The Great Behavior Fallacy: Why The New York Times Is Wrong To Think That ABA Can Treat Autism10 min read

I felt a need to write a response to The New York Times article, “Early Treatment For Autism Is Critical, New Report Says,” in part due to my great respect for this paper. The NYT is the American paper of record, and I have always taken its jour­nalism seri­ously. This is why I was espe­cially trou­bled to find this piece pub­lished within.

The article pro­motes the use of ABA (Applied Behavior Analysis) therapy on chil­dren as young as 18 months to two years, pre-formal autism diag­nosis. Dr. Susan E. Levy, a co-author of the study, is quoted saying that ABA therapy is, “very very impor­tant.” All I could think upon reading this was, “Et tu, New York Times?” It seems that even the best and brightest minds have bought into the Great Behavior Fallacy around autism, and my heart cries for the chil­dren who are bound to get hurt.

Many of my bril­liant autistic col­leagues at The Aspergian have pub­lished amazing and wrenching pieces about how ABA actu­ally tor­tures autistic chil­dren. It puts tremen­dous psy­cho­log­ical, social, and at times phys­ical pres­sure on chil­dren to get their behavior to appear more neu­rotyp­ical. This bom­bard­ment can last for 20 to 40 hours a week in chil­dren under five years old, and can lead to depres­sion, anx­iety, and PTSD— which can last into adult­hood.

But even the pain caused to autistic chil­dren isn’t my largest problem with ABA “therapy.” The worst part is that after inducing all of this suf­fering, it doesn’t even work. ABA may make par­ents more com­fort­able with their autistic chil­dren, but it will never treat autism itself or make life less painful for those born autistic.

“But ABA is evi­denced based,” you may argue. “They have all of these charts and graphs and exten­sive research that show that ABA changes behavior.” Yes, in some cases, ABA will change a child’s rote behav­iors. I say some because ABA apol­o­gists do not even want to talk about all of the chil­dren who “fail” out of ABA because they aren’t good can­di­dates for behav­ioral con­di­tioning, but I digress.

What ABA won’t do is treat or cure autism because autism is not a behav­ioral con­di­tion. And this is The Great Behavior Fallacy under­lying behav­ioral autism treat­ments. Autism is a neu­ro­log­ical dis­order and/or way of being, not a behav­ioral one. And to treat a neu­ro­log­ical con­di­tion effec­tively, neu­ro­log­ical dif­fer­ences cannot be over­looked and ignored.

This is a common premise in med­ical theory, not one of my own cre­ation. For example, the common cold is a virus– well, many viruses. When a virus infects you, you feel fatigue and your nose runs and your throat burns and tickles. Sometimes you get a low grade fever to try to combat the virus. When you feel these awful feel­ings, you may choose to take a pain reliever/fever reducer, such as ibuprofen or NyQuil, and these med­i­cines will make you feel better until the virus is gone.

Claiming that you can treat a cold with a pain killer or decon­ges­tant is the equiv­a­lent of what ABA is claiming to do. By their logic, if you are no longer aching and coughing, you don’t have a cold any­more, nev­er­mind that the virus is still large and in charge. It is like saying that a bandaid can “treat” a cut. All it does is make you a bit more com­fort­able while it heals.

But NO ONE in modern med­i­cine will claim that a pain reliever or a fever reducer can treat a virus. They may lessen the impact of viral symp­toms but can do nothing to erad­i­cate the virus itself. This is why modern sci­ence pro­motes vac­cines for severe viral infec­tions. We have no effec­tive treat­ment for viruses. All we can do is pre­pare our bodies for them if they attack us. A sup­pres­sant may stop our bodies from coughing, but sci­en­tists and doc­tors are smart enough to know that coughing is a mere symptom of a cold, not the cold itself.

To extend this analogy, coughing is an observ­able behavior. It might mean someone has inhaled a harmful or irri­tating sub­stance. It might mean they need to get rid of fluid in the lungs, clear an object lodged in the airway, or because of a med­ical con­di­tion like asthma, acid reflux, or a heart con­di­tion. Coughing serves a pur­pose in each of these sce­narios, and though it might look the same from the out­side, the internal trig­gers vary. Suppressing a cough could pro­long an ill­ness or lead to com­pli­ca­tions. It would be treat­ment of an under­lying cir­cum­stance without regard for what caused the cough.

