After starting this post, I realized I was overly optimistic about containing this series to four posts. I’m going to need to expand the series to do the topic justice.
Touch Nose. Gummi Bear: ABA in our Family
Touch Nose. Gummi Bear: What is ABA and why does it suck?
Touch Nose. Gummi Bear: Why treatments designed using ABA are all the suck
Touch Nose. Gummi Bear: If ABA is sooooo bad, why is it used so often?
Touch Nose. Gummi Bear: Voices of Autistic Adults. Adult Autistics who are willing to take a brief survey. Click here.
What ABA is and is Not
I think that I have had a moment of understanding about ABA(Applied Behavior Analysis). I am going to attempt to share what I think I’ve learned…what ABA is and isn’t. If you already have a solid understanding of this—skip this part because it is kind of boring. But I would caution that MOST people don’t—even those writing law which mandates ABA treatment.
ABA is, in the most simple terms, a “research methodology” (Schreibman, 2007).
ABA is not “a treatment for Autism” (Schreibman, 2007).
It doesn’t change my opinion about the treatments which are developed by the ABA process. But it does explain why so many different treatments are called ABA (in reality designed using the ABA process); yet look so different.
I’m going to try to illustrate this using an example. I use a computer to design a virus which causes the entire US economy to crash. We wouldn’t say that the computer is the cause of mass devastation. We would say that the virus is the cause of the devastation. The computer can still be used to do good things. (In the case of ABA, I actually still think the computer is pretty much always bad, but will get to that in a bit).
So let’s start by talking about what ABA really is. I already explained that it is a research methodology—and I’m sure that I’ve oversimplified that but go easy on me.
Applied: Socially significant behaviors are selected.
Behavior: The behavior must be objectively measured and changed.
Analysis: “An experimenter has achieved an analysis of a behavior when he can exercise control over it.” (Baer, Wolf, & Risley, 1968, p. 94)
Baer, Wolf, and Risley described ABA as “the process of applying sometimes tentative principles of behavior to the improvement of specific behaviors, and simultaneously evaluating whether or not any changes noted are indeed attributed to the process of the application.” (Baer, Wolf, & Risley, 1968, p. 91)
ABA is Inherently Unethical
When I originally endeavored to write this series for my blog, I didn’t realize that there was a distinction between ABA as a research methodology and what are commonly referred to as ABA treatments—treatments for Autism which were developed using the ABA process. They are used, interchangeably, even in law. With this understanding, I realized that I will need to examine both the ethics of the methodology and the treatment. In this post (which will be quite boring, sorry), I will strive to reveal the intrinsic immorality of the ABA process as it relates to how the process is applied to Autism treatments.
Often, when I speak to people about treatments designed using the ABA process, they claim that that the treatment that they are employing for their children is not like Lovaas, for example. And that’s great because Lovaas type programs are abhorrent. But here’s what we need to keep in mind. ANY program which is designed on unethical theory is inherently iniquitous.
Let’s start with the Applied. In order to be applied, behaviors are selected that are meaningful and socially important must be targeted. This almost always (when the rights of others are not being infringed upon), unquestionably, falls outside of scientific capacity. It requires subjective decisions to be made about behaviors by fallible and biased human beings. What happens when human beings make judgments about which behaviors are important?
We get Autistic children touching their noses on demand in exchange for gummi bears. Touch nose. Gummi Bear.
I challenge anyone to make a case for scientific guidelines for determining which behaviors are and are not meaningful and significant for society. CANNOT BE DONE. What happens when people try?
We get Autistic children being coerced into quiet hands. Into making eye contact.
If you don’t agree with me that these are not behaviors that should be subjected to modification? Well, that just illustrates my point about subjectivity.
One of the things you will hear behaviorist say is that in the field of ABA, behavior is treated as a function. Which is why I find it so hard to understand how they miss the boat so often. Behaviorists are given free reign to label things like eye contact and self-stimulatory behavior as maladaptive.
