ABA Haters







Clearly from the title and content of this blog, I respect and believe in ABA as a science that can be used to teach a variety of new behaviors, and reduce or replace (with safer, more feasible behaviors) old, entrenched, dangerous or harmful behaviors.

My backstory: I started in this field working in a rural area, as an in-home therapy provider to 2 families. This was before my state had an insurance mandate, which meant families paid professionals directly to work with their children. There were very few agencies or ABA centers, very few BCBAs, and public understanding of Autism was near zero. Both of my clients were boys, they went to the same school, were roughly the same age,  and they were about as different from each other as the day is from the night.

When I started in this field, I knew very little about Autism or ABA. I quickly got a crash course in behavior, motivation, the science of behavior analysis, sleep issues, feeding issues, toileting challenges, self-harmful behaviors, and special education/IEP meetings, from working with the Consultant who trained and supervised me.

As my knowledge, literature review, and clinical training increased so did my passion. I found the different children I worked with to be smart and capable, once you figured out how best to motivate them. I realized that even though they rarely spoke, they had lots on their mind. I learned to interpret and understand their behavior, how to get their attention, how to KEEP their attention, and things they hated that I should avoid doing (like wear perfume to therapy sessions).

 I quickly caught the ABA bug and became hooked on the Lightbulb Moment. What's the lightbulb moment? I'm glad you asked.

The lightbulb moment is when you have been painstakingly trying to teach a skill to for quite some time, and then one day out of the blue something clicks and the client just gets it. The clouds part, angels sing, and you happily yell "That's RIGHT!" Its an amazing moment, actually seeing someone understand something for the first time.

The more I learned about ABA the more I wanted to learn about ABA. 
I probably drove my first few client families insane, because long after my therapy sessions were over I would still be in their home asking question after question about Autism and ABA. There was just so much to learn. Thankfully those parents were patient with me and my endless curiosity.


As my love of ABA grew, I started to become aware that there are people out there who absolutely do not like ABA. 



Really? Yes, really.


There are even some who hate ABA. 



Hate it? Really? Yes, really.


Many of these people are adult Autistics, who advocate against 'conversion therapy'. Their beliefs about the detriments of ABA are just as strong and vocal as mine about the benefits of ABA. In no way is it my goal to demean or invalidate their voices or experiences. 

My blog isn’t about bashing or putting down other therapy methods, or attacking people who hate ABA. Not at all.


I think the best decisions are informed decisions. There are many reasons people dislike ABA, but there are also myths and outdated info that some people proclaim as facts. Which is dangerous, because for parents out there just trying to find help for their children, they may not know the difference between opinions and facts.

So hopefully, this information will shed some light:  



Reasons Why People Hate ABA



Think ABA is Just Discrete Trial Teaching/DTT- I've had new clients say to me they don’t want their child to be drilled 50 times to say “banana”, because cousin so-and-so told them that’s what ABA is. ABA is a broad term that covers a wide range of therapeutic approaches. Depending on the needs and learning style of the child, there are many ways to implement ABA therapy. Each method is unique, and has advantages and disadvantages depending on the specific treatment goals. If you don't want your child to be intensively drilled in a very structured manner, then don't use a Discrete Trial approach. There are many other ways to teach skills, and if you are working with a provider who refuses to implement anything other than DTT: that is a problem.

"ABA Therapy is an unnatural treatment!"- So here is the problem with this criticism: the science of ABA is all around you, all the time, whether you sign up for therapy or not. Behavior contingencies explain how you learned to answer a ringing telephone, why you say sorry when you offend someone, and why you reduce your speed when you drive past a police car. ABA is based in conditioning, which to put it simply is the fact that we learn what to do/what not to do by what consequences follow our behavior. All ABA therapy does is apply this science and research to create individualized strategies, that are taught in a precise way. So unless you plan to completely stop behaving (hint: that's impossible), then every single day you are adjusting your own behavior based on the consequences to your behavior.

