ABA Rhetoric #1: ABA interventions are the most evidence-based effective autism intervention
Actually evidence for ABA programmes is overwhelmingly poor and considered low/ very low and this was confirmed once again by a May 2018 Cochrane review . A good resource that is updated periodically and includes research that is independent and by national organisations against ABA, such as the Cochrane review, is this article.
You can also follow #ABAResearch on Twitter for up to date and triggering ABA research, where punishments, aversives and stopping of harmful stims is widespread in the field today.
Also, at the time of writing this, Ambitious about Autism, who run two ABA schools and an ABA college around London states on its website that “there is very little research about how ABA is applied in ABA schools” and they don’t know why or when ABA will help or harm.
This poor quality evidence is despite over 500 published studies and three decades of ABA research. No NHS guidance recommends ABA programmes, yet ABAers think having low standards for autistic people is OK. How many more decades does the global $8 billion ABA industry deserve?
No one seems to know for who ABA helps or harms. No one seems to be able to find any quality evidence that those subjected to ABA have a better longer term outcome. Rather we are finding increasing anecdotal accounts of harm from ABA ( as is addressed in ABA Rhetoric #3).
ABA Rhetoric #2: ABA is not offered in the UK, unlike the US, because of cost
In fact, ABA programmes are not offered due to lack of a quality and relevant research evidence base. Thank goodness for that with increasing anecdotal accounts of harm which are simply dismissed and not addressed by ABAers. Chris Packham was horrified by ABA in the US (Google: Packham ABA 2017). ABA is akin to Trump’s fake news.
ABA Rhetoric #3: ABA is not abusive lol, it is just like normal parenting!
No it is not! How ABA can abuse is really not understood at all by the field. This article “Invisible Abuse: ABA and the things only autistic people can see” illustrates well what is happening in ABA, whether old or new, from the internal autistic experience. As an update an academic research paper published in July 2019 Reframing Compliance: Exposing Violence Within Applied Behaviour Analysis discusses how an analysis of ABA methods in research published in the Journal of ABA in 2018 are linked to ways that are described in other situations as oppressive and violent. Another good article about the problems of ABA is that by Real Social Skills here.
The issues of ABA are not necessarily to do with a bad therapist, ABA not being done properly (in fact we prefer ABA that is not “genuine” ABA), a “tricky” child, or to do with the number of hours or explicit punishment. Its issues include the coercion (lack of real choice), power imbalance, oppression, compliance, unnecessary overload, invalidation, rewarding masking or camouflaging (refer the #TakeTheMaskOff campaign on social media). The increasing anecdotal accounts of harm can no longer be ignored.
A good, comprehensive discussion of how and why ABA is abusive was written by an ex-ABA therapist on this Madasbirds blog. ABA harm and links to PTSD are also discussed in this Autistic UK article written by Shona Davison. The Appendix to the recent Labour Party Neurodiversity Manifesto is a critique of ABA and PBS
ABA harm often stems from its mindset. We think this little girl is being subjected to abusive ABA here . However, the video was recently shared by UK ABA to show how great ABA is at getting a child to use verbal speech! What do you think? With ABA the ends really do appear to justify the means and psychological well-being of the person is out of any ABA equation.
ABA Rhetoric #4: Behaviour Analysis is about understanding behaviour
No, ABA is about changing observable, measurable behaviour by trial and error until compliance is gained and the data demonstrates that is has changed.
ABA therapists often use Functional Behaviour Assessment (FBA) in an attempt to understand behaviour, however this is just what the behaviour is seen to achieve and is nearly always documented to be (1) avoidance/escape, (2) access to something tangible, (3) social attention or (4) internal reinforcement. This is nothing to do with the “why” or root cause of the behaviour (ie anxiety, sensory, cognitive or other internal need). In fact FBAs are not mutually exclusive and are a pretty useless way to categorise behaviour. They leave the therapist guessing and using trial and error to get a behaviour change.
Think of a child, after coping with a day at school, in meltdown (a word not in the ABA dictionary). How will a therapist observing (1), (2), (3) or (4) at home understand the behaviour? You may think an ABA ABC (Antecedent, Behaviour, Consequence) analysis would help understand the behaviour. But as in this example in practice does not help either. The Antecedent in this situation is really unrelated to the cause of the overload and is simply the straw on the camel’s back.
The best way to understand autistic behaviour is to talk to autistic adults and read literature from autistic people all over the spectrum. Have you ever spotted an ABAer doing this? We only see them silencing autistics and instead talking to autism parents and fellow ABAers.
Board Certified Behaviour Analysts (BCBAs) think going to chicken training camps is a useful thing to do to learn how to better train autistic children! Other ABAers think it is more than acceptable to talk about training animals and autistic people in the same breath as we see here with TagTeach Clicker training parents and presenters. What must ABAers think about autistic people if they believe that they need to learn in the same way as we train animals?!
