“You’re torturing your child with ABA therapy”
Just like society at large, the autism community is not unified in their beliefs about autism. The first time I mentioned ABA (Applied Behavior Analysis) therapy on my blog, it only took a few minutes before someone said to me, “you’re torturing your child with ABA therapy.” This didn’t come as a surprise. Before Charlie was even diagnosed with autism I had searched the web for therapy options, and found that ABA wasn’t liked by everyone. ABA is the number one therapy recommended by medical experts for children on the autism spectrum, however many autistics reject that conclusion. As an autistic adult, I see both sides of the argument but overall I’m in favor of ABA therapy.
ABA therapy now and then
I think a bit of context is necessary here. ABA therapy has evolved tremendously through the years. It’s not the same as it was 60 years ago when Dr. O. Ivar Lovaas designed the first implementations of ABA to help autistic people. He did so based on principles developed by famed psychologist B.F. Skinner, found in his book, published in 1938, The Behavior of Organisms. Back then they used robotic repetition of learning trials held in sterile rooms, and administered punishment to help autistic people learn new and appropriate skills. In early behaviorism, rewards and punishments were used equally. Later, it became clear that rewards worked better than punishment, and punishment, while it might have encouraged learning for some, also produced fear. The methods used to help people with autism today have changed so much since Lovaas’ initial experiments – it’s unfair that they even bear the same name.
Play-based ABA therapy
Charlie’s ABA therapy is play-based. There are no punishments. Therapists may give a consequence to Charlie by taking a toy away from him if he’s hitting them or screaming, but most parents do that with their children whether they’re autistic or not.
ABA is not “one size fits all” and a good BCBA (Board Certified Behavior Analyst) will work hard to develop the best program for a child. For instance, we wanted Charlie to gain more independence, so our BCBA designed a program to teach him to brush his teeth and another one to teach him to put on his clothes by himself. There is no punishment if he can’t do it, but if he does, he gets whatever reward he’s into at the time. Some weeks that might be his tablet. Other weeks it might be a teaspoon of Nutella, or a cookie.
Is ABA therapy ableist?
The biggest criticism about ABA therapy is ableism, discrimination in favor of able-bodied people. I don’t agree that ABA therapy is ableist. You can help someone without changing who they are. Charlie isn’t in ABA therapy because we want him to be normal. We want him to be safe, independent, and to learn to communicate, to decrease his, and yes, our frustration. We want to fade away the less functional and dangerous behaviors, like playing with the cats’ litter box, swallowing rocks, and running in the street, to give him a better shot at life. I’m not trying to “fix” Charlie’s autism.
Therapy is here to make his life easier by providing him with ways to communicate, and most importantly keeping him safe. If it takes giving him a cookie to make him stop these dangerous behaviors and learn self-care, as well as communication, then I’m okay with it.
ABA and horror stories
Everyone working with Charlie is amazing. But, not all BCBAs, therapists, and therapy centers are great. Some of them are poorly run and the methods used are imprecise and borderline abusive. Though this is becoming less common, it may explain the more current ABA horror stories you read on the internet. It’s important that parents choose an ABA center that aligns with their values, a place where therapists and BCBAs will listen to them when they have concerns or don’t feel comfortable with the way a specific skill is being taught.
ABA therapy and stimming
On the flip side, there is a part of me that sees how ABA therapy can sometimes be harmful to autistic people. For instance, some ABA therapists may prevent a child from flapping his hands or rocking. To me, there’s nothing wrong with stimming as long as it doesn’t get in the way of learning. In school, hopefully the teachers will teach the other children what it means, rather than try to get Charlie to stop because the other children don’t understand it.
But I also get it, constant stimming may prevent a child from focusing in class. I don’t think we, autistic people, should have to change to fit in with neurotypical people, but I also want Charlie to have all the opportunity he can possibly have to learn, and maybe that does mean preventing him from stimming in certain situations. The balance, between wanting people to accept the non-harmful behaviors autistics often engage in and wanting Charlie to be accepted and able to focus in real-life situations, is sometimes difficult to find.
Yes to ABA therapy with certain conditions
ABA therapy has been a huge help for Charlie, and for us. It saddens me how little importance is given to parents of autistic children. I get that sickening feeling in my stomach when people tell me that I’m torturing Charlie with ABA and that Charlie learning to communicate and developing self-care skills isn’t important because what matters is that he’s happy. Charlie is perfectly happy playing in the cat’s litter box. Charlie’s happy banging his head on the wall. Charlie’s happy running in the street in front of cars.
How about Charlie’s safety? How about me as mother? Should I let my child put himself in danger because he’s happy? Charlie isn’t happy either when he can’t communicate and make himself heard. Thanks to his ABA therapists, Charlie can now communicate basic needs with an app on his iPad, called ProloQuo2go.
I was at a loss before ABA therapy came into our life. There’s no way I could have accomplished what Charlie’s therapists did for him, on my own. An autistic child grows up in a world comprised almost completely of neurotypical people, and they have to learn how to function within it. ABA’s ultimate goal is to help autistic people live an independent, safe, and happy life in this world – and I think that’s wonderful. While I understand some of the concerns with ABA therapy, in my opinion, when done well, administered by caring people who are open to criticism and who keep a child’s best interest in mind, ABA is the best therapy for children on the autism spectrum.
Does ABA cause PTSD? The answer is no. You can read about how that one and only study was flawed and debumked here.
