Editor’s note: As an publication, we have been critical of ABA therapy for autistic children. We have decided to publish this article written by a guest contributor, a non-autistic BCBA, because the content is relevant to our values and the emotional health of our autistic children.
I have been a BCBA (board certified behavior analyst) for over 10 years. I was trained at a “great” ABA (Applied Behavior Analysis) program, and I believed in ABA, just how I was trained.
I have worked in state hospitals, group homes, schools, home and community settings, and more. I developed a breadth of experience, and with every experience I gained, I grew more and more disenchanted by ABA.
I have made my mistakes along the way, I will admit and I have done things I was trained to do (not just looking at you planned ignoring and escape extinction) that I am deeply saddened by and regret. I learned things I did hurt people and still struggle to come to terms with my actions, especially as I feel trapped in this field.
My words here are a plea to ask that ABA practitioners consider the impact of how they practice therapy. They are not in any way intended to be against the code of the BACB (specifically sections 6 and 8, since the code engenders fear about speaking out against ABA). My words are here to address the shortcoming and failures in how we practice, specifically with autistic children.
Post-publication edit: Disturbingly, as of today, June 2, 2020, all versions of the ethics code and even articles referencing the code have been removed from the BACB website. A copy of the code can be accessed here.
I know this conversation is needed, that ABA needs voices pushing for this change, and spaces for this conversation to be had. Science evolves. We should not fear to have open, honest, and especially critical conversations about the state of the profession.
When a field resists change, growth, and evolution, it becomes a dogmatic echo chamber and encourages tacit complacency from those who don’t see themselves as part of the problem.
But where to start?
Collaboration
ABA likes to operate in isolation. The main autism treatment model is set up for a BCBA to oversee a behavior tech (a person trained usually with just a crash course in basic ABA and often in problematic and rigid teaching techniques (e.g. discrete trial training, planned ignoring, etc.) in a home or clinic.
If you are in-home, you are pretty much alone as a BCBA or BT with very little opportunity to grow collaboration skills.
In clinics, it is usually an office with an echo chamber of ABA people. We are trained in ABA and in none of the new advances in understanding of the brain, trauma, child development, and social/emotional learning.
ABA must humbly collaborate with these professionals and accept their research as valid in order to create approaches that attend to the social, emotional, sensory, and physical wellness of the whole child. There are some who are trying (ACT, DNA-V, practical FBA, etc.) but they are considered fringe, 3rd wave, new, and too focused on internal (read: emotional or developmental) “stuff,” according to the repeated complaints from BCBAs about them.
Just listen to any ABA podcasts on these topics. Behavioral Observations receives repeated questions from listeners whenever these topics come up, and they always center discourse around, “Is it really ABA?”
Or even worse, these techniques are used to make parents ignore their own feelings of trauma and pain when being told to use ABA strategies with their children.
ABA professionals are given a framework of deification with our ABA gods (some are calling out the problem with this, but not loudly enough) and admonished if we question it. Indeed, on one of my first days of grad school, my class was told: If you think you have any new or great ideas, you don’t. Someone already thought of it.
Anecdotally, many ABA students report feeling like their university program didn’t want them to “like” other professions. Mine specifically discouraged us from collaboration with social workers and school psychologists by insulting their professions, students, and professionals.
This isolationism carries over into our collective actions as professionals- when non-ABA professionals criticize ABA, our profession circles the wagons and vigorously counters by going into ad-hominem against other professionals and labeling them “mentalists,” hurling accusations of “not evidence based,” or worse, as being a part of the problem.
ABA seems so afraid of collaboration, many in ABA discourage “dilution” of ABA services to make sure no other therapies are involved.
Just as there is a need to collaborate better with other partners and seek to incorporate scientific research that originates outside of the ABA world, we must collaborate with our clients, especially our disabled clients.
Our clients are the experts in their own lives and know better than us what makes for a happy, healthy, and productive life for them. We can’t do better by our clients without listening to our clients. Too often, we impose our vision of their own lives onto them, with the arrogance that we know better.
Or, we choose to not believe clients and parents when they give us information. Truly listening to our clients and acting on their wishes, their vision, their values, their goals and how they want to achieve them is paramount and should lead to a full world of naturalistic learning rather than contrived reinforcement.
When we work to collaborate with our disabled clients, no matter age or ability, we elevate them to the level of respect that we, as a field, give our typically-developing clients. When we work toward collaboration with our clients directly, we actively work against this discrimination with treatment that ABA perpetuates.
How we treat the voices of dissent
Autistics have been decrying many of ABA’s techniques and approaches for a long time. Personally, I started learning and listening to autistic voices when I stumbled across the Wrong Planet forums. Sadly, it was still a very slow process to learn to listen in the way a true ally would.
Though I am a person of color, we (generally-speaking) white, neurotypical therapists in positions of power have been consistently working to dismiss, explain away, diminish, or outright attack those autistic voices.
We use whataboutisms as if we were trained to wholesale dismiss concerns by saying, “All professions have a checkered past,” and “That it is just a few providers,” and “ABA doesn’t do things like address stimming or force eye contact anymore” (spoiler, we do! We tell critics: “I don’t do that, I do good ABA,” (#notallABA)– while turning a blind eye and refusing to take ANY ACTION.
Social media is awash with these scenarios repeating over and over. If we were to truly care about our field, our clients, and ourselves, we would work to address and end bad practices we KNOW exist in ABA, the exact practices our many clients and critics repeatedly bring to light.
If we are going to defray criticism by saying “we” do “good ABA,” then we have a responsibility to be better; to be a LOUD VOICE actively addressing those among us that do harm by not living up to what we claim is our practice.
Caring would be working to correct our problems that our critics, especially critics that come from the primary community we purport to serve, bring to our attention.
Autistics are the primary population we serve (argue this one away as much as you want, this is where ABA put its $$), and when we get feedback, this is how we behave?
To belittle them? To explain it away as misunderstandings? Why aren’t we listening? Why do we only tolerate autistic people in our space when they are our token cheerleaders?
Why aren’t we responding to voices of dissent? Why are we waving them away with meaningless platitudes: “We have heard you, and we are changing”? Why aren’t we giving the critical voices positions in our committees where, currently, we have exalted ABA professionals dispensing decrees as if ABA is the only way and needs no change.
I’d hope we’d all decry an all-white diversity panel, rules about women’s bodies made without women, or a paper about what low socioeconomic status families need without even asking them.
Why then, do we do this to people with disabilities, autistics, and other neurodivergent diagnoses? Why is it, when we have autistic voices willing to tell us what they think, we choose to deride them, instead of including them? We must do better.
How we treat those with disabilities
I had a moment in my career when I was trained on sexuality and rights on the issue of consent. I could not believe that this wasn’t an emphasis or requirement for our education, especially with how much personal physical space we occupy with our clients.
Long-term impacts of poor modeling of physical boundaries can be disastrous for clients.