So the claim that ABA is a way to understand behaviour is highly questionable, not just due to its methods but because understanding autism and the internal autistic experience is nothing to do with ABA , and is not needed with ABA either for its certification, continuing education or practice. ABA is an “outside-in” approach, focusing on observable, measurable behaviours, not an “inside-out” approach, ie focus on meeting needs: there is almost no ABA literature on anxiety, sensory or cognitive differences.
ABA Rhetoric #5: ABA is regulated
No. ABA is not regulated or standardised. ABA tutors use psychological manipulation on autistic children as young as 18 months old for up to 40 hours a week and there is NO UK regulation, NO recognised UK supervisory body, NO complaints procedure. ABA is NOT even a recognised UK profession. Almost anyone can be an ABA tutor.
We saw a recent example of poor ABA standards and lack of regulation in December 2017 when an independent rigorous scientific review discredited BCBA-D Dillenburger’s three year, five volume report funded by the Northern Ireland Government that spuriously recommended intensive ABA. This report thought to have cost almost £1 million was annulled by the Government in 2018.
ABA Rhetoric #6: only a handful of autistic people and allies dislike ABA
This is demonstrably untrue. You only need to search the #ActuallyAutistic hashtag to feel the weight of feeling against ABA in the autistic community.
In 2017 we published an article that showed that autistic adults should be considered experts on matters relating to autism and that 10,000s in the wider autistic community do NOT support ABA. Furthermore, 98% of over 5,000 autistic respondents said they did not support ABA in a 2018 survey by Autistic not Weird.
ABA Rhetoric #7: Not doing ABA means not teaching skills…
“…and allowing your child forevermore to head bang with trails of blood along the floor and streaks of smeared faeces along the walls”. Wow, what a scaremongering bunch the ABAers are. There are always Better Ways Than ABA
They start with acceptance, understanding and seeking to meet internal and cognitive and other internal needs. They also presume competence and we have had trouble finding an ABAer who seems to who understand what this means.
Connect with the wider autistic community on-line to understand how to support autistic children or follow and ask on Twitter using the #AskingAutistics hashtag. Don’t train your autistic child like you would a chicken, dog or horse or be taken advantage of by ABA sales talk because you don’t understand your child or are unaware of the issues surrounding ABA.
ABA Rhetoric #8: ABA today rarely uses aversives
This so illustrates how ABAers do not understand the psychological impact of what they do! Putting a child in an aversive situation in ABA “therapy” is common: whether ignoring communication of distress, timeouts, withholding loved things for reinforcers, not letting a child leave an aversive situation, physically prompting or repetition, repetition, repetition.
Even the BCBA Task List allows for punishments and the Behaviour Analyst Certification Board (BACB) and ABA International condone the use of aversive electric shocks, inviting perpetrators to speak at their conferences (Google: ABAI and Judge Rotenberg Centre).
ABA Rhetoric #9: ABA is not about manipulation and compliance
ABA is every bit about manipulation and compliance. In practice ABA teaches children that they have done the right thing when they get their reward, regardless of how meaningful, natural or comfortable to do so. Children learn that their own feelings and intuition do not matter and that doing good means pleasing the person in position of authority.
ABA issues of lack of self determination and autonomy are discussed well in this article published recently.
ABA Rhetoric #10: Don’t listen to adults with autism, they’re not like your “low functioning” 2 yr old
We hear this over and over again. A cause of great divide in the autism communities, where ABAers like to do what they can to keep “autism parents” away from autistic adults and allies who speak out about how ABA has harmed them or their children or their colleagues and want nothing more than to help parents understand their child so that they do not go through the same thing as them.
By the way ABAers, it really is time you start listening to autistic people, including about the harmful language you use about us. The majority of autistics prefer Identity First Language and consider (high/low) functioning labels problematic. The links can be followed to understand more.
Moving on to the reference about age, of course adults are not like two year olds! Anyway, ABAers do not know what we were like as children or how we have developed and learned skills using non-behaviourist ways as we mature. And there was also no social media back then for “warrior parents” to share our most personal and intimate doings with you when we were younger!
Thank you Autistic advocates, individuals and allies for your input enabling us to carry on the discussion surrounding ABA controversy.
Further reading and resource:
What is ABA?: https://www.youtube.com/watch?v=PEhlSPB9w7Y&vl=en-GB
ABA Controversy Autism Discussion UK: https://www.facebook.com/ABAUKAutismDiscussion/
Autistics and Allies Against ABA Ireland: https://www.facebook.com/Autistics-and-Allies-Against-ABA-Ireland-622764574790755/
Better Ways Than ABA: https://www.facebook.com/Better-Ways-Than-ABA-1853865171523852/
Safe Spaces on-line for Parents of Autistic Children to learn about Autism http://www.theautisticadvocate.com/2017/11/safe-places-online-for-parents-of.html