But at least band aids, sup­pres­sants, and pain killers make sick people feel better. ABA does the oppo­site, applying “treat­ment” by making life harder for autistic people. And autism is not like a cut or a virus. It’s not a dis­ease or an injury. It’s a way of existing.

If you look closely at ABA research, it never claims to treat autism in any sort of exis­ten­tial or neu­ro­log­ical sense. What it does is break down the behav­iors that the DSM (Diagnostic and Statistical Manual for Mental Disorders) uses to diag­nose autism and attacks those behav­iors. In large part, I actu­ally blame the DSM for this fal­lacy because, due to their lack of con­cep­tu­al­izing and defining what makes autistic people tick inter­nally, many of their diag­nostic cri­teria are behav­ioral in nature. This is what makes the ABA decep­tion pos­sible.

For example, the DSM lists dif­fer­ences in eye con­tact as to make eye con­tact as an example of a deficit in non­verbal social com­mu­ni­ca­tion in its diag­nostic cri­teria for autism. It does nothing to explain that autistic people CAN make eye con­tact but often avoid it patho­log­i­cally, due to neu­rology that makes it extremely painful or uncom­fort­able.

ABA then relent­lessly drills the child until they finally give in and start making eye con­tact just to make the ABA stop. After awhile, the ABA trainer sees an increase in eye con­tact sta­tis­ti­cally and tells you that the child is less autistic or behavior has improved.

The problem is that this inter­ven­tion hasn’t cured the under­lying autism at all. The child still has the same neu­rology and finds making eye con­tact as painful as ever. They are still autistic. All the ABA “ther­a­pist” has suc­cess­fully done is make non-compliance even more painful for the child than com­pli­ance. This is why in order to func­tion, ABA has to create con­sid­er­able dis­com­fort for chil­dren, even if it isn’t dis­com­fort that NT par­ents can see or under­stand.

This is how ABA can pro­duce study after study showing that it treats autism– and why it will always fail to do so. ABA can force a child through end­less rote rep­e­ti­tion to increase eye con­tact, to give up the flappy-handed stims that bring them com­fort and peace, to touch their noses and smile at strangers, but it cannot make these behav­iors com­fort­able and safe for these chil­dren inter­nally. They cannot cure autism.

This is where ABA will rou­tinely pull out its second great lie. “ABA is not painful for your child,” they tell par­ents, “because after repeated rep­e­ti­tions, autistic chil­dren habit­uate to a given behavior. It becomes less painful for them. Autistic activists just don’t under­stand basic neu­rology. The chil­dren wouldn’t per­form the behavior if it wasn’t becoming less painful for them.” That is one theory, but as an autistic person, I dis­agree and have an alter­nate theory. I will explain.

I learned about behavior theory and habit­u­a­tion in my psy­chology and devel­op­ment classes while training for my Master’s degree in Social Work. Apparently, (I say appar­ently because I am not neu­rotyp­ical and do not know first­hand.) a Neurotypical person when exposed to the same stim­ulus repeat­edly will even­tu­ally begin to adjust to this stim­ulus. This theory is often used to treat pho­bias, since a Neurotypical person who fears– say, clowns– can become less scared of them over time when exposed to clowns repeat­edly in a safe set­ting with safe people.

I do not refute this, not being Neurotypical myself; it may very well be effec­tive. What I can tell you as an autistic person, how­ever, is that our minds are not wired to quickly habit­uate based on per­sonal expe­ri­ence. Yes, I am more habit­u­ated to noises and smells than I was as a child, but I habit­u­ated over many YEARS of grit and work, on my own terms and devel­op­mental curve, and not a forceful reg­i­ment of therapy ses­sions.

And there are some things that I can’t or don’t tol­erate, but I’ve worked out accom­mo­da­tions for myself that allow me to par­tic­i­pate in life on my own terms. I truly believe that the chal­lenge of habit­u­ating is a part of the neu­rology that sep­a­rates autistic people from the rest of humanity.

And ABA has done no studies to prove oth­er­wise neu­ro­log­i­cally. They merely claim that their suc­cess in cre­ating behavior change is proof of autistic habit­u­a­tion. But there is another ironic behavior theory besides habit­u­a­tion that can explain the “suc­cess” of ABA just as accu­rately, and if this theory is cor­rect, the impli­ca­tions are truly heart­breaking. I under­stand why ABA prefers their theory of habit­u­a­tion.

