Sunday, July 14, 2013

Why ABA therapy unsettles me

First, a crash course in what ABA therapy is. ABA stands for Applied Behavioral Analysis. In short, ABA therapy initially inspired by B.F. Skinner's work in operant conditioning. Basically, ABA is used to modify behavior, primarily by means of rewards and punishments (the psychological terms are reinforcers and punishers).

ABA therapy is the most commonly used form of therapy to "treat" ASDs. Specifically, the Lovaas model is used. This model recommends 30-40 hours of therapy per week in order to gain the best results. This many hours is recommended for children under the age of five. Yes, you read that right. Proponents of this model assert that autistic children aged 5 and younger should be in full time therapy. If that makes you uncomfortable, good. Sit with that discomfort.

And now I'll put up this disclaimer: I do not know everything there is to know about ABA. I have not personally been subjected to it. However, I have observed it in practice, and I have read numerous accounts by Autistic adults who decry it. I do know many Autism parents say that their child has greatly benefited from it. I will not be making sweeping generalizations and saying that all ABA is bad. However. Autistic voices should weigh more heavily than non-autistic voices in this matter, and there is enough bad out there to make me very unsettled by ABA in general and certain core tenets of it in particular.

My first problem with ABA is that it approaches Autism from the perspective of something that needs to be treated. It says that certain (many?) autistic behaviors need to be modified and made extinct. So from the outset, it is not respectful of Autistic people. It reeks of ableism, emphasizing that there are certain behaviors which are better or more right than other behaviors. ABA operates from the basic tenet that Autistic behaviors are not acceptable. This unsettles angers me.

One thing that ABA therapy does is it tries to teach autistic kids to engage in "functional play". I.e., "functional play" is however the neurotypical, non-autistic kids play. This is implying that the way autistic kids choose to use (or not use) their toys is dysfunctional by nature, and the autistic kids need to be retrained how to play in "functional" (read: normal) ways. This is absurd and I'm not okay with this. I hope you aren't either.

My second problem is that ABA therapy is a lot like dog training. Or more accurately, rat training. B.F. Skinner did his operant conditioning trials with lab rats. He used rewards and punishments to train his rats to push levers and go through mazes. He trained his rats to act in ways that were not natural for them. Your average dog owner applies similar behavior modification techniques to train their dogs to sit, stay, heel, etc. I'm unsettled angered by the fact that the leading "treatment" for Autism is often not too different from how we train animals.

"But Rae," you might protest, "what if kids engage in self-injurious behaviors (SIBs) that are damaging, and what about other problem behaviors? What about teaching them to communicate and other basic skills?" I am not denying the fact that there are certain interventions that may need to be employed. I'll reiterate this: My number one problem with ABA is that it often does not respect the basic human rights of an Autistic child and instead views them as less than human who need to have certain behaviors trained out of them (much like dog training), and replaced with "normal" behaviors. It operates from the viewpoint that Autism is lesser and needs to be fixed. It is steeped in ableism and posits that acting non-autistic is preferred.

So. If interventions and therapies do need to be used, they should start with viewing the autistic child as a person possessing inherent worth, not as a diseased/lesser person that needs to be fixed or changed or healed or treated. Start by seeing the autistic kid as a human being with unalienable human rights, and you'll be okay.

8 comments:

  1. This was EXCELLENT. I hope more people read this too. Very valid points. I have had ABA tried on me and it was VERY frustrating. Cognitive therapy helped with anxiety aspects but I do not like it when it is focused on AS exclusively either....I am so glad you wrote this. I will be reading it to my hubby too.
    YAY human rights!
    Love your passion!

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    1. thanks for the encouragement, friend! :) i hope your husband likes it!

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  2. I did not like ABA when they tried to use it on my oldest son who is autistic... so I pulled him out of therapy and he has done much better now without it. :) But i'm a hippy like that and I believe that I child learns best by the environment around them then learning about the world through flash cards.

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    1. I *totally* agree. It sounds like you're doing it right! :D

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  3. I watched the show talking back to autism and disagreed with most of it, the professionals theories and the way they talked about us and the lingo and speech about cures. I just hope most people don't watch it. Hearing professionals speak like that continues the myth. For instance they site that 80% of parents divorce with autistic kids ... Physchology today wrote that its a myth. Yes about half divorce but that half usually had a rocky relationship pre autism. There are many other factors. Or it was saying girls are way less on the spectrum... They've disproved that too. It's just that we are misdiagnosed. It sucks cuz it was made with such good intents and its educating people but in a way that furthers the ignorance and stigma!;) argh!!!! Don't watch it. It'll just frustrate you

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    1. Ugh...thanks for the heads up. I hate such awful misinformation. :/

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  4. My degree is in psychology. My behavioural professor had studied with Lovass. The footage was soul crushing. I took more courses than I had to so I could get to the course where it was shown as I wanted autistic eyes to witness it but I still cringe.

    I never got the hang of playing properly. All the same for a brief 3 year window because I could make up new playground games on the spot I was the centre of all lunchtime social activity.

    Of course since an autistic person cannot actually be creative enough for that to not need explaining. Nor social if they never learned all the proper behaviours someone would eventually point out this golden period of social competence was related to the pathology of using people as objects.

    Rolls eyes.

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  5. I wanted to let you know I linked to this post on my blog. Thank you for sharing your voice! http://www.onequartermama.ca/2014/10/autism-and-aba.html

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Thank you for taking the time to share your words with me. You are so Valued.