tized by my own expe­ri­ences of being an employee at an ABA clinic. To the chil­dren I served, I am sorry. I am sorry for all the com­mands I was ordered to give to you. I am sorry for how I treated you, and I am sorry for par­tic­i­pating in instilling trauma into your life.

You are all beau­tiful beings despite what these so-called experts are telling you. Please con­tinue to dis­obey and rebel; do not give into them. I wish I could do more to help you escape other than con­tin­u­ously tell your par­ents of the rotten place they drop you off at each day.

I wish I could expunge the trauma from you and have it cling to me as some sort of magnet. I wish that each and every day. I am truly sorry, from the bottom of my heart. I will do the best I can to con­tinue to fight the good fight with the rest of the fellow autistic adults in demanding ABA to be shut down.

The Aspergian
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6 Comments

  1. I am SO sorry that this was the expe­ri­ence you had while working with ABA. But I am cur­rently an RBT working towards my BCBA and I can say without a doubt that at the two com­pa­nies I’ve worked for and all the super­vi­sors I’ve had (both doing in home and in a clinic) that what your super­vi­sors told you is not a typ­ical response and I agree what they had you do was ridicu­lous. It sounds like they were only out there to make them­selves look good but in reality the pur­pose of ABA is to look at each indi­vidual child and develop a plan based on them alone and behav­iors that are “socially sig­nif­i­cant” (ie what are functional/not func­tional and what’s really holding them back from learning). Everything we do is researched based from pre­vious studies and if a plan is not working for a child we don’t force it upon them we come up with a new one that may better fit them. I’d love to have fur­ther dis­cus­sion with you about this, I’d hate for your expe­ri­ence to taint your view of ABA and for it to ruin it for everyone else, because I know it works, I’ve seen it work, and I’ve seen fam­i­lies come away hap­pier and healthier because of it.

    1. That may be true on paper, but how can someone on the out­side tell what is and is not func­tional without expe­ri­encing it them­selves? Even if any kind of abu­sive ele­ments could be stripped out of ABA, the under­lying sen­ti­ment of “I know better than you” is pre­sump­tuous.

    2. I am a former behavior ana­lyst. And I now advo­cate against it, strongly. ABA inher­ently pre­sumes INcompetence. It inher­ently ignores internal actions (how one feels and thinks) because it’s not mea­sur­able or observ­able. ABA values com­pli­ance above autonomy.

      Yes, people who go through ABA can exhibit learned, “func­tional” behav­iors. But ABA ignored whether or not those behav­iors work with Autistic neu­rology. It’s called masking. And masking leads to Autistic people living with anx­iety, depres­sion, burnout, and a hor­rif­i­cally high sui­cide rate.

      Or you have non-speaking people, with motor con­trol issues, who may be teenagers or adults and the ther­a­pist is still teacher preschool level mate­rial because they can’t show mas­tery.

      So please, instead of defending ABA, take the time to read more from actu­ally Autistic people.

  2. Thank you for writing about such a dif­fi­cult and trau­matic expe­ri­ence. I can tell from your words that it was so painful for you. You are a com­pas­sionate person who was used and manip­u­lated by a ter­rible pro­gram. You did the best you could at the time. I’m glad you’re in therapy now to help you process the awful things that hap­pened.

    I want you to know that you are helping others by sharing your truth. I have cited your account in an article on iden­ti­fying bad ABA; there is now a step about noticing the child’s reac­tion to starting therapy. https://www.wikihow.com/Tell-if-an-Autism-ABA-Therapy-Is-Harmful (You may not want to read the article because it could be upset­ting.) I hope that this article will help par­ents of chil­dren like Joe to rec­og­nize when there is a problem and pro­tect their kids.

    (Also, thanks to the Aspergian mem­bers who are cool with me putting wikiHow links every­where. As you may have noticed, it is one of my pri­mary forms of com­mu­ni­ca­tion.)

  3. I really appre­ciate reading your article and feel­ings! I’ve worked in the spe­cial edu­ca­tion field for a long time. Three of those months was with an ABA com­pany. It was indeed trau­ma­tizing. Both for my spirit and for the sen­si­tive children..wondering WHY the rigidity of expec­ta­tions and demands put on them.
    With already having so much internal struggle, having to con­form and con­stantly please others without devel­oping INTRINSIC moti­va­tion is a big huge error!
    ABA foun­da­tional thought is out of touch with the WHOLE PERSON!!
    Sure, now we can see ABA might be little less rigid but.…it con­tinues to focus on training ther­a­pists to be behavior ana­lyzers and con­trollers. Who does this truly benefit?The kids? hmmm…
    Why not focus at least half of the pro­gram­ming on innate GIFTS and inter­ests?
    Imagine what it would feel like as a child To have NONE of your spe­cial quirks and genius be val­i­dated but hours and hours a week focusing on making you into some­thing else.
    What kind of THERAPY is that?
    This is my point. Why does this ABA system treat Behaviors as more impor­tant than EMOTIONS??
    Actually…completely deval­i­dating emo­tions in exchange of con­trol­ling behav­iors! Its crazy!!!!
    Therapy should be THERAPEUTIC…which means…bringing well­being, self love, healing, under­standing, ful­fill­ment, inte­gra­tion and hap­pi­ness.
    Compliance, puppy training and ego grat­i­fi­ca­tion on part of the “behav­iorist” is what I see more often than any­thing with ABA. Time to change folks!!!!! put your pride aside and listen to the autistic voices them­selves!!!!!!!!!!!
    Its sooo pos­sible. COLLABORATE

  4. Joe was responding to the posters just exactly the way you’re sup­posed to respond to them.

    He made them part of his world and of yours in that very direct way.

    And his bois­terous and excitable ways.

    I imagine the only use he had for that rocket was to fly out of this room.

    You never tried to make a poster of your own together? That other kids and adults in the clinic would respond to?

    [here Big Data would be of use as you iden­ti­fied the pref­er­ences and quirks of everyone in the clinic and the most pop­ular ones and com­mon­al­i­ties and sig­nif­i­cant differences/trigger points]

    Yours truly was reading a WikiHow about chairs and the sit­ting thereof — the first thing men­tioned was “Comfort”.

    “Is that what being a parent is like? Is that what it’s like to be a teacher? I was in com­plete misery and so was the child as we both tried to mask our misery during break times by doing enjoy­able activ­i­ties as mere dis­trac­tions– or what ABA refers to as “rewards”– before going back to pro­gram­ming or “work.””

    Misery and masking: and when you asked “Is this what being a parent is like? A teacher?”

    [I would have replied No! and n‑o-o-o‑o].

    And thinking, too, about how ABA is like prison/worse than prison and court orders.

    Especially the parts about Joe feeling like a stray dog and you acting as a catcher. Animal con­trol — it devolved to THAT.

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