Some BCBAs, especially the ones with experience and training only in autism ABA (not to be confused with actually knowing anything about autism), have a hard time explaining how apply ABA with neurotypicals and what to do when working with neurotypical adults, neurotypical kids, and society on a grand scheme.
It requires a lot of understanding of behavior, being accepting of internal states, and figuring out alternatives when the NT client says “no,” to really be able to practice better.
Autism ABA and Bias
The application of ABA with people with disabilities (including neurodivergent people) is different from the other applications of ABA (geriatrics, neurotypical adults, staff development, health and fitness, etc.).
ABA makes billions of dollars off treating autistics.
The ABA industry uses methods derived from a tired approach from more than half a century ago and have barely made any changes in teaching for autistics despite many fields (including those of developmental disabilities) moving forward while we dig our heels in the past. ABA needs to be better (NOTE: ACT is not doing better).
We cannot continue to treat autistics, neurodivergent people, and developmentally delayed people as “less than.”
The way we treat them now regards them as “less than.” Autistic consent matters less than other people’s. ABA therapists commonly run plans on autistic and other disabled people that they have not bothered explaining to the children– this is exponentially worse if the child is non-speaking.
Simply outlining a plan to a parent or guardian is just not good enough. What would our tolerance be for this if our own care providers operated without communicating directly to us?
Imagine (or maybe you don’t have to since this is a common occurrence in ABA) a child with a new ABA therapist or new demand screams every day for a while during ABA. What child development research recommends to do in this scenario is to empathize with the emotions and help the child work through them, reducing stress until the child feels safe and ready to learn.
What does ABA do with autistics? Escape extinction for the win! Ignore-and-redirect for the win! No concern for the child’s feelings. Little effort made to make the learning environment more tailored to their needs. Nothing about child developmental needs are incorporated into ABA’s work with autistics.
Meanwhile, we give them terrible coping techniques like asking them not to show their feelings and to eat their feelings (suppress them) with pieces of candy. This also reinforces to the child that their dissent, choice in how they learn, consent, and voice, don’t matter. ABA teaches autistic children to shut up and fall in line.
Compliance and Consent
Teaching obedience without question is, frankly, terrifying– especially since teaching blanket compliance to authority grooms people with developmental disabilities to be even more likely to be taken advantage of, abused, and bullied. ABA therapy has also just coerced them into silencing their internal and external “no.”
If I were an adult with skin picking, suicidal ideation, and anxiety, and I went to a provider for treatment, I would have tremendous say on which of these issues were addressed, how we address them, when, where, and in what way they would be treated. If I were not listened to, the provider would be quickly fired.
However, an almost-universal hallmark in ABA as applied to autistic people is that programs for behavior modification are built without ever considering the consent or wishes of the actual person.
We are so unprepared to work within the bounds of consent granted by an autistic person that we often totally neglect it, even in cases working with adults where we are legally required to seek informed consent.
We write blanket following instructions (i.e. noncompliance) as a targeted behavior for behavior reduction in plans for non-conserved adults and then pretend the adult actually gave us informed consent.
We often play games with consent and say the parent is giving consent, but remember the enormous position of power we, as BCBAs are in: We are the “PROFESSIONAL.” We are often viewed as “the cure.” (Which is gross, but that is how we often market ABA.)
We are “the answer” (cue melodramatic holy light shining down). We tell parents that we are the only way to help their child. We throw “evidence based” out like it means “proven to work.”
Parents are in a very vulnerable position, and we monetize that, all while ignoring (if we ever bothered to understand it in the first place) the wishes of the person that we purport to be our “client.”
How we speak about autistics and other neurodivergent people
Autistics and other neurodivergent people have communicated that language matters. The way we as professionals speak about autism is problematic.
Autism $peaks is one of the worst offenders of violating the preferences of autistic adults and is generally viewed poorly by autistics. ABA and A$ are often partnered and perform as a united front against autistics.
Are we as a field even aware of A$’s many controversies or of the profound dislike the vast majority of the autistic community has towards AS? ABA professionals often use cure language and participate as ABA organizations in “walks for the cure!”
We often talk about autism as if it is a disease or a public health crisis, a tragedy.
We participate in a conversation that demonizes the population we exist to serve, and we allow discussions about autistic people using language and imagery we would never tolerate being said about ourselves (even if it marginally improved our fundraising)!
We pride ourselves in our operational definitions and the idiosyncratic language we reserve for our field. Heaven forbid if someone uses “negative reinforcement” improperly around a BCBA because you’ll get a pedantic lecture– but we resist identity-first language (autistic, as opposed to “person with autism”) as if it matters more what we prefer instead of (once again) caring what the main population we work with wants.
In the same way you wouldn’t misgender somebody by ignoring their preferred pronouns, stop misidentifying autistic people who have clearly and repeatedly made their language preferences known and hold those preferences by a strong majority. If you would misgender someone just for your own comfort, then you are probably teaching gendered programming to autistic children without consent.
Yes, this happens; how many times do ABA professionals encourage traditional gender roles in children under the guise of social skills? Have we thought critically about doing that? Have we considered that the autistic population is enormously more likely to be LGBTQ+, including 10x more likely to be gender non-conforming?
Continuing to try to modify someone’s gender expression would keep in the long tradition of ABA’s link to gay conversion therapy.
If it is news to you that the overwhelming majority of autistic people prefer identity-first language (despite virtually all of them being told by others that the way they prefer to be referenced is wrong and the “right” is way person-first language), I would challenge you to honestly consider how much interaction you actually have with any autistic people.
Can you truly claim allyship with a group when you don’t know things as basic as how that group prefers to identify?
How we address internal states
ABA professionals like to say, “It’s not that we think internal states don’t exist. We just can’t measure them, so we don’t work with them.”
That is pretty scary.
We should be saying: we haven’t developed consistently good ways to measure internal states, but we are constantly working on improving by consulting autistic people (note: throwing “have you looked at ACT/RFT/DNA-V/etc.” at this problem doesn’t change that).
ACT
ACT (acceptance and commitment therapy) being implemented by BCBAs is a terrifying prospect. ACT is PART of a theraputic approach for helping clients. ACT is used, usually by mental health counselors, to help with persistent difficulties with thoughts and feelings by helping clients reframe their verbal language into different context to make behavior changes.
For BCBAs, it also requires a pretty firm understanding of relational frame theory (RFT), the ABA tie to ACT. Instead of using it appropriately, BCBAs weild ACT to claim they are working with covert (feelings and thoughts) behaviors without actually acknowledging how important a complete picture of a person’s mental health is to changing difficult internal feelings and thoughts long term.
Take this study as an example. Parents were trained to show “overt” behavior that looked like increases in values behavior (behavior that tied into your personal life values). In fact, the study reported that since ACT’s sole goal is to increase overt, value-driven behavior, that overt behavior should be the primary measure of success, not reported feelings or indirect measures.
The study specifically stated they didn’t concern themselves with mental health screening since they didn’t want to address that– so poof, they just pretended it didn’t matter.