Frauds/Shysters Exploit Desperate Families- Another criticism is that the field of ABA is full of amateurs claiming be experts. The national certification for ABA professionals has been around since 1998. Before that time, anyone who could convince people of it could label themselves an Autism Expert or Consultant. Accountability was very low. The ABA field established board certification specifically to protect the public from amateurs calling themselves experts, and to raise the requirements of working in this field. The BCBA certification process is difficult and lengthy, and in some states licensure is required on top of certification. My response to this criticism would be to look for credentialed and experienced professionals, and be very leery of programs with "pseudo-ABA" staff and not a single certified individual supervising or training them. 


ABA Creates Robots- You've probably heard this criticism before: ABA creates robotic learners incapable of spontaneous thought who can only spit out memorized responses. Some ABA programs do start off with rote memorization. That’s how many of us initially learned skills. How did you learn the multiplication tables? It was likely by memorizing it. At some point someone helped you move from memorizing to flexible learning. That’s what a quality ABA program does. I also must note that robotic, rigid, overly repetitive teaching can be an indicator of a poor quality ABA program. This resource should help you evaluate if you are receiving quality intervention or not.

Autism is a Medical Disorder and Should be Treated Medically – There is some truth to this criticism. Autism can affect the body and brain in many ways. The child can have toxic yeast, allergies, comorbidity (such as Autism & ADHD), etc. Each of those issues may require a separate treatment. Behavioral interventions also require a medical rule out, so your physician may recommend other treatments in addition to ABA therapy. OR, ABA just might not be needed for your child. That is okay too, if you do not enroll your Autistic child into ABA, and instead seek out medical treatments.

ABA Therapy is TOO intensive –  "Parent shaming" is not ok, as families struggle to make the best choices for their children that they can. Some parents want to start therapy as intensively as possible while the child is young. Other parents feel they want their child to enjoy being a child and not just shuffle from one therapy session to the next. While therapy should be balanced with other parts of the learners life, it is ultimately the intensity and severity of current challenges that determines how many hours of ABA should occur each week. No one should be forced to receive more therapy than they want their child to have, but also no parent should be attacked or shamed for deciding they DO want their child to have intensive treatment. This is far from a black-and-white issue, its quite nuanced.


ABA is about Erasing Autistic Traits and Forcing "Normal" Traits- The Autistic community has spoken out loudly against things like forced eye contact programs, reducing stimming, teaching neurotypical ways of play, etc. It is very, very important that the goals in the ABA program do not consist of "Autism erasure". It is a sad thing to view Autism as a disease to wipe out. Autism is a neurological difference that exists on a spectrum, meaning Alison will experience one type of Autism that will be very different from the type of Autism Jonathan experiences. Am I saying that no ABA provider, ever, anywhere on earth, has ever had the goal of making their clients as 'normal' as possible? I cannot say that. But, what I can say is that this should not happen. It is old, archaic, anti-disability thinking to view clients as problems to fix. Instead, ABA therapy should be about helping the individual (not just their parents) manage some of the more debilitating and difficult parts of the Autism diagnosis, while strengthening and celebrating areas where the client excels.   



Many of these criticisms are likely true for poor quality ABA programs, or unethical providers.
Does ABA still have a long way to go, in terms of public acceptance, ethics, reform, and accountability? Yes. 

We need to do better with listening to Autistic voices. We need to do better with training up practitioners. We need to do better with diversity, of race, cultures, genders, and of thought. We need to do better with explaining to the general public who we are and what we do.

The BACB recently revised the clinician Code of Ethics, specifically to move toward some of these very changes.

There is much work to be done, yes. But, there has also been great work achieved. 
Individual clients of varying ages, diagnoses, and needs, have learned specific skills that help them in their life. Challenging or harmful behaviors have been reduced or replaced with non- dangerous behaviors, to improve health outcomes. Individuals have learned coping skills and new behaviors that moved them from most restrictive to least restrictive settings.

Ethical, quality ABA services implemented with compassion, can have an amazing impact on someone's life. While the voices and dissent of Autistics and Autistic Allies should not be ignored, the way to move forward is with continued commitment to making ABA better and safer for the populations served.





ABA Reform Movement (podcast episode) 








4 comments

  1. Very well said!

    ReplyDelete
  2. I came across this post though the search term 'ABA hate' so it was good to read your responses to the different hate responses. Thank you and keep writing!

    ReplyDelete

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