Episode #49: MP - The ABA Controversy
The ABA Controversy
Hello. I thought I would weigh in on the controversy over ABA, also known as Applied Behavior Analysis.
For those of you new to autism, ABA is now commonly prescribed by pediatricians as the 1st line of support when a child is diagnosed with autism. Families receive between 10-20 hours per week of support by an ABA trained center that is typically covered by insurance. A trained behavior technician visits the family’s home or the child attends the center for skill development.
However, there are many autistic adults speaking out against the treatment, stating that it is harmful and even abusive. I am a strong advocate for listening to autistic voices, so I am definitely listening here. Especially since I personally left being an ABA provider in 2005.
A little history, ABA or Applied Behavior Analysis, has been around for a very long time and has its roots in behaviorism and psychology. Basically, it is a way to observe, track, and remediate behaviors or habits - not specifically having to do with autism but human behavior. If you wish to stop smoking, you might use ABA to break down the situations and triggers that make you want to smoke - so that you can then create and train yourself in new ways to stop smoking - maybe doing something else instead.
Dr. Ivar Lovaas in the 1960’s began using ABA to address the challenging behaviors often associated with autism. His work was both ground breaking and upsetting in hindsight. His techniques were very often focused on the use of consequences for challenging behaviors. I was trained by one of Lovaas’ doctoral students in the 1980’s and was appalled to be asked to use a wooden spoon on a child’s behind when he asked to use the bathroom when it seemed he was trying to “get out of” some of our more challenging work together. I refused and actually quit, as they were requiring that I stick to that protocol.
As you can imagine, ABA, as with most therapies and approaches has changed, grown and evolved over the years. The focus is now much more on setting children up for success, breaking tasks down into manageable amounts for teaching and integrating play into lessons. The problem in my mind is, it is still focused on skills versus relationships, and is still very compliance focused.
I am not here to defend ABA, as I think the industry is lagging severely behind current research in the field indicating the importance of parent-mediated intervention and voices from those on the autism spectrum themselves.
What I will say, however, is that ABA has its place and there are now different types of ABA out there. But, I am not sure why we think that parenting or guiding a child with autism requires a completely different set of skills than used with other humans. Yes, we need to be more deliberate, mindful, and specific but that does not mean that we parent completely differently. In ABA, we currently bring young professionals into homes who are not parents themselves to guide our children with autism - telling parents essentially that they can do it better than they can. That is ludicrous in my opinion. Then these lovely young professionals move on to other training and their own lives, causing disruptions in the ability to form bonds and relationships long term. Again, why do we feel this is a good idea?
Now, again, I do think that ABA has its place. Just not front and center. We as parents need tools for addressing specific behaviors we wish to increase or decrease. We need to ensure our child knows, for example, to walk with us when in the community rather than running off away from safety. An ABA approach is perfect for this situation to ensure quality teaching for safety purposes.
However, ABA is still commonly telling a child to stop stimming and focus, for example, which may be an oxymoron - the child may need to stim TO focus. Or playfully engaging with a child when they are reading a book may be ideal for bringing the words to life but traditional ABA may try to reduce the off-topic questions or behaviors in favor of that focus on the discrete skill of reading.
So just like typical parenting… use ABA strategically. If you are a parent listening to this and you need help addressing specific behaviors that are either unsafe or important to you for other reasons, by all means, consult with an ABA provider. But do not simply surrender to them. They do not know your child as well as you do. And parent-mediated intervention is showing the best results so stay as informed about what they are doing as you can. If you need a break, knowing your child is safe and learning - contact an ABA provider. They might be able to go on walks, make a snack, and brush their teeth using some pretty awesome ways to break down the tasks so they are manageable and make sense for your child - but again, do not let this be the only way your child learns.
The world out there is a dynamic and social place. We want your child to be flexible, social, engaged, distracted sometimes, playful a lot, and curious about the world and others. ABA providers work for you. Tell them what you need and what you do not need. They will appreciate feeling successful with the things that are important to you and you will stay in the lead of your child’s upbringing.
If something makes you feel uncomfortable about what an ABA provider or anyone is doing with your child, please do not hesitate. Ask questions and ensure answers. These people all work for you. And you have choices. One provider may not work with your family and another very well might be an amazing fit.
Listen to autistic voices who are saying that the old ABA is abusive and the interventions you choose for your child should be more relationship based, interactive, supportive, respectful, and not compliance based. Be sure that your provider values and respects those autistic voices as much as you do.
History of ABA
https://www.inbloomautism.com/post/the-history-of-applied-behavior-analysis
What is ABA?
https://www.appliedbehavioranalysisedu.org/what-is-aba/
What is ABA from perspective of autistic adult
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