André2019-03-16 at 3:16 AM
Removing loved things from the child to make them earn it as an reward is abusive and makes the child lose intrinsic motivation and stop sharing what they like
Andreea2019-03-20 at 5:16 PM
And you’ve walked how many miles in these parents’ shoes? Abusive is when you cause intentional harm, professional therapy for a child who needs to learn certain skills, skills that he does not have the ability to develop on his own unlike many of us, is not abusive. It may be unpleasant, but then again so is time out (for any child).
Marco2019-06-24 at 2:03 PM
I walked in the child’s shoes. I am now 56 and a university professor. I’s abuse plain and simple.
David N. Andrews - M. Ed., C. P. S. E.2021-11-01 at 8:00 PM
So what if you’re a professor? You have a very high likelihood of being wrong on this.
I was a visiting lecturer at my alma mater: psychology & autism studies; research methods & quantitative techniques. So it is entirely likely that I understand this better than you do. And, given her experience of applied behaviour analysis, I’d say that Eileen herself has a better understanding of it than you do.
Mr Jones2022-06-19 at 9:10 AM
It’s unfortunate that you are teaching. Learned behaviors and earned rewards go hand in hand, are intrinsic, and inherently natural, causal and consequential! Goodness, please do not teach weakness to your students!
Donna T2023-02-03 at 3:04 AM
So you think it’s abuse to keep an autistic child from eating cat shit because that’s what he wants to do?
Katherine2019-05-18 at 4:45 PM
Removing things is literally what every parent does.
BD2022-04-02 at 3:58 PM
Tamsyn2021-08-07 at 3:07 AM
If a child is using a loved object to hurt themselves or others, what is your suggestion?
If a child hurts someone how do you propose to change this inappropriate behaviour?
Offering rewards for appropriate behaviours and consequences for inappropriate behaviours is not abusive. My child loses access to his tablet if he kicks the cat. He has learned that kicking the cat doesn’t get him what he wants so he no longer kicks the cat. We also used ABA to teach him to communicate better and we are giving him the tools to self-regulate.
There are too many incidents in the news where an autistic person has been tackled or handcuffed or arrested by simply stimming or not correctly answering the questions of the police officers. I prefer to teach my child to communicate than go through this. I also prefer to teach him to walk beside me rather than run into traffic.
Darcy2021-10-15 at 1:07 PM
The idea of “intrinsic motivation” is flawed and has been debunked a long time ago.
phxrrs12022-05-22 at 7:30 PM
Can you even IMAGINE what any public setting would be like if parents ddidn’t PARENT their children?? Just let them run amok doing what makes them ‘happy’?? You should really consider incorporating the real world into your black and white opinion. <3
Caren2022-06-02 at 2:08 PM
my child doesn’t have any intrisic motivation to learn neurotypical skills including self-care and independence skills. Should I leave him in diapers his whole life? Should I get him dressed, feed him and brush his teeth his whole life if he doesn’t have intrisic motivation to learn? Lots of children, including my other, neurotypical son have more extrinsic (in his case, Pokemon cards) than intrisic motivations. He loves his iPad, but he won’t get it until he’s done with homework. Why should it be different for an autistic child?
Sue2022-06-19 at 11:47 AM
Virtually every parent of every child does this (ie “no TV until you do your homework,” “no dessert until you eat your vegetables,” “first clean your room then you can go out and play,” etc). So every parent is abusive?
B.2022-11-21 at 2:22 PM
The idea that it’s abusive to autistic children but not regular children would stem from the idea that autistic children are somehow lesser than their neurotypical peers.
Thank you for recognizing that is not the case.
Eve2022-10-30 at 7:18 AM
As someone who practices ABA I can tell you contingencys are made or removing a toy after proper “disengagement warnings” are given. How each kiddo gives assent is different if they say no its respected, I can try again later. Yes assent is new and a work in progress but its like when you get reminders to pay your bill you have till the 1st and when you don’t pay the lights are cut off or the water is( except in ABA you can have it back if you want to, just ask). Another example: We work and do things we don’t necessarily like to get money thats a contingency and the government takes a part of it away in exchange for not throwing you jail(the consequence). The science of ABA is in every behavior we strive to develop to work out more we start with small increments, to drive we begin with knowing basic road signs and build it up. Its in what we live through everyday. It wasn’t perfect yes, but I’m proud of what I do and the kids I help.
Nikki2019-03-21 at 4:10 AM
As a pediatric PT, I can tell you what you are doing is not abusive. Good for you and good for Charlie for working toward greater independence and less frustrations! It takes a lot of work and dedication and selflessness on your part to commit to this much therapy. Pat yourself on the back.
Jessica W2019-03-21 at 12:35 PM
Mama, you are amazing. You are so inspiring. You are a wonderful mom to your boys.
Sonia2019-03-21 at 4:25 PM
I am an autistic mom with kids on the spectrum. Ans i believe ABA fo e well CAN and DOES help the child. Good job mama
Jen Phillips2019-04-28 at 5:43 AM
Intensive repetitive forced behaviour all for a bite of cookie is abusive. It may not seem that way to some especially because it is effective at altering behaviour. Yes it can help to change behaviour that is dangerous but there are also other less intensive or repetitive methods that can do this. Research is beginning to emerge that shows how ABA and behaviour therapies damage mental health in the long term. If you can access it here are the references: Gardner, F., (2017). First-Hand Perspectives on Behavioral Interventions for Autistic People and People with other Developmental Disabilities.
