NeuroClastic

An Open Letter to the NYT: Acknowledge the Controversy Surrounding ABA

As an ABA sur­vivor, I’m dis­ap­pointed by the New York Times’s recent deci­sion to pub­lish a biased article lauding the neces­sity and merits of ABA Therapy, or Applied Behavioral Analysis, for autistic chil­dren.

Within the autistic com­mu­nity, ABA is seen as one of the largest, if not the largest, con­tro­ver­sies. It has a dark and deeply uneth­ical past, as well as a highly ethically-questionable present and future. I want to share with you what I sur­vived in ABA, but first I will res­ur­rect the Ghost of ABA past…

The Past:

Before we talk about the his­tory of ABA, I’d like to dis­close my past his­tory with it and admit my per­sonal bias. I don’t think it weakens my argu­ment in this case.

They used food depri­va­tion in my pro­gram and they made us pair up and do it to each other. I feel incred­ible guilt over this.

Every morning I’d cut up a peanut butter and jelly sand­wich into as many pieces as pos­sible. Each piece was like a little bigger than an m&m.

Then I’d be told to force this non-verbal autistic boy to do behav­iors for each piece of the sand­wich. He’d cry, hit his head in frus­tra­tion, and say “hungry” which was one of like four words he could use.

I have no words to describe how bad I feel about being forced to do this as a child. If he didn’t “behave” he’d get no food and he’d go hungry.

He and the rest of us were expected to per­form like trained circus ani­mals for basic rights, like the ability to go to the bath­room.

UCLA & Lovaas:

In 1961, Olé Ivar Lovaas, a native of Norway, was hired as an assis­tant pro­fessor at the Los Angeles Neuropsychiatric Clinic. Lovaas’ goal was to use Skinner-style operant con­di­tioning to “recover dis­turbed chil­dren” from autism or other dis­abil­i­ties. This new therapy used harsh pun­ish­ments and rewards:

The role of “moral entre­pre­neur” and “expert” comin­gled in the figure of Lovaas, who lent sci­en­tific exper­tise as well as moral con­vic­tion to the emerging behav­ioral treat­ment reg­imen of autistic per­sons (Douglas, 2016; Becker, 1963). The tech­nolo­gies involved were elab­o­rate and pre­cise while also brutal and blunt. Electrified floors or prods and detailed mea­sure­ment devices were used in some instances along with snacks, slaps, and daily mon­i­toring check­lists that could be more readily trans­lated out­side the exper­i­ment room. While ini­tially hes­i­tant about the capacity of par­ents to repli­cate the rigor of tech­niques being inno­vated in his UCLA lab­o­ra­tory, Lovaas’s exper­i­ments on autistic bodies extended the reach of sci­en­tific reg­u­la­tion to par­ents, and par­tic­u­larly mothers, whom he trained to be home ther­a­pists (Douglas, 2016; Lovaas et al., 1965, 1973; Lovaas, 1987; McGuire, 2016).

Disturbing Behaviors: Olé Ivar Lovaas and the Queer History of Autism Science
Photo of Lovaas at UCLA, pun­ishing an autistic boy for not paying atten­tion

“Lovaas believes the whole present con­cept of “mental ill­ness” is flawed because it relieves the patient of respon­si­bility for his actions. Lovaas is con­vinced, on the basis of his expe­ri­ence and that of other researchers, that by forcing a change in a child’s out­ward behavior he can effect an inward psy­cho­log­ical change. For example: if he could make Pamela go through the motions of paying atten­tion, she would begin even­tu­ally to pay gen­uine atten­tion . Lovaas feels that by I) holding any men­tally crip­pled child account­able for his behavior and 2) forcing him to act normal, he can push the child toward nor­mality.”

Screams, Slaps & Love
A sur­prising, shocking treat­ment helps far-gone mental crip­ples
Life Magazine, 1965

The idea behind behav­iorism at the time was that all behavior could be changed through the use of pun­ish­ments and rein­force­ments, no matter how strongly ingrained and ignoring the emo­tional and neu­ro­log­ical needs met by the behav­iors.

Behaviorism rejected the idea of unchange­able behavior at the time, believing that the ther­a­pist could modify any and all behav­iors, even behav­iors that stemmed from genetic dis­or­ders. This led to behav­iorism being used to develop a number of treat­ments, some of which remain very con­tro­ver­sial.

Gay Conversion therapy has a his­tory with both Lovaas and autism sci­ence. Lovaas worked with “gender non con­forming” chil­dren at UCLA in the 1970’s, along­side infa­mous pro gay con­ver­sion researcher George A. Rekkers.

