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.
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12 Responses
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.
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.
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.
Stop using other places as scapegoats of “bad ABA practioners” and just look through the tag here for this site. Read the stories about it from people who go through it. You are not helping people if you are using ABA. You are abusing them, it may not be obvious immediately in the short term, but there are studies showing that masking or camouflaging, which is the prime focus that ABA aims to achieve, correlates strongly with the increased suicide rate of Autistic people. Your Board still allows Lovaas’ place, the JRC, and its employees, board certified seats and allows them to attend conventions to preach about ethics when they routinely and still in modern day use electroshocks, starvation, isolation, and other cruel methods on Autistic children, it allows it despite the fact that the JRC has an actual BODY COUNT of autistic children it has killed using those methods. Not a single one of the employees of the JRC, or the JRC itself, is denounced and condemned by your Board. And your Code of Ethics was even used in court to make it permissable for them to continue to use these cruel, sadistic, and harmful methods on the people that are forced to reside there.
I am an autistic person who went through ABA. It is abuse, full stop. Even the “gentle” versions are abuse. You will never convince me of otherwise when I have first hand trauma and experience from it, and when I can still see JRC in operation under your board, and no sign of your Code of Ethics changing to take into account the emotional and mental wellbeing of your learners. Let alone actively specifying between the parent, learner, relative, or company entity rather than as your current one uses, filing them all deceptively under the term “client” to provide the idea that you are actually asking the consent of the learner. I know many of you don’t. I know many of you go to the parents first and ask them. You don’t ask your learners. And you don’t provide an environment where they feel safe to speak up. So please, take your hogwash outside and dump it into the Abyss never to be seen again, because there are far too many horror stories from learners who are now adults, and from people who quite being BCBA or RBT for me to ever believe it’s just that specific clinic or practioner. It’s all of you. And if you aren’t doing it yourself, by defending and scapegoating those who are more obvious to then continue to say that it is helpful, you are complicit.
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.)
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
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.
I really appreciate you sharing this. Ever since I first found NeuroClastic, I’ve been working to expose ABA’s wrongdoings to the entire commonwealth, the entire world even. You have given me a huge lead in doing that and I truly appreciate you. Keep speaking up about this. You could change so many attitudes for the better.
You know, when I was little I had a teacher we can call Miss Abby who used to do what she called The Hold, and what that was is she’d hold my wrists behind my back so my arms were like a straitjacket and not let go until I stopped screaming and stopped trying to get her off, I don’t know why. But I always wondered what she must have been thinking. I hope she was at least a little like you.
Thank you so much for writing this article.
I’m the parent of a child with ASD Level 1, and we have homeschooled him from the start (he’s in 3rd grade now). I have been trying to do reading about what therapies and schools are out there as some of the stress of homeschooling him with other small children in the home has increased. As I keep reading about the options in the public school system, as well as ABA clinics, I’m increasing glad we made the choice to homeschool, even if it has its difficulties.
This poor little boy you shared about should have been spending 4-6 hours a day outdoors in the woods, fields and beaches exploring and jumping and digging in sand or mud NOT in an empty room–utterly cruel. All children need to be outdoors, but especially kids with Autism!
My son with autism spent maybe 20 or 30 minutes a day on reading or math at age four (he is gifted with reading, otherwise I wouldn’t have bothered), and the rest of the time he explored outdoors (except when he was getting into trouble in the house, which was so hard for me to understand at the time because we didn’t know he was autistic). I’m just glad we at least gave him the freedom to be himself outdoors.
You hit on something in your article: YES, the school system at large has ethical problems. YES, ABA is simply a natural outgrowth of the idea that children must produce a uniform behavior and intellectual product to be “successful.” This is why I homeschool, even though, yes, it’s hard.
Consider reading the works of John Taylor Gatto about how we do “education” in this country. You may like his ideas.