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Applied Behavioral Analysis

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Applied Behavior Analysis (ABA) is a psychological science of reinforcing behavior, which used to be called Behavior Modification, and is sometimes synonymous with the ABA subtype, Positive Behavior Support (PBS). Most people inaccurately think that ABA refers specifically to treating autistic children. ABA subtypes used for autistic children include Early Intensive Behavioral Intervention (EIBI) and, for older children, the Lovaas Model, which is named after its inventor, Dr. Ivar Lovaas. Pivotal Response Treatment (PRT), formery called the Natural Langauge Paradigm, is a play-based teaching methodology that utilizes the science of PBS to modify behavior.

EIBI begins with an intervention that focuses on, what is known as, Discrete Trial Teaching (DTT), which is a one-to-one interaction between the child and a trained therapist, who creates a highly structured, individualized and systematic learning environment. The process requires a significant investment in time to be effective; Lovaas recommends 40 hours a week of intensive therapy for two years. [1]

In the intervention, skills are broken down into small, achievable tasks. Every task then consists of three parts: The therapist asks the child to perform a specific action; the child responds; and the therapist reacts to the child's response.

When the child successfully completes a task, the therapist gives the child praise and reinforcement. The rewards for successful completion may be small bites of food, playing with the child's favorite toy, hugs, and tickles. Gradually, external rewards like food and hugs are replaced with verbal praise and social reinforcers. Aggressive and self-stimulating behaviors are redirected into more socially acceptable responses.

Eventually, it is reccomended to further "generalize" what the child has learned with EIBI-based methods using child instructed, play-type methods in more natural settings such as Natural Enviroment Teaching (NET, a generic term for Incidental Teaching) and Fluency-Based Instruction.

Research shows that utilizing both structured and play-based EIBI methods yield the most effective results. Moreover, 42% fully recover in that they no longer have deficits in social interaction, sterotyped behaviors or interests, or in verbal and non-verbal communication. They also no longer show signs in the core deficit of autism spectrum disorders (ASD): mind-blindedness (or Theory of Mind).

2007 studyEdit

A study completed in April 2007 by the UK foundation Research Autism found that 25 hours a week of therapy could significantly raise IQ scores. [2] According to news service NewsWales, "IQ increased for two thirds of the children receiving the early intervention and very substantially for more than a quarter of them. For example, one child moved from an IQ of 30 up to 70; another from an IQ of 72 to 115. Most of the population of the UK has an IQ of between 85 and 115." [3]

Criticism Edit

ABA therapy has been roundly criticized by the people who have experienced it. They argue that ABA is full of ethical violations, and reduces children's skills by undermining their independence,[4] and causing emotional damage.[5][6]

The Foundation of ABA Edit

ABA holds that if you make a child behave in the way you want, their brain will eventually change until it works the way you want.[7] Autism advocates consider this dangerous, because it ignores the thought processes behind the behavior.

The goal of ABA is to "make the child indistinguishable from his or her peers." This alone gives many advocates pause.[7] They argue that no child should be forced to become someone who they are not. Tactics such as Quiet Hands, a practice that involves physical restraint and can result in Post-Traumatic Stress Disorder,[8] are commonplace.

Children as the Enemy, and Lack of Consent Edit

Many ABA therapists have fought against their patients, rather than working with them. Autistic people argue that the intense 40-hour weekly schedule, just as demanding as a day job for adults, is designed to break the children's will.[9] Videos of ABA show therapists waving candy in front of sobbing and confused children, while the therapist tells the parents that they will not let the child "win."[10]

ABA therapists will continue fighting even when the child is clearly distressed. Crying,[11][6] attempting to leave the room,[10][6] screaming for help,[12] and lashing out are labeled "tantrums"[12] and do not result in the therapist stopping. In some cases, the therapist may become violent.[6] The child is given no way to communicate a withdrawal of consent, and may begin resorting to violence because a verbal "no" never meant no.[13][14]

This is particularly dangerous when considering the fact that autistic people are more vulnerable to trauma.[15]

Compliance and Coercion Edit

ABA therapy relies on a child obeying everything that an adult asks.

Children's agency may be completely ignored. Alternative communication devices may be taken away,[4] protests may be written off as "tantrums" or manipulation,[16] and children may be physically grabbed and moved[17] (regardless of whether they want this or not).[4]

The emphasis on complete obedience may make a child unable to say no when needed, making them vulnerable to sexual abuse in the future.[18][19]

Goals Edit

Self-advocates and parents alike have expressed concern about the goals that many ABA therapists define. They call into question whether forcing a child to do something for the sake of others' comfort is worth it,[16] especially when these goals come before skills such as expressing basic needs.

  • Making eye contact (which may be highly distracting[20] or painful[21] to autistic people)[17]
  • Hugging or kissing on cue
  • Smiling on cue[19]
  • Toilet training (for the sake of the child's peers, not because the child seems ready)[17]
  • Touching the nose,[14] and other tasks that feel pointless to the child[22]
  • Speaking (rather than communication)[13][14]
  • Saying phrases that please the parents before teaching how to express basic needs (e.g. "That hurts" or "I need a break")[10][13]

Ethical Violations Edit

ABA has been roundly criticized for violations in ethics. It dismisses the parents' right to know by claiming that "autistic regression" is a regular phenomenon, and that all autistic children are or will become anxious and violent, when these changes may in fact be caused by trauma.[12] Parents may be barred from witnessing ABA, on the grounds that they would intervene.

