Understanding ABA Therapy: Its Intended Goals and Misunderstandings
As a Board Certified Behavior Analyst (BCBA), my role has been to help individuals with autism gain meaningful skills to thrive, rather than changing who they are. However, despite these positive intentions, there exist significant concerns and criticisms around the implementation of ABA therapy, particularly from autistic individuals and their advocates. This article aims to clarify the intended goals of ABA therapy while also addressing the challenges and potential harmful effects that many autistic people perceive.
ABA therapy is often misunderstood as simply a technique for altering behavior, with an emphasis on increasing specific behaviors such as language, social skills, and other adaptive skills. However, the intent of ABA therapy is not to modify the core aspects of an individual's behavior per se, but to create a safe and supportive environment that can help individuals with autism reach their full potential.
The Real Intentions Behind ABA Therapy
One of the key criticisms of ABA therapy is that it is often designed to make life easier and less stressful for parents and caregivers, rather than directly improving the quality of life for the autistic individual themselves. Many parents and caregivers may feel embarrassed, ashamed, and desperate, leading them to seek out ABA therapy to address perceived deficits and behavior challenges.
ABA therapy, when implemented with reward and consequence methods, may inadvertently focus too much on compliance rather than fostering a well-rounded personality. This can result in the reduction of stimming behaviors, which are often calming for autistic individuals. Moreover, the structured and regimented nature of ABA therapy can be overwhelming and stressful for some individuals with autism.
ABA Therapy: Beyond Behavior Modification
At its core, ABA therapy is intended to make life easier for parents and caregivers, often at the expense of the individual's own well-being. This is evident in the coercive methods used to shape behavior, such as the use of rewards and punishments. While these methods may produce short-term behavioral changes, they can have long-term negative impacts on the individual's mental health and overall well-being.
ABA therapy is often compared to dog obedience training or routine ritualized child abuse, with its rigid and repetitive nature. The daily demands of ABA therapy, typically requiring 20 to 40 hours of intervention per week, can be overwhelming and taxing for both the individuals receiving the therapy and their families. This can lead to stress, anxiety, and even post-traumatic stress disorder (PTSD) among many autistic individuals and their families.
The Cost of Masking: PTSD and Dissociative Personality Disorder
Autistic individuals who engage in behavior masking, a technique often encouraged by ABA therapy, face a significant risk of developing PTSD and dissociative personality disorder. Masking is the practice of hiding one's true self to conform to perceived societal norms and expectations. While the intention may be to reduce social awkwardness or embarrassment, the long-term effects can be detrimental.
Many autistic individuals who are described as "high-functioning" or "mild" may have engaged in extensive masking to fit into neurotypical social norms. However, this sustained effort to conform can lead to severe mental health issues, including PTSD and dissociative personality disorder. These conditions are not merely a byproduct of the therapy but are often the direct result of the pressure and stress imposed by the therapy itself.
It is important to recognize that the outcome of PTSD is not influenced by whether the behavior conditioning feedback is positive or negative. ABA therapy, regardless of the feedback method, is fundamentally focused on implementing social masking that benefits others, often at the expense of the autistic individual's own health and well-being.
Conclusion: A Call for More Compassionate Approaches
The harmful effects of ABA therapy on many autistic individuals highlight the need for a more compassionate and human-centered approach to autism treatment. While ABA therapy may have benefits for some, the criticism underscores the importance of considering the well-being and autonomy of the individual rather than solely focusing on behaviors.
As advocates and practitioners, we must critically evaluate the effects of ABA therapy and seek alternative treatments that promote holistic well-being and respect for the individual's autonomy. It is time to prioritize the needs and experiences of autistic individuals and their families, ensuring that any therapeutic interventions are both effective and humane.
Ultimately, the journey toward a more supportive and understanding approach to autism therapy is one that requires ongoing dialogue, research, and collaboration between families, therapists, and the broader autism community.