But they routinely ignore that the function of these behaviors are, in fact, adaptive. I’ve lost count of how many Autistics have told me, “I can listen to what you’re saying, or I can make eye contact. I cannot do both at the same time.” The identification of these divergent behaviors as needful of modification restricts the access of Autistic people to the behaviors that they have adapted in order to function. I fail to understand how anomalous behavior (of which adaptive function is habitually ignored) is worthy of modification. Behaviorists have proven, time and time again, an intolerance to Autistic characteristics and the way that they manifest themselves in behaviors. It is not okay to decide that self-stimulatory behavior is worthy of modification—especially when we slap labels like “scientifically proven” and “evidence based” on these decisions.
Further, even if we examine behaviors which infringe upon the rights of others, is modification the right strategy. Let’s say that every time I put my daughter in her car seat, she hits me. She is violating my rights by hitting me, right? Does it make sense to modify this behavior when we don’t even know why she is hitting me? Is it ethical to focus in on the hitting behavior?
I say, no. I say there are a myriad of reasons for which she could be hitting. Maybe there is something sharp in her car seat. But I’ve ignored this possibility and just assumed that she is hitting in protestation. By pursuing behavior modification of this behavior, my child is endangered. Both by the sharp thing in her seat and by the fact that I have taught her that communication is not valued. I’ve also taught her that she cannot count on me to meet her needs.
Can we talk about the analytic part of ABA now?
The result of this, mostly, unchecked control ignores the value of an Autistic person’s right to bodily autonomy. The implications of this cannot be overstated. Modification of subjectively selected (very rarely by the person receiving the treatment) behaviors, behaviors which are rarely infringing on the rights of other members of society, is considered of higher worth, than the most basic of human rights. Hence, the human rights of Autistic people are considered not equal to the rights of non-autistic people.
We all have behaviors which may be judged by others as socially unacceptable, bizarre, and/or maladaptive. But are we willing to permit other people to draw, not only, conclusions that these behaviors are not meaningful to us in some way, but to relinquish our autonomy to another human being to exert control over them? I’m unwilling to do so. Is my daughter, and other Autistic people, not entitled to this same sovereignty? To answer this question with, “no” is to debase Autistic people. To designate Autistic people as less valuable human beings. As my Autistic friend K from Radical Neurodivergence Speaking will tell you, “I’m not a real person anyway.” Is she right in your eyes? Not in mine.
But, but, but…ABA works!
Lots of things “work” that are intrinsically wrong. But what do they work to do? Let me point out the obvious—just because something “works” that doesn’t mean that the end result is a moral accomplishment. Guns work to kill people. But is what they work to do an ethical victory?
Or really any worthwhile accomplishment. I leave you with the example of, “Touch nose. Gummi Bear.” Yes, behavior modification can teach my daughter to touch her nose on demand in exchange for a gummi bear. I’m wondering how on earth this is socially significant.
Further, and more importantly, I am wondering how and why we are making the assumption that my daughter does not know how to touch her nose. The presumption is that she is incompetent. That she does not know how to touch her nose. It ignores the fact that there are any number of reasons why she may not be touching her nose when I ask her to—including that it is ridiculous to repeatedly ask her to touch her nose.
Because I was curious. I intended to tell my three (almost four year old) to touch her nose repeatedly. She complied two times before saying, “Why are we doing this? I don’t want to. Let’s paint.” And then she got off her chair and went to get the paint. Should I assume that her non-compliance with my demand means that she does not know how to touch her nose? Should I demand that she continue to touch her nose to prove that she has, in fact, mastered the skill? Or can I assume that it is absurd to continue to insist that she do this to demonstrate she understands? Shouldn’t we be doing…oh I don’t know…ANYTHING else?
Oh! In case you missed it above: Adult Autistics who are willing to take a brief survey about their ABA experiences, Click here. Trigger warning for ABA questions. This is not a survey for parents of Autistic children.