Where are the fail-safes? How did the BCBAs know there was no trauma or abuse in the parents’ histories? How do BCBAs know they aren’t unintentionally teaching kids to strengthen aberrant coping skills, like shutting down feelings?
The terrifying thing is ABA practictioners do not know how to navigate these issues (because we are literally not trained), but instead use things like ACT as shiny new toys to play with. Like everything in ABA, ACT gets taken, broken down, and turned into an acceptable form of therapy in ABA: only what you can see matters. When all we care about is what we can see, we miss a lot, including masking (see below).
Internal states are integral to how stimuli in the environment change for the individual. Internal states change how much response effort you are able to give. Internal states change how aversive a stimuli or activity is (or one small thing within that activity).
Internal states change how reinforcing an item, person, or activity might be. Internal states alter our delayed discounting and pretty much all behavioral economics. Internal states exist and can change very rapidly.
Internal states can only be measured by the impact they have on the environment, including other humans. We could come up with great ways to see, define, and measure internal states, but we are trained not to question what we already do in the field.
There is an abundance of research across many fields (neurology, psychology, medicine, etc.) that tells us emotions, emotional regulation, sensory processing, self calming, etc. are integral to developing a child’s resilience (a positive long term outcome).
It’s also known that neurodivergent children have difficulty with these skills, and that these skills are foundational building blocks for all areas of learning and development for the future. We know how important it is for caregivers to be the teachers and for the role of professionals to help the child and the parents and other care sharers to develop positive relationships.
There is abundant research on trauma and the effects of chronic stress on a child’s threat system. Neurodivergent kids and adults are more sensitive to trauma and stress. Trauma research also shows the different ways trauma manifest– there is a reason ABA kids get called “calm, quiet, compliant” and its called the freeze shut down response.
Unfortunately, all of that is internal, so ABA wants to plug its ears and look away. Why? Picture a 3 year old kid being forcibly separated from their parent for ABA. Child is screaming while ABA therapist holds a fighting kid in lap. Kid kicks off shoes and is freaking out, screaming, flailing, now on the floor. Kid is ignored and monitored. Data is collected.
When the kid is quiet, the therapist tells her to put her shoes back on. Child melts down again after just having to work out emotional regulation with no help from caring adults. Hand-over-hand (a violation of bodily autonomy) to put on shoes from large, powerful adults and brought to circle time to learn songs and colors despite probably still being in a neurophysiological state of escalated stress (a.k.a the opposite of an optimal learning context).
That’s why.
In the end, the therapists will get their data and call this child “improved” as the girl has given up.
So much of what ABA does is not in alignment with current understanding of child development and brain science. It seems to line up more with methods that are linked to poor long term mental health outcomes.
The sad thing is, it could be changed. Saying “Have you seen our most recent research in (insert whataboutism here)” doesn’t change how we are educating our students and supervising our upcoming and new BCBAs.
We need a major paradigm shift.
A certainly not-final note on internal states– if we aren’t putting a lot of weight into internal states, we will fail to detect when people are masking, or pretending to enjoy what we have been “reinforcing” them with and speaking for them by telling them they enjoy it.
We won’t notice they are pretending that they are not stressed and anxious, from all the effort they are using in suppressing their natural selves. If we are only looking at what the person externally expresses, but we have reinforced them to express a certain thing regardless of how they truly feel, we are treading into dangerous territory, but more on that below.
Use of punishment, extinction, shock
Judge Rotenberg Center.
The Judge Rotenberg Center is a residential institution that has an infamous international reputation.
ASAN has so much important information about the Judge Rotenberg Center (JRC). BCBAs work at JRC, run the programs, and sit on the board– some of the most notable names in our profession sit on that board. They annually present at our most major yearly conference and are received with applause.
We give them a platform to present evidence-light defenses of their practices (like electroshock punishment used on intellectually disabled children) while neglecting to invest equal effort and equal energy to learning from the far larger body of more recent and more compelling evidence that would deter those practices.
We give JRC legitimacy, and then have the gall to try and distance our industry from those same practices when our critics mention them!
Our tolerance for JRC inhibits our growth in other ways. Because we tolerate JRC within our profession, we have a code of ethics that also tolerates JRC, and as a result ALSO would tolerate virtually every bad act done in the history of ABA, in 2020.
JRC may be only one place, but JRC BCBAs can leave the JRC and set up their shingle in another town with skills developed to do things the vast majority of our profession would never do and never feel appropriate to do. And they can do it all within our code of ethics.
We as a field should not be associated with this at all. In what world is it okay to attach a shock device to someone and give the power to shock them to other humans? Humans are flawed. There is no way to keep this humane.
Imagine having a hard time in life because of how disabling the world can be due to your sensory perception. Imagine being institutionalized (which research shows is ALWAYS associated with terrible outcomes) and developing trauma over your years of institutionalization– and now you get shocked for the behaviors you have developed to cope.
Shocking teaches nothing but learned helplessness and leaves no room for healing.
Extinction (including planned ignoring) goes against what all the research is showing us about child and human development. Extinction doesn’t care about trauma, in fact it can cause trauma.
We should have extreme trepidation about extinction and planned ignoring programs being run that have the effect of making the person feel that accessing love, comfort, reassurance, and affection in their lives is conditional to their behavior. Just because something works behaviorally doesn’t mean it is something a therapist should have in their tool bag.
Masking
We need to address the suicide crisis happening in the autistic community, and we need to honestly and critically consider the very real probability that we are contributing to that crisis.
The vast majority of autistic adults identify with having psychiatrically significant suicide risks, and research indicates suicide risk among autistics is TEN TIMES greater than the general population.
Studies researching this crisis, and a huge number of anecdotal reports by autistics reflect that a primary factor contributing to suicide risk is masking or “camouflaging” autistic traits- pressure felt by autistics to mask and “pass” as neurotypical or “allistic” people.
How often do we address stimming? How often do we write plans for forced eye contact and “whole body listening?” Research has come out showing us that eye contact can be physically painful. Stimming helps decrease anxiety and stress in autistics (and I’d say in most humans – check your own stim).
How often do we discourage autistic people from talking or learning about subjects they “obsess” over? How often do we encourage “age appropriate interests?” Have we EVER considered or put in writing an acknowledgement that we could be putting our client’s mental health in jeopardy by doing these things?
Why are we encouraging autistic people to present based on our version of normal instead of as unapologetically themselves with the skills to advocate for their needs as themselves rather than some theoretical “fixed” version of themselves?
Imagine you were hired by a gay high school age client. The client discloses that he is being bullied by his classmates because he is gay. Would you EVER, EVER, EVER consider writing a behavior program that taught this client to act in a stereotypically heterosexual manner to reduce bullying?
Now, be honest, and think to yourselves how often we give advice to autistic clients that they will be more acceptable if they can act more neurotypical, even if you don’t use those words. The autistic community has a term for this – a common critique of ABA – “Autistic Conversion Therapy.”
What next?
If ABA wants to keep up with what the mental health, medicine, and neurology fields have demonstrated is the best way for the village to help children, we must do something big and fast.
