Why we oppose ABA in any form

by Autistics for Autistics Ontario

Autistics for Autistics opposes ABA in any form, because ABA is founded on a dehumanizing, segregationist approach to autistic people.

Applied Behaviour Analytics (ABA) — an autism therapy based on the works of BF Skinner and O Ivar Lovaas–is predicated on a medical model of autism (autism as a set of behaviours to “fix”) and is a holdover from the era of residential institutions. ABA stands in stark contrast to current understandings of autism based on the social model of disability. Under the social model of disability, the community is best served through inclusive services and accessible design.

In this piece, we give 5 reasons not to support ABA, offer historical background into ABA and discuss alternatives to ABA.

Reason 1: Autistics who have undergone ABA are more likely to suffer from PTSD. The risk of suicidality is also significantly higher for ABA participants.
Research shows that ABA is overwhelmingly traumatic and has a lifelong effect. One study linked increased exposure to ABA with increasing severity of PTSD. There is also a correlation between ABA and suicidality according to a study by the International Society for Autism Research.

Behaviour is communication –but instead of listening to the communication, ABA providers silence their students with aversive and “rewards”. For example, when an autistic toddler flaps her hands, she is communicating something to the adults around her (that she is excited or upset, for example). An ABA provider will say “quiet hands” or physically hold down the child’s hands to discourage this communication. Quiet Hands and other aversives severely impact autistics’ expressive abilities and have a lifelong effect.

Reason 2: ABA training makes children vulnerable to abuse throughout their lifetime.
A child is not allowed to say “no” in ABA. ABA teaches compliance at any cost: children are told over and over to ignore their gut feelings and abandon their sense of personal space. ABA providers punish children who say no, using aversives such as taking away something the child loves (in the “nice” ABA) or physical aversives like electroshock (in other forms of ABA.)

Adults may see it as “success” that a child no longer expresses views or preferences, but in fact it is a devastating loss. Punishing autistic children for saying no has long-lasting psychological effects and can impact future judgement and relationships, making us particularly vulnerable to sexual and other physical abuse throughout our lives.

Reason 3: Young children who undergo IBI or ABA are denied a normal childhood.
Many ABA/IBI centres keep toddlers and preschoolers in 25-40 hours a week of therapy at a time in their lives when they should be connecting with their families, playing outside and getting to know the other children in their neighbourhood. They are segregated from their peers into “intensive” ABA centres… the beginning of a lifelong pattern of segregation.

Full-time therapy is recommended simply because is profitable for the ABA industry. There is no rational reason for it. Children in jurisdictions that do not broadly support ABA — such as in the UK — learn life skills without it. In fact, they are better able to integrate into mainstream classrooms because they have been in proximity to their peers from early childhood. This intensive approach of ABA is not natural, and it is counter-productive to healthy child development.

Reason 4: Autistic people do not like or want ABA. 
Really, this should be the only reason we need to give. The very people being “served” by the therapy report trauma from it. Autistics overwhelmingly report that their experience of ABA is negative. In a survey of 11,000+ people, 98% of autistics opposed ABA. These findings are standard, whenever a survey or study is done on autistic views on ABA. In fact, we have yet to find an autistic adult who experienced ABA and endorses it.

Autistics deserve to feel comfortable, safe and have dignity at every age. Unfortunately, our province still funds programs that force autistic children to receive a century-old “treatment” that they do not want.

Reason 5: There are better ways than ABA — but ABA organizations lobby for dominance.
The ABA lobby uses fear to sell its product, claiming that only their “life-changing” therapy can help autistic children learn life skills or communicate. That is a lie.

There are many therapies, services and approaches that effectively teach life-skills. AAC, the communication platforms that assist non-speaking people, were invented by teams including autistic people and are in no way affiliated with ABA. And there are always better ways than ABA. Read our Human Rights Report to learn more about the impact of ABA-run public policy and read our report on the Ontario policy situation to learn how the ABA lobby shut out useful services in Ontario.

History and philosophy of ABA

ABA, also know as autistic conversion therapy, is a form of Radical Behaviourism, which has its roots in the thinking of BF Skinner, who studied animal subjects in the 1930s and 1940s, using electric shocks and other aversives to control animal behaviour. ABA’s founder, O. Ivor Lovaas, did not understand autism and the myths he perpetuated still power the ABA movement.

Writing about his autistic patients, Lovaas stated:

“You have a person in the physical sense –they have hair, a nose, a mouth, but they are not people in the psychological sense. One way to look at the job [of autism therapy] is to see it as a matter of constructing a person. You have the raw materials, but you have to build the person.”