Disclaimer: My kiddo is in ABA therapy. Frankly, I’m not sure why it is called ABA therapy because we pretty much play the whole time, he does not work for gummy bears (or any other food), and his NT sister participates and enjoys it the entire time. However, in my former life (before kids) I worked as an ABA therapist. The kind that had kids sit at the table for hours on end and earn gummy bears for touching their nose repeatedly. (And now that I know better I feel really badly for doing all that therapy with all those kids.)
However….I’m going to throw out the question….where does “ABA” end and “life” begin? Think about little kids at school….complete a project “correctly”, earn a sticker. Older kids….do a full page of multiplication problems (even they they know full well how to do them)….get a smiley face on their homework. Really older kids….study for a test….write down the “correct” answers….get an A. Even older kids…..land that deal at work (ethnically or not)….get a big raise. How is this any different than ABA we do with autistic kids? It seems like it is just on a “bigger scale”.
Note that I am NOT saying that the discrete trial type of ABA is OK. It is NOT. I”m just questioning…where is the line?
Looking forward to the rest of this series!
I think the question of where the line is SHOULD cast some suspicion on how the American educational system treats kids generally. Because a whole lot of that is not okay, either.
This same discussion is very real in educational circles as well. You can check out writers like Alfie Kohn and Ross Greene, and here’s a very interesting video reflection on the topic by Ken Robinson. http://www.youtube.com/watch?v=zDZFcDGpL4U
Love this chavisory, and it only gets worse training children simply to pass standardized tests! At the same time schools are so invested into making children think they’re special, equal, and no one can tell them not to be themselves, but no one thinks we should do the same for our children with different ways of learning and dealing with the world? No, public education is not exactly a standard by which to judge anything.
What exactly is Aba. I do not have a child with Autism but I have recently learned they are doing quiet hands with him….which I stated clearly I did not want done with him. Are there any good parts of ABA or is it negative as a whole?
Thank you for delving so deeply into this topic. Much needed and much appreciated!
I have a 4 year old boy, autistic and wonderful, and I just want so much not to infringe on his way of doing anything. As long as he’s safe in exploring our world, I want him to find his way in his own time. My son is brilliant- he just does not speak in words all the time. I do my best to meet his needs, but just like another person commented, if we stifle their version of communication we could be missing something HUGE, and all because the child didn’t know how to speak about the need in plain words. Ever heard “actions speak louder than words”? It only takes patience on our end to figure out what’s being construed.
This was NOT boring at all! You have managed to explain what ABA is and then give examples through the eyes and feelings of a parent who wants the best for her child, and by using so much common sense! I love that you thought to try out the “touch nose” example on your three year old, That little story was worth a thousand more words for those who finally see autistic children and children first and not damaged humans who have to be “trained” to fit in to someone else’s subjective idea of “normal.” When my two NT children were growing and learning I constantly listened to and observed them and deduced what they needed to learn and reach their potential, however they communicated it, why on earth why wouldn’t I give my autistic child the same respect and let her know that any way she could communicate with me was just as important? Loving this, thank you!
I wanted to take your survey but it asks whether you participated in ABA and only has “yes” and “no” for an answer.
I don’t know what the stuff they did to me was called. I was a kid.
I thought that the article was very good, I dislike ABA on a number of fronts, starting with the claim for “success”. Approximately 50% of Autistic children develop significantly without any therapies at all. Just under 50% of children receiving ABA develop significantly improved communication and social skills too. Is this the same group? Are families paying many, many thousands of dollars for no good reason? Are children being denied their liberty in contravention of the United Nations “Rights of the child”. These are questions to be asked.