The connection between ABA and Gay/Trans Conversion Therapy:

(Text in the image below is typed below the image)

Image of a study abstract from 1974 written by George A. Rekers and Ivar Lovaas. Text below.
This study demon­strated rein­force­ment con­trol over pro­nounced fem­i­nine behav­iors in a male child who had been psy­cho­log­i­cally eval­u­ated as man­i­festing “child­hood cross-gender iden­tity”. The clin­ical his­tory of the sub­ject par­al­leled the ret­ro­spec­tive reports of adult trans­sex­uals, including (a) cross-gender clothing pref­er­ences, (b) actual or imag­inal use of cos­metic arti­cles, © fem­i­nine behavior man­ner­isms, (d) aver­sion to mas­cu­line activ­i­ties, cou­pled with pref­er­ence for girl play­mates and fem­i­nine activ­i­ties, (e) pref­er­ence for female role, (f) fem­i­nine voice inflec­tion and pre­dom­i­nantly fem­i­nine con­tent in speech, and (g) verbal state­ments about the desire or pref­er­ence to be a girl. The sub­ject was treated sequen­tially in the clinic and home envi­ron­ments by his mother, trained to be his ther­a­pist. The mother was taught to rein­force mas­cu­line behav­iors and to extin­guish fem­i­nine behav­iors, by using social rein­force­ment in the clinic and a token rein­force­ment pro­ce­dure in the home. During this treat­ment, his fem­i­nine behav­iors sharply decreased and mas­cu­line behavior increased. The treat­ment effects were found to be largely response-specific and stimulus-specific; con­se­quently, it was nec­es­sary to strengthen more than one mas­cu­line behavior and weaken sev­eral fem­i­nine behav­iors, in both clinic and home set­tings. A multiple-baseline intra­sub­ject design was used to ensure both repli­ca­tion and iden­ti­fi­ca­tion of rel­e­vant treat­ment vari­ables. Follow-up data three years after the treat­ment began sug­gests that the boy’s sex-typed behav­iors have become nor­mal­ized. This study sug­gests a pre­lim­i­nary step toward cor­recting patho­log­ical sex-role devel­op­ment in boys, which may pro­vide a basis for the pri­mary pre­ven­tion of adult trans­sex­u­alism or sim­ilar adult sex-role devi­a­tion.

Lovaas is most known for being the founder of Applied Behavioral Anaylsis, but he also had a clear role in the devel­op­ment of gay and trans con­ver­sion ther­a­pies.

Less com­monly rec­og­nized is Lovaas’s simul­ta­neous involve­ment in the Feminine Boy Project during the 1970s, where he cat­a­logued and devel­oped inter­ven­tions into the gender and sexual non-conforming iden­ti­ties and behav­iors of young people (Burke, 1997; Dawson, 2008; McGuire, 2016; Silberman, 2015; Yergeau, 2018). He engaged in the latter project while funding, super­vising, and col­lab­o­rating with his stu­dent George Rekers who con­tinues to be a cen­tral if con­tro­ver­sial advo­cate for so-called gay and trans “con­ver­sion ther­a­pies.” In this lesser-known project, Lovaas cat­a­logued and devel­oped inter­ven­tions into the gender and sexual non-conforming iden­ti­ties and behav­iors of young people (Burke, 1997; Dawson, 2008; McGuire, 2016; Yergeau, 2018).

Disturbing Behaviors: Olé Ivar Lovaas and the Queer History of Autism Science

Kirk Murphy was a gay man sent to Rekker’s and Lovaas’ exper­i­mental UCLA pro­gram. Applied Behavior Analysis was used on Kirk Murphy for years, starting at age 5. He com­mitted sui­cide at age 38, and his family has blamed the therapy.

In Rekers’ study doc­u­menting his exper­i­mental therapy (PDF), he writes about a boy he calls “Kraig.” Another UCLA gender researcher con­firmed that “Kraig” was a pseu­donym for Kirk.

The study, later pub­lished in an aca­d­emic journal, con­cludes that after therapy, “Kraig’s” fem­i­nine behavior was gone and he became “indis­tin­guish­able from any other boy.”

Therapy to change ‘fem­i­nine’ boy cre­ated a trou­bled man, family says

Both modern ABA and con­ver­sion have the set goal of making a child appear “normal”, or “indis­tin­guish­able from one’s peers.”

Lovaas’s research pro­vides a stark demon­stra­tion of how a “scientific/expert” pro­jec­tion of children’s futures has effec­tively ratio­nal­ized coer­cive and vio­lent prac­tices against the chil­dren them­selves, reshaped pro­fes­sional and familial rela­tions, and bol­stered the ongoing deval­u­a­tion of the adults who are ges­tured to as a “bad out­come,” be they queer, trans, autistic, or gender non-conforming

Disturbing Behaviors: Olé Ivar Lovaas and the Queer History of Autism Science

Behaviorists like Lovaas had over-inflated egos regarding their ability to alter the nature of an indi­vidual through training:

In 2004, Ivar Lovaas said to Los Angeles Times Magazine, “If I had gotten Hitler here at UCLA at the age of 4 or 5, I could’ve raised him to be a nice person.”

Yeah, and maybe he could’ve raised him as a girl, too. Just to be safe.

NYT Buries Researcher’s Ex-Gay Legacy

Animal training:

Evie Faye fea­tured in compliance-free, force-free animal training pro­ce­dures at Wolf Park, Indiana

I was a pro­fes­sional animal trainer for around a decade, working with wolves, lions, bison, otters, eagles, domes­tics, and many more.

Animal training orig­i­nated using harsh methods: fear, pain, total com­pli­ance. But as the sci­ence of animal behavior evolved, the inner emo­tional state of the animal became cen­tral to any decent pro­gram.

Previously, trainers didn’t ask why ani­mals with “problem behav­iors” acted that way-it was all about the sur­face level of behavior, as B.F Skinner believed ani­mal’s minds to be “an input output black box.”

