Applied behavior analysis (ABA) can mean a lot of things, and there’s not a standardized definition for it. Essentially, it’s looking at what causes a behavior and then modifying conditions to modify the environment. Sometimes, therapies are called ABA in order to be billable for insurance, and some other types of providers, like speech or occupational therapists, use ABA principles.
If you’re confused about whether or not your child has a good– or bad– therapist, you can use this guide with a printable checklist to help you figure it out.
ABA is a type of therapy that involves as much as 40 hours per week of one-on-one therapy with a certified technician. Certified technicians distribute or overlook the programming procedure, organized around the child’s specific goals.
The goals are assigned by a board-certified behavior analyst (BCBA)—like developing social skills, for instance, or learning to make eye contact. ABA breaks down “desirable” behaviors into steps and then rewards the child for completing each step along the way via positive reinforcement.
But most autistics object to ABA on the grounds that it is programming children to ignore their basic needs, to blindly accept authority, to forfeit consent to their bodily autonomy, and to not be able to set boundaries. It makes their innate autistic traits into “behaviors” and attempts to train those behaviors out of children.
Dr. Ivar Lovaas considered the goal of ABA to make autistic people ‘indistinguishable from their peers.’ This goal puts all the responsibility for change on autistic people. Autistic people try so hard to survive in this world and often that means we compromise ourselves to ‘fit in’ with non-autistics. We force ourselves to do things that hurt us or make us uncomfortable, which partially explains the high rates of mental health problems and suicide in our community. Despite all this effort, we often still stand out as different and so still get judged and criticized. This aim of ‘indistinguishable’ still gets cited by ABA providers. While society strives for this goal – the goal of making us ‘normal’ – our human rights will be violated. Aiming for ‘normal’ is unethical, often unachievable, and many first-hand accounts suggest it comes at too high a cost to the autistic person.
-Shona Davis on Autistic UK
Giving Back to the Autistic Community
I was an employee at an ABA clinic for only a few months. I don’t know the exact span of time anymore as it all seemed to blend together. I got into the ABA field just after graduating from college.
I was only just starting to be openly autistic with myself and society. While in college, I resolved that I was going to give back to the autistic community in some way, shape, or form.
I remember going on job search websites typing: “Autism Employment Near Me.” The only results that came up were various ABA clinics. Unbeknownst to me was the controversy surrounding ABA. I knew very little about ABA going in, such as they used the positive and negative reinforcement models.
In fact, that’s all I knew about it before entering the field.
I resigned my position as an employee at an ABA clinic less than six months after starting there. A lot of people have requested of me that I talk about my point of view and experiences being at the ABA clinic and being openly autistic. To summarize it all in a few short sentences: 1. I’m still processing it all with my therapist 8 months later. 2. Every day I worked there I could count multiple occasions when I questioned the system.
It’s for their own good…
Whenever I had doubts, I was always immediately reassured that [insert uncomfortable situation I was in] was helping the autistic child overall. I was told that the autistic child would grow with better, more “appropriate” behaviors as they learn from the programming, which in turn will help them socialize and be a proud member of society once they are older.
Before I go any further, let me inform readers that I am not a parent. I never had experience babysitting, and I was never in a direct mentor position for children or parents– so it’s also hard for me to judge anything about what was really happening. I had no precedent or barometer for “normal” when it came to working with kids.
I can just say, I questioned the processes and system of ABA while at the clinic, but again I was told numerous times I was really helping. I never saw how; I just saw children being uncomfortable often, and I, myself, feeling the same sentiments in exchange.
Is that what being a parent is like? Is that what it’s like to be a teacher? I was in complete misery and so was the child as we both tried to mask our misery during break times by doing enjoyable activities as mere distractions– or what ABA refers to as “rewards”– before going back to programming or “work.”
Joe
I recall one time working with a child whom I will refer to as “Joe.” Joe was a 4-year-old boy, and he was boisterous and excitable all the time, running around just everywhere. He was a child with so much energy that he didn’t know how to handle it all.
In the clinic, where we worked with the children, we each had rooms with a desk, 2 chairs, and a few decorative and cliché motivational posters displayed on the walls. Joe couldn’t sit still in his chair and would crawl under the desk and chairs or stand at the top of one or another.
He would lick, rub, tear, stare at, and smell the posters as if they were some magical entryway into another realm. The clinic supervisors suggested we remove everything from the room and strip it away bare. The room was completely empty, just a small, blank room with no posters, no furniture of any kind or anything: just four white walls and a dirty beige carpet.