One thing did strike me. “The analytic portion of ABA gives “its practitioners the ability to control what other people do.” Every parent, every teacher uses analysis of behaviour to determine what the child needs to learn to do next. When you first put on a diaper, you are making an observation that your child is making an odorous mess and needs to wear a bulking article to contain that mess next to the skin. The child becomes accustomed to this garment but we suddenly decide that the time has come to discard the familiar and start to use the lavatory or pottie. The child’s wishes are not taken into account as we reward or bribe for success, depending on point of view. Children need input into their lives. They need to be heard but they do not have the developmental skills or information required to make sound judgements. So, we have to acknowledge that at times, some behavioural techniques are appropriate and even desirable. I do not know about you, but even if my child is happy wallowing in excretia, my social conditioning makes that impossible for me to enjoy or accept.
As for observation of behaviour to determine needs, I think that you have glossed over this. A behaviourist technique which is commonly used is Functional Behaviour Analysis. This goes far beyond a simple observation that a person does or does not perform a certain action. Determining the function of the behaviour is an implicit part of the process. I think that it often does not go far enough. For example, when I was a child, I refused to enter rooms with closed doors if I had not been in them before. I would open the door a speck and pace back and forth peeking in until I had a fair idea of what was in that room. No amount of analysis would have determined the cause of the behaviour. Had anyone asked me, the reason would have seemed strange or fanciful. I did not know then but I have linked perceptions – imperfect depth perception which can make colours leap out at me or recede into the distance resulting in highly patterned and coloured surfaces appearing to ebb and surge. Imagine walking across a carpet that appeared to move like the sea. I also perceive emotion through colour, so walking into some rooms immediately triggers terror, love, fear etc. As a child, I did not have the words to explain all this, and this is an area where I think we have to realize that even sound behaviourist techniques have their limitations.
Something that you did not touch on in your article is the claim that ABA raises IQ. For a long time, I found this difficult to argue against, but in talking to a parent, I was horrified to find the answer. She had taken her son for a reassessment of IQ after 4 years of ABA. She was furious because he was asked some questions to which he had not been taught the answers. Further enquiry resulted in her telling me that many of the items on the test were also items specifically taught during therapy. Appalling.
I believe that the success of ABA has been based on fear tactics and incredible marketing. It is a very profitable industry, but I believe that even though some powerful understandings have come from it (Lovaas was the first person to say that Autistic children can learn) the unethical principles of deprivation of freedom, blind ignoring of the principles of learning, lack of consultation with the Autistic community and confidence that observation can give all the information about behaviour required, means that ABA should not be used as a therapy for autistic children.
Thank you for posting. I just found your blog. My son (almost 5) was recently diagnosed as autistic and I’m trying to learn whatever I can to do right by him.
Great discussion! My 5 year old grandson was diagnosed with Aspergers a little over a year ago. I spent a great deal of time trying to gain access to ABA because I was told that he needed it. Long story short, we were unable to afford it and his insurance wouldn’t cover it so he never received it. The more I’ve read about ABA the happier I am that things worked out the way they did. Thanks for the valuable input.
From what little I’ve read of your blog, you seem like a good woman and a very good mom. Your little girl is blessed to have you. You are right: people who think autism is horrible and must be cured/prevented at all costs are frightening.
In defense of ABA: my daughter was in an ABA program for 2 years. At times I hated it because it did seem cruel. However, she is much happier now than she was before she had therapy. People outside our immediate family can come into our home now without her sobbing until they leave, which is what used to be her reaction. People can say hello to her and she can say hello back, instead of sobbing in reply. She enjoys school now and doesn’t have to suck her thumb all day to cope. She will always have Asperger’s, and that’s nothing to be ashamed of, but thanks to ABA she also has the skills she will need to live in a world where most people don’t have Asperger’s.
To illustrate: if some day our whole family had to move to France, it would be wise for us to learn French. There is nothing wrong with the fact that English is what we are most comfortable with, but there is no doubt that we would be much happier living in France if we learned the language spoken there.
Another illustration: giving a child vaccines is painful. No child likes it. No parent enjoys it. However, most parents agree that painful but brief shots are preferable to death or living with the after-effects of a debilitating disease.
Tony Atwood says he believes there is room in the world for both our views: we need to accept those with autism, and therapy for autism can be helpful. I think he is right.