Michelle Dawson has written an in-depth criticism of ABA and its ethics.[23]

Can ABA ever be helpful? Edit

Autistic advocates are split on whether there are any helpful forms of ABA. It is important to note that some consensual therapies are labeled ABA for tax purposes, and thus the "ABA" that one child receives might be radically different from the form of ABA described in this article.

Some advocates believe that ABA is irredeemable, because behavior modification is inherently demeaning, and its intense schedule requires total control over the child's life.[24] A minority of activists believe that in some more drastic cases, carefully-monitored ABA can be consensual and constructive.[4] One autistic mother has ABA for her daughter, which teaches her to redirect destructive stimming, and allows her to ask for a break whenever she needs it.[25] The mother monitors the sessions to keep up with what her daughter is learning, and make sure that everything runs smoothly.

Safety Tips for Parents Edit

Parents can help keep their child safe by evaluating the following for a specific kind of therapy:[10]

  • Are you allowed to witness what is going on?
  • Does the child enjoy therapy? (A good therapist can make therapy be enjoyable, and let the child feel a sense of agency.[10])
  • Can the child express the need for a break?
  • Are basic needs held hostage? Will the therapist ignore a "no" because it isn't stated in the "correct" way?
  • Does the therapist want to end stimming?
  • Is the therapist trying to help the child feel happy and be competent, or trying to make them appear normal to others?
  • Is the child's competence being presumed?[21][26]
  • If your child is typically nonviolent, do you hear about them becoming aggressive in therapy?
  • Would you be comfortable with a non-autistic child being treated this way?[4][16]
  • Is gaining speech being prioritized over communication?
  • Is the child afraid of their therapist?

Know that it is possible to have a happy life with an autistic child. [13] If you feel that a therapy is hurting a child, it isn't too late to stop it: parents have stopped controlling therapies and reported that their children are doing much better.[14][16]

Parents suggest occupational therapy, exercise, and alternative communication apps as alternatives.[27]

External linksEdit

ReferencesEdit

Be warned: some of these articles contain highly disturbing content, such as descriptions of Post-Traumatic Stress Disorder, violence, and abuse.

This article's references contain many personal testimonies in the hopes of revealing the consistent culture of gaslighting and obedience in ABA. This is how "real ABA" looks to the people who have experienced it day after day.[28]

  1. The National Autistic Society: "Lovaas"
  2. Research Autism: "Outcome of early intervention for autism", April 2007. PDF file.
  3. NewsWales: "Wales breakthrough on autism"
  4. 4.0 4.1 4.2 4.3 4.4 Would you accept this behavior towards a non-autistic child?
  5. Children Injured by Restraint and Aversives: Parent Testimonials Regarding Dangers of Behavior Modification
  6. 6.0 6.1 6.2 6.3 An Open Letter to Families Considering Intensive Behavioral Therapy for their Autistic Child Part 2
  7. 7.0 7.1 Unstrange Mind: ABA
  8. Julia Bascom: Quiet Hands
  9. Autism Myth Busters: The Truth About ABA
  10. 10.0 10.1 10.2 10.3 10.4 Unstrange Mind: Helpful vs. Harmful Therapy
  11. ABA is Not "Tough Love," It's Abuse
  12. 12.0 12.1 12.2 An Open Letter to Parents Considering Intensive Behavioral Therapy for their Autistic Child
  13. 13.0 13.1 13.2 13.3 Caring for an Autistic Daughter Note: The child in this story is nonspeaking, has epilepsy, and would be labeled "severely autistic" by anyone who asks. Don't assume that your child is "too low-functioning" to ever be happy.
  14. 14.0 14.1 14.2 14.3 Touch Nose, Gummi Bear: ABA in Our Family
  15. Emma's Hope Book: Trauma and Autism
  16. 16.0 16.1 16.2 16.3 Emma's Hope Book: Tackling that Troublesome Issue of ABA and Ethics
  17. 17.0 17.1 17.2 Thinking Person's Guide to Autism: The Cost of Compliance is Unreasonable
  18. Parenting Autistic Children with Love and Acceptance: Compliance Therapy and Sexual Abuse
  19. 19.0 19.1 Unstrange Mind: No You Don't - Compliance Training
  20. Indiana Resource Center for Autism: Should We Insist on Eye Contact with Autistic People
  21. 21.0 21.1 Emma's Hope Book: More on ABA
  22. Quotes from Ido in Autismland
  23. The Misbehavior of Behaviorists: Ethical Challenges to the Autism-ABA Industry
  24. Real Social Skills: Why I Oppose ABA
  25. My Experience with ABA: The Good, The Bad, and The Ugly
  26. Emma's Hope Book: What is Presuming Competence?
  27. Emma's Hope Book: Early Intervention
  28. Emma's Hope Book: Controversy and Commenting

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