Joe and I would just sit on the floor, and I was supposed to work with him on enunciation of words such as “Rocket.”
Joe still would do anything to find distractions. He would play with his own foot or gaze at his moles while ignoring me completely. It was my duty to corner Joe in the tiny room each time we entered the work room. We were to be knee-to-knee as we sat cross-legged across from one another.
This position was prescribed so that I could physically hold him back or do any sort of hand-over-hand gestures if Joe would attempt to escape. I would hold up a card of a picture of a rocket and demand, “Say Rocket.” I was told by my supervisors that I couldn’t leave the room until Joe at least attempted to make a sound.
Ro-cket, Rock-et, Ro…
We sat there for what felt like an eternity in a lifeless, joyless room as we both avoided any sort of contact with one another. This was after I had already held up the rocket card and ordered him to say “Rocket.”
As I waited for Joe to show any sort of response, I kept thinking to myself: “He is 4 years old! How is he going to be able to handle regular classrooms or anything next year when he starts kindergarten– when we are like this in this empty room knee-to-knee?”
I felt slightly suffocated in that room, so I could only imagine how Joe felt as he frequented this room daily. I wondered, Is this what being in a padded room feels like? Even prisons have more stuff than this!
Checking the Box
For the sake of both our sanity, I fudged the data saying he attempted to say “rocket,” and we both left the room after 5-8 minutes. I tried to make it look like I really tried to wait it out so the supervisors wouldn’t get suspicious of me.
If I’d admitted he didn’t try, they would have tried to shadow us the rest of my shift with Joe. If that were to happen, the misery would be a lot worse, and I would lose all power on making the rest of the time we shared less miserable.
I tried to extend Joe’s breaks, or “reward times,” as long as I could, until a supervisor would tell me Joe and I needed to do more programming in their designated work room. Trying to get Joe to his work room involved me chasing him as if I was a dog catcher and he was a notorious stray dog running for his freedom.
Just everything about the whole situation was awful, and I never felt right about any of it. I could see the pain in Joe’s eyes still to this day, looking back at me in panic as I finally caught him and had to drag him to the work room, then corner him into a knee-to-knee position.
After working with Joe for the first time, I had nightmares day in and day out. I think that was the final straw that made me realize I was in a terrible place no matter what anyone said to me. Less than a week later, I resigned.
Confirmation Bias
My boss didn’t understand why I left, and kept telling me I did everything right, and that I was overreacting. They begged me to stay because their company looked great having an autistic person as an employee.
To this day, I wish I knew better alternatives for working with Joe. I still ponder how he will be able to handle school once he is eligible for kindergarten. All I can say is, the programs at my clinic didn’t serve him like they were meant to serve him.
Even now, after my time working in the clinic, I still don’t have anything to offer up as a better method when it came to the programming with any of the children. I can just tell you what we did was always ineffective.
To this day, not being in that clinic for over 9 months, I am still questioning everything around me like a mad woman hopped up on conspiracies. Part of me is questioning everything because I am starting to see some level of toxicity traits in other educational systems, and the other part me feels so guilty for being involved at such an abusive facility that I am terrified of suggesting any alternatives: what if they are just as damaging, if not worse, to the autistic community?
Modern ABA
Here’s what I can tell you, and I will let you decide for yourself: the history of ABA is dark and paved with bad intentions. The only thing that has really changed is that there is more money poured into ABA now, and they have reframed their original goals to sound less ableist.
They may have changed some words, but they still have the same bad practices with the same bad motives. They still don’t try to do research or seek input from autistic adults, and they still don’t do any research on how the autistic individual is doing over time in a span of years after ABA. How can one grow in quality of services if they are not asking input for the ones being served?
I’m Sorry
I myself am still traumatized by my own experiences of being an employee at an ABA clinic. To the children I served, I am sorry. I am sorry for all the commands I was ordered to give to you. I am sorry for how I treated you, and I am sorry for participating in instilling trauma into your life.
You are all beautiful beings despite what these so-called experts are telling you. Please continue to disobey and rebel; do not give into them. I wish I could do more to help you escape other than continuously tell your parents of the rotten place they drop you off at each day.
I wish I could expunge the trauma from you and have it cling to me as some sort of magnet. I wish that each and every day. I am truly sorry, from the bottom of my heart. I will do the best I can to continue to fight the good fight with the rest of the fellow autistic adults in demanding ABA to be shut down.