Saturday, 27 May 2017

Analysing Responses to ABA Critiques



I recently did a post about why I loathe ABA. What I noticed, in doing my research for it, is that there are an almost standard set of replies you tend to get from the pro-ABA crowd, when you critique it. I’d like to take those replies one by one, and analyse them.

1) “But my ABA isn’t like that”. Often called the “not-my-ABA” response. There is more than one possible reason for this.

a) You’re doing the ‘Not-ABA’ ABA. It’s quite common for other therapies that aren’t actually anything like ABA to get called that. If it doesn’t insist on compliance and repetition ad nauseum, doesn’t try to ‘normalise’ the child, or use any of the manipulative tactics I outlined in my post on ABA, then chances are it’s not actually ABA. Count yourself, and your child, lucky. But be aware that others aren’t so fortunate, and don’t generalise your own experiences to all ABA.

b) You’ve got the ‘nice’, ‘new’ ABA. The more modern ABA doesn’t use physical punishments, and its manipulations tend to be disguised under a layer of niceness, smiles and hugs. But don’t be fooled. If it still uses classic ABA techniques such as discrete trials and emotional withdrawal, and still demonises autism and tries to suppress autistic behaviours, it’s still ABA, and still harmful.

c) You’ve got the classic ABA, but you’ve been brainwashed not to see it. It happens. A lot of the ABA ‘therapy’ is actually training the parents into accepting that whatever the therapists do to the child is ‘good for them’. A typical ‘defence’ from these brainwashed parents is to insist there’s no difference between ABA and ‘normal parenting’ of the child. It should be obvious that there’s a world of difference between training a kid not to run out into traffic and trying to eradicate something that’s intrinsic to the child’s very nature. But they try to deny it anyway. Here’s a typical example, and an autistic response to it.

2) “But my child loves it/the therapist”. Again, several possibilities.

a) You’re not seeing the signs that say they don’t. Are you ignoring meltdowns? Are they frequent, or were they frequent at first, but then the child ‘settled down’? This is a danger sign – they’ve learnt that their fears and wishes will be ignored, and that they can’t trust the adults around them to respect their needs. It’s also possible that you’re simply not reading them right – our emotions are frequently not visible to non-autistics. 

However, the first generation of younger autistics who have been subjected to ABA are now grown up, and their opinion of ABA is pretty negative. Read here, and here, and here, for more on this. Read this too, by a parent who saw the light – unfortunately too late for their young son.

b) They’ve been brainwashed too. Here’s how it’s done. When children are being emotionally manipulated, having their boundaries disrespected, and/or having the therapist withhold favourite toys, etc, until they express the ‘right’ emotions, they often lose touch with what they really feel, and might even have convinced themselves that they ‘like’ it, after all, they’re always being told that they do, and adults are always right - aren’t they? 

c) They might simply want the ‘goodies’ offered. This one is an extension of c), and the result of the manipulation. When all your toys and favourite things are only available to you during therapy, at the discretion of the therapist, yeah, you might appear ‘eager’ for therapy too.

3) “But it works!” The Holocaust worked, if your goal was to eradicate most of the Jews of Europe. The Hiroshima and Nagasaki atomic bombs worked too, if your goal was to end the Second World War, and never mind what it does to the Japanese people. Just because something ‘works’ doesn’t mean it doesn’t cause immense damage along the way. You need to ask yourself, is it worth the cost?

You also need to ask yourself, what is your definition of it ‘working’? Is it the making over of your child into a ‘normal’ one? Or stopping them from ‘obvious’ autistic behaviours, such as stimming? Be warned that normalisation of this kind has a VERY high cost. Your child is far more likely to self-harm, become aggressive, get abused, become an addict, or acquire low self-esteem, depression, anxiety disorders or other mental health issues, as they get older. Is this really what you want for your kid?

It might be of course that your goals are simply things like getting them toilet trained. ABA is not the only way or even the best way to achieve this. There are other therapies out there that are far better and far more respectful of the child’s autonomy and autistic way of being. It’s worth remembering that we tend to be late developers, and even without rigorous ‘therapy’ of this kind, we can eventually reach the goals you want us to reach – in our own time, and when we’re ready.

It's also worth remembering that ALL BEHAVIOUR HAS A REASON. Yes, even the faecal smearing, headbanging, screaming, etc. If parents can figure out the reason for the behaviour, they stand a better chance of diverting their child’s attention to something else more socially acceptable or less harmful. Without that, you run the risk of eliminating one undesirable behaviour, only to have it replaced with something even worse, as the original need has not been met.

4) “But it’s scientific!” This is an outgrowth of ‘but it works’ (see my comments above). A good question is, what do they mean by ‘scientific’? It seems to largely mean ‘because we say it’s scientific’, and/or ‘because our trials prove it works’. This supposed ‘effectiveness’ of ABA is largely unquestioned, by the people that do it and the parents that support it, at least. (Plenty of autistics have other views of course, but we’re largely ignored.) 

There are three things wrong with this. Firstly, self-validated ‘research’ is not convincing scientific research at all. Just because someone says ‘my product is great!’, doesn’t mean we should take their word for it. Secondly, at least one trial has shown that ABA works no better than other therapies. And lastly, of course, that ABA is harmful even when it does ‘work’.

5) “It’s only a few high-functioning autistics who oppose it”. This usually goes with something like “you don’t understand my child”, or “the most severely autistic need this”. This is an issue I’m planning to address in another blog post, so here I’ll only say that –

a) It’s more than a ‘few’, and not just autistics, but many parents and former ABA therapists as well.

b) It’s not only the ‘high-functioning’ or even the very young who get ABA.

c) We get to define what harms us. Not the therapists.

One final note -  I have noticed when researching ABA that it’s a tremendously mixed bag. Because it’s become so popular, all sorts of people are offering it, with or without classic ABA training, and with all sorts of modifications upon modifications, and even, as I have said, many therapies that aren’t in fact ABA at all but are called that (in the US this is usually for insurance reasons). 

I acknowledge this. HOWEVER the truth remains, that the more classic ABA elements there are in your ‘mix’, the more harmful it is likely to be. Please, think very carefully before continuing down this path. For your children’s sake.

2 comments:

  1. Really good job on this. And I think these therapies that call themselves ABA need to be exposed, not because they're doing harm, but because it is incumbent upon them to be honest about what there therapy actually. Calling yourself ABA when it is not does a great disservice to parents who do not know any better. I get that you need to have your therapy covered to make it more accessible, but let's see a detailed description of what it is you are doing that you are disingenuously calling ABA. Also, I have written about the "science" aspect of ABA before on my blog. https://ageofneurodiversityblog.wordpress.com/2017/02/28/thoughts-on-the-science-and-evidence-of-early-intervention-and-aba/

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  2. Thank you for this very useful summary. I agree with every point you have made. As a student the early 1980s, I saw Lovaas beat up a 12 year old boy in front of a professional audience including psychologists and psychiatrists. Not one challenged his violence; behaviourism was much more dominant then in the social sciences. Sadly.

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