“You’ve known this kid for a few weeks. I’ve known her for two years” was the response I received from a Board Certified Behavioral Analyst (BCBA) after bringing to her attention concerns I had regarding a client she was treating.
I knew when I decided to take the job as a Behavioral Technician (BT) that Applied Behavioral Analysis (ABA) therapy was controversial. I did my research before accepting the position as a Behavioral Technician at a location that implemented ABA therapy with autistic children. I read articles discussing the positive experiences associated with ABA therapy; many parents of autistic children found ABA therapy to be immensely beneficial for their children.
Then, I found @paigelayle on Instagram. She is an advocate for those with Autism Spectrum Disorder (ASD), and she is autistic. A poll she had taken—directed solely at those diagnosed with ASD, not their parents or loved ones—had asked if ABA therapy was a good option or if alternatives, such as Occupational Therapy (OT) and Speech-Language Therapy (ST), were safer and more beneficial. 100% of those diagnosed with ASD voted for “alternatives” over “ABA therapy.”
This intrigued me. The other articles I had read focused on the perspectives of neurotypicals (NTs: those without ASD or other neurologically atypical characteristics or disorders). This poll was the first piece of information I received about ABA therapy from those diagnosed with ASD. This was my first exposure to how autistic people, including autistic adults, felt about the field I was about to jump into.
Moving forward with the position, I soon found that ABA therapy could be extremely effective for teaching children to function in NT ways. The children I worked with were being taught to work cooperatively in groups, to follow multiple-step directions, and to “use your words” and say what they wanted or needed rather than physically hitting someone to gain attention.
These are all useful skills. Functioning in our society’s current state requires certain skills. Hitting people to get their attention can get you thrown in jail. Following directions, such as driving at speed limits, prevents further disciplinary actions, such as receiving a speeding ticket. Communication with others is necessary when signing up for health coverage or when paying for groceries, although the internet is slowly allowing for other forms of communication.
I also learned that ABA therapy is largely centered around reinforcement. Reinforcement is what happens after a behavior. ABA uses ABCs to explain behavior: “A” stands for antecedent, or what happens before a behavior, “B” stands for behavior, and “C” stands for the consequence. “C” is often where reinforcement takes place. For example, A: I ask you to get me some water. B: you get me water. C: I respond, “thank you.” The reinforcement here is me expressing gratitude for the water you gave me.
ABA therapy emphasizes that no behavior is inherently bad or good, and I agree with that. Punching is an inappropriate behavior when it is directed at another human or an animal in defiance, but it is not inherently bad. Many people box, and directing punches at a bag, or even at another compliant human in a boxing match, is appropriate. Context determines “appropriate” behaviors as deemed by current society.
ABA therapy can be effective in shaping behaviors. If a child screams to gain a BT’s attention (antecedent), and if that BT turns and looks at the child (behavior), the child was reinforced as their screaming proved to be effective (consequence). If the BT does not turn their attention to a screaming child, the child may realize screaming is ineffective and search for other ways to gain the BT’s attention. If the child is encouraged to “use your words,” approaches a BT, and says: “I need help,” and if the BT then turns their attention to the child, a new—and in this context, more appropriate—behavior is being shaped. And that is awesome as it helps the child understand societal rules and expectations, both of which are necessary for independence in this society.
You may have noticed I keep using the phrase “this society.” The society we currently live in is not the only society. Societies in other geographical or historical locations functioned much differently than ours does currently in the United States. Societies will function differently in the future.
We have seen during the Covid19 pandemic just how quickly societies—their rules and expectations—can change. A year ago, walking into a gas station with a mask covering half your face would be suspicious. Today, not wearing a mask in almost every setting seems suspicious.
In current society, NTs make the majority of the rules. Those who fall outside of that realm, such Neurodivergents (NDs, or those whose neurons function atypically) or those diagnosed with ASD, are expected to follow those rules to be successful.
Many people deemed “successful” by today’s standards were likely autistic, according to the New Scientist website: “Autism is heritable, and there are clues that the genes for autism are linked to those that confer a talent for grasping complex systems … Mathematicians, engineers, and physicists, for instance, tend to have a relatively high rate of autism among their relatives.” According to the Autism Community Network (ACN), Leonardo Da Vinci, Michelangelo, Steven Spielberg, Woody Allen, Tim Burton, Benjamin Franklin, and Bill Gates are all said to have had—or are currently diagnosed with—ASD, just to name a few.
I bring this up because, through my endeavors in my latest job, I learned more than I thought there was to know about advocating for autistic people—very NT of me, especially for an ND myself. For one, I have learned, through those with ASD diagnosis, that their preferred identity is “autistic” rather than “person/people with autism.” This contradicts what I learned from NT’s in the field. @neurodifferent, an account on Instagram run by an autistic person, shares:
“If you feel the entitled impulse to force me to use person-first language when describing my experience of autism to remind YOURSELF of my personhood, then you are the one who does not see Autistic humanity as inherent. … The language we use to describe autism, and WHY WE USE IT, shapes how Autistic people are perceived and treated by society. … if Autistic people can’t trust you to care about us IN THE WAYS WE NEED AND ASK FOR with matters as simple as language… How on earth can we trust you to help us to dismantle systemic ableism to truly safeguard the needs, safety, and well-being of our beloved community in this society?”
Those encouraging “person-first” language are likely doing so out of good intentions. However, when autistic people share their preferred identity, that should be respected, whether we agree with it or not.
Those using ABA therapy likely also have good intentions. I know this is true from many of the BTs I worked and talked with during my short time in the ABA field. While many treated the job as a paycheck, others had a passion for helping autistic people. Their intentions were good. However, good intentions do not excuse abuse.