Psychologist Martin Seligman estab­lished the con­cept of learned help­less­ness through a rather cruel exper­i­ment on dogs in 1965. He put dogs in small, con­fining con­tainers, the kind that no normal dog would habit­uate to, and left an opening in one side of the con­tainer. The dogs would all imme­di­ately try to leave through the opening and be attacked with pow­erful elec­tric shocks until they retreated back into the con­tainer. The dogs tried to escape many times and received extremely painful shocks. The dogs began to cower in their crates and stopped even trying to escape.

But that isn’t all. Eventually, Seligman removed the gad­gets pro­ducing the elec­tric shocks from the holes in the con­tainers. He expected that since he did this in full view of the canines, that they would all imme­di­ately escape their con­fine­ment. But they didn’t. The dogs had given up and did not even try to get out of the boxes. But it gets worse. Seligman thought that maybe that box wasn’t a bad enough stim­ulus to get the dogs to take one last shot at escape, so he tried again. He elec­tri­fied the enclo­sures for a bit leaving no way to escape while the dogs received shock after shock.

Then Seligman made a door in each con­tainer. All a dog had to do to escape those con­tainers was to walk for­ward a few feet to freedom. But the dogs stayed in those con­tainers and con­tinued to get shocked the vast majority of the time even with a gaping hole in front of them. Stunned, Seligman coined the term “learned help­less­ness” to explain this behavior.

Learned help­less­ness posits that once an animal or person suf­fers enough inescapable pain, they may be psy­cho­log­i­cally broken to the point where they no longer try to escape the pain, even if handed the per­fect oppor­tu­nity.

This is an equally plau­sible expla­na­tion of what hap­pens through repeated ABA expo­sure. When chil­dren begin ABA, most resist. They try to run away, they dis­so­ciate or shut their eyes, they have melt­downs, they turn their bodies away. After hun­dreds of hours, they do the behavior and stop trying to escape in some cases, though in many cases the stress actu­ally causes dis­tress, depres­sion, anx­iety, and/or PTSD. Why? I think that likely these chil­dren are the dogs in Seligman’s non-electrified enclo­sures from the first exper­i­ment. The chil­dren suf­fered so greatly when they attempted to run away from or resist ABA that they just quit trying and set­tled for the lesser pain of eye con­tact or quiet hands.

“Well smarty,” the ABA ther­a­pist might say, “if that were true, then why would the kid be making increased eye con­tact at home with no threat of ABA bom­bard­ment?” Because if the child has learned help­less­ness as the dogs did, they will give up on resisting these behav­iors, even when the “shock” of ABA is removed. They will con­tinue to make eye con­tact and have quiet hands, even though it causes them pain, because they have learned help­less­ness. They have given up.

Does ABA therapy still look ther­a­peutic to you given the very real pos­si­bility that training Neurotypical-looking behav­iors into chil­dren does not spare them the very real neu­ro­log­ical pain that these behav­iors cause? This is why autistic people behave dif­fer­ently in the first place. Is it worth tor­turing autistic kids to force “normal” behav­iors knowing that it does nothing to cure autistic neu­rology? Would we be so eager to achieve quiet hands if we actu­ally accepted that we were lit­er­ally breaking autistic chil­dren to get them?

I issue this chal­lenge to par­ents, the New York Times, and to prac­ti­tioners of ABA itself. Prove me wrong. Step out from behind the cir­cular con­clu­sions you draw from behavior and run a real neu­ro­log­ical study. Prove to me that you are neu­ro­log­i­cally treating autistic wiring through habit­u­a­tion, rather than breaking autistic chil­dren using learned help­less­ness by cre­ating autistic pain and forcing com­pli­ance.

And if you cannot prove me wrong, ask your­selves if we are the very mon­sters that I am sure you were thinking Seligman was as you were reading this article, by forcing ABA therapy onto tod­dlers when we truly have no idea what it does to them. I hope that you are having an easier time living with this reality than I am.

10 Comments


  1. “They merely claim that their suc­cess in cre­ating behavior change is proof of autistic habit­u­a­tion. But there is another ironic behavior theory besides habit­u­a­tion that can explain the “suc­cess” of ABA just as accu­rately, and if this theory is cor­rect, the impli­ca­tions are truly heart­breaking. I under­stand why ABA prefers their theory of habit­u­a­tion.

