How to Spot a Good– or Bad– Therapist for Your Autistic Child

Editor’s note: Heather is a non-autistic neurodivergent ally to autistic people who has been working as an autistic ally for many years.

The best advisors for your Autistic child are autistic adults.

One thing that may confuse you, however, is their intense dislike of ABA therapy, which stands for applied behavior analysis– something which may have been heavily recommended to you for your child.

Chances are after a diagnosis, your child will be recommended for some kind of therapy. With all the confusion, which ones are safe and will help, and which ones are harmful?  Who should you listen to?

A few things I have discovered in my advocacy work: it’s not always as simple as just saying, “ABA is bad and speech therapy and occupational therapy are good.” Here are the reasons:

  1. Many, if not most, therapists who don’t bill as ABA use the same techniques and may actually be more harmful
  2. Some ABA therapists practice radically differently approaches that are trauma, neurology, and sensory informed and follow the lead of Autistic adults to operate in harm reduction

So choosing a therapist really needs to be a careful decision. There are many other points we could consider, but lets get down to the main point:

What aspects of therapy are wrong?

Please watch this video with transcript.

Please print out that transcript and make sure you don’t witness these therapy methods, or make sure they aren’t included in your child’s therapy plan.  Printable transcript available for download or printing by clicking here.


How do you know if your autistic child’s therapy is harmful?

Bad therapy can be abusive and has far-reaching consequences like increased anxiety, depression, and PTSD in later life.

What does the therapist hope your child will achieve with them? What are they aiming to do?

Cure them?
Heal them?
Reduce their autism symptoms or make them less autistic?

If so, then please keep your child away from them.

If their goals are to help your child thrive as their autistic selves, to help them learn to successfully navigate a world they’re not built for, without betraying their nature-– they’re worth keeping.

What are the warning signs of a harmful therapist? What can you see in your child’s plan that might signal danger?

___ How about forcing or encouraging increased eye contact?

Eye contact can be painful for autistic kids, can make it more difficult to listen and divert their attention.

___ Do they use the phrase “quiet hands” – stopping your child from stimming, which is vital for the regulation of their thoughts and feelings?

___ Is the term “extinction burst” used to describe your child’s emotional reaction to being forced to do something that feels wrong for them?

___ Do they listen to your child’s pleas to stop when it gets too much for them?

___ Do they treat meltdowns as if they were just tantrums?

___ Do they think sensory needs should be combated or overcome, rather than respected?

___ Is pushing your child to achieve results more important to them than preventing sensory overload?

___ Do they understand the need for sensory breaks?

___ Has your child’s behaviour ever been described as “attention-seeking”?

___ Do they use “planned ignoring” as a teaching tool despite the distress being ignored can cause anyone, especially a child?

___ Is the way your child chooses to play a problem to them? Are words like “inappropriate” used about the way they play – as if playing wasn’t just playing?

___ Do they push your child repetitively to play “their way” without investigating their cognitive level or abilities?

___Do you see words like “dysfunctional” or “non-functional” in their reports or sales pitch?

___ Do they insist on speech as being the ONLY acceptable way to communicate?

___ Do they use sweets, treats, or privileges as tools to bribe your child into compliance?

___Is your child’s autonomy and right to self-determination respected the way you would?

Ask yourself these questions, and if you don’t like the answers, this therapist will not help your child to grow. In fact they may lock them into a cycle of stress and self-loathing that never ends.

Beware of therapists that describe themselves as using “the gold standard” of service and techniques. Steer clear of those who address lack of progress by pushing extra hours of therapy.

Always be ready to act if you see any of these signs. Your child’s future is your responsibility and yours alone. Don’t let false promises and slick sales techniques convince you that YOU aren’t in charge.

So what makes a GOOD therapist?

Some ABA proponents would say autistic adults advocate against any therapy, but this is completely untrue. There are many excellent therapists who help Autistic kids every day.

Good therapists help children with finding ways to communicate, fostering independence without pushing too hard, understanding sensory issues, self-advocacy, learning to jump or ride a bike, understanding how to assess people and situations for danger, processing emotions in a way that is self-validating, and learning many new things the child desires to enhance their life.

These therapists can be amazing.

So how can we spot these people?

Please watch this video:

Please print out the transcript and use it to help you assess your child’s therapist or potential therapist. There are many providers like thisfind one who is like this for your child.  You can find a printer-friendly version of this checklist for printing or downloading by clicking here.


How to spot a good therapist for your autistic child

First things first, there is no “autism therapy.” Every autistic person has different needs.

__ Good therapy builds on a child’s intrinsic motivation to learn and connect with others.

__ Has no expectations or aims for eye contact.

__ A good therapist focuses on your childs own needs, not those of someone who wants them to be different

__ The therapist needs to respect your child and “gets” their experience. Never try to tell your child how they should feel.