Milton, D., & Moon, L. (2012a). The normalisation agenda and the psycho-emotional disablement of autistic people. Autonomy, the Critical Journal of Interdisciplinary Autism Studies, 1(1).
Kupferstein, H. (2018). Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis. Advances in Autism, 4(1), 19–29.
David N. Andrews M. Ed., C. P. S. E.2019-06-26 at 5:14 PM
Kupferstein, H. (2018). Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis. Advances in Autism, 4(1), 19–29.
That paper is an absolute embarrassment to any autistic adult who wants to get taken seriously in science. I say that as an autistic adult who wants to get taken seriously in science. I also say it as an autistic psychologist who taught research methods and data analysis at postgraduate level for two years at his alma mater.
There was NO clinical verification of any diagnosis of either autism or PTSD. There was no definition given of what ABA actually is, and nor was there a description of what was being done in any intervention being given to autistic people taking part in the ‘study’ – this makes it impossible to differentiate between ABA, per the definition given by the BACB, and anything being ffered under the name of ABA but not fitting the definition. I don’t remember reading about a control group of any sort.
Had she been my student, I would have failed that paper. For a master’s graduate, I expect master’s level performance. That was not a master’s level paper.
Keisha B2019-07-18 at 9:06 PM
This is because she’s not a scientist. She has a music degree and a “Master of Arts in Transformative Leadership”.
She claims to be a doctoral student but both schools I’ve seen listed for her are unaccredited diploma mills which I assume she chose because they would also her to claim “doctoral research” for poorly-conducted studies supporting her own biases and agenda without the right or oversight of a real college.
Danielle2019-09-29 at 2:46 AM
The thing that’s just so unfortunate is there is not enough research about the long-term effects of ABA- positive or negative. I hope at least that this article encourages more and improved research on related topics.
Stephanie2021-06-02 at 12:59 AM
I’m interested in your thoughts on my almost 4 year old who began aba and has had an increase in behavior problems that he never had before. I started the program to help him with life skills and it seems like it’s having an opposite effect. He did much better at another facility with just ot and speech. He’s ASD and Gdd rating ‘moderate’
Jen Phillips2019-04-28 at 5:45 AM
Also I forgot to mention that there is a strong evidence-base in the research related to mental health and intrinsic/extrinsic values that can be used to argue against reward based systems too. In a nutshell: teaching children to do something for a reward teaches them that what is important is doing things for the rewards (extrinsic gains). The research surrounding mental health has shown that when a person’s choices in life are weighted more towards doing things to gain extrinsic rewards their mental health suffers. These people are more likely to undertake tasks that they often hate just so that they can gain the reward and this pattern continues throughout their life i.e. they might end up chasing high flying careers just for the large wage that comes with that so they can buy the big house, nice car etc., rather than the fact that they love the job, therefore they make themselves miserable but they don’t realise that the things they are chasing won’t make them happy. This is because the reward satisfies briefly but it is fleeting happiness and it is not self full-filling, Some people might also develop problems with addiction too, because they feel they have to constantly reward themselves. They might become addicted to shopping, smoking, alcohol, drugs, food etc. Reward systems for young impressionable minds, whether autistic or not, are not good for mental health in the long run.
Meg2020-01-08 at 5:20 AM
There is a strategy in aba called fading. We fading and pairing. Ultimately we program so that client will be naturally reinforced. An awesome bcba will also program for generative learning… teach cognitive flexibility.
cynthia2022-05-21 at 8:42 PM
You are comparing apples and oranges – everything we’ve learned as a child was based on extrinsic values of the person teaching/supporting that new skill with a reward whether that be a cookie or smile/praise… and over time we internalize those skills and no longer need a reward.
Christophe2020-09-02 at 1:14 AM
Hi Jen, I have tried to find research papers on that on Google scholar, but couldn’t find any recent relevant ones. Could you give me the references of the most important and recent research article son that subject if you can?
Thank you, Christophe
Elana F2021-01-29 at 2:07 AM
Jen! Unless you have a child with autism, severe autism you are unable to understand it!!’ ABA the will lead to Drug abuse!!! Have you met children with autism? Severe autism? Enough. Unless you have a child on the spectrum you need to understand where we as parents are trying to support our children to ensure they can have a happy life. Because we don’t live in your text books. These are real children with real needs!! Enough!!!! Unless you are a parent with a special needs child/children you have no idea how we feel and what WE chose for our kids!! Drug abuse…. and so on. You make me laugh!!!!
Leanne2022-03-13 at 2:12 PM
I’m not autistic, so let’s get that out there. But I disagree with your assertion that extrinsic rewards are harmful in the long run. As a former student who absolutely adored my fourth grade teacher’s candy jar, I can confidently say it both helped me maintain good attention, and still adore those little candies today. She was a very kind and loving woman, and applied rightly, extrinsic motivation can be a powerful tool for good, especially when teaching math. All of adult life is framed by external rewards and consequences, so it’s not altogether wrong to use this with intentionality in childhood. When applied with love as a training method, it can be useful. As an adult I learned self-control, which prevented the addictive behaviors you mentioned. All of life is comprised of choices.
connie edwards2019-06-27 at 12:37 PM
when i was a kid my mum wanted me to learn to love books; she would put aside half an hour of an evening, turn the lights down low and make reading “a special time”. we would cuddle and enjoy reading together. my brother and i have been avid readers all our lives. THIS IS ABA. people forget that the principles of aba are 99% common sense; they are the things that we do as parents/carers all day, every day. ABA principles are utilised in every intervention that works. let’s not vilify a science because of a whole lot of pre-conceived ideals. conversely, let’s accept that there have been lots of wrongs that have been performed in the name of aba but that we need to spend more time talking with open minds about what we want to achieve and how we are going to do that…
Suzie2019-06-29 at 12:01 PM
Thank you for writing this 🙂 all the best. I hope many other parents find it helpful, positive and objective.