Sadly, in ABA literature we still often still see the idea that autism is a deviation to be fixed and a “real” child constructed through the therapy.

Countering this myth, autistic self-advocate Maxfield Sparrow writes: “Autism is not a shell surrounding a ‘normal’ child. …Autism in your child’s DNA, brain, sensory organs. Autism is so much a part of who your child is that many of us Autistic adults who are able to communicate, and who choose to talk about being Autistic, will tell you that it hurts us to hear or read phrases like ‘fight autism,’ because it feels like people want to fight us.”

Lovaas was also the founder of a brutal gay conversion program, which falsely claimed to stop young people from being gay. Gay conversion therapy is now illegal for children under age 18 in Ontario because it violates human rights. It has also been banned in many jurisdictions for adults because it violates the Charter. Similar to its founder’s gay conversion therapy method, ABA likewise attempts to convert autistics towards the goal of appearing “indistinguishable from peers” –at any cost.

The Practice of ABA
Through ABA’s early interventions, autistic children are exposed to hundreds of repetitive discrete trials, where they are forced to perform simple tasks over and over to earn rewards or –if they don’t perform– they are given aversives, which range from electric shocks and other physical punishment to psychological torture such as being isolated, having beloved objects taken away or providers refusing to address their communicated needs.

One example of physical aversives in ABA at a residential/day centre is the Judge Rotenberg Center in Massachusetts, where autistic and other disabled residents are deprived of food and given electric shocks to correct “behaviour”. While the Center has been condemned for its practices by the United Nations among others, note that none of the major professional organizations of ABA providers have condemned the actions of the Center. (For updates on the campaign to stop the use of shock aversives, visit the ADAPT website).

In Ontario, children as young as two years old are put into programs that consist of 6-8-hours per day of repetitive drills at a therapy centre – segregated from their neurotypical peers (who, unlike them, get to engage in free play and other developmentally appropriate activities.) At the end of the child’s day, ABA drills typically continue in the home because parents are told to continue the program there, essentially playing the role of therapist rather than parent. This can quickly erode trust and compromise the parent-child relationship.

Forbes science writer Emily Wilmingham points out: “With ABA, the burden is on the child to somehow understand and modify behavior in situations that they often aren’t even old enough to intellectualize.” With other approaches, “the onus is on the [parents and teachers] to understand and communicate with their child, rather than to try to ‘fix’ them.”

Why ABA doesn’t work
ABA’s impossible expectation (for the child to act the same as neurotypical peers) is a setup for failure –and failure is too often blamed on the child. Parents who start out with a standard ABA program may then be encouraged to increase the intensity of aversives; an example would be a parent who escalates the situation and engages in practices that are damaging to the child.

Children who react naturally to the (highly unnatural) expectations and protocols of ABA are seen as “non-compliant”, resistant and burdensome to practitioners and even to some families. And then the situation escalates.

As a former ABA provider writes: “The overall concept of compliance training is an integral part of many ABA programs. The rule is, once you give a command as an ABA Therapist, you must follow through with it no matter what. If a child tries to cry or escape or engage in any other ‘behaviors,'” the therapist can’t intervene to help or comfort the child.

Even if the ends could justify the means, ABA doesn’t appear to actually “work”. Research reviews show that ABA studies have been historically plagued by poor methodology. As neuroscientist Laurent Mottron of the University of Montreal writes in his study, ABA research’s “efficacy has been called into question in the last decade due to poor-quality data, small effects, low cost-efficiency, and the evolution of ethical and societal standards.”

Unsurprisingly, newer research in the neuroscience field is incompatible with the Behaviourist approach.

The Politics of ABA
There are alternatives to ABA; in fact, many jurisdictions outside of Ontario (such as the UK) have stopped funding ABA in favour of useful services and therapies. Other jurisdictions provide a range of service options, not just ABA.

Unfortunately, after the Ontario Association for Behaviour Analysis hired lobbyists targeting eight Ministries at Queen’s Park in 2017, the government unveiled a $500 million government autism plan (Ontario Autism Program) where only ABA is funded, only ABA is allowed in schools –and therapists who receive public funding (including SLPs and OTs) now must become ABA-certified. Ontario’s entire autism programming budget has thus been earmarked for ABA. Some parent-led organizations also have professional relationships with the ABA industry.

Why is ABA the mandate in Ontario, since so many jurisdictions have abandoned it and autistics consistently voice against it? Partly it is because ABA is the only provincially-funded therapy (due to lobbying), so some parents and teachers believe that it is better than nothing. From talking to parents, we have also learned that some were frightened into thinking ABA was the only way to help their child.