Change our education, change what is still acceptable, change our views, change the culture of ABA, change our ethics code. We must work together to do this, and that includes with other professions and especially with autistic people.
We have the research. We have the principles. We need to incorporate all the current outside-of-ABA research into ABA and use it as the starting platform for a path that leads us back to humanity.
Individual practitioners need to make change now. Waiting until the systems change will be too late for too many children. I have fundamentally changed how I work, but I grieve for those who knew me when I was a “good” BCBA.
I’ve finally been able to put an escape plan into action by starting work on a mental health counseling degree. My hope is to continue working to elevate the call for change in ABA while providing mental health services and trauma care to ID/DD communities.
I urge ABA practitioners to pay attention to autistics and make the urgently-needed changes to their practices. For any changes to have meaning, ABA professionals must also add their voice to the steadily rising call for systemic, cultural, and educational changes in the field of ABA.
- I am a disillusioned BCBA: Autistics are right about ABA - June 2, 2020
40 Responses
the author’s take on ACT is mistaken. likely a result of the BCBA emphasis on techniques and tools
That’s your takeaway?
wow! Yes, this!!!!
If this is all the case then the treatment, for the want of a better word, simply will not last forever in the subjects mind and actions. In the next few decades a whole army of survivors will rise. ABA as described will be forced to pacify or be denied practice. I have always known this treatment needed an effective pre – test to decide if it would case PTSD and issues around being forced to lie because that’s normal and okay for everyone else in your life. Lie to your heart and assume responses to everyday situations that are simply not true. To pass as ‘normal’ and not to have ones spontaneous, bad behaviours.
Just a matter of time.
I’m quite skeptical that this author is who she claims to be. I looked up her name on the BCBA registry and there is no BCBA with the surname ‘Ram’ in the United States. Also, it seems that all of the so-called “ABA therapists” who write for Neuroclastic have a bizarre obsession with Jason Travers. So do you, Terra.
“Emily Wade” wrote the infamous 50 Shades of ABA based off of him, and I somehow doubt an actual ABA therapist would write that and put their job in jeopardy. To improve your credibility, I would suggest that your articles are fact-checked and that the authors have profiles to verify that they say who they are.
Also, not all autistics think the same way. We are not a hivemind. Many of us have gone through ABA therapy and unequivocally support it. So please stop saying that the autistic community hates ABA, when it’s only a few people who dislike the therapy.
Uh… you do know pseudonyms exist, right?
Pseudonyms? As in, false names people write under so that, for instance, their jobs aren’t at stake? Which hers certainly would be if she revealed her real name? And besides, even if it is her real name, it’s possible she isn’t working in the US – she didn’t say she was. She might have known about the JRC, not because it’s in her home country, but because she would have heard of her own profession supporting it. Either way, it’s her business whether she quits her job or not, and when, and what steps she takes – decisions in a path towards leaving a career and/or changing it are never easy.
And as for Jason Travers, his arguments are pretty typical of what ABA supporters say. Up to and including decrying facilitated communication and RPM in a way that is less concerned with the validity of the methods themselves and more about the validity of severely autistic people’s ability to have a voice. Hence things like focusing certain cases of FC debunking on people who use other, more verified methods of communication in addition to FC (i.e. Deej, who uses pointing cards on trips where FC would not be handy, a method not terribly different from PECS), or considering RPM debunked solely on the basis of prompt dependency, which is a common trait among most special needs interventions and therefore means that if that is enough to debunk RPM, then not only ABA should be rendered invalid for the same reason – even more so given the more varied and subtle use of prompts and the conditioning that leads ABA survivors to consider hundreds if not thousands of unrelated things prompts as well (as well as going on to treat total strangers on the street as they would potential therapists) – but nearly every other special needs intervention should be invalidated on that basis as well.
And besides, I used to think it was good that I had been put through the abuse that I was – I wished at one point that it had started younger so I could’ve gotten to the point where I never cry again. And I’m sure many of the folks who decry it now used to support it. But, it so happens that those who decry ABA outvote those who support it in the autistic community. So it can’t be “just a few”, or the vote would look totally different.
And if you’re right that most autistics support ABA, then I can only assume that means that the vast majority of autistics are where I once was – feeling it was a good thing to be abused with ABA methods, yet also not wanting to lose the things they love, and also too afraid to speak out and even click on those types of polls. Which means that if indeed most autistics support ABA, then there is an epidemic of fear cowing a vast number of the autistic people out there and making them too afraid to dissent – one so bad it’s as if a dictator already ruled us. Worse than merely an epidemic of Stockholm syndrome.
And since there ISN’T a dictator telling us to stay quiet, I figure the polls are true, and most autistic people do not support ABA – especially since, in my recollection, ABA therapists aren’t looking over people’s shoulders every second of the day and tracking the polls to ensure that they don’t so much as click on it. And it would make no sense for them to do that – if ABA therapists were looking over autistic people’s shoulders and forcing their hand at these polls, we’d see most of the autistic community supporting ABA and would not be able to tell how much of this is ABA therapists and how much of it is autistic folks. But they don’t. they don’t have that control, and thus we see an overwhelming LACK of support by autistic people of ABA in these polls.
Okay, maybe she is using a pseudonym, but I still find many of these articles questionable. Until there’s evidence she is an actual BCBA, I have no reason to believe her. How do we have any evidence that this woman is actually a BCBA, or just someone trying to make ABA therapy look bad? All of the BCBAs I know support ABA therapy. Also, my therapist (who has a strong background in psychology) has decried the offensive “conversion therapy” analogies.
You should consider how many times Terra has tweeted at and harassed Jason. I find it quite disturbing. Also, facilitated communication has no basis in science. Considering that a double-blinded study has debunked FC, there is no reason to support it. Any studies “proving” it works are poorly designed, such as the recent one with a sample size of nine verbal autistic children. Great science there…
I was in ABA therapy and had no trauma from it. I refuse to be told I have Stockholm Syndrome, because I don’t. And it’s quite funny you mention ABA therapists holding autistic children’s hands and forcing them to type, because that’s exactly what FC entails. Your hypocrisy is astounding. Plus, if ABA polls are being conducted in neurodiveristy circles, the resuls will obviously be skewed toward anti-ABA sentiments. Please research bias before you respond to me again. 😉
There should not be a call to change ABA. It should be to end ABA. As you pointed out it seeks to modify external behavior not inside what’s going on such as emotions.
Then why do all empirical studies point to success with ABA therapy? The goal of ABA isn’t to change people; it’s to help teach life skills. By ending ABA, you are calling for the endangerment of severely autistic children and adults who need behavioral therapy so that they don’t run out into the streets and end up dying. Any criticisms of ABA are based in emotion, not facts.
Reply to your reply:
“Then why do all empirical studies point to success with ABA therapy? The goal of ABA isn’t to change people; it’s to help teach life skills. By ending ABA, you are calling for the endangerment of severely autistic children and adults who need behavioral therapy so that they don’t run out into the streets and end up dying. Any criticisms of ABA are based in emotion, not facts.”