ABA therapy often pushes unnecessary expectations and behaviors on people with ASD. Those with ASD experience the world differently than NT’s. Do they need to have some skills necessary for independence and safety? Definitely. Using words, sign language or other communication methods are necessary in the real world and cannot be replaced with violence. Some skills, like proper communication, are important to learn, and they also allow for people, including those with ASD, to advocate for themselves.
Is physically forcing a child who is in the middle of a meltdown (repeatedly screaming “let me go!”, kicking, and sobbing) to sit down, hold a marker, and color-in an animal on the page in front of her excusable because of “good intentions?” Two adults holding down a six-year-old and physically forcing her to color is excessive, especially for an ND child who is overstimulated.
ABA encourages compliance, or following through with demands given, such as the one given in the reference above: “sit down and work on your coloring packet.” The location I worked at did not explain why certain behaviors were demanded of the clients, even when the clients asked, “why?” in response to a demand.
If someone tells me to do something that I do not understand, I am going to ask why, and I should. If someone tells me to “pull my pants down” (a target some children have for bathroom independence), knowing why is not only helpful, but it further ensures my safety. Compliance, like behavior, can be bad or good depending on the context.
Complying by eating your lunch during lunch hour, rather than going to Wendy’s in the middle of your shift, helps you keep your job. Asking why compliance is necessary is also helpful as it allows people, especially those who may not understand social norms as easily as others, to understand why certain behaviors are helpful or harmful.
When the response from the three BCBAs I reached out to about the treatment of these children was, “I’ve known them longer than you,” I wondered why they felt that their duration with the children offered them allowance for abuse. If I am treating people poorly, no matter how long I have known them, I am at fault.
“According to the data, tantrums are becoming less frequent,” one BCBA said while referencing a graph of a child’s behavior as if data was the most important thing when dealing with human beings. Using manipulation to get sex may get you more sex, but that does not mean it is the right way to do it. Inhumane is inhumane, NTs or not.
One study “found evidence of increased post-traumatic stress symptoms in those exposed to ABA … future generations can compare this kind of abuse to the abuse we recognize in classic experiments” (Sandoval-Norton & Gary Shkedy). In another study, 46% of autistic people interviewed had PTSD from ABA therapy, according to the Emerald Insight website.
Stimming (self-stimulating behaviors) is often attacked in ABA. @the.autisticats, an account on Instagram run by three autistic people, shares “Who care if my ear defenders and purple starfish chew necklace look ‘unusual’? I use those tools to keep my senses balanced and my emotions stable… It’s not childish at all. It’s sensible and responsible. It’s a way to meet my need,” pointing out that other adults may misuse drugs or alcohol for similar effects, and that coping mechanism is deemed more acceptable by society.
I believe all humans deserve respect, not just the ones who look, think, and experience the world the ways NT’s do.
I do not think giving a kid two handfuls of skittles and eight Oreos daily before 10 am to get him to comply in group activities and giving him sugar drinks and more candy throughout the day, is healthy or teaching helpful long-term habits. I do not think it is respecting that person or his health.
Autistic people are people, too. ABA therapy, when used incorrectly, reduces them to less-than; that is what I saw at the location I worked at, at least. We, as humans, are all trained in many ways. We grew up, and we were trained to use the toilet, to communicate with language—verbally or not, and to live in current society. That training, at this point, is necessary.
The problem arises, however, when you reduce someone to their behaviors. When you become hyper-focused on the training of that person that you forget they are, still, a person.
Encouraging kids to “ask before touching,” and then tickling those same kids in the name of “reinforcement” without gaining their permission is hypocritical. You are not giving that person the same respect you are requiring of them. You are reducing them to their disorder, to their behaviors, and essentially implying that some behaviors are acceptable when exhibited by you but not when exhibited by people who are different than you. You are essentially putting yourself on a pedestal, as someone worthy of being a person, and excluding that right from someone else.
Quitting my job one month after starting it and two days before taking the exam that would qualify me as a Registered Behavioral Technician (RBT) was scary, especially because I did not know I would be quitting that day. What was scarier was the idea of following through with the “treatments” that were expected of me.
Many in the ABA therapy field, BCBAs, and RBTs have good intentions. Ignoring feedback, especially feedback from those in the field you are “treating,” is an action, not an intention. Treating humans inhumanely is an action, not an intention.
ABA therapy, just like behavior and compliance, is not necessarily bad or good. It can be extremely helpful. It is not helpful, however, when the person you are treating is simply a “client” and loses the definition of “human.” It is not helpful when it is misused and overused instead of implementing more humane practices.
Autistic people are not data points for your graph. They are not a paycheck. They are people.
People are more important than paychecks. And that is why I quit my job four weeks in.
Autumn is a recent graduate in English-Literature and lives in Colorado Springs. During her personal time, Autumn likes hanging out with her super handsome horse, Red, and all the other 4-legged creatures in her life. Autumn is a fan of tall trees, forests, and all the wild and untamed parts of nature. She loves reading, researching, listening to others, and gaining as much insight into the physical and spiritual world as she can.
Autumn knows life can be hella hard, but she also thinks it is astonishing, amazing, complex, and fascinating. She hopes to be ever-growing and evolving, and she does her best to remain open to new perspectives, insights, or opinions that challenge her own. She would love to hear your personal stories and why one of her own articles resonated (or didn’t) with you. Autumn writes mostly about philosophy and mental health but loves to explore all topics. She can be reached at firstname.lastname@example.org.