Typically, providers tell parents ABA is their “only hope” and “the only evidence-based early intervention.” The term early intervention simultaneously lends providers a veneer of professional credentials, as well as creating a sense of panic that causes parents to make radical decisions about their child’s care in haste.

ABA versus Acceptance
Some parents also support ABA for a more disturbing reason: the idea that their autistic child is not the child they wanted, and the desire to transform their autistic child into one that mimics a neurotypical child.

Whether the child is autistic or neurotypical, every parent has to eventually accept that they are not getting the mini-me they may have dreamed of. The later this knowledge comes, the more damage is done. Many of us have felt this rejection from our parents and it doesn’t get any easier. No matter the therapies, we cannot change who we are. So when our parents perceive us as perpetually not good enough, not NT enough, it has a profound effect.

As Aaden Friday writes in their essay When You’re Autistic, Abuse is Considered Love: “I was told that I was loved every day, and yet I sincerely believed there were parts of me that I needed to destroy in order to be worthy of that love — and so I tried, and failed, and grew up traumatized, without ever understanding what healthy love looks like.”

In contrast, autistic acceptance is crucial to ensuring a child gets the supports they need. ABA’s focus on “behaviour” often makes it confusing for parents to recognize and accept their child’s needs, because much of the child’s communication efforts are mislabeled as “negative behaviours” to be punished rather than communication to be responded to. In addition to being cruel, this approach also stymies problem-solving and alienates parents and children from each other.

There is no “good ABA”
Some of us have been asked if we support “the good ABA”. But from the perspective of neurodiversity, there is no good ABA. ABA approaches autistic children as a series of behaviours and deficits to fix and retrain, rather than as, well… people. The founder of ABA, O. Ivor Lovaas wrote: “You start pretty much from scratch when you work with an autistic child. You have a person in the physical sense – they have hair, a nose and a mouth – but they are not people in the psychological sense. One way to look at the job of helping autistic kids is to see it as a matter of constructing a person.” This attitude about autistic people remains pervasive within the field of ABA.

For these and other reasons above, we don’t see that ABA can be redeemed or re-branded: it should just be relegated to the dustbin of failed psychiatric approaches. And the sooner the better. It is heartbreaking to think of the many useful services and accommodations that have been neglected due to our province’s over-focus on ABA.

But it’s not too late to change!

Alternatives to ABA
What are the positive alternatives to the negative ABA cycle we’ve been experiencing in our province? Here is a brief look.

Inclusive Design. As with other conditions or disability, accommodations for autistic people should be central to any home, workplace, school or public space. The concept of inclusive or universal design is that accessibility is “a fundamental condition of design”. It is good for everybody!

According to the Ontario Human Rights Commission’s recent report, special education in Ontario essentially hasn’t changed in more than 30 years. Currently in Ontario, accessibility is left to the discretion of individual teachers and boards.  The Province should consult with autistics and teachers and undertake an Inclusive Design study for making classrooms across the province accessible and inclusive for autistic learners.

Augmentative and Alternative Communication (AAC). The term AAC means the communication methods used to supplement or replace speech or writing for non-verbal or partially-verbal autistics. There are various platforms depending on the user’s preference and situation.

AAC can be learned and taught by a variety of providers. We encourage parents to work with an SLP or another professional outside of ABA, since many BCBAs discourage this crucial toolset for communicating.

Speech Language Pathology, Occupational Therapy and Developmental Therapies (RDI, Floortime). There are a range of therapies for children and adults geared towards life skills, motor planning and building connections between parent and child. Please contact us to learn more and get resources on what is available to you locally.

Moving Forward
Autonomy, comfort, freedom and dignity are important to us all – yet none of these appear on any Individualized List of Goals and Objectives for ABA Services. If Ontario is to become a province that embraces equality, policymakers need to move sharply away from the approach of prioritizing ABA (which segregates children and limits their potential) and instead focus on progressive services and inclusive practices.

ABA tried to teach us never to say no. But we are going to remain non-compliant, stand with our allies and say NO to ABA in this province. Because when you say no to ABA, you discover what you can say yes to. It’s time for our province to find out, too.

Take Action
If you are located in Ontario and would like to get involved with A4A, please Contact us or find us on Facebook (A4A Ontario) or Twitter @a4aontario.

If you are outside Ontario, we have a list of organizations working for better ways than ABA, you can Contact us by email to learn more.