    Psychologist Martin Seligman estab­lished the con­cept of learned help­less­ness through a rather cruel exper­i­ment on dogs in 1965.”

    About that, here’s the thing — if ABA altered behavior through habit­u­a­tion, why do ABAers deem it so cru­cially impor­tant for par­ents to con­tinue the ABA at home when the pro­fes­sional therapy ses­sions are over? And why is it equally impor­tant that all these ABA demands be repeated in var­ious “nat­u­ral­istic” set­tings? Could it be because habit­u­a­tion isn’t enough to account for these behavior changes (given that if it were the ther­a­pists wouldn’t need to be pushing 247 therapy and in “nat­u­ral­istic” set­tings)? Could it be because by making the ABA spill over into all sorts of set­tings, they are shut­ting mul­tiple exits in the child’s mind and making it more likely that the child will exhibit learned help­less­ness that gen­er­al­izes to more set­tings?

    I think it could be. If a kid only expe­ri­ences ABA lite in one set­ting and the par­ents don’t repeat it (as I did) they may expe­ri­ence mental damage, even a lot of it, but they won’t exhibit the level of learned help­less­ness needed for them to exhibit an “optimal out­come”. Whereas kids who find that the ABA fol­lows them wher­ever they go will expect that the ABA could follow them at any minute and thus are less likely to try and escape the masking in other sit­u­a­tions. Thus, making the ABA follow kids wher­ever they go makes learned help­less­ness more likely to develop. Though of course ABAers will sell you a very nice pitch about “con­sis­tency” when they describe that plan.

    1. Lucy:

      sat down to read the 1965 Seligman experience/experiment in its full horror as AspieGurl shared with us.

      I do not know that he was a mon­ster. The sit­u­a­tion mon­stered him. Like Milgram and Bandura and their respec­tive col­leagues and the­o­ries.

      And I am less sure he has changed his ways — Positive Psychology is every­where in the schools.

      I thought it was “set and set­ting” issues myself. [this comes from the biological/drug world — music fes­ti­vals a great exem­plar].

      Learned help­less­ness has a way of gen­er­al­ising and spreading.

      Yes, if it is in just one or two set­tings [like math­e­matics and phys­ical edu­ca­tion] one has more of a chance to access feel­ings of safety; accep­tance and com­pe­tence. [Yours truly is quoting Bill Nason here]. And in a sense one needs to pull on them more.

      The whole “per­va­sive and per­ma­nent”. [and there is another P‑word] Could exhibit just enough to tip over their per­sonal edge/comfort zone.

      And things that follow where you go? In the Benelux world and in France — sur­veil­lance is so much a thing. It has been so from the 1790s to the 1980s … Even during the strikes which are across the fields and workers.

      And when the child for­gets or does not know that Masking is a Thing you CAN Escape [the four “rea­sons” ].

      That con­sis­tency pitch — much enhanced by these neolib­eral and neo­con­ser­v­a­tive memes.

      Talia Welch is a very good ally whose “Meta Helicopter Parenting” I read and dis­cussed yes­terday [13 January 2019 — it con­tinues until the 31st].

      Did you see ABA rise in 2003 [late Bush]? I did.

      There are more decent; stronger; safer ways to become com­fort­able with the autist in your house. That is what I would wish to tell fam­i­lies and par­ents. Things which may actu­ally be con­gruent with your values than judge­ment and con­ve­nience.

  2. If we take this out of the autism con­text it’s per­fectly obvious why the habit­u­a­tion “expla­na­tion” is false. I learned in the field of trauma recovery that in order for habit­u­a­tion to work, the exposed person has to feel safe. Not just “be” safe, by some out­side arbi­trary stan­dard — actu­ally *feel* safe. (Sometimes you can fake this, as in a study where people with spider pho­bias lis­tened to a steady, strong heart­beat while looking at spi­ders, and grad­u­ally became less fright­ened of them, but that hardly com­pares to an ABA envi­ron­ment!)

    I tried for years to habit­uate myself to using the tele­phone, as tech­nology improved such that my hard-of-hearing self the­o­ret­i­cally would have been able to use it — but I never felt safe doing it, or even using relay or TTY ser­vices. The threat of not under­standing, or being dis­missed and humil­i­ated, was always there. It wasn’t until I gave up trying to be okay with it that the sheer terror that came with a tele­phone ring began, slowly, to abate. (Not learned help­less­ness — I gave up trying to use the phone alto­gether.)

