TW/CW: ABA, torture, abuse, ableism, conversion therapy
This is so loaded, I gotta take a deep breath…
“ABA” stands for “applied behavior analysis” and it continues to be regarded as the gold standard “treatment” or “intervention” for autism. The methods are based on the theories of BF Skinner (1904-1990) whose work centered around behavior modification using rewards and punishments. You reward or “reinforce” a behavior you want and you punish a behavior you don’t want. O. Ivar Lovaas (1927-2010) is credited with being the “father of applied behavior analysis (ABA)” and creating a systematic method of behavior modification based on Skinner’s theories. As you can read about on Appliedbehavioranalysisprograms.com, his behavior modification methods first targeted homosexual “behavior” of young boys in “conversion camps” that he established. He then expanded his methods to target modifying the behavior of autistic children. Those methods included corporal punishment, screaming in kids’ faces (there are pictures), withholding of affection and shock treatment. Instead of distancing themselves from this monster- and I don’t think it’s hyperbole to call him that- ABA establishments continue to bear his name. People defend him by talking about how his methods were just as bad / comparable to the methods of others in the field of psychology at the time. How that kind of excuse continues to fly in this cultural climate where people are publicly shamed and/or fired for posting insensitive tweets 10 years ago is beyond me, but here we are. Not only is he not exiled, his core methods/theories (although toned-down and reframed in most cases… but still not in others) are now replicated by behavior therapists as part of a billion-dollar industry.
Today, 50 years or so later, ABA services are covered by major insurance companies. ABA services are provided to students in public schools through intensive sessions and reinforced many times by 1:1 aides who serve to uphold the “behavior support plan.” Parents of autistic children receiving new diagnoses are advised to immediately put their children into ABA services- sometimes for 20-40 hours a week. The Autism Speaks website claims
“More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years.”
(Ugh… so if you do 25-40 hours a week for 1-3 years, you might get an “improved outcome.” And that vote of unconfidence is from ABA’s biggest and loudest supporter…)
If I ever have the time, I will be writing more about the “efficacy” of ABA therapy according to available research (spoiler alert, it’s scant and inconclusive), but what I believe is the strongest argument in support of rejecting all ABA practices outright is the feedback we are getting from the autistic community. ABA attempts to change “problem behaviors” and this is often how their “success” is measured (they don’t throw themselves on the floor when they want something anymore=success). Those measures do not include or acknowledge the side effects reported by people who have been subjected to these treatments. In a study titled “How much compliance is too much compliance: Is long-term ABA therapy abuse?” the author found that
“Compliance, learned helplessness, food/reward-obsessed, magnified vulnerabilities to sexual and physical abuse, low self-esteem, decreased intrinsic motivation, robbed confidence, inhibited interpersonal skills, isolation, anxiety, suppressed autonomy, prompt dependency, adult reliance, etc., continue to be created in a marginalized population who are unable to defend themselves.”
In “Invisible Abuse: ABA and the things only autistic people can see” , CL Lynch describes how the “new” ABA is still harmful. She includes several videos of typical current ABA practices. Her criticism is similar to those of other autistic authors- that ABA seeks to make an individual appear less autistic (by reducing harmless stimming, forcing eye contact, etc.), that it demands blind compliance, that it ignores reasons for “problem behaviors,” that it encourages autistic people to ignore their sensory needs instead of advocating for them and ultimately that their feelings don’t matter.
In “On hurling myself into traffic to avoid ABA therapy” by alexanderstreasuresblog , the author provides a first-hand narrative of his ABA experience including forced eye contact and the labeling of any of his protests/refusals as “scripting” (and so therefore, not valid and counted as a “problem behavior” according to the ABA therapists).
In the post titled “ABA” from the blog “Unstrange Mind” by Max Sparrow we are given a breakdown of the many problems with ABA as well as an account of personal experience. Please read the quote from the post below:
“A therapist might tell you that “a little crying” is a normal thing, but I was once an Autistic child and I can tell you that being pushed repeatedly to the point of tears with zero sense of personal power and knowing that the only way to get the repeated torment to end was to comply with everything that was asked of me, no matter how painful, no matter how uneasy it made me feel, no matter how unreasonable the request seemed, knowing that I had no way out of a repeat of the torment again and again for what felt like it would be the rest of my life was traumatizing to such a degree that I still carry emotional scars decades later. It doesn’t matter whether the perpetrator is a therapist, a teacher, a parent, or an age-peer: bullying is bullying.”
–The article “Why No Autistic Child Should be in ABA Therapy” by Shannon Des Roches Rosa provides yet another autistic perspective and an overview of the issues with ABA and how we need to change the way we support our autistic community: “…autistic children need supports and accommodations, not interventions based on non-autistic child development and conversion therapy.”
I have been researching this topic for over a year now and I keep hoping that there’s something I’m missing. I keep hoping the situation isn’t what it looks like. Because what it looks like is that people are making money compelling vulnerable parents to enroll their autistic children in absurd amounts of therapy hours- services which do not reliably meet their subjects’ target goals (which are problematic in and of themselves). These therapy services are based on archaic principles that the field of psychology abandoned long ago and methods created by an abusive monster conversion-therapist. These therapy services are performed on a marginalized minority of individuals- who have a PRIMARY DIFFICULTY EXPRESSING THEMSELVES VERBALLY- making them the most vulnerable population to abuse because they either can’t protest, or their protests are labeled as “problem behaviors.” I am not okay with this reality- and I keep doing more research hoping to find evidence that I’m wrong, but the more I learn, the worse it looks. This is a human rights issue that we need to, as a first baby-step, make the general public aware of.
More to come.