Perhaps it is worth reading this link, which may explain the “happiness” your daughter feels.
There is no one ABA. Just like there is no one occupational therapy or physical therapy. My children loved some of their therapists, hated some, and I kicked plenty out of my home. I think this is true for special education and teachers of all kinds in general. My son on the autism spectrum loved his piano teacher, loves his violin teacher, and could not deal with the punitive teaching of his steel drum teacher, and so he quit steel drum (I was sad, but I had to stop the lessons as the teacher never listened to me about how to be positive and encouraging). My kids all had ABA therapists that I SUPERVISED, and all of them used natural teaching strategies (NO GUMMY BEARS for touching noses at my house!). My ABA therapists played pokemon and video games and helped my children learn some important skills like how to hold a pencil without pain. Yes, I think holding a pencil without pain is a good goal. If you don’t, then whatever therapy you choose, or teacher, make sure that person reflects your goal. I work as a BCaBA now, and I play with kids and teach parents – often overwhelmed and living with daily exhausting tantrums – how to play with their own kids, too. Play is essential. I also help teens who are in jail or hospital settings get out. None of those teens were in jail due to ABA – all were there due to punitive teachers. My best advice: don’t judge “therapies,” judge individuals who come into contact with your children, be they scout leaders or therapists. Make sure you see your child having fun, in school, therapy, or scouting, or piano lessons! Learn about effective, and positive teaching methods – I was using ABA principles all the years I taught preschool, and I only used play – and especially make sure whoever works with your child knows about antecedent interventions (like playing with your kid instead of dealing with a bored child – never an easy thing!).
Claudia, you raise a very good point about the need to define terms.
We live in a city where there is a government-funded ABA program, which is connected to our University and is respected as a leader in the field.
There is no way our consultant and tutors would have considered play a part of ABA therapy. I tried very hard to incorporate a play approach in our program, and got nowhere with them. It was discrete trials, and specific measurable behavior, all the way.
The author of this blog defined her understanding of ABA clearly, and based on 3 years of ABA experience, I agree with her concerns.
My daughter seemed happy for much of her ABA – and then developed a lot of anxiety. She blossomed when we took her out. My second child had no ABA (we went the developmental route) and he’s both happy and learning new skills every day.
By the way, play is also a term that needs to be defined. Loosely speaking, play is child-directed activity that explores objects and ideas in a social setting, and never looks the same from one episode to the next.
Your definition of play rocks, though I do think kids have solitary play, and that it can be important, too. Whether I’m teaching preschool, hanging with my own children, or doing behavioral programs for families who choose to work with me, I want child-directed activity to be central to all I do.
And I didn’t mean to imply by my vaccination example that autism is a disease. My point is that sometimes the end justifies the means.
After wrestling with it, we’re trying ABA right now. I HATE it. It goes against everything I believe but was scared into it. What mother wouldn’t want the best intervention for her child. Sounds neglectful…
Well as I said we’re trying ABA. His whole issue is not listening or complying. He might be nonverbal but I tell him every day if he doesn’t want to do this, show/tell me. Imagine how proud I was when he asked the therapist WHY after a request. Now that’s my boy!
We tried ABA with our three year-old son and just ditched the in-home company we have. I blog about it in my latest post. It was so stressful for our entire family and wasn’t helping with any of the actual concerns we have for our son. We don’t want to “fix” him. We do, however, want to teach him coping mechanisms for dealing with his anger and aggression, not just because he does hurt others, but I can see that it hurts him when it’s happening. It’s not going to go away (if it could, then I’d like to know how because I have anger management issues too), but I do want to help him learn how to manage it when it does to alleviate his stress. Anything out there for that that’s valid and respects my son’s awesome uniqueness?
We abandoned ABA for a combination of DIR/Floortime and RDI (we find the two approaches compatible, although they emphasize things a bit differently). It’s a much better fit for us, and respectful of our children’s emotional development.
Thank you! I need to research a little more about RDI. I’m not as familiar with it.
