What needs to change about ABA?
“I’ve heard awful things about ABA”, “ Adults that had ABA therapy as a child have said they have post-traumatic stress from it”, and “ABA wants to change who people are”. These are just some of the worries and concerns that I have heard from the wider community about ABA services. I will admit, at first, I felt shocked and upset hearing and reading about these criticisms. I wanted to say, No! ABA is good! It’s here to help people learn important skills and live their lives and participate in things that they enjoy! I wanted to immediately rush to the defence of the field I love so much. But, I didn’t. I paused, took a deep breath, and kept listening to and reading about these experiences. And it made me think; if people are experiencing awful things from ABA and are being traumatized - how did this happen? What went wrong? Or maybe the underlying question is, what needs to change about ABA?
ABA is for all of us - not just a select population with a diagnosis - it is for us all. And the behaviours that are selected for treatment have to be significant and helpful for that individual in their lives. ABA should never be used to treat behaviour to change who a person is or to make them seem “normal”. That is not ethical, that is not good ABA.
The society in which we live has particular expectations or “social norms'', that are expected of us all. Right from the start society places us and our behaviours in a box and says if you exist outside of this box, you aren’t “normal”. Some of what we are told in order to be “normal” are things like, “make sure to be polite to others”, “look people in the eye when you talk to them”, “sit still and pay attention”, and the list goes on. We are told that if we behave in these ways, that it will help us to be successful in the world, get jobs, and make money, people will like us and we will have lots of friends. For some, these skills and abilities may come naturally and for others, maybe not as much, and for a variety of reasons. If these skills don’t come easily to you, does that mean you have to change? Well, it seems and rightfully and relievingly so, that this idea of “normal” is constantly shifting and changing into the current era that we are in today; an age of awareness, acceptance, and celebration of neurodiversity. But how does ABA fit into that world? After all, ABA is all about changing behaviour. For ABA to continue to be helpful and relevant in this new age, it needs to continually evolve in a variety of ways.
ABA needs to be regulated. ABA should be implemented by trained, qualified professionals. BCBA, RBTs, and others that are supervised by a BCBA. If someone has completed a weekend workshop about ABA - this does not make them a professional in the field AND they should not be implementing any ABA with anyone. Just like any type of therapy (e.g., CBT, psychotherapy), ABA has to be implemented only by trained, qualified professionals that have experience and are being supervised by a BCBA. Ontario has taken a step to ensure that ABA is regulated in the province - this will be very helpful at preventing harmful practices from occurring. ABA should never hurt; ABA should only be helpful. And if it’s not helpful, then the strategies need to be modified to make it helpful and effective.
ABA needs to be ethical. If a clinician is implementing ABA in an ethical manner, abuse and trauma will not be part of that service. BCBAs and RBTs are bound by an ethical code that ensures safety and quality services for the people and families they serve.
ABA needs to continually improve and make changes to better serve our community. ABA is not only used to serve the ASD community, it’s used for people with acquired brain injury, people with dementia, organizational behaviour management, exercise and sports, and so much more. ABA is for all of us - not just a select population with a diagnosis - it is for us all. And the behaviours that are selected for treatment have to be significant and helpful for that individual in their lives. ABA should never be used to treat behaviour to change who a person is or to make them seem “normal”. That is not ethical, that is not good ABA.
We need to listen to our friends in the autistic community and their families about what needs to change. We need to focus on important behaviours for the individual to help them recognize and build upon their strengths and abilities and be able to participate in things they love.
ABA has evolved a lot throughout the years and it needs to continually evolve with changing perceptions and needs of our community. ABA is not a “treatment” for ASD- this is a misnomer. In the past, this is how it’s been “packaged”. This implies that ASD is something to “cure” (when this is not the goal or point of ABA). We need to listen to our friends in the autistic community and their families about what needs to change. We need to focus on important behaviours for the individual to help them recognize and build upon their strengths and abilities and be able to participate in things they love. The world we are living in is changing rapidly which is a great thing and ABA needs to continually change with the times and make adjustments as needed to serve our community in the most effective, ethical ways possible. If we aren’t listening, then we aren’t helping. What we are hearing is that some people, unfortunately, have received bad ABA, unethical ABA, that should have never happened. Gorycki et.al (2020) stated that “ABA is not perfect, and continues to evolve, for the benefit of the individual with ASD, family, guardians, and service providers. Criticism is welcome. Practitioners of behavior analysis have been taught to “look at the data” and to adopt a basic philosophy of science, that of “philosophic doubt,” meaning to question current data when new data arise that conflict with current practice. In that regard, criticism is welcome, “it may help improve the quality of services and, ultimately, improve the quality of the outcomes for individuals with ASD.”
Reference:
Gorycki, Kathryn.A., Ruppel, Paula.R., Zane, Thomas (2020). Is long-term ABA therapy abusive: A response to Sandoval-Norton and Shkedy, Cogent Psychology, 7 (1), https://doi.org/10.1080/23311908.2020.1823615