Becky2019-07-09 at 7:12 PM
ABA therapy saved my son. We started at 18 months and continued until he was 3 and he is currently 9 and THRIVING. Happy as a clam, able to function beautifully in society, has friends…is an all around different kid. If that’s abuse then call me the biggest abuser on earth because I’m so thrilled with all it’s done for him.
Joanne P2019-07-19 at 3:15 PM
I live in the UK and we don’t really have ABA here. Our health service exists to support people not make money for “therapists” who insist the child NEEDS 40 hours a week of their expensive services!
My son is currently learning his life skills such as getting himself dressed. I lay the clothes out the right way round and he puts them on. Once he is dressed he can either carry on playing or we go out, whatever we’ve planned for the day. There is absolutely no need for an extrinsic reward like a cookie (aside from the issues around sugar defeating the teeth cleaning lessons LOL). We need to promote intrinsic motivation to help him later in life.
Same with learning to use his AAC – he also uses ProLoQuo2Go but the reward is getting us to understand his wants and needs, not getting a cookie for doing so.
All the other things the author describes can be learned without ABA. Thousands of British children have done this for many years, I chose the two examples as they resonate with the life stage we are currently at.
My final question is always the same – if ABA is so different now, then why use a name which actually affects autistic adults with PTSD so badly that the very acronym is banned in many support groups?
Marsha2020-01-08 at 5:25 AM
Hmmm.. so he puts his clothing on and he gets to do something fun! You have positively reinforced him, which means u have increased his behavior getting dressed in the future. Essentially u provided him the motivation to learn to dress himself. Aba is everywhere
Adam Dayan2022-08-14 at 7:36 AM
Tell me that you are applying behavioural science without telling me that you are applying behavioural science. Well done, you cared for your son and ABAed him really well! Very pleased for your child.
Angelica2019-07-25 at 1:18 AM
I would strongly recommend that any parent considering ABA for their child makes sure to ask a very important set of questions of the BCBAs:
– A UN Special Rapporteur on Torture says what is done at the Judge Rotenberg Center is, in fact, torture. The BACB has not stripped the credentials of the BCBAs involved in using shock devices as aversives, and will not, as it is not against BACB ethical guidelines. Are the ethical guidelines at your facility different from the BACB’s? If so, in what ways? (If no, run. Run like hell. Ethical guidelines that allow torture are insufficient to protect your child.)
– Have you lobbied the BACB to get more stringent ethical guidelines so that children are protected from harmful practices like those currently in use at the Judge Rotenberg Center? If not, will you do so? Will you encourage fellow BCBAs to do so?
– Have you boycotted ABAI conferences that include the Judge Rotenberg Center as a speaker, and have you lobbied for the Judge Rotenberg Center to no longer be included as a speaker? If not, will you do so in the future?
– BACB ethical guidelines do not require that my child’s needs are put above my own. We are both defined as the “client”, and no prioritization is given to the needs of the one receiving services over the needs of any other person defined as a client in that document. What guarantees do I have that you will ALWAYS put my child’s needs above my own, seeing as the ethical guidelines of your profession don’t require you to do this?
– Do you agree with the use of physical punishments and physical aversives, which are permitted under BACB ethical guidelines? (If yes, run. For your child’s safety, run.) If no, have you lobbied the BACB to remove their inclusion among things considered ethical by your profession? If you have not in the past, will you begin now?
No facility (or person) that condones or excuses torture like that at the Judge Rotenberg Center is safe for your child to be near. No ethical guidelines that permit torture are stringent enough to keep your child safe. A person who isn’t willing to speak out against a member of their profession committing torture cannot be relied upon to tell you if it’s happening to your child. If you’re going to consider ABA, please, PLEASE ask these questions. Keep your child safe.
Further reading/viewing for context:
BACB Ethical Guidelines for BCBAs: https://www.bacb.com/wp-content/uploads/BACB-Compliance-Code-english_190318.pdf
Judge Rotenberg Center Torture Compilation by former JRC Staff (video): https://www.youtube.com/watch?v=Ko-ip3MImik [It’s long and hard to watch at times. Watch the whole thing. It’s from 2012, but JRC is still using GEDs today.]
How the ABA Industry Endorses the Use of Electric Shock Devices on Autistics: http://autisticbride.co.uk/2019/05/24/how-the-aba-industry-supports-the-use-of-electric-shock-devices-on-autistics/
Marsha2020-01-08 at 5:27 AM
Please read the bcba ethics. Punishment is unethical. A Bcba must use reinforcement procedures… punishment can only be used under specific circumstances.