Modern animal sci­ence rejects this con­cept as out­dated because an ani­mal’s nat­ural behav­iors can only be sup­pressed, never fully elim­i­nated. No matter how many thou­sands of hours you spend training a tiger to act like a house cat– it’s still a wild animal that can and may kill you because killing is within its nature.

For my final exam in animal training school, I trained a betta fish to retrieve a ring from the bottom of an aquarium and hand it to me. I’m very familiar with behavior mod­i­fi­ca­tion as a sci­ence; how­ever not all behavior mod­i­fi­ca­tion is equal.

In animal training we have a saying, “Punishing a dog for growling is like removing the ticker from a time bomb. You got rid of the ticking noise, but the bomb will still go off, now without warning.”

Punishing a dog for growling might seem like “it works” because the dog stops the unwanted behavior. Sadly, you’ve not addressed the under­lying reason WHY the dog is growling, meaning the dog still WANTS– needsto growl.

Without addressing the dog’s inner feel­ings, you are risking cre­ating a dog who bites “without warning” because you have trained the dog that it’s nat­ural warning signs are a pun­ish­able offense.

You’ve not changed how the dog feels deep down, as he still feels like growling; you’ve only trained him to sup­press his dis­com­fort in the pres­ence of an authority figure that might punish him.

There may be eth­ical lessons here when we think about the still wide­spread use of behavior mod­i­fi­ca­tion of humans in con­tem­po­rary clin­ical set­tings: the need to respect how a person thinks and feels, respecting their real nature, rather than simply focusing on whether they can be trained to change their sur­face behavior.

2014: What Scientific Idea is Ready for Retirement?

What hap­pens to kids in ABA would never be allow­able according to ethics guide­lines if you were training dogs with aggres­sion issues; but because these kids are dis­abled, stan­dards that are unfit for ani­mals are con­sid­ered appro­priate for human beings.

This North American River Otter, a res­i­dent of Topeka Zoo, was trained to lie down in a plastic tube and receive vac­cines in the belly, without force or com­pli­ance!

That and– just because some­thing is “evidence-based,” that doesn’t mean it’s eth­ical. Using inten­sive behavior mod­i­fi­ca­tion pro­grams designed for lab ani­mals on human chil­dren car­ries deep eth­ical impli­ca­tions.

Many autis­tics report feeling dehu­man­ized by behavior mod­i­fi­ca­tion pro­grams like ABA. It isn’t sur­prising, con­sid­ering that autistic people aren’t caged ani­mals.

This lion was trained to vol­un­tarily lie down, swoosh her tail under the med bay bars, and allow a tech to draw her blood for testing. Topeka Zoo says NO to forced com­pli­ance!

Having observed, filmed, and par­tic­i­pated in wild animal training and han­dling at zoos, I can say we quite lit­er­ally trained zoo ani­mals with more com­pas­sion and sci­en­tific basis than what is used to treat autis­tics.

The vast majority of zoo­log­ical insti­tu­tions say NO to compliance/force-based behavior mod­i­fi­ca­tion pro­grams. Look here at modern, sci­ence based, force/compliance free training:

Zoo ani­mals are allowed to say no. Why shouldn’t dis­abled chil­dren have the same right? Don’t we deserve better? If not, are we autis­tics lower than ani­mals?

The Present:

A survey of autistic people found that the majority didn’t like or support ABA:

These results are sur­prising out­side the autistic com­mu­nity, but gen­erate a sar­castic, “You think?” from within the autistic com­mu­nity. Image demon­strates only five per­cent of autis­tics sup­port ABA therapy for autistic chil­dren.

ABA has repeatedly been linked to PTSD.

“Compliance, learned help­less­ness, food/reward-obsessed, mag­ni­fied vul­ner­a­bil­i­ties to sexual and phys­ical abuse, low self-esteem, decreased intrinsic moti­va­tion, robbed con­fi­dence, inhib­ited inter­per­sonal skills, iso­la­tion, anx­iety, sup­pressed autonomy, prompt depen­dency, adult reliance, etc., con­tinue to be cre­ated in a mar­gin­al­ized pop­u­la­tion who are unable to defend them­selves.”

—Sandoval-Norton and Shkedy (2019)

One study demon­strated that respon­dents who had expe­ri­enced ABA therapy were 86% more likely to have PTSD.

People worry a lot about their “vio­lent” Autistic chil­dren as they get bigger and stronger and harder to con­trol. But far too often, the “vio­lence” is stirred up by years of very frus­trating therapy…. There’s only so long that a person can take being pushed into sob­bing melt­downs of frus­tra­tion before they are willing to do what­ever it takes to get the tor­ment to stop.

Maxfield Sparrow, an autistic adult who under­went ABA-style therapy

Therapists will often defend crit­i­cism of ABA by stating that they‘d never inten­tion­ally harm chil­dren and that they love helping chil­dren. They are telling the truth. They believe they are doing the right thing. This is irrel­e­vant.

My ABA ther­a­pist was the nicest woman on the planet, and what she did to me was still immensely dam­aging. It doesn’t matter how “nice“ a ther­a­pist is. You can be the most well-intentioned person and still harm the people you‘re trying to help. If you’re training people to go against their very nature, to do or stop doing behav­iors without addressing the under­lying causes, then you’re causing harm. If you don’t know about sen­sory pro­cessing dis­order and apraxia, then you are causing harm.

