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.