ABA – A Point of View
Let’s get one thing out of the way. ABA services are controversial. And the controversy is well deserved. And not all of you will agree with the below.
There are many, many, MANY sources of information, opinion, personal stories, historic treatises, and research available on the internet. My goal is not to capture every detail and nuance or to synthesize it all. This is a back-of-the-napkin overview. I also am not interested in trying to please everyone in my position on the use of ABA as a support of autistic individuals. If you disagree with the information or my point of view in this blog, you have my blessing to live your own truth around this issue. In addition, I know ABA services are restricted by funding policies and this is a factor in how ABA is provided but I won’t get into that either here. Finally, there are staffing issues that are just a reality of ABA and that is a whole other issues that impacts the quality of ABA. Sigh…….
But on to the POV
A SHORT history of the dark underbelly of ABA, in case you didn’t know: There is a long history of ABA being used to “improve” the lives of autistic children. Unfortunately, in the early days these services missed the mark because “improvement” was interpreted as discounting the individuality, distinct personality, unique quirks, and distinctive habits that were an integral part of who an autistic person was. In essence, based on the research of Lovaas et al and published in 1985, the misguided (IMO) goal was to make an autistic child “indistinguishable from their typically developing peers” (Lovaas, O. Ivar (1987). "Behavioral treatment and normal educational and intellectual functioning in young autistic children". Journal of Consulting and Clinical Psychology.).
To be sure, there are a lot of problems with this goal on the face of it. However, the merits of this goal have to be taken in the context of the time period. And to be fair, this was a much better practice from what had come before this research; marginalization, disdain, bullying, scorn and institutionalization. For the most part, autistic people were not “treated” or education, they were thrown in institutions (i.e. as was recommended in the movie Temple Grandin). So seeing autistic people as being worthy of treatment was progress.
But this doesn’t mean that this approach didn’t cause trauma of its own. It was inherently NOT person centered, did not value the uniqueness of the autistic person, did not respect the right of the autistic individual to have their needs met, and did not value to needs and presentation of this person as much as a “neurotypical” standard, did not acknowledge the strengths of a different way of doing things. The broad brushstroke was often experienced by the autistic person being taught that they, as they were, were not “acceptable” and had to be something different. And what was often used to bring this about what that the things the child valued the most or gave them comfort were hijacked and leveraged as “reinforcements” to compel the child to mold themselves to this neurotypical norm. And this doesn’t even speak to the use “punishments” or “extinction procedures” that are part of ABA and were delivered often with a lack of nuance or compassion. The trauma the then-children and now-adults who went through this is very real, and the controversy and condemnation of the ABA practices by these people is well deserved.
And…. there is another story. ABA is the “applied” practice of Behavior Analysis, or in other words the analysis of behavior, or in other words learning theory. It is the application of the scientific understanding of how organisms, including people, learn. This understanding was/is used to develop the constructs of ABA that are implemented to help autistic people learn things that will make their life better. That in itself is not a bad thing, it’s just a thing. Organisms - individuals, children, adults - we all learn according to this learning theory. It’s the way the specific interventions are constructed and delivered, the APPLICATION, of this learning theory that can be marginalizing, discriminatory, or traumatic or it can be positive, empowering and person centered.
My point of view is that applied learning theory, or ABA, can be applied in ways that keep its integrity intact but also put the person receiving treatment at the center of the interventions. That the person can be valued, respected, acknowledged, and lifted up. That the ABA treatment is not focused on erasing and invalidating the person’s neurodiversity but to help this person lift up what is empowering, mitigate what is hindering, and learn new tools that are available should they become useful and the person chooses to use them. ABA can be a powerful tool to help an autistic child, teen, or adult to learn skills they can choose to use and teach them how to determine how and when to use them to have the better quality of life in the way they choose. Period.
So, as with all things, the important consideration is not whether this learning theory or ABA is good or bad, but instead what techniques are used within the paradigm, what is targeted to support, and HOW the theory is applied.
The application of learning theory can be used to help an individual gain a skill they are struggling to learn and for which not having this skill is causing pain, marginalization, lack of empowerment, and loss of opportunity. The key is for these techniques to be used in collaboration WITH the individual vs applied TO the individual (even children), to empower the individual vs subduing the individual, to teach skills that are relevant to the individual vs making the individual compliant with others’ wishes. ABA can and should be applied in a way that is in alignment with the wants and needs of the individual under treatment, and should ALWAYS have the individual at the center of the treatment.
So how to do this is a big topic and is surely to spark debate. But IMO, this should be done by, in short, supporting the autistic person to identify their own goals (with support if necessary) and not have goals prescribed to them by parents or professionals. This can be the first goal of ABA – to identify my own goals. The autistic person should be in control of who they work with, and have the power to change behavior professionals if they want. This is a great way to support a self-advocacy goal. The Autistic person should have agency to direct the treatment and be supported to discover what will help them meet their own goals. You get the idea…. In the end – the process of this treatment is in many cases just as important as the product. The empowerment and validation of the autistic person through the ABA process is a goal in and of itself.
So, what is my point of view of ABA and its validity and usefulness in supporting our kids to reach their goals? It’s a powerful tool that can help our kids learn valuable skills if used in a person-centered way. So, if you have access to it, use it.