    These kids get­ting ABA’d non­stop never even get to learn what feeling safe feels like.

  3. “Is it worth tor­turing autistic kids to force “normal” behav­iors knowing that it does nothing to cure autistic neu­rology? Would we be so eager to achieve quiet hands if we actu­ally accepted that we were lit­er­ally breaking autistic chil­dren to get them?”

    I think for some par­ents and other people involved in “treating” autistic kids, it’s exactly that: they’re per­fectly willing to break the kid as long as the kid will after­ward “pass for normal” and “not look so autistic.” It’s not about helping the child — it was never about helping the child — but intead about helping everyone else not have to be around a kid who “acts autistic.”

  4. “Would we be so eager to achieve quiet hands if we actu­ally accepted that we were lit­er­ally breaking autistic chil­dren to get them?”

    I have reason to believe the answer would be “yes”. ABA was never meant to help anyone (not even the par­ents, who for the most part are simply deceived) other than the neu­rotyp­i­cals who want to main­tain the status quo.

    It wouldn’t be the first time that psychiatry/psychology was repur­posed as a tool to con­trol people either. The Soviets were quite fond of diag­nosing anyone who opposed their régime with “slug­gish schiz­o­phrenia”, locking them up in mental insti­tu­tions for tor­ture and calling it treat­ment. Is it any sur­prise that people us, who ques­tion why the cur­rent social norms exist, are put through a sim­ilar expe­ri­ence?

  5. Hmm.. I’m a little speech­less and don’t know what to say. I’ve been working as an ABA ther­a­pist since 2014. I do agree with many of the points in your article. For example, don’t believe ABA cures autism and that’s been our motto. The BCBA’s I’ve worked with never promised par­ents a cure was pos­sible or their chil­dren were com­pletely going to change, etc. In fact we never made such promises and that we’re there to help the child become more inde­pen­dent and help manage mal­adap­tive behav­iors such as severe tantrums and how to appro­pri­ately inter­vene based on the func­tions of the behavior. We taught many self-help skills which is only going to help the child in their day to day lives. ABA actu­ally has great teaching method­olo­gies such as task analysis for instance to help teach brushing teeth, tying shoe laces, etc. There’s many skills acqui­si­tions being taught using DTT, task analysis, nat­ural envi­ron­mental teaching, etc. So it’s not all about teaching eye con­tact or etc. Again, I do agree with a lot of your points espe­cially, teaching through exces­sive rep­e­ti­tions, trying to stop hand flap­ping, drum­ming which is part of the four func­tions of behavior sen­sory stim­u­la­tion or SSB. In those cases I was taught to help the child replace it with more socially appro­priate behav­iors such as clap­ping. So we didn’t com­pletely try to extinct the behav­iors. There’s chil­dren who would bite their wrists as a sen­sory stim­u­la­tion to the point of hurting the skin around it it. We had her bite into a sen­sory diet neck­lace. And it didn’t work, so went back to having her wear wrist pro­tec­tors because her hands would get bloody due to all that biting.

    1. Author

      I read this very care­fully before trying to respond. I get why the lit­eral appli­ca­tion of learned help­less­ness theory does not feel rel­e­vant to you. You don’t use a zil­lion trials and try to soothe and change behav­iors that are bad habits with good habits. But this can be equally insid­ious and I will try to explain why.

      I didn’t go through formal behavior training as a child, but I did have my behav­iors “adapted” by behavior pro­fes­sionals. The pri­mary lesson I learned as a child from this expe­ri­ence was that adults hon­estly didn’t care about my thoughts, feel­ings, or suf­fering as long as they liked my behavior. This was a depressing rev­e­la­tion for a six year old.

      You see even if a child doesn’t learn help­less­ness from sys­tem­atic tor­ture, they learn help­less­ness because pro­fes­sionals like you just don’t seem to hear them. Wrist biting and all other behavior are our form of com­mu­ni­ca­tion. We don’t need “good habits” and “wrist guards”. WE NEED YOU TO CARE THAT WE ARE IN SO MUCH PAIN WE BITE OUR ARMS. And speak for us. And adapt our envi­ron­ments accord­ingly.

      We need you to learn from us rather than the other way around. We need our ther­a­pists to be our voices and advo­cates, not ignore our needs while trying to alter our behavior.

      Thank you!


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