May2021-01-21 at 3:04 AM
Hi Angelica, to clarify, the BACB ethical guidelines make a clear distinction between who is considered the ultimate client. When making decisions, the client considered primarily is the direct recipient of services, which in this case would be the child participating in ABA therapy. Therefore, there is a moral and ethical obligation to put the child first. I appreciate that you posted the guidelines as a resource, but I encourage all to read the document and take it for what it is before drawing conclusions about what is outlined in the document based on these comments. This blog post shows beautiful consideration of what a good BCBA can and SHOULD do to support both autistic children and their families. BCBAs who deny the dark history of ABA are likely to repeat the mistakes of the past, engage in ethical violations, and tarnish the good that other BCBAs do in the future. The current trend in ABA is to teach while learning from the child and teach by creating joy, something all professionals should do.
Charles Teague2019-09-20 at 2:48 AM
Just got the book. My wife and I are so impressed! Full of beauty and insight, worth pondering like few books you will ever have the opportunity to read. :^)
Behaviour Analyst2020-01-24 at 7:18 PM
I find it so frustrating and upsetting that some people ‘blanket policy ABA as abusive’. I’m a Behaviour Analyst. I am NOT abusive! I absolutely love, respect and care about the children that I am lucky enough to support. The ABA therapy that I see delivered, focus’ on fun and learning through play. It looks at helping a child to learn important skills. Where possibly intrinsic reinforcement is used (if it’s there then you use it).. for some though we don’t always have that luxury. Then we look at positive reinforcement that can be used to help motivate until the intrinsic reinforcement comes. This therapy that I see day in and day out prevents children from having more teeth removed because they now feel ok about teeth brushing and accessing the dentist, allows a child to feel ok about having a medical assessment without heightened anxiety and gut wrenching parental or hospital staff restraint. It has helped children to stay IN THE FAMILY HOME when the support network was struggling to cope with severe challenging behaviour and risk to siblings. This BLOODY AWFUL therapy has given children a voice AGAIN and AGAIN so that those children without communication can advocate for themselves. They can tell people to back off, to give something back, that they are IN PAIN!!! I have watched children struggling to make friends. Sat on the periphery with no way of navigating the complex dynamic of social interaction. I have watched the same children make friends, join in with playground games and feel happier and more content.
The children that I see are hi-5ing me (through intrinsic reinforcement) as I walk through the door. I get hugs, fist pumps and the odd fist in the air accompanied by a ‘YES X is here – what a treat’ (quote verbatim). That’s because this therapy that is so TERRIBLE can he delivered with incredible kindness and compassion, where best interest and a child centred approach is at the heart of every decision.
I appreciate that not all ABA is good. BAD ABA and these professionals need to be held accountable!!! However a well rounded account of criticism might also want to focus on the TYPES of special schools that sing about the weather every bloody morning, play skittles every Tuesday for four years and do the same mundane jigsaws over and over again. The types of places that don’t realise that I child can actually SPEAK after being in a provision for 2 whole years. It might want to look at treatment and assessment units – the type of ones that once you are in you don’t come back out! I spent a proportion of my career trying to help adults come out of places like this and to live a life of value – their own VALUES, safety and CHOICE!
The ABA bashing sometimes gets me down but then I go back to my reality and to what I KNOW, with the children that I care about and then I know I am trying my best to do the ‘right thing’ to help a child to learn skills that will enrich their quality of life, better advocate for themselves so they are less vulnerable, to safeguard their health and just as importantly mental health by working on self esteem and confidence when developing social skills. I watch those children laughing their heads off through the session, reaching out to their therapists to initiate more interaction and to prolong play.
Becky2020-01-25 at 11:17 PM
Hi there! I found your article very insightful and well-balanced and close to the conclusion I had come to already. My one question that still lingered, is one you touched on, but didn’t really elaborate on, which is in regards to stimming. As a parent, I have no desire to stop him from stimming and I would for the most part, object to any objective to make it so. Keeping him in mind though, while it is important to me that he is happy with himself however he may be, I think its important that he becomes aware of others and being mindful of others feelings. I have a feeling if I presented this question to adult autistics in general, it would be met with a backlash of “what about us? What about our feelings?” But it’s a legitimate question… For context, I am likely an undiagnosed autistic raising an autistic son, so I say this with utmost respect, but his stimming can sometimes be incredibly distracting, disruptive, and irritating to others. In many settings, I can see how this would be a big hurdle for others, such as focus in a classroom. For instance… I dont want to raise my son to think, that if he can help it, he should just stim away, because he is neurodiverse and everyone should accept it. I’d like him to be able to acknowledge that certain types of stimming could be disrespectful in certain settings because it’s not being mindful and considerate of others. Do you feel this is unreasonable? I want to do the best by and for my son. I want him to be comfortable being exactly who he is, but also not to believe the world revolves around him. I’d love to know your thoughts.