The reason empirical studies point to the success of ABA therapy is the same reason that people discover that giving dogs treats for doing a behavior works, or that people discover that spanking works. Both types of things produce immediate behavioral changes. However, here’s the rub – be it the “pleasant” forms of ABA (reinforcement, i.e treats) or aversive ABA (punishment, which is what spanking and other such forms are), you cannot fully control what behavioral changes will occur. And you cannot ensure through that method that a child is not being traumatized – yes, even if you only use treat. Because ABA does not take into account the actual lessons kids take from it. Actual lessons which could lead to new behavioral issues down the road. See: studies on why spanking doesn’t work, and research on why extrinsic rewards kill intrinsic motivation, to see why claiming ABA works in the long run runs contrary to what the broader psychological field says – and there is no evidence that autistic people conveniently have a psychological profile that enables extrinsic motivation to cause intrinsic motivation in a manner contrary to what those studies suggest.
The reason ABA seems to find evidence of it “working” is they don’t bother to study internal states, even though they are doing their practices on a lot of people who can be asked. Including folks like you who were likely subjected to a cookie-cutter program designed for people with more severe disabilities than they actually had, enabling them to meet the “goals” easily because those behaviors weren’t personally hard for THEM. And I say you were likely subjected to such a thing because if, as you say, you do not have Stockholm Syndrome, you were never given goals that micromanage your tone to the last millimeter, never told to give up every interest you had that was not 100% normal (or else you lucked out by having apparently normal interests, i.e. sports for a boy or drama shows/fashion for a girl) and not had your posture or movements micromanaged into perfectly polished positions in which not the slightest gesture could be made and you had to aim to stand 100% still, either. Which means you were given goals designed for people more disabled than you, which to THEM would feel like micromanagement and like they were constantly failing but which to you would be readily doable. And, contrary to what the ethos of ABA says, once you met all those goals you were not given a goal designed to “challenge” you – that is, a goal to stop a behavior that wasn’t a problem for any of the other kids but was something you did and had to learn to stop (i.e. moving) or a thing you didn’t do but had to learn to do (i.e. giving a huge sparkling grin at the very thought of being given the “opportunity” to do menial labor and respond to any and all orders in a chipper way) so as to constantly “improve”.
And as for “life skills”, you don’t need ABA to teach kids not to run out into the street. You might use things like “Stop-Go” and other call-and-respond games, which, while ostensibly ABA, are things parents can do on their own without hiring a therapist and paying them thousands of dollars, and which, unlike ABA, can be the same types of tools that are eventually able to foster meaningful consent, as well, if used within a framework that, unlike ABA, is inherently meant to encourage consent. And if the kid has even so much as the language understanding of a three-year-old, you can begin to reason with them as to why they should not run out into the street. And if they are old enough and able enough, they can be given swimming lessons so as to reduce the risk of drowning.
And the fact that you even used this example (as surely as I recently saw another pro-ABA person use the example of teeth brushing and the resultant tooth rotting, which can be solved by trying different kinds of toothbrushes and different kinds of toothpaste while taking kids’ sensitivities into account), instead of something else like, say, cooking, shows an appeal to emotion – we are clearly meant to focus on the dire fate that will befall the kid if they don’t get ABA RIGHT NOW.
And as for teaching other, less essential life skills, like cooking – some of those can wait (not to mention that some of the ways ABA teaches these skills can be profoundly violating, in a manner akin to the sort of work Chihiro gets put through in the Ghibli movie Spirited Away). As for diapers (another common whataboutism), adults have incontinence too and sometimes need to wear diapers even if they are working a 9 to 5 every day – and if the person can’t use the toilet, they could possibly, if they have the motor skills for it, learn to change their own diapers and flush the solid contents down the toilet. And as for life skills in general, either those are simple enough that people could learn them via watching, simple instructions, and practice, or they are too complex to be taught via operant (which yes, I also know is called instrumental) conditioning.
I have. I have researched bias.
And I think you missed the part where, while FC can be fake (which is what the science shows, not that it is ALWAYS fake but rather that it CAN be fake), I specifically pointed to pro-ABA folks using an example of a person who not only uses FC but ALSO more proven methods as a means of debunking FC. The fact that this person, Deej, uses methods that are generally considered more reliable than FC is, methods that have not been debunked by science, and yet all of his voice is debunked by these people, is why it seems as if there might be issues with the debunking, too. Especially when you take into account things like hyperlexia, which is more common in autistic people than neurotypicals, and the fact that motor disabilities exist. And so far, there has been no research into one specific (and possibly very important) component of FC: that of backward resistance to help motor disabilities. Those can take many forms.
And one form of such a disability (so far) is likely present in a person I saw in a video facilitating herself. The very core of facilitated communication being a fraud is the idea that the words are not those of the person being facilitated. Yet, if the facilitator is the same person as the one being facilitated, that argument holds no water. It does suggest, however, that while it isn’t correct to claim that all verbal disabilities are due to a motor condition (an overly sweeping claim, and one that people in the FC field probably made because their careers were born in a climate in which claiming nonverbal people had much of a mind at all was deemed unscientific) it is also incorrect to say it’s always a language or cognitive disability, especially when we know people exist even at the genius level who cannot move their bodies – and that’s the thing, if geniuses can exist who are unable to move their bodies, it stands to reason there are many more people who cannot move their bodies or can’t reliably control body movement who are of average intelligence or otherwise not severely intellectually disabled. And therefore, it might be worth, at the very least, researching to see if backward resistance might be a tool people with certain motor disabilities can use to aid in their ability to type – and if it is, it might be helpful for some people to eventually learn to facilitate themselves in their own typing.
And whatever the case here, you cannot rightfully debunk the voice of a person who is using both proven methods and ones considered debunked. If they are communicating with proven methods, first of all, that calls the degree of debunking into question if the proven methods agree with what is said by the same person in FC, and second, even if it didn’t, their voice should not be discredited wholesale, but rather the words they say with the proven methods should be taken as theirs. And this goes for ABA too – in fact, ABA methods, in the area of animal research, HAVE been debunked as an effective means of teaching language – it leads to false scripts and a form of the Clever Hans effect (an impossible thing to achieve with a letterboard or the more hands-off stages of FC – those involving things like light shoulder or back touches – without telepathy or without the letterboard being moved in the precisely identical fashion each time). People who have been subjected to ABA, and trained to respond within three seconds, have reported giving normal scripted responses to people when they are in distress and a different response is warranted. If that isn’t a fake response, I don’t know what is. And, again, this has been debunked in animal science because operant conditioning is not a good language-teaching tool.
