There is no treatment and certainly no cure for Autism, which is a difference, not a disease.
ABA is generally the first, and often the only, practice suggested to parents when their child is diagnosed.
While generally referred to as a therapy, it is better understood as a practice or or framework. For instance, it differs from psychology which is an integrative multilevel science, in which the combination of cognitive, social, and neuroscience topic areas are used to understand the inner workings of mirror neurons, and by extension, social behaviors of imitation and empathy. ABA looks to explain behavioral variability by appealing to internal causes that are typically seen as inside the mind (e.g., mood states, personality traits). Behavior analysts seek to identify how changes in the environment that occur as function of a behavior occurring relate to the occurrence or non-occurrence of that behavior in the future. It looks to identify functional relations between these two variables (behavior and its consequences). Analyses of behavior are conducted using the Operant Learning Paradigm. "... it’s a branch of science concerned with the application of basic principles of behaviour and learning to solve socially important problems and teach functional life skills.
Dr Erin Leif, Monash University Master of Education in Applied Behaviour Analysis
APPLIED BEHAVIOURAL ANALYSIS (ABA)
Applied behaviour analysis (ABA) is an intensive, individualised practice advertised to make autistic children behave in more ‘normal’ or socially acceptable ways. ABA claims to teach Autistic children basic life skills, including language, social and motor skills and to reduce stimming, non-compliant and ‘challenging’ behaviours, which may be (assumed to be) obstacles to learning.
WHAT DOES ABA INVOLVE?
ABA programs are based on functional behaviour assessment, which identifies the purpose of behaviours. Children are observed, and data on their behaviours, communication and task performance are collected and analysed. An extensive report sets out what the child can do, prescribes goals and a program for changing specific behaviours, (and progress since the last plan).
This plan aims to train the child to substitute more ‘normal’ behaviours that meet the same needs as their natural behaviours. Replacement behaviours are not selected by the children, nor must they consent to the plan. Goals range
from reducing self-injury and absconding to reducing swearing, daydreaming or repetitive questioning. A program may even seek to reduce or eliminate the pursuit of special interests – which help autistic children to regulate emotions, restore their energy and feel safe.
HOW DO YOU ‘DO’ ABA?
ABA programs train children by reward and punishment. Rewards (e.g., emotionally laden praise, hugging, food, tradeable tokens) are more commonly used today than the electric shocks, slapping or beatings used in the 1960s-1980s. Training may include forced physical and eye contact, deny children control of hours of their lives, and may teach the dangerous lesson that adults’ demands must be complied with.
WHAT ARE THE EFFECTS?
Now called ‘good’ or ‘new’ ABA - and many, less transparent names* - all forms of reward and punishment are aimed at correcting the child.
ABA teaches Autistic children that their natural way of being is wrong, which can lead to life-long mental health issues.
ABA practice assumes that Autistic children are motivated by rewards. This is not guaranteed and is especially unlikely in children who are demand-avoidant. Equally, a modern ABA punishment like a time-out may feel like a reward to some children. Children may learn by example that words like ‘no’ or ‘stop’ can be ignored. ABA is claimed by some supporters to be scientific, although the evidence presented is poor and behavioural improvements are not well-maintained when ABA ceases or generalised to new contexts.
IS IT WORTH IT?
ABA is time-consuming and costly. Some well-endowed autism charities fund the ABA movement to offer ABA diplomas to teachers, run dedicated ABA boarding schools and falsely advertise ABA as the only treatment or as a cure for autism. The impact of ABA on family life (and finances) is significant: ABA is intensive, at up to 40 hours a week for pre-schoolers, and up to $200,000 per year.
It is important to know that the impact on Autistic people who have experienced ABA includes many reports of trauma which continues to affect their adult lives.
*Practices that are typical of ABA include table-top training, token economies, task analysis, shaping, prompting and fading, hand over hand techniques, chaining,
Various types of ABA and other practices that may do harm can be seen here:
Warning signs for practices that are ABA, or seek to "treat" Autism:
For more information:
Millman, Carol (2019). Behaviorism is dead. How do we tell the parents?
Milton, D. (2020). Applied Behavioural Analysis and the autistic community: time to listen. In: Are We Asking the Right Questions About Behaviour? https://kar.kent.ac.uk/83599/1/ABA%20and%20the%20autistic%20community%2C%20time%20to%20listen.pdf
Shoyer, D. (2015) ABA and Autism – the thorny problem of control and consent
Shyman. (2016). The reinforcement of ableism: Normality, the medical model of disability, and humanism in applied behaviour analysis and ASD. Intellectual and Developmental Disabilities, 54(5), 366–376. https://doi.org/10.1352/1934-9556-54.5.366
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