RBT2020-02-21 at 11:36 PM
I am a registered behavior technician in route to becoming a BCBA/LBA. I spend too much time getting sucked into click-hole articles about the controversy surrounding ABA, but this is the first time I’m replying or engaging with anyone (on the internet) in regards to the topic. Trying to reduce stimming that causes no harm to the individual doing the stimming has always raised ethical concerns for me. I will use vocal stereotypy (i.e., non-contextual utterances that vary from snorting and grunting, to repetitive phrases unrelated to the present situation) and hand flapping as examples. Assuming that the vocal stereotypy isn’t of high volume, like screaming or screeching, it’s likely to not be harming those around the individual either. So if a learner snorts and it serves some sensory-satisfying function that causes no harm, why is the behavior trying to be reduced? Under the same assumptions, I ask the same question in regards to hand flapping. The way I have seen most of these behaviors addressed is only in the context of learning–a person cannot pick up a pencil and write if their hands are flapping; a person cannot functionally communicate if they’re engaging in vocal stereotypy, etc. So, when goals such as functional communication and tracing/writing letters are being worked on, these stims are “competing” with responses that the goals are targeting. It’s during these times that I have interrupted stimming and redirected the learner to whatever it is we’re working on. When new, socially significant behavior is not actively being taught (when the learner is on break or has free time during a session) they are free to stim. I see this as an ethical implementation of aba techniques. But as you mentioned, stimming can be disruptive to those around the individual. So great, the learner has learned to not flap their hands during “structured” portions of an aba session…but what about at the grocery store? In the movie theater? And if stimming is interrupted or attempted to be quieted in community settings are we then just trying to make them appear like a neurotypical person? Of course this not my, nor most aba professional’s, goal, but I understand why people are likely to assume such an intention. Just like how stimming can interfere with learning during an aba session, it can compete with opportunities to socialize, navigate, and functionally interact out in the community. Sometimes these behaviors keep parents and caregivers from taking their loved ones into the community, period. They may be embarrassed (which is as upsetting to me as it is to anyone else), or they can foresee their child’s stimming being disruptive to those around them. They may want to take their child to the movie’s but the last time they did, other patrons couldn’t pay attention the movie, rude comments were made, etc. In regards to others accepting these behaviors because the person is neurodiverse…I mean I think our culture/society is becoming more aware of neurodiversity and how it presents itself, but the reality is that talking to oneself, rocking back and forth, flapping ones hands will continue to draw people’s attention; these behaviors can cause disruptions and severely limit the opportunities an individual has. Sorry, I feel like I’m talking in circles here. Point being, stimming during times and in environments that impede one’s ability to learn, socialize, and/or perform a functional task is something that needs to be looked at closely. We all learn what things are “acceptable” public behavior–I bite my nails, especially when anxious, but I have learned from aversive social interactions that people find it pretty gross. For the sake of my own dignity, I don’t bite my nails in public. Should people not be grossed out by this because I have an anxiety disorder? I would certainly like think people might be sympathetic, but I wouldn’t expect someone to shake my hand right after my fingers were in my mouth. I know, that’s not a perfect comparison, though I hope the point I’m trying to make still translates. I still struggle with when and how often (if at all) self-stimulating behaviors should be targeted as behavior-reduction goals. Each individual and each behavior needs to be assessed on a case-by-case basis. Luckily I worked with a team of BCBAs that are receptive to feedback, suggestion, and any questions–ethical or otherwise–that someone else poses. If you’ve made it through this jumble of thoughts (there’s more I want to blab about but I worry I’m not articulating myself well enough as it is, haha) thank you for indulging me.
- Dada2021-02-08 at 1:57 AM
Our non-verbal son had severe behaviors at school.
An ABA based toilet training was a complete failure. In that case, he was using the toilet independently since he previous year.
And at home few if any. We wen ton a two week road trip. Everything new every day, people, places and food. Not only was he a great travel companion, but there were no behaviors at all. On other blocks of time away from school he was also well behaved. He once asked for a swamp boat ride. I was reluctant, but we went and he loved it! Over each of the trips (many more than a week) there were no stiming or other behaviors.
So, ABA based efforts to stop stiming or other behavior was a near total failure.
Our experiences showed that living a healthy life was better than “therapy”.
Don’t pretend to contrive to be normal, be yourself…
The only clear result of the ABA was an aversion to “therapy” and anyone with a divisive agenda.
cynthia2022-05-21 at 8:49 PM
perfect example of “if you know one autistic person you know one autistic person” ie… what works for you works for you and can’t be used to justify a blanket belief/statement
Confused about ABA2020-05-28 at 10:35 PM
What about other therapies? Why is ABA the gold standard? Are they not addressing the same things that an OT or speech therapist would when those other therapists would address the needs from a perspective outside of the behavioral realm? Or are they just finding ways to address those skills and calling it ABA for the sake of billing??
And if we haven’t experienced ABA for ourselves how can we totally discount the voices of those who have, whether this is “new ABA” or not? Are there experiences and insights not valid?
ABA Team Member2022-05-24 at 9:28 PM
We use them at our center together, OT, SLP and ABA are all used and collaberated because each kiddo learns dofferently and need access to various modealities in teaching a skill!
JEAN-PHILIPPE PIAT2020-07-05 at 12:10 PM
I’m autistic and I use ABA to help many autistic children, for me it’s just a tool to understand behaviour and to help to find alternative behavior less harmfull for the children himself.
Autism mom2020-10-09 at 12:43 AM
Thank you so much for your post S2
- Dada2021-02-08 at 1:44 AM
Our non-verbal son had no behaviors when he started at the Melmark school, renowned experts in ABA. More than a decade later, after many millions of dollars he had every behavior in the book and was a holy terror. Melmark was completely ineffective at pretty much anything. And at $460K/yr it was clear that there were no resource issues. They could not stop him from shredding clothes, disrobing when in transit, running wild and being disruptive, attacking staff…. The time I observed the class he either sat alone with headphone or was engaged in some infantile activity. I saw no evidence of progress in any area, despite many claims and a tomb on their ABA expertise.
