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, 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.

Thursday 11 May 2017

Why I Loathe ABA

I’ve always been suspicious of ABA, but I’ve held back on commenting on it much in the past, because I wanted to know what I was actually objecting to. But I’ve found that the more I researched it, the more my horror deepened. The result is that I am now more opposed to it than ever, for the following reasons. (Bear with me, this could be kind of long.)

1) Its Behaviourist Origins. The roots of ABA are in the behaviourism of psychologists like B. F. Skinner. I wasn’t impressed by this theory when I first encountered it at university more than 20 years ago, and I’m even less impressed now.

Behaviourists are only interested in measurable human behaviours, and regard underlying causes of these behaviours as irrelevant, or as something that will change if the behaviour is changed. Lovaas followed their ideas when ‘treating’ autistic children. He even saw autistics as ‘not-people’, empty shells, or raw material that, in his own words, he could ‘assemble into a human being’. 

ABA’s behaviourist approach tells them that autistic behaviours can be ‘extinguished’, and the child will then become ‘normal’ as a result. So, for instance, if an autistic child is stimming, ABA ignores WHY the child is stimming, ie what need it fulfils, and simply works to suppress it. 

2. Its lack of understanding of autism. Because ABA sees autism as just behaviours to be extinguished, ABA therapists usually have zero training in what autism actually IS. In fact, many of them have few qualifications and little training at all, in anything other than delivering the ‘therapy’. They consequently lack any understanding of the underlying neurology. They fail, most of all, to understand that autism is intrinsic to our very beings.

Even where ABA therapists do consider our motivations for behaviours, they invariably get them wrong. And they not only don’t really understand us at all, but refuse to try, or to listen to us when we try to explain. (They tend to simply reply with more jargon instead.) 

3) Its Alarmism. ABA therapists will tell you that your child only has a certain developmental ‘window’, and that if you don’t put them through intensive ‘intervention’, as young as possible, they are ‘doomed’. They paint a scary picture of your child becoming a faecal-smearing, head-banging, non-verbal, non-toilet-trained, highly dependent adult, if they don’t have this therapy.

It’s nonsense of course. It entirely ignores that autism is a developmental DELAY, and that there is no predicting how any child will develop in the future. They may not progress even if they’re ABA’d to the max, or they may progress just fine without it, but in their own time. Because a child is not doing ‘x’ at a given point, doesn’t mean they will never do it. Autistic personal histories are replete with instances of sudden leaps in abilities and skills. I have experienced them myself.

But ABA promoters don’t want you to know that, because that would take money out of their pockets. Make no mistake, ABA is primarily a money-making enterprise, and autistic children and their real needs and developmental trajectories come way down the list of importance. (It also seems to have some of the hallmarks of a cult, but that’s a post for another day.)

4) Its Creation of Compliance Junkies. ABA places great emphasis on training the child to do exactly what the therapists and other adults around the child want, when they want, as they want it. The child is not allowed to say no or refuse to participate. It uses repetition ad nauseum, till the child learns to ‘behave’, ie to do what is demanded, over and over, regardless of whether what is demanded makes any sense to them, or is even useful to them. They learn that their needs and wishes will be ignored, and that they must comply or else.

The end result is that ABA’s compliance/approval junkies lose touch with what they really feel. They become approval seekers, always doing as they are told, ignoring their own feelings and invasions of their personal and physical boundaries, and thus they become ripe targets for any abuser.

5) Its Abusive Nature. Forty plus hours of ‘work’ per week? Much of it boring and repetitive in the extreme? What other young children have that expected of them? The rigid insistence on the therapist/parent ‘winning’ against the child’s desire to get out of it is abusive in itself. The child’s will is systematically broken.

And that’s without the physical forcing often done – I have watched video after video where the child is pushed to do the ‘right’ thing with ‘hand over hand’ (ie the therapist forces the child’s hand to pick the right card etc), or pushed into or pulled out of a chair. Even supposed ‘rewards’ can be physically invasive, tickling and grabbing the child for a bearhug was also common. 

Manipulation is also frequent, and can be a form of abuse. Emotional withdrawal when the child does something ‘wrong’, or taking away the child’s favourite things and doling out time with them as a ‘reward’ for compliance, are common tactics. Any distress the child displays over this is ignored. Meltdowns are also ignored, as ‘unwanted behaviour’ that must be ‘extinguished’. They are not seen as the cries for help they actually are. 

Originally, ABA was accompanied by hitting or yelling if the child didn’t comply. Some (though not all!) modern ABA tends not to do that, leading some proponents to claim it’s ‘different’ to ‘old’ ABA, and hence not harmful. But don’t be fooled. Physical violence or no, mental/emotional abuse is frequent and almost intrinsic to the therapy.

6) Its Ignoring Consequences. Some of the first children who went through the whole ABA-for-years thing are now young adults. Many of them now suffer from PTSD, depression, anxiety disorders, low self-esteem, fear and mistrust of adults, or other mental health issues. Yet the ABA industry has never done any follow-up on the long-term consequences of their ‘therapy’, that I’m aware of. 

They also refuse to acknowledge that extinguishing an essentially harmless behaviour can see it replaced with another and far worse one, if the original need is still unmet. Suppressing stimming, for instance, can lead to an individual developing self-harming habits instead, such as cutting or gouging their skin. Or they might develop addictions, aggressive behaviours, suicidal ideation, etc.

But even these things, bad as they are, still don’t get to the heart of what I loathe most about ABA, which is this…

7) Its Demonisation of Autism. Autism is cast as a Big Bad Thing, a horrible ‘disease’ or epidemic, which has ‘stolen’ your child and which only ABA can ‘rescue’ them from. Parents are told that autism is ‘ruining’ their child’s life, and potentially that of the parents and the rest of the family also. So ABA is saturated in the autism-negative mindset. It promotes normalisation, at the cost of the child’s autonomy and natural way of being. It’s not alone in this, of course, but it does play a big role in perpetuating all this negativity.

The truth is that autism simply *IS*. It comes with its share of difficulties and problems, but it’s not a horrible thing to be in itself. The horrible part of being autistic is how we are treated, including by ABA therapists and parents who, having swallowed the rhetoric, have lost sight of the child in front of them, at least for now. Some do come out of this trance later, and regret what they’ve done, when they see the results in their kids. But many seem to be almost brainwashed – as do their kids.

ABA proponents have a standard set of answers for criticisms like the above, which I’ll get to in another post (this one is long enough!). For now, I have this to say – 

Autistics have the right to BE autistic. They have the right to behave autistic, to develop at their own pace, to receive support that actually helps them, and to be free of being coerced into behaving like the NTs they are not. They do not deserve to have an essential part of their very being quashed, denied, hated and forced into repression.

Please, parents, don’t ABA your kids. For their sakes, and your own.