Better ways than ABA?

ABA doesn’t out­per­form alter­na­tive ther­a­pies in sci­en­tific studies. In fact, there’s no evi­dence at all that is it “The Gold Standard,” which is pri­marily a mar­keting term, rather than a fac­tual claim about ABA’s effec­tive­ness.

“All of the chil­dren in the study showed improve­ments in lan­guage, cog­ni­tive, and social skills—regardless of the type of treatment—indicating the ben­efit of early inter­ven­tion in gen­eral rather than of any par­tic­ular method.”

Clinical Trial Compares ABA and Other Treatments

ABA is rou­tinely mar­keted as this myth­ical “Gold Standard,” but in studies it is out­per­formed by speech and occu­pa­tional therapy. Not all chil­dren need therapy simply because they are autistic, and many ben­efit pri­marily from dis­ability accom­mo­da­tions and com­mu­nity sup­port. Autism is unique to the person, and a “one size fits all” approach isn’t advis­able.

Most of the lit­er­a­ture review papers con­clude that the inter­ven­tion pro­grams are con­tro­ver­sial, expen­sive and depen­dent of external vari­ables. Although the arti­cles describing inter­ven­tion processes include 663 par­tic­i­pants, a meta-analysis is not pos­sible due to the lack of com­pa­rable inclu­sion and char­ac­ter­i­za­tion cri­teria.
CONCLUSION: There is not enough evi­dence of ABA’s pre­pon­der­ance over other alter­na­tives.

Applied behavior analysis and autism spec­trum dis­or­ders: lit­er­a­ture review.

ABA has been harshly criticized for it’s link to Autistic masking.

Whether we were diag­nosed early and our guardians taught us how to hide our autistic traits (or force them out of us) through harmful applied behav­ioral analysis tech­niques, or we learned the con­cept of masking or prac­ticed self-degradation on our own as a way to “appear normal” to everyone else — existing as an autistic person in a world that hates us is phys­i­cally and emo­tion­ally debil­i­tating.

When You’re Autistic, Abuse Is Considered Love

My expe­ri­ence in ABA was typ­ical, not atyp­ical, but I‘m still atyp­ical, because ABA will never suc­ceed at it‘s goal of making autistic people “indis­tin­guish­able from their peers.” It will never “recover” people from being autistic.

I think we should be cau­tious to embrace any “therapy“ with the pri­mary motive at its foun­da­tion of making someone appear normal or per­form a cer­tain way in public, because even­tu­ally, the per­for­mance can‘t be main­tained and the real person slips through.

Eventually the weight of wearing a mask that says “Normal Person“ wears you down, and you can‘t handle it any­more. I think it’s impor­tant to ask if ABA therapy is embed­ding shame and guilt in dis­abled chil­dren when we tell them that their goal should be “being normal,” rather than, “being happy,” or “being a good member of society.”

ABA taught me that I should hide as hard as I can, for long as I can. So I hid, and hid, and hid. Until I hit a breaking point and started expe­ri­encing severe depres­sion and sui­cidal thoughts.

The response from the ABA industry to abuse allegations has been… less than optimal.

ABA Therapists have often lashed out defen­sively at autistic people who raise con­cerns about abuse. This is so well-known within our com­mu­nity that ABA pro­fes­sionals are banned from par­tic­i­pating in many online groups that are meant to be “safe spaces” for talking about issues affecting autis­tics.

If not for these bans of ABA and BCBA ther­a­pists, there would be no space to dis­cuss abuse expe­ri­enced in ABA without starting a “debate” about whether or not the abuse really hap­pened.

ABA pro­fes­sionals have also per­son­ally attacked other autism pro­fes­sionals who have crit­i­cized the field, as well attacking par­ents who choose not to send their chil­dren to ABA, or choose to stop ABA in favor of a dif­ferent therapy.

These inci­dents of gaslighting have been talked about on Rationalwiki’s ABA page:

Concerning responses to crit­i­cism:

When hearing “some chil­dren have been abused and trau­ma­tized,” the typ­ical eth­ical human response would be “that sounds awful and we need to inves­ti­gate this and ensure it never hap­pens again.”[cita­tion NOT needed] Yet ABA pro­fes­sionals tend to turn defen­sive at the hint of sug­ges­tion that the ethics of their pro­fes­sion might need reviewing.

Check the com­ments in a dis­cus­sion about abuse in ABA (even one that dis­cusses a spe­cific inci­dent) and you’ll see com­ments that boil down to “not my ABA” or “that’s not real ABA and I want to ensure you don’t think that about all ABA” (instead of maybe “give us the name of where this hap­pened so we can inves­ti­gate those hor­ri­fying alle­ga­tions”).[66][67] “Honestly, the hos­tility we get for sharing our neg­a­tive expe­ri­ences should really say it all,” an autistic Reddit user has pointed out.[68]

Professionals in other fields have voiced con­cerns over ABA ther­a­pists attacking the rep­u­ta­tions of pro­fes­sionals who have reser­va­tions about ABA, claiming that con­cerned critics are “spewing hate” and making “threats and accu­sa­tions.”[69]

Rationalwiki’s ABA page

ABA vs. Autistic Neurology:

No training in autism is required to be an ABA therapist/registered behavior tech­ni­cian (RBT). You are trained in behav­iorism, but not in autism, neu­rology, psy­chology, or any­thing related to dis­ability studies. This is why it’s hardly sur­prising that ABA ther­a­pists mis­un­der­stand autistic peo­ple’s behav­iors.