The school used therapeutic binding and when the DoE stopped that they used chemical restraints.
They claimed it was ABA.
Conversely, he had no behavioral problems with me.
No sensory issues, no dietary sensitives, no aversion to needles, dentists or whatever.
ABA is a tool, perhaps even an effective one.
But like a scalpel it can be used to help or maime.
Hershee2021-05-13 at 5:26 AM
Have you tried doing an aac assessment for him and trying a homeschooling option? If work interferes you can get ihss.
Eileen2021-05-21 at 11:11 PM
His ABA therapists taught him AAC when he was 2. He’s been using AAC since then.
Ashley2021-06-05 at 2:19 AM
What about speech therapy?
Eileen2021-06-06 at 1:49 PM
It’s great, as an added therapy. Our ABA therapists, OT and speech therapist work together.
Susie Hopkins2021-02-14 at 3:07 AM
Clearly, there have been huge problems in the past with ABA and I imagine there are still some therapists doing terrible things – which is horrendous. However, the argument about the problem with extrinsic motivation doesn’t wash with me. I have ADHD and create extrinsic motivators in my life all the time (e.g. accountability to someone else, artificial deadlines in my work) because poor executive functions make sticking with things so difficult. It’s not hurting me at all – quite the opposite if enables me to live the life I want. Yes, it’s better if it’s intrinsic but it doesn’t follow that extrinsic motivators are harmful. It’s absolutely ALL in the implementation. Dentistry can be abusive. Rewarding kids for learning and effort is not abusive. There is not a parent alive that hasn’t done it with good results.
Leslie2021-03-19 at 11:16 AM
Stimming actually HELPS autistic people to focus in class. It is necessary for them to regulate their emotions, so it is the opposite of distracting. Distracting is having to concentrate extra hard to STOP themselves from doing it.
David N. Andrews - M. Ed., C. P. S. E.2021-11-01 at 8:35 PM
Show me five good studies that demonstrate this to be true.
I doubt that you can find even one.
BTW, I taught research methods & quantitative techniques as visiting lecturer for my alma mater … postgraduate level. So, whatever you find better pass muster.
BCBA2021-12-22 at 3:43 AM
What is the function of stimming? Automatic. It feels “good”. This is ABA 101. Unless they are harming themselves or others, we should never block it.
S. Kerr2023-05-05 at 10:16 PM
I mean, do you have studies that prove that stimming makes it difficult to focus in class for autistic folks?
ARE there any studies on how stimming impacts the autistic brain or the autistic experience?
I have looked around a little, but most of what I’ve found is anecdotal or speculative, rather than research based. Which, if there IS almost no research, still has some value. And I’d assume it has more value from those who participate in the practice of stimming than those who don’t (like myself- I am not autistic. I’ve no idea how it feels.)
Anon2021-05-13 at 5:21 AM
Look, I have a kiddo that I work with that has similar behaviors. Have you heard of cal Montgomery? He was that kid who banged his head as a toddler. He gets overwhelmed and overstimulated sometimes from too much sensory input. Try using the word safe and unsafe. His brain knows safe and unsafe and just point. Have you heard of the austitic self advocacy network? They’re the ones who are nonspeakers and have received ABA as children. One of my kids headbands and that’s his way of showing us that something is wrong. Sometimes it’s from not having eaten, sometimes it’s from sensory overload, sometimes it’s because his autistic brother gripped his hand a little too firmly (because he’s receiving ABA and the therapists have grabbed stuff out of his hands so now he’s realized that grabbing is acceptable).
Anon2021-05-13 at 5:37 AM
It’s also almost always the result of negative thoughts or moodiness and often that of unmet needs.
Anna Kate2023-03-03 at 3:59 AM
I have very mixed feelings about ABA to this day. I will not fault any parent for doing what they believe is right for their child, including ABA. But, I do have a problem with ABA International allowing an infamous “treatment center” that routinely shocks its patients to present at ABAI conferences and market itself as legitimate. I take issue with the overall premise of ABA, as defined by Lovaas, where success is making autistic kids look virtually “indistinguishable” from their neurotypical peers.
The positives of ABA are a focus on life skill-building, decreasing aggressive behavior, fostering independence, etc. But, at its core, it is purely behaviorist and is more focused on surface behaviors than the inner emotional experience of participants. That’s a problem for me. I also take issue with kids being pushed into 40 hours per week of behavioral therapy with ABA para-professionals while only being authorized 1 hour per week of OT to address sensory integration issues w/ a licensed, master’s-level OT.
I think behaviorism is, frankly, an unsophisticated science, and I wish other newer approaches got the same amount of attention for research and funding. There are probably several other approaches that could be “evidence-based” if funded and studied properly.
That said, I do think lots of folks in the ABA field care about autistic children and setting them up for success and are attempting to do so in the best way they know how. It is perfectly natural for parents to want their kids to be able to be as independent as possible and to put their kids in whatever approach promises this (and that insurance will fund).
The reality for most parents is that they will die before their children do, and they want to impart as many life skills as possible before that day comes. (This is especially pressing for parents with higher support needs kids.) Right now ABA might look like the best available option for a lot of folks. So, I don’t fault parents for wanting to try that route.
I do hope for better alternatives to come along. Or, at the very least, fund professions like speech, OT, etc at a higher level.