And besides, even if FC were as debunked as it is said to be, even if autistic commonalities weren’t considered (the least of which is that if FC were totally fake, you’d see an increase in meltdowns in the “users” due to the facilitator being in their face all the time followed by learned helplessness much as you see in ABA programs, rather than what caretakers actually see, the person becoming more settled in general over time without a meltdown extinction burst like you would expect both from ABA and fraudulent hand-over-hand prompting like FC is believed to be) there is a false dichotomy here. That is, there is another method that was discovered via animal research over a decade ago, which could help teach language to nonverbal individuals – the model-rival method. And outside of Dr. Irene Pepperberg’s lab, there is practically ZERO research on that. And that is a thing that, while it would not help motor disabilities or complete aphasia, it could help people with intermittent aphasia, or certain intellectual disabilities, in addition to those who can’t talk due to other unspecified disabilities, as well as helping them to use alternate communication. And that is before you get into the effects of language deprivation, which is sometimes treatable via speech therapy and teaching sign language, neither of which require operant-conditioning-heavy programs (which is what ABA is – operant conditioning, nothing else – and in fact in practice it will punish certain forms of operant conditioning not “on the list”).
About the “conversion therapy” analogies – those aren’t analogies. Conversion and ABA therapy were developed by the same man, in the same lab, using the same methods of operant conditioning, to achieve a similar goal – changing behavior to better fit the norm (in the case of autistic people, this is referred to as “increasing socially significant” behaviors, with no one questioning exactly why a behavior is “socially significant”)
And about this:
“Plus, if ABA polls are being conducted in neurodiveristy circles, the resuls will obviously be skewed toward anti-ABA sentiments. Please research bias before you respond to me again. 😉”
By that logic, it is a surprise that you are here. Because ABA therapists, and autistic ABA supporters like you, frequently show up in neurodiversity circles (sometimes lots of them in one thread). And why would it be “obvious” that ABA polls would be skewed against ABA in neurodiversity circles, when, clearly, if your example is any case, you are in a neurodiversity circle, giving your opinion on ABA.
And you could rectify that bias right now, if what you say about ABA polls is true. Reach out to other autistic people in pro-ABA circles. Like the neurodiversity circles, post a poll in those circles asking whether autistics support ABA, make sure that your poll about ABA, asking whether autistic people support it, is restricted to autistic people ONLY – we don’t want the results skewed by therapists who aren’t autistic and thus are not on the receiving end because it would be in your interest not to have pro-neurodiversity people able to make that complaint.
Then, once you have your results, conduct some more polls in pro-ABA circles. And don’t throw out any which still end up saying most autistic people support ABA with the claim that these are “trolls” – keep ANY and ALL polls you find, whether they support ABA or are against it. Then, taking EVERY poll you conducted and comparing it with polls in pro-neurodiversity circles, do a version of what political site FiveThirtyEight does – run an analysis comparing the pro-ABA circle polls to the neurodiversity circle polls, to get a result that, in your view, is realistic because it accounts for said bias.
And if it turns out that you do this in pro-ABA circles and your autistic-people-only polls still get the results you see in the neurodiversity circles – then accept the conclusion that no, autistic people do not support ABA. And you could start right now – you could make a poll on Twitter and have people answer it – again, making SURE that you specify not to answer if you are not autistic, in polite wording explaining that we want to do this on a level playing field wth the neurodiversity circles so they can’t claim the results are skewed. If you get vitriol from ABA therapists for doing this, you might want to think about why you are getting vitriol. Same if you get blocked. And if this does happen, kindly and politely ask them why you are getting vitriol when all you are trying to do is build bridges with the neurodiversity community. And if they tell you building these bridges is bad, ask yourself why that is.
“Okay, maybe she is using a pseudonym, but I still find many of these articles questionable. Until there’s evidence she is an actual BCBA, I have no reason to believe her. How do we have any evidence that this woman is actually a BCBA, or just someone trying to make ABA therapy look bad? All of the BCBAs I know support ABA therapy.”
All of the BCBAs you KNOW support ABA therapy. And, as is most likely, all of the (other) BCBAs SHE knows support ABA therapy. That does not discount her experience
Oh, and there is a special term for what this is. No True Scotsman.
No True Scotsman is a logical fallacy in which someone is considered a true version of something – up until they do something the group does not approve of. Then, they are considered not to be a true member of the group. The example given is “no true Scotsman likes sugar on his porridge – this Scotsman puts sugar on his porridge, therefore he is not a true Scotsman”.
A common real-world example of the No True Scotsman fallacy is when a disillusioned Christian (even a pastor) expresses disbelief in some of christianity’s core tenets. They say so – and Christians (particularly evangelicals) respond that person is not and has never been a true Christian. And if this Christian is a pastor at X church, there will be a way he (usually it’s a he in these cases due to sexist beliefs in those churches) can be looked up too and have it confirmed whether he really is a pastor.
Oh, and ABA therapy does not need help from concerted actors to make itself look bad. In recent years, psychological researchers, from journals outside the specific field of ABA, have reviewed ABA studies and found little to no evidence of it actually being effective (especially considering that basically none of the studies you were referring to have a control group even though there are enough parents willing to have their autistic kids be without ABA to have one):
https://link.springer.com/article/10.1007/s40614-019-00191-5?fbclid=IwAR36cocTUo810v8Z73PA4-XT-eVyGBowAjrG1t_XI4I1V0E4Q7TZ9EQVDLE
https://pubmed.ncbi.nlm.nih.gov/24408342/
https://eprints.soton.ac.uk/417238/1/BaseReportCritiqueFINAL13_12_17.pdf
The thing is, the vast majority of people crying out against ABA have never been in ABA. They’ve read a handful of blogs (like this one) and seen a handful of misrepresentations online, and decided they know enough about ABA to cry out against it when in fact, they don’t. I am Autistic. I used to be a member of this activist community until I looked around and realized they were full of assumptions, misinformation, and inaccuracies. I spent a lot of time in Autistic forums reading hundreds of posts about Autistics’ worst laments, and almost all of their frustrations (i.e. making friends, succeeding in school, keeping a job, controlling emotions, etc) could’ve been helped by ABA. The vast majority of people receiving ABA are learning functional skills that will give them a more fulfilling life than if they hadn’t had it. The vast majority are also learning the same lessons any other child would. As an Autistic advocate, this whole subject intrigued me enough to study ABA academically to learn what it is truly about and how it actually works. All the anti-ABA rhetoric may have had some validity 20 years ago, but not so much anymore. And I agree that the writer of this article does not sound like someone who has actually been a BCBA. Not by a longshot.
Whereas I am studying at doctorate level and have found much that backs up the sentiments here. You are also missing the point the central tenets conditioning to alter behaviour and seeing the autistic as “broken” is the issue, not whether ABA has changed or not
This is very thoughtful and informed. Thank you for sharing.
This is such a helpful article! I am an assistant teacher at a school for autistic students – I want to go back to school and also enjoy working with students who have so called “behavior problems” – I had been considering a BCBA program with the hope that I could be a “good”/more ethical BCBA. This article really makes it clear how hard that would be to actually do. I will of course continue to do my own research but if anyone knows a good way to stay in the autism specialized special ed industry (and actually get a job!) without going the behaviorist route I would love suggestions.