Stimming:

Clearly, I’m not the only autistic who has been shamed, pun­ished, bul­lied, or abused for stim­ming.

Interventions that result in years spent trying to force a child to engage in eye con­tact, con­di­tion a child to stop stim­ming or obey com­mands such as “hands down,” with no apparent under­standing of the func­tion of such behav­iors for chil­dren with ASD, is undoubt­edly abu­sive and frankly irre­spon­sible when under­standing the autistic brain. Research indi­cates hyper­ac­tivity in var­ious areas of the autistic brain which results in over­stim­u­la­tion and can explain a number of symp­toms, such as aver­sive responses to eye-gaze (Dichter, Felder, & Bodfish, 2009; Martineau, Andersson, Barthélémy, Cottier, & Destrieux, 2010; Markram & Markram, 2010). This over­stim­u­la­tion is seen in the over-activation of the amyg­dala when eye-gaze is held for longer (Dalton et al., 2005; Markram & Markram, 2010).

How Much Compliance is Too Much Compliance?

Stims are repet­i­tive, self-soothing behav­iors autistic people engage in, both vol­un­tarily and invol­un­tarily. These behav­iors, like hand flap­ping, twirling a lock of hair, staring at a sparkling object, or rocking were pre­vi­ously believed to be “without cause or pur­pose.” It’s known, at least since 2005, that eye con­tact causes over-activation of the amyg­dala– fight or flight response. That’s what’s being encour­aged.

For many years, experts thought repet­i­tive move­ments resulted from depri­va­tion or even trauma, and that they hin­dered learning. Psychologist Olé Ivar Lovaas, an early autism spe­cialist, report­edly referred to them as “garbage behavior.”1 He made sup­pressing these habits a pri­ority. Lovaas and his fol­lowers elec­tri­cally shocked, screamed at, shook and slapped autistic chil­dren2. Others pre­scribed antipsy­chotics and other stu­pe­fying drugs. Even in today’s some­times gen­tler treat­ment par­a­digms, ther­a­pists often train chil­dren to have ‘quiet hands’ as opposed to freely flap­ping ones3.

But growing evi­dence sug­gests that repet­i­tive behav­iors have been mis­un­der­stood — and that they may in fact be incred­ibly useful. My col­leagues and I have found that the behav­iors give autistic people a sense of con­trol, helping them cope with over­whelming external stimuli, and a way to calm and com­mu­ni­cate their moods

Stimming, ther­a­peutic for autistic people, deserves accep­tance

Autistic people them­selves have never con­sid­ered these behav­iors to be an issue; rather, the issue is that because we move differently-we flap, rock, bounce our legs- that’s “not normal” and there­fore we must be changed.

We now have research to con­firm what autistic people have been saying about stim­ming– it’s impor­tant to us and healthy and should be socially accepted; yet many ABA ther­a­pists con­tinue to punish or sup­press this harm­less and often-involuntary behavior.

Eye contact:

ABA Therapy often trains autistic chil­dren to main­tain eye con­tact to help them “pay atten­tion.” On the sur­face, this sees harm­less enough.

The problem is that autistic people have REASONS why we avoid eye con­tact, rea­sons that aren’t con­sid­ered at all.

I expe­ri­ence blurry vision after a few sec­onds of pro­longed eye con­tact. Voices become muf­fled, and it’s impos­sible to under­stand what anyone is saying–I feel like Charlie Brown talking to the adults from the old Snoopy car­toons.

Eye con­tact isn’t just uncom­fort­able for us, it makes it nearly impos­sible to pay atten­tion: my eyes water, my eyes burn, and I start to dis­as­so­ciate if I stare too long. I com­pletely zone out, unable to process any­thing that’s hap­pening to me until I break eye con­tact.

I switch between two extremes, each have an unnerving stare that I need to read emo­tion on people. Most people feel like I’m staring through them. Or, when I’m com­pletely over­whelmed with life it takes very little to trigger me. Eye con­tact on some days feels like an lamp shined in my eyes in a dark police inter­ro­ga­tion room. “Where were you on the night of…?” Terror. You’re hurting me. The judg­ment. Cornered Animal.

-Heather, autistic author

Thus, ABA trains autistic chil­dren to ignore the best way they nat­u­rally focus in favor of “looking indis­tin­guish­able from one’s peers” or “engaging in behav­iors of social con­se­quence” (the stated goal of ABA).

I have vivid mem­o­ries of this hap­pening to me in ABA. I remember feeling like I was trapped in a pos­i­tive feed­back loop, because the ther­a­pist wanted me to look her in the eyes when she spoke to me and answer her ques­tions.

I had to look at her mouth in order to under­stand her, but if I did, I’d be cor­rected for non-compliance because that’s “not real eye con­tact.” What was I sup­posed to do? Magically over­come my hard-wiring and pay atten­tion “like a normal person”?