Hayley2021-08-10 at 1:53 AM
Curious the thoughts of RBTs, BCBAs, and BCaBAs working on “communication” instead of speech therapists. Do individuals with ABA training have the true skill set to teach communication? “Everything is communication” absolutely but do these individuals have the skill set to teach communication?
Darcy2021-10-15 at 1:13 PM
BCBA2021-12-22 at 3:44 AM
Yes, we are explicitly trained on verbal behavior.
Angelina2021-08-19 at 8:52 PM
My son will be starting ABA soon and I was terrified because of all the horror stories, so I really appreciate you sharing your experience. It turns out his development worker who has been with us since he was 6 months will also be his BCBA so we already know and trust her. The therapy is play based and being tailored to his needs. She explained all the ways it’s changed and the ways she’s continuing to change how she does it -if we’re uncomfortable with anything or something isn’t working for him we will change that. We’re just at a loss for what else to do because he needs to learn safe behaviours and we need to fade away the dangerous ones (like hugging complete strangers and chewing rocks) and we just don’t have other options here. She’s taking some courses so she can provide other forms of therapy but none of it is covered yet. My son needs to learn to be safe and his father and I can only do so much without help.
Mauro2022-03-11 at 2:37 PM
Me gustó la nota. Si me permites, la traduciré al español para publicarla en un portal de divulgación de psicología científica.
Eileen2022-03-13 at 2:17 AM
Sí, gracias por preguntar.
RBT2022-09-29 at 3:30 PM
I am an RBT and I have only worked at and will only work for clinics/centers with BCBAs who submit to ethical practices meaning they only use reinforcement and replacement behaviors and they fade those out over time, only using extinction if the behavior is harmful to them or others and as a last resort. Bcbas who keep table time limited and let the session be child led, who teach self advocacy to the children like saying/signing/using pecs “no” or “I need space” and giving them appropriate ways to escape demands. BCBAs who do not target stimming but rather educate their teachers, their family and community its purpose and how it helps them regulate and that we all do it, unless as the author says it’s interfering with their life or learning in a harmful way, then we can give them other tools that serve the same purpose. I truly believe good Aba improves their lives, helps the children communicate in ways that will be understood by others and is not harmful to them or others. I had a client who came in who had highly aggressive behaviors-hitting, biting, pinching and sometimes even self injury. It turned out to be frustration because no one knew what he wanted because he couldn’t express it. We taught him how to use a PECS book and now he can give you a picture that says “water” when he’s thirsty or “hug” when he wants a hug. His aggression decreased. Imagine having no way to tell people in your life your needs. No wonder he was getting so upset. I have seen the quality of life of many children increase as they received quality Aba services. In my center we work alongside speech, ot, pt and sped teachers and we are often the ones advocating for client’s rights and ethical practices including no restraint. We model positive ways to encourage good behaviors and we discourage punishment. We meet the kids where they are at and we are as flexible as possible, often asking the question why is this important? Example:Does the child need to sit in their chair? Is it a safety concern?
All this to say there is good Aba out there. I hate that there is bad Aba going on. I wish the BACB would intervene more and shut down unethical ABA clinics and centers. But to paint the whole field as abusive is just not true. If you go to a doctor and he turns out to be a bad doctor you wouldn’t say “the whole medical field is bad”, you would look for a better doctor.
Libby2023-03-14 at 9:17 PM
i would just like to thank you for this article. My son is about to age out of his current therapy options and i was set on an ABA center i had a personal recommendation for and trusted – then i fell into the hole of all the individuals against it (specifically autistic individuals). Your views and comments really align with my thinking on the matter and it’s been extremely helpful to read.
LW2023-06-02 at 8:45 PM
I think there are good ABA therapist’s and bad. I do wish there were quality peer-reviewed studies on the longterm impacts of ABA. ABA is a life saver for many autistic people who have behaviors that harm themselves or others but there is little information on the efficacy of the many practices found in ABA into adulthood. The methods used often achieve the desired goals quickly but I don’t think it can be truly evidence-based without quality retrospective or longitudinal studies on functional independence and mental health of Autistic adults who had ABA growing up. Additionally, I have issues with the number of hours children are in ABA therapy. Some autistic adults who had ABA as a child have reported feeling like their childhood and teen years were consumed by it and when they age out they don’t know what to do with their time. Therapy, no matter how fun it is, is work. Constantly having behaviors modified and redirected is work for that child. Some children are in 40 hours of ABA therapy a week, as much as a full-time job. And frankly the fact that RBTs (those who, in my experience, complete the majority of ABA hours with a child) only receive 40 hours of training to be able to work with a child one-on-one for 40 hours a week is not appropriate no matter what supervision is provided. I am not saying that ABA is bad but a significant number of adults who had ABA growing up are raising alarm bells about the practice and it’s longterm impact. That should not be ignored simply because the therapy is effective at getting results quickly. The longest follow-up study that I have been able to find is only six years after the fact. I see a lot of ABA analysts and RBTs in the comments talking about how much the children they work with love ABA. I would love to hear from some of those people on how those they work with function and feel as adults. I am autistic and currently working on my doctorate in occupational therapy and have the same questions about longterm efficacy of therapeutic interventions for my field. There are increased rates of depression, anxiety, substance abuse, and suicide for those on the spectrum. I do not think any intervention can be considered evidence-based until we (everyone who works with those on the spectrum) start ensuring that interventions are, at minimum, not contributing to poor mental health in adulthood and ideally supporting good mental health and functional independence across the lifespan.