Thank you a million times for writing this. I have been struggling with deciding whether or not to continue aba therapy for my son. Some have argued that because we go too infrequently, or aren’t assertive enough, or don’t do everything at home that the clinician teaches us, that it isn’t working, but I truly believe it is because my son feels disrespected and is refusing to comply. I have been searching for a post like this for months, thank you so much again.
Many proponents of ABA argue that in order to be effective, it needs to occur upwards of 25 hours per week. I don’t see how any child would have the energy for such a rigorous schedule–say nothing of the ethics of ABA.
Are you on Parenting Autistic Children with Love & Acceptance? Please feel free to private message the page with any questions you might have–we can can post your question for feedback on the page. We are lucky to have a lot of Autistic adults who offer the benefit of their experience. The best advice I have gotten when it comes to parenting my child has come from Autistic people.
Since my daughter stopped ABA at school, she has returned to her typical demeanor which is easy going and happy. It took me too long to say, “no more Autism specialist.” But it is the best decision I have made. Feel free to email me if you’d like to talk privately at any time. bethryan2659 at aol dot com.
I’m an ABA therapist and ALL I do is play with children. And I have helped many non-verbal children learn to speak, many children with sensory issues become more able to participate in multiple environments, and helped lots of weary parents learn to have FUN with their children. Applied Behavioral Analysis mandates that therapists use the parent’s goals for the children, so I am not deciding ANYTHING about the children. The parents determine the goal. That is what ABA SHOULD LOOK LIKE – FUN, and PARENTS IN CHARGE. Anything else, and like most professions, you have a bad practitioner.
that is what every practitioner claims whenever abuse or aversives come to light… it’s also known as the no true scottsmen fallacy.
Well, I see abuse every day in school settings, in OT and PT offices, and in lots of therapist interventions that are psychological or medical. I am, however, the mom of kids on the spectrum who insisted on child choice and play with my children at all times, and I don’t care what the practitioner calls him or herself, if they use abuse or aversives, then I kicked them out. I want to empower all parents – whatever the therapy they choose – to base decisions on their child and their family. I don’t think that is a fallacy. I think it is the essence of promoting all families.
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I too am completely lost on the ‘touch nose’ thing. Maybe you’re supposed to have one of those clicker things to click before you toss them a gummi bear? Don’t they have shows an things where they give the autistic child points on touching noses? I heard one lady took her child to Britain’s Got Talent and won so she could take her child to the Royal Variety Concert and show the Queen how her child could touch her nose. And they both wore costumes and did a little dance to James Bond music. Oh wait I’m even more lost. What are we talking about again? Children or dogs?
I would expect that a BCBA would not make claims that there is no one aba. ALL ABA therapies are based on behaviorism– The behaviorist uses stimuli to control the behavior of the subject. If that’s not what’s happening, then it isn’t ABA. You can’t wrap your ABA therapy up pretty and call it pokemon or steel drums and think that makes it okay.
I DO judge ANY therapist that chooses to employ this method of therapy on any individual who has not given INFORMED consent. I’m not talking about the kinds of things that BCBAs and behaviorists repackage and claim to be novel concepts–like “antecedent interventions” aka not being an asshole parent/person by not accommodating and supporting your child. I’m talking about the core of behaviorism. Using stimuli to control the behavior of a subject.
Antecedent strategies are ABA; check out the textbook. When I was a preschool teacher I used antecedent strategies when I allowed children to have their loveys (and got in trouble for it), and I use the same simple teaching strategy now when I encourage parents to do messy and fun art with their kids. Using stimuli to increase a behavior is absolutely very common in ABA, usually with silliness like gummy bears. But antecedent strategies are often more fun and my fave suggestion (and I have a gazillion play dough, slime, and paint recipes, too). I am sorry you have decided to judge me based on my working in the ABA field. I’m really a very committed child-rights advocate, who has been doing children’s rights, homeschooling, and child choice for 30 years.