My ther­a­pist ignored my com­plaints, saying I “just didn’t want to work hard” so I worked hard at faking eye con­tact in therapy, and avoided eye con­tact out­side therapy.

Punishing my nature did not alter it, but it did make me wish I was dead, because of the mes­sage that I received in therapy. I’m not “normal.” I needed to “be normal.” I have to try really hard to look people in the eyes, even though it hurts, because then I’ll be “more normal”!

Apraxia:

Apraxia, a neu­ro­log­ical dis­order that affects the ability to con­trol one’s body parts the way you want to (like the hands or mouth), is not tested for before a ther­a­pist starts an ABA pro­gram with a child. This is absolutely inex­cus­able, espe­cially con­sid­ering how common apraxia is in autistic people.

The three-year study, pub­lished in the Journal of Developmental and Behavioral Pediatrics, showed that nearly two-thirds of chil­dren ini­tially diag­nosed with autism also had apraxia, and also found that the Checklist for Autism Spectrum Disorders (CASD) does not over-diagnose autism in chil­dren with apraxia.

Apraxia a common occur­rence in Autism, Study Finds

I remember being pun­ished in ABA for move­ments that I couldn’t con­trol, and in some cases, I wasn’t even con­sciously aware I was doing it.

My hands make ges­tures on their own, my mouth mut­ters words under my breath con­stantly without my per­mis­sion, and my mind and body aren’t fully con­nected.

My body has a mind of it’s own. My legs have sat me down without asking, my hands point at random non­sense, I talk to myself near-constantly.

One time I looked at my room­mate and my mouth said, “You’re a cen­trist…” for no reason. Apparently my brain and mouth have dif­ferent opin­ions about my room­mate’s pol­i­tics! Another time my mouth said, “I love you,” to a total stranger.

Believe me, I can’t con­trol it. If I could con­trol it, I wouldn’t have spent most of my grand­moth­er’s funeral laughing and gig­gling uncon­trol­lably. I didn’t think it was a humorous event, but I have always laughed for no reason all the time, even when I was a small child.

The ther­a­pist tried in vain to train me to stop laughing inap­pro­pri­ately, stop pointing rudely, stop talking to myself under my breath.

During ABA drills, an autistic person may be asked to demon­strate intel­li­gence through com­mands like “touch red” or “touch cat” with cards in front of them. If the person has serious apraxia, they may be unable to touch the cor­rect card, even though they know what it is. Thus, they may be assumed to be unin­tel­li­gent when they are not.

RationalWiki’s ABA Page

The ther­a­pist believed that I could con­trol it if I really tried. The same ther­a­pist who received no edu­ca­tion in autism and had no idea what apraxia was, knew that I just wasn’t trying hard enough.

I feel ABA is the brain dis­order equiv­a­lent of telling people who use wheel­chairs that they could walk, if they really wanted to.

Work hard, Timmy. One day, you’ll pull your­self out of that wheel­chair by your ableist boot­straps and next thing you know, you’ll be run­ning marathons! Everything can be over­come by the power of effort, according to ABA, even per­ma­nent dis­abil­i­ties!

Reinforcement or blackmail?

If I held all your favorite things hostage, demanding that you sit down and stand up over and over, for 40 hours a week, every week, would you like being around me? What if I never even explained why I want you to do this? What if I pun­ished for not wanting to do it?

What if I pun­ished you for not standing up…And then you stand up next time I asked, so I stuff a piece of candy in your mouth? Would the candy make up for how I’ve been treating you?

Autistic kids under­going ABA therapy fre­quently report hiding their favorite toys, hob­bies, or inter­ests from par­ents, teachers, and ther­a­pists. In ABA, all poten­tial rein­forcers are to be used during therapy. Parents are told not to give the child access to these items or activ­i­ties out­side ABA.

That means that a child doesn’t get to have a hobby, a pas­sion, a toy, or a book, without it being fil­tered through an inten­sive behavior mod­i­fi­ca­tion pro­gram. If a hus­band treated his wife this way, espe­cially if it was 40 hours a week, it would con­sid­ered emo­tional abuse.

“The first step in a pro­gram based on pos­i­tive rein­force­ment is to find out what someone most enjoys or cares about…. And then making sure they have no access (or lim­ited access) to those things out­side of ses­sions or other sit­u­a­tions in which someone is actively rein­forcing them to do some­thing.”

Appearing to Enjoy Behavior Modification is not mean­ingful

The use of food rewards on humans is ques­tion­able, because in the animal training industry we know that ani­mals fre­quently become prompt depen­dent and have issues with inde­pen­dence from the trainer, which we have also seen in autis­tics sent to ABA:

Spouses of indi­vid­uals with then-called Asperger’s Syndrome who were exposed to con­di­tioning uti­lized in ABA, dis­closed living with the con­se­quences of prompt depen­dency and iden­ti­fied lack of self-motivation as a con­stant source of stress within their rela­tion­ships (Wilson et al., 2014). These spouses also iden­ti­fied as filling a parent or care­giver role instead of a partner role. Additionally, prompting was found to be embedded within most that cou­ples’ inter­ac­tions and gen­er­ally per­me­ated their rela­tion­ship (Wilson et al., 2014). Other research indi­cates that prompt depen­dence has been found to inhibit or pre­vent the devel­op­ment of age-appropriate social rela­tion­ships and inter­per­sonal skills in chil­dren, which also con­tributes to lack of moti­va­tion and unsuc­cessful learning (Malmgren & Causton-Theoharis, 2006). Considering research pre­vi­ously noted, it is not sur­prising that ABA therapy has long-term con­se­quences, and has cre­ated prompt-dependent adults who lack in self-motivation and self-esteem. Shockingly, there is a lack of research that describes the many years of relent­less con­di­tioning of non­verbal chil­dren who cannot defend or express them­selves.