Your should check it what they are doing over at In Tune Pathways as a model for alternate “other than behaviorist” routes.
Their model is amazing.
Kinda confused as to why people don’t already realize that ABA is apparently nothing even remotely close to ‘help’..it sounds like a professional cult at the best. Cults aren’t limited only in religions. You have the religious, the political, the corporation and even the professional cults for each field. Been studying psychology and global history for many years, the things that ABA does and believes in sound more like a very careful and discretely ‘covert’ eugenics ideology hidden behind the veil of supposed mental health professions and methods. The fact alone that ABA tries to *change* the natural behavior and neurology of autistics as if autistics are puppies that must be ‘trained’ out of their natural insticts so they will stop peeing inside the house, is enough proof for anyone that this ‘method’ has nothing to do with helping autistics and is in fact way darker in its intentions and goals than it sounds. If anyone here knows eugenics and its many modern ‘veiled’ ways of being applied, you’ll see the similarities. Key word..’veiled’, ‘modern’, ‘covert’. Trying to train one’s nature out of them is dehumanizing and downright abuse, whether it’s in physical or emotional ways. The west is supposed to be much more evolved and ‘forward’ in things like mental health yet there are such things still occuring, just like illegal bootcamp ‘behavioral’ schools for rebellious kids that verbally, emotionally and even physically abuse kids before returning them to their parents in shiny new boxes with ribbons on top of them as ‘new improved and well behaved’ models of their former kids. I get so many creepy vibes by ABA, I’m just glad this isn’t going down where I live but at the same time pissed off that is exists anywhere in the first place. Yes some autistics might have had no problem with it but the exception doesn’t represent the example here. The majority does and from what I gather the majority of autistics don’t want to have anything to do with this and understandably so. I’m autistic and I’d be downright tempted to go against this thing even on a legal basis. Can’t understand how so many people don’t see the obvious abuse and dehumanization behind these organizations. methods and institutions working like that.
I agree, the fact that ABA therapists are told to discount all other interventions is also cult like
That is completely ridiculous. You all need to educate yourselves.
Hi there, I am writing from a Special Education teachers point of view. I am also studying ABA (master’s certificate program) while studying for my PhD in Developmental Psychology. I have seen really great things achieved through ABA, but I also have many of the same viewpoints as the author. I worry about sitting for the examination as a BCBA because I have such a divergent view of ABA as a whole. It has amazing potential within the field, but when it isn’t evolving to encompass other psychology fields and valid research, is it really more than just a cookie-cutter band-aid to “get” kids to do what we want them to do when we want them to do it? Much like education, mental health fields have so much more to consider than the limited scope of our own learning. It would take ten lifetimes to adequately apply knowledge across disciplines to get a person the right help (with the application of wisdom) for behaviors that stand in the way of their successes. Like the author, I look at many individuals with ASD and see the subject they fixate on as their ticket to success. After all, with as much schooling as I have subjected myself to, my interests often are fixated on the subjects I study that fascinate me. (Not particularly great for small talk with friends), and yet I would consider myself to be very highly achieving. I also have a keen interest in, and am studying for CBT (Cognitive Behavior Therapy). I think that unless we as professionals can embrace each others’ fields (including their expertise and insight) as well as the individual AND their families’ input, we will never be able to make those positive impacts on their lives. If that is the case: What are we even doing?
Throughout history, a close-minded approach has shown to be very dangerous-especially so when we are working with ANY vulnerable population. That being said, I often learn more from my students overall more than what they learn from me. Perhaps this is not just a professional misstep, but a major misstep within society as a whole: We are often taught to conform (at least to an extent) instead of celebrating the beautiful neurodiversity and eccentricities that go along with that.
This is just my two cents, not worth much in many circles. But I have been on the teacher and parent side of things, and have identified so many things that could effect self-esteem negatively in how we view these quirks in our children’s personalities. My favorite reference: Temple Grandin. Very successful, and was encouraged to embrace her truest self regardless of other people’s perceptions.
Many autistics reject this fetishification of Temple Grandin from the NT world, she does not speak for us all nor do we all agree with her. You talk about the positive impact of ABA, however you have been taught to measure behavioural outcomes only. How do you know if what you see on the outside ie improved social skills, less invasive stims is reflected on the inside? You don’t, you have no idea if that apparent “positive benefit” is more masking and compliance and inside the autistic is actually worse off as they must deny their true selves and has lost valuable outlets for their feelings. This is what you NTs aren’t getting about ABA
I have not worked with a BCBA who has not been affected by an archaic mindset that makes them focus on the raw data and an adherence to the brief ABC observations they make during their short time with their clients. Luckily I went to a great undergrad with a 7 course ABA curriculum, with teachers that are current on research and spoke about the nuances in our field, and topics like motivating operations that help tie in our understanding of the root causes of behavior; So, when I receive a program from a BCBA, I am often picking it apart, reporting back what isn’t and is not functional. At this point it is hard for me to see the value in becoming a BCBA, other than to replace what came before and make a decent living. That said, it would be hard to change the status quo. The structure in which we practice is so bogged down by insurance agencies and company administrations, that I am almost convinced that what BCBA’s actually take away from grad school is how to file insurance paperwork and juggle 15-20 clients. Often my BCBA’s are showing up with no clue about what we talked about on their last visit, because me and my clients are just a few hours of their thought processes in their busy month. Most RBT’s are trained far less than I am in ABA, but to be less trained than me is the standard, and that may be to avoid any potential disagreement by RBT’s about the actual fundamentals of a BCBA’s proposed program. Until BCBAs have less clients and RBTs have tougher requirements for entry and better pay to help with retention rates, then I don’t think we will be seeing a change in this field. Currently BCBAs are not incentivized to care about their clients, however the illusion that care is maintained by the upward trend on their graphs without them ever actually having to do the work of understanding their clients behavior. BCBAs should see less clients and spend more time “caring” about the ones they have. I am sure I can’t be the only RBT who sees that everything that is wrong with this field is right above our underpaid and overworked heads.
I think ABA cannot be salvaged, only destroyed, because even if ABA has some redemable parts, its history of being an overwhelmingly manipulative abusive practice attracts manipulative abusive people, and those people cannot be changed. Manipulative people will lie and distort and reassure you this time will be different, but that’s just a manipulative technique to maintian their power. I’m sorry but they do not deserve any more second chances.
You mentioned so many many things that are wrong about ABA and you’re right. As a neurotypical Mom of a now 21 year old Autistic, I shied away from ABA therapy even though as a little guy he was non speaking and ABA was touted as the one way to make him compliant. It scared me. I thought it was cruel so I never did it. I wanted a “conversation” with my child and for him to have an understanding of the world and to find his place in it. I can’t really speak from personal experience but all I need to know about going forward is this statement in your article, “Autistics and other neurodivergent people have communicated that language matters. The way we as professionals speak about autism is problematic.” I wonder now if all those years of seeking strategies to make his way easier in this world was just a veiled attempt to make him more neurotypical so it would be easier for me. I try really hard these days to provide guidance by helping him understand how others affect him and vice versa without pushing my idea if what will work best. What do I know? Nothing beyond my own view. I can only speak to what works for me and and encourage him to do the same. That is the respect that Autistics and all neurodivergent people deserve. I don’t know that ABA fits into that in any way.