__ Happily accepts your child’s harmless stimming

__ Respects your child’s choice of communication – sign language, AAC, letterboard, other…

__ A good therapist respects bodily autonomy

__ Good therapy addresses root causes (anxiety, sensory, cognitive)

__ The therapist and child should work together to come up with useful strategies for dealing with problems

__ The therapist talks about profiling and supporting sensory needs, as these are so common.

__ Good therapy focuses on the child’s emotional well-being.

__ The therapist should try to help your child achieve their goals in ways that feel authentic to them

__ A good therapist respects a child’s limits and encourages self-advocacy, even when a child communicates, “No.”

__ A good therapist will not rely on motivating through extrinsic rewards and punishments.

__ Connection is made without rewards, treats, or conditional access to special interests.

__ When the child shows signs of distress, they are validated and unconditionally allowed to stop/avoid/access safe space – rather than pushing them through it or seeking compliance.

__ A good therapist is kind, and trusts that a child is doing their best

__ Unconditionally reduces demands when the child shows any sign of distress, however communicated.

__ The therapist is transitional, empowering parents and carers to support in the day to day.

__ Your therapist helps your child understand the non autistics in their life and helps others better understand and accept your child when possible.

__ A good therapist shows warmth and kindness at all times.

__ Your therapist helps your child reframe their experience in ways that enhance their self esteem.

__ Is keen to learn from Autistic Adults.

A therapist like this, and your child will thrive.


Finally I would like to thank Autistamatic for volunteering to make the spectacular video and for all the parents, experts, and autistics who contributed at each stage of making this post.  Please take a moment to follow Autistamatic’s YouTube by clicking here and hitting the red “Subscribe” button.

Related Articles

15 Responses

  1. whether i’m autistic is debatable (fwiw, at least one ex-therapist thinks i am and i’m formally diagnosed as neurodivergent) but H*LL F*CkING YES to “therapists should not attempt to force eye contact”. i hate trying, because if it’s more than briefly i feel like i’m violating that person’s boundaries, and that is an intensely revolting experience for me as a full-grown adult.

  2. I’m really confused. ABA is no good. But is this article saying to sample different ABA providers to find one that is good?

    1. No its saying if u have no choice but to take ABA with your child, because yes some places it is mandatory, do all u can to make sure they aren’t doing those bad therapist methods. Try and change objectives etc. It you can avoid ABA yes 100% avoid it. This guidance is also to spot if other therapists are using this method

  3. This website horribly mischaracterizes ABA. The autistic adults that it claims are the best advocates for autistic children likely learned to speak and advocate for themselves due to their exposure to ABA training. Following the recommendations of the volunteers on this page rather than credentialed ABA therapists will not help your autistic child gain independent living skills and language.

    1. I am an ASHA certifiedSLP and must say this is the false information many ABA practices present. Communication is a complex activity. It is NOT just a behavior. It includes all forms of language (body, specific gestures, sign, eye gaze, pitch, tone, spoken words and AAC). I have had to “undo” so much damage from ABA therapists who “train” children to speak and make them little robots. I respectfully and professionally disagree with your statement. Most ABA practitioners are BTs who have a high school or bachelors degree. They are supervised by BCBAs who have a masters degree. None of them have the extensive background in communication SLPs do (BA and MS specifically on communication). They may have one to two courses in how to coerce language from a child but they know almost nothing about normal language development in neurotyps and neurodiverse people.

      1. Ya know, Queenstar, there is a thing called cause and effect – if the effect is that the portrayal here is that ABA is not healthy then there is a quite high probability that the cause of said effect is that ABA is not healthy and/or is not applied in a healthy manner; effects do not just arbitrarily manifest without cause or foundation. As for Warren, are you neurotypical? In looking at “The autistic adults that it claims are the best advocates for autistic children likely learned to speak and advocate for themselves due to their exposure to ABA training.” it brings to mind the long history of neurotypicals, and especially neurotypical educators and health care providers (and then there are the general public, who are a whole ‘nother essay) incorrectly assuming things and/or issuing generalized declarations about we who are autistic. There is enough of that which has gone on and goes on that even the state government of Nevada has published a 3 page PDF titled ‘Autism Myths and Misconceptions’.

    2. Wow, you really are making a big assumption that most of us had ABA. ABELIST BS. Having NOT had ABA and being a full grown adult with a college degree, a home, and a family I look at ABA as the thing that will prevent many from having all these things as they are “trained” to comply, lose their independence and creativity, and be open to abuse due to no self confidence or ability to say NO.

  4. Instead of “child’s choice of communication,” I would write “child’s way of communicating.” A child who uses BSL or PECS, for example, may do so because they can’t access other methods of communication, whether due to their autism or other factors, meaning that the way an autistic child communicates isn’t always a choice.

  5. @ Warren: And you accuse us of gross mischaracterisation. FYI, I had been speaking for five years before I was put through ABA at the age of eight for my ‘disordered’ (read: sensorially defensive) eating. Before ABA, I used to eat most foods. Afterwards, I would eat only ‘safe’ foods. So no, I didn’t learn to talk with ABA, but I did get what is now called ARFID through it, as well as cPTSD.

Talk to us... what are you thinking?

Skip to content