How Much Compliance is Too Much com­pli­ance?

Meltdowns:

Meltdowns are not behav­ioral, they’re not tantrums, and they are not vol­un­tary. When a melt­down hap­pens, it is a neu­ro­log­ical firestorm in the brain some­where between a severe panic attack and a seizure. Click here to read about how melt­downs feel from the inside.

Best example of ABA mis­un­der­standing autistic behavior? Meltdowns. Autistic melt­downs are an invol­un­tary stress response that can look on the sur­face, a lot like a typ­ical tantrum.

The problem with a surface-level under­standing of behavior mod­i­fi­ca­tion is that many behav­iors caused by dif­ferent things can look alike.

Politeness is a sur­face behavior. Nothing about the per­son’s polite­ness can tell you why they’re being polite to you. Are they a salesman, or just friendly? Without investing the “why,” you can’t make any mean­ingful assess­ments of this “behavior.”

Unfortunately, ABA believes melt­downs are “atten­tion seeking behav­iors” due to the surface-level sim­i­lar­i­ties, and as a result, pun­ish­ment is not unique in ABA. Punishing a child for a neu­ro­log­ical reac­tion they can’t con­trol is abuse, and it’s inex­cus­able.

Sexual abuse and ABA:

Content Warning: this sec­tion con­tains an account of sexual abuse

When I was 9 years old, I will­ingly per­forming oral sex for a teenage boy who was much older than me. He did exactly what my ABA ther­a­pist did: he told me that he wanted me to do some­thing that I wasn’t com­fort­able doing, and he offered me my spe­cial interest, a pokemon toy, for my “com­pli­ance.”

Years of being trained to obey adults who made me uncom­fort­able, years of forced eye con­tact that caused me suf­fering, forced hugs, forced closed mouth kisses, sit up, sit down, sit up, sit down, sit up, sit down… These ther­a­pists had unin­ten­tion­ally taught me that adults should be able to do what­ever they want to my body, and I was never allowed to refuse the ther­a­pist’s requests; after all, I’m sup­posed to be com­pliant in therapy.

The problem is what hap­pens out­side therapy. Outside therapy, I had no skills aside from blind obe­di­ence.

When an older teen pres­sured 9‑year-old me into giving him oral sex, I agreed for the same rea­sons I agreed to let my ther­a­pist hug me. My body wasn’t mine, and my wishes weren’t impor­tant.

I’m not alone in asking how ABA impacts abuse sta­tis­tics:

A life­time of being forced to sit still with no regard for actual cog­ni­tive abil­i­ties can create fur­ther emo­tional and psy­cho­log­ical harm. With such drastic methods of con­di­tioning, it is heart­breaking but not sur­prising to learn that the odds of being a victim of a vio­lent crime is dou­bled among indi­vid­uals with dis­abil­i­ties, and indi­vid­uals with cog­ni­tive dis­abil­i­ties have the highest risk of vio­lent vic­tim­iza­tion (Harrell & Rand, 2010). Additionally, indi­vid­uals with dis­abil­i­ties are sex­u­ally assaulted at nearly three times the rate of those without dis­abil­i­ties (Disabled World, 2012). So how much com­pli­ance is too much com­pli­ance?

How Much Compliance is too Much Compliance?

Radical Behaviorism is outdated science:

My sci­en­tific reason for arguing for Radical Behaviorism should be retired is not to revisit the now stale nature-nurture debate (all rea­son­able sci­en­tists rec­og­nize an organ­ism’s behavior is the result of an inter­ac­tion of these), but rather because Radical Behaviorism is sci­en­tif­i­cally unin­for­ma­tive. Behavior by def­i­n­i­tion is the sur­face level, so it fol­lows that the same piece of behavior could be the result of dif­ferent under­lying cog­ni­tive strate­gies, dif­ferent under­lying neural sys­tems, and even dif­ferent under­lying causal path­ways. Two indi­vid­uals can show the same behavior but can have arrived at it through very dif­ferent under­lying causal routes. Think of a native speaker of English vs. someone who has acquired total flu­ency of English as a second lan­guage; or think of a person who is charm­ingly polite because they are gen­uinely con­sid­erate to others, vs. a psy­chopath who has learnt how to flaw­lessly per­form being charm­ingly polite. Identical behavior, pro­duced via dif­ferent routes. Without ref­er­ence to under­lying cog­ni­tion, neural activity, and causal mech­a­nisms, behavior is sci­en­tif­i­cally unin­for­ma­tive.

Given these sci­en­tific argu­ments, you’d have thought Radical Behaviorism would have been retired long ago, and yet it con­tinues to be the basis of ‘behavior mod­i­fi­ca­tion’ pro­grams, in which a trainer aims to shape another per­son’s or an ani­mal’s behavior, rewarding them for pro­ducing sur­face behavior whilst ignoring their under­lying evolved neu­rocog­ni­tive make-up. Over and above the sci­en­tific rea­sons for retiring Radical Behaviourism, I have an eth­ical reason too.