Good article except ABA theoretical foundation is totally false and disproven which is pretty much stated in the article. You can’t reform ABA. It had to be extinct.
I work for a company that provides wrap around services with Speech, OT, PT, music therapy…and the ABA appears very naturalistic. I see value it in. This is also what good preschool and elementary teachers use..
I hear your dissatisfaction toward the use of ABA but I don’t seem to be hearing any solutions you have for helping a parent who has a (let’s say) 3 year old, who can’t regulate themselves, climbs up the outside of the blocked off staircase up to the top level with no fear what so ever, climbs up onto the kitchen counters, grabs the hanging light and tries to swing on it before you can reach them to keep the light from pulling out of the ceiling, how do you protect the child from pulling/twisting/breaking off every child lock and climbing to the top shelves and pulling everything off to take a nap.(well not actually a nap as they really have sleep issues) How do you sleep at night, knowing they will quietly stack things up to unlock the front door lock that even Houdini would have had trouble with. How do you help them when they are knee deep in a melt down, you can see fear and rage in them, with no idea of what the “trigger” was . what skills do you use when they are biting everyone or gouging deep furrows on the arms and faces of anyone nearby (including themselves) how do you keep your child from all the self harm they are determined to try, unhooking seatbelts, opening the child door locks without you noticing so that they can open the door as your flying down the freeway, will only eat Taco Bell beans, and no other foods. absolutely nothing else!! Can’t communicate because they have speech apraxia that won’t be diagnosed for another year or so. Sign language is hit and miss at best, and PECS are more fun to just throw across the room. Now throw in the added brain issues of seizure clusters That’s right !….now all those climbing to high places take on a whole new fear for a parent. So I am asking why is it so wrong for a parent to reach out for help. I am left to wonder if you aren’t referring to the ABA of years ago, or pandering to people who are on the so called higher end of the (spectrum) I wonder this because our family has been either blessed to have an absolutely awesome ABA in home staff for the past 5 years. They have given us incredible guidance and ideas and worked with our family to move our child in a positive direction, we don’t stop the stemming, to some it may be annoying, for me its calming because we know where said kid is LOL, she has learned how to use her voice to communicate or to guide us to her needs/wants , she has learned toilet skills (if you want to call this masking-(pretending to be like others) well I can live with that !) Just in general the ABA staff gives us the knowledge on how to be respectful and sensitive to her needs/wants and gives us the skills to help her (stay alive ) and be all she wants to be. Are we just lucky to have a modern day version of ABA or are all the others still living in the past.( ours works side by side w other therapy workers as or when we need them)
I was this child. So was my younger brother. We were diagnosed as autistic as adults. I was a speaker, my brother was in speech therapy for 5 years, first for his ability to use words and then for his stutter. We weren’t considered broken or determined to injure ourselves. Back in 90s Britain, we were just called precocious. I learned to read and write early, reading by 3, writing by 4, because my brain was a sponge and I was trying to understand the world and my place in it. Instead of pathologizing my desire to write every new word I learned, repeatedly, all over the walls and furniture, my parents understood that I needed to express myself like that and redirected it into a painted wall that as long as I used my special pens, I could write as much as I wanted on that wall. When I had internally reinforced all the words by writing them repeatedly, I stopped, picked up a book and never stopped. My mother took me to the library as much as she could and we took as many books as we were allowed home for me to read that were an appropriate level. When I pulled at my own hair because it calmed the chaos outside that turned into chaos inside, my mother recognised my distress, tried her best to soothe the outside chaos and taught me that brushing my hair would give a similar pull if I couldn’t get away.
I, too, had an obsession with a high shelf for sleeping in. It was a perfect cubby hole, I fit perfectly, it was far cozier than my bed, and the unknowable monsters of the floor wouldn’t get me because I could see them and they couldn’t get to me. I kept this desire until my mid twenties, when I was in an environment I could fully control, so it could be as cozy as I wanted and could be sure that the monsters of the world weren’t waiting for me.
When my brother was 3, he was a runner. He very quickly learned where the keys lived, how to get the keys, and open the locked door. He was scooped up by kind neighbours 5 times before my parents realised what he was doing – he was extremely sneaky with it! They strategised better, harder, and longer, for the door, and it might sound terrible, but a retractable harness, where he felt he was exploring on his own terms, but my parents had sight and control was the way they got that energy out.
I compare our behaviour to my 3 year old niece, who is an absolute joy and delight, cannot regulate her emotions, and is very neurotypical and drives my sister up the absolute wall, because the secret to toddlers is that they’re all into everything, all of the time. They’re actively curious and learning about everything and everyone all of the time, are picky eaters, aren’t afraid of anything (toddlers love to find new ways to kill themselves), get obsessions on particular things, LOVE to throw things (seriously, my niece learned that my water bottle made a great sound when it hit the floor – so I got her a water bottle, drank from hers, and now hers is the throwing bottle), and they haven’t learned to regulate their emotions in the slightest. It’s just in autistic toddlers this behaviour is pathologized.
If your toddler is in the middle of a meltdown full of fear and rage – why is that? What about the environment is producing that? Are their needs being met? Not the needs you think they should have – the ones they have: have they been showing any sign of discomfort up til now, maybe pulling at themselves, maybe fidgeting in a way unlike their happy behaviour? Have you been ignoring their need to understand what’s going on, even if they can’t really understand, or have you brought them to an environment that is uncomfortable and are making them sit with that discomfort – because trust me, they have learned by now that their discomfort does not matter and the pressure builds and builds and builds until the outlet is a meltdown.
The car – do you even know how awful a car is as a sensory experience? It’s vibrating, it’s loud, everything outside is moving really fast, if the sun is out and you keep going in and out of shadow it’s genuinely the worst, even as an adult I struggle to tolerate that. Kiddo understands when kiddo gets out of the car, everything stops, so of course they try to get out by any means necessary. Understanding where the behaviour comes from is the first step to properly redirecting it. Having a toddler is a fucking nightmare in and of itself, autism just makes it more difficult for that kid to communicate and understand.
Please check out In Tune Pathways for resources other than ABA for your child. Please, before they end up as an adult with PTSD and an inability to say “no” to the wrong people. #ActuallyAutisticAdult here
This article feels so weird to me. As an rbt we are taught that good rbts make an impact and low quality rbts dont. It seems this bcba has a bias towards supporting lgbtq idealogy in their clients. Also if I can handle a condition on my own as a competent adult if I couldnt handle a condition the smart thing to do is outsource for help. Of course you have to work with the physician to aud you but if you deny them youre back at square one. No ine is forced into aba, kids are not competent adults yet so their guardians (if they are responsible) make most decisions for them.