The Issue with ABA
Applied behavior analysis, or ABA for short, is a popular form of therapy used to treat autism spectrum disorder. ABA is supposed to help improve communication skills, attention, memory, social skills, motor skills, behavioral regulation, academic performance, and daily living skills. Though it is more commonly used with children, it is a myth that ABA is only for kids. Even adults have been shown to benefit from ABA. A main component of ABA is using operant conditioning in order to alter behaviors via reinforcement schedules. Reinforcement is an integral part of ABA as it allows for more frequent replication of the desired behavior. There are two types of reinforcement: positive and negative. Positive reinforcement is a technique that increases the likelihood of a behavior being repeated by rewarding the behavior with something desirable. Positive reinforcement can be tangible – such as giving a child a toy after they clean up – or social, which can be verbal praise as simple as “good job”. Negative reinforcement also increases the likelihood of a behavior being repeated, but by removing an undesirable stimulus. An example could be if an autistic child is struggling with sensory overload and feels overwhelmed due to auditory stimuli that are present, and therefore cannot focus on the task at hand. The therapist could remove the aversive stimulus by giving the child noise-canceling headphones, which makes them more likely to complete the task effectively. Both types of reinforcement are used frequently in ABA in order to obtain a desired behavior and increase the likelihood that the child will replicate that behavior in the future. The earlier version of ABA used punishment along with reinforcement, yet punishment is no longer implemented due to being too controversial. Despite the removal of punishment, doesn’t this still sound like training a puppy?
Many autistic people strongly disagree with applied behavior analysis due to its inhumane nature and the associated perception that autistic traits are undesirable behaviors that must be modified. Many claim that ABA programs children to ignore their basic needs, blindly accept authority, forfeit consent to their bodily autonomy, and not be able to set boundaries. Those have been subject to ABA deem it “conversion therapy”, but for autistics. One autistic teenager detailed his experience with ABA as a horror movie, and said that he felt like a lab rat in a maze. He endured a repetitive cycle of completing inference and idiom flashcards and worksheets – probably due to the stereotype that autistic people take everything literally – as well as analog clock quizzes and far-too-easy reading comprehension. He was also forced to make constant eye contact when talking about anything, even uncomfortable topics such as his feelings. As a neurotypical, even I struggle to make eye contact during awkward conversations. I can’t imagine being content with constant reminders to look someone in their eyes, or seeing how the amount of eye contact I make is recorded at every moment. In an article sharing his story, he wrote: “But really, it’s always the same stuff”. Inference, idioms, clocks, retell, math, conversations, repeat. One day, the teen experienced a panic attack and ran outside the clinic. Two of his behavior therapists chased him so he had no choice but to run into oncoming traffic, where he was hit by a car. Before being taken in an ambulance, he watched the therapists slowly back away and leave him there on the road.
Another story comes from an employee who worked at an ABA clinic. She was working with an energetic four-year-old who became easily distracted and enthralled by the furniture and posters in the room. The supervisors at the clinic suggested that the room be stripped bare, so this employee would sit with the child in the empty room, sitting knee-to-knee so that she could restrain the child if he attempted to escape. She would hold up a card with a rocket on it and demand “Say rocket”. Her supervisors told her that she could not leave the room until she got the child to at least attempt to make a sound. However, he still became easily distracted by anything, even his own foot. The employee ultimately had to fudge the data by lying that he did say “rocket” so that they could leave the room and take a break. Every time they had to go back to the room to continue training, she would have to chase the four-year-old and physically drag him into the work room, then corner him into the knee-to-knee position. She claims that she could see the pain and panic behind his eyes and felt very uncomfortable with what the clinic supervisors were forcing her to do, so she resigned a week later.
If ABA is so bad, you may be wondering if there are any alternatives. Other options include occupational therapy, which helps children develop fine motor skills or other skills needed for everyday tasks. Cognitive-behavioral therapy, or CBT, is another method that allows autistic individuals to better understand their thoughts and feelings, or develop coping skills. However, these types of structured therapy – even non-ABA ones – should not be the only resource that parents turn to. If your child struggles with social interaction, it’s best to foster relationships in an organic way rather than force them to practice robotic, repetitive phrases and mannerisms.
Ultimately, ABA only teaches autistic people to mask their autistic behaviors and conform to societal expectations in order to appear normal. Many say that ABA does not allow them to freely express their personality or exercise their autonomy. ABA is merely programming children to act like robots. What good is a society in which everyone loses their unique self-identity by being conditioned to behave in the exact same manner? It sounds quite dystopian to me.