2014 : WHAT SCIENTIFIC IDEA IS READY FOR RETIREMENT?

ABA pro­fes­sionals act like they don’t want to listen to the very indi­vid­uals they claim to be helping. The highly eth­i­cally ques­tion­able, “But it works,” should never be the base­line require­ment for therapy, and ABA pro­fes­sionals have an oblig­a­tion to take the eth­ical con­cerns with their industry seri­ously.

Unfortunately, they haven’t. There appear to be no signs of major eth­ical reforms or changes based on what adult sur­vivors are reporting.

As long as the ABA industry denies it’s dark past, gaslights autis­tics who com­plain about abuse, refuses to include training on autism in their require­ments, sup­ports the use of elec­tric shocks/hot sauce/wasabi and other painful aver­sives, doesn’t man­date learning on sen­sory pro­cessing dif­fer­ences, doesn’t man­date edu­ca­tion and screening for apraxia, and claims uncon­trol­lable neu­ro­log­ical responses like melt­downs are “attention-seeking behav­iors,” I see no reason to change my mind.

ABA pro­fes­sionals owe our com­mu­nity an apology, at the very least. It would mean the world to me to hear, “I’m sorry, we didn’t know any better,” in regards to my therapy, a pro­gram which had the goal to get me to sup­press uncon­trol­lable behav­iors through sheer will power, increasingly-creative and horrid pun­ish­ments, and the use of M&Ms.

M&M’s aren’t a solu­tion to neu­ro­log­ical imped­i­ments, by the way. No matter how many M&M’s you feed me, I’ll still be autistic and want to act autistic.

Training my out­ward behavior does nothing to change my under­lying neu­rology or moti­va­tions, it only teaches me to be ashamed about my lack of con­trol over my body, my dis­ability, my neu­rology, and my ‘failure’ to be ‘indis­tin­guish­able from my peers.’

The Future:

The only eth­ical future for autistic chil­dren is one where we don’t rob a two year old of a child­hood by sub­jecting them to 40 hours a week of inten­sive behav­ioral mod­i­fi­ca­tion.

No non autistic child would be expected to hold down a full time job, and expecting a dis­abled child to handle some­thing that many non-disabled adults struggle with is unac­cept­able.

ABA would never fly if we were talking about a typ­ical child. Non-autistic chil­dren aren’t sub­jected to the over pathol­o­giza­tion of every aspect of their lives and are allowed to be chil­dren.

Autistic people are dehu­man­ized when we pre­tend that a five-year-old won’t be emo­tion­ally impacted by having to main­tain a full time job in terms of work­load, on top of kinder­garten. Where is there time to just be a kid?

These chil­dren in intense behavior mod­i­fi­ca­tion have no week­ends, no free time, and no time to socialize with other kids out­side a therapy or school set­ting. Is “being normal” worth having no child­hood?

How many hours did ABA steal from my child­hood? I don’t know, but I do know that I spent many days in ABA crying, kicking, screaming, and being sui­cidal, and those sui­cidal thoughts stem from years in therapy being told to try to hide an impor­tant part of who I am.

It’s com­pletely unac­cept­able that BCBAs and ABA prac­ti­tioners don’t have to have any training in autism specif­i­cally, and yet they are touted as the pre­mière autism experts.

ABA is behav­iorism. They are behav­iour mod­i­fi­ca­tion spe­cial­ists, not experts in devel­op­mental dis­abil­i­ties, autism, or neu­rology. This is a pretty big problem because autism isn’t a behav­ioural dis­ease, it’s a neu­ro­log­ical dis­order and devel­op­mental dis­ability.

No amount of behavior mod­i­fi­ca­tion can change that I’m dis­abled. As a child, I didn’t know that, and tried very hard to pre­tend to be “not dis­abled” so I’d get good marks in ABA.

Is it advis­able to teach chil­dren to hide their strug­gles and dis­com­fort in order to get rewards, toys, games, and praise from adults? Is that a healthy thing to teach a kinder­gartner?

It’s not accept­able, eth­i­cally, to deny the prob­lems with ABA. It’s not eth­ical to deny the elec­tric shock and its his­tory of being used on gay and “fem­i­nine boys.” It uneth­ical to deny the recent Government Report from Tricare that found ABA therapy is largely inef­fec­tive.

It’s uneth­ical to ignore that many autistic adults who went through ABA are out­spo­kenly against it and refer to them­selves as “sur­vivors.” If there were no eth­ical issues with ABA as a field, people wouldn’t be com­paring it to gay con­ver­sion therapy and branding them­selves “sur­vivors.”

Chemotherapy is noto­ri­ously awful, and yet cancer sur­vivors aren’t protesting chemo en masse. Dialysis is a night­mare to go through, but people aren’t protesting dial­ysis en masse. Autistic adults aren’t protesting speech therapy, or occu­pa­tional therapy, dialec­tical behav­iour therapy, or neu­rology (which is far better suited to help us because autism is neu­ro­log­ical, not behav­ioural).

We are only protesting ONE type of therapy, and it’s about time people started asking why.