5: ABA Reality Check

Follow up to Blog 2: (Eng)

A version of my Book in Russian

I’ve talked a bit about the Anti-ABA crowd in Germany during this blog in the past. I want to use this follow up post to show how the information shared in blog post #2 should alleviate their complaints and refocus their efforts. Rather than aggressively arguing against ABA in any form, I feel with better information they would be working to try to improve the education of uncertified providers. I believe they would also be interested in updating the approach to ABA used by providers around the world who may not be incorporating more modern research and technique. I have personally found most who argue against ABA in Germany to fit into one or several of the following three categories.

  1. Mistakenly thinking that ABA still uses outdated procedures or regularly uses procedures that are only ever warranted in very serious or dangerous situations. Assuming that no account is taken for child rights to a least restrictive learning environment.
  2. Misunderstanding scientific terminology and putting incorrect connotations on procedures based on that terminology that do not exist in reality. Rather than seeing these terms as descriptions of interactions that occur quite regularly and naturally in daily life, see them only as things “done to a child.”
  3. And/or they are Neuro-diversity advocates who believe that any attempt to change people with autism or Aspergers Syndrome is inherently anti-autism and therefore inappropriate.

It seems to me that most of the time, when someone online complains about ABA, they complain about methods or procedures that are no longer considered appropriate in the field. Or, these procedures might only still be considered in severe cases when the cost/benefit is strongly weighted toward the benefit. If you look at the explanation of our program in the last blog post you will see that we focus our interventions based on the child’s motivation and fun. We also work to do everything with the goal of bringing the child into teaching as part of a developing relationship with their teachers. I plan to discuss “The 7 Steps to Earning Instructional Control” in my next blog post. When I do, you will see that we advise all teachers that at least 75% of their interactions with the child should be saved for the child having fun and experiencing preferred activities. We argue that this fun has to be expected to be fun experienced “with the teacher” and not reliant on the teacher saying, “Go play.” Only a maximum of 25% of the time do we recommend that the adults ask for something from the child in terms of learning. Even then, we teach them how to avoid forcing the child to participate. Instead, we teach them to motivate that participation. The goal is to set up the environment so that participation is a choice the child will want to make. This is done because it is set up to be more fun and beneficial to the child than playing alone can be. We all make these choices related to cost/benefit when it comes to our participation in activities. We decide how much pay we would expect before agreeing to a full time job. We decide what we will learn when we consider how much we will pay for a university class. When we have the ability to consent to participation (or in the case of a non-verbal child demonstrate assent) we are more likely to benefit from that participation. When a child is having fun with their teacher and prefer that fun to being alone, they are willing to answer questions and make effort at new skills. They also begin to learn that social relationships have value and offer opportunities that do not exist without it. But, those relationships always come with responsibility and that the child has a role to play in maintaining relationships with others. This includes, when need be, the child being able and willing to repair a relationship with others. If anyone wants a relationship to grow and maintain they will have to do their part. Kids who are taught through ABA/VB to seek out more play with their teachers, also then learn how to react to the responses and emotions of their teachers as they learn to maintain and repair that relationship. I strongly disagree with the opinion that children with autism cannot do this. I have regularly seen children learn to enjoy social interaction and seek it out as neuro-typical children do. But, the best way to get this to occur is to make social interaction fun for the child. If the teachers don’t take the time to learn what the child enjoys and figure out how to make that enjoyment even better for the child, the child is never given a reason to attend to the emotions or responses of that teacher. They then also never learn the skills necessary to identify when they need to act to maintain that relationship. This is my problem with negative reinforcement and “go play” as a reinforcer. It doesn’t serve to support this important aspect of social education that should be at the forefront of all intervention for children who have not naturally been able to experience the benefits of social interaction in their daily lives.

ABA programs can be designed for a very young child who is demonstrating behavior that would get them diagnosed as autism. And when done well, ABA can not only teach the child important language and behavior skills but, can truly address the core symptoms of autism without disregarding the child’s personal preferences or desires. It is not to suggest that there is anything wrong with being autistic but rather suggests that the difficulties that sometimes come with autism that a person might want to avoid, can often be avoided with good behavioral education. The earlier it begins the better. Because, ABA doesn’t have to include forced participation. It doesn’t have to be long sessions of table teaching the child would rather avoid. It doesn’t have to use positive punishment or Negative Reinforcement procedures but, can instead, rely on extinction of inappropriate or dangerous behavior and positive reinforcement to teach new skills. ABA doesn’t have to be something the child would rather avoid but, can instead, be developed in a way that the child actually picks up their teaching materials and runs to the parent or teacher asking for more learning fun! When you understand this and have seen this in practice, then you realize that ABA doesn’t have to be abusive as some try to suggest. It doesn’t have to cause PTSD or feel like conversion therapy. In fact, when so applied, it will be the safest and most secure part of the child’s day.

I believe that faction of people against ABA seem to be so because, they don’t understand, or don’t know, or don’t want to consider, the growth and development of ABA over the past 40 years beyond the programmed formalized and clinical approach of its distant past. They imagine all ABA as forced table teaching. They assume incorrectly that we are focused on forcing kids who do not like to be touched to be willing to be touched, who do not like eye contact to be forced to make eye contact, who do not want to talk to be forced to talk and who do not like to interact with others to be forced to interact with others. And they see it as happening for as many as 40 hours per week. If that were true, then in my opinion, there could be a real reason for their advocacy. In fact, if an ABA program still promotes any of this against a child’s assent on a regular basis, I would join in the fight to get them to update their program and improve their training and credentialing. Nobody should be subjected to 40 hours a week of hard work with no consideration to fun and joy. Especially a child who might have a harder time than normal understanding the world and the social beings in it. But, this is normally the opposite of the truth in most modern ABA programs and it is certainly the opposite of our approach. Nobody, in any ABA/VB program I have been attached to, works to force kids to deny their own desires and interests or to succumb to uncomfortable or difficult situations against their will. It certainly isn’t a goal of our to ever many anyone “more normal.” If a child does not like being touched, then touch is not a useful tool for us as a reinforcer for that child. Forcing touch would only hurt our ability to teach. What would be the benefit of forcing an uncomfortable child to accept negative stimulus? It is not what we do and any suggestion that it is would be false. But, I hear this complaint or argument all the time on anti-ABA sites regardless of how many times we have corrected this misunderstanding.

Rather than force a child to use behavior against his desires, we set up the environment so that it mostly motivates and then reinforces more effective behavior. For example, in our program nobody is ever told to make eye contact or forced to look at someone beyond their level of interest in doing so. We, instead, show them over time, that eye contact will earn better attention from their listeners as is natural in the environment and if they find that what they want is better attention from their listener, they may start using eye contact. But,they will only ever use it to the level that it is effective and comfortable for them. That would be our only expectation. The result of these types of arguments against ABA is always, the Anti-ABA advocate listing a series of things that they think is bad about ABA and we respond with, “well, what you are describing doesn’t look anything like what we do.” For some reason, this never seems to stop them from perpetuating these misunderstandings and falsehoods. So beyond this blog, I’m looking for any advice as to how to best address this issue of changing false narratives and incorrect stereotypes of ABA.

I find that a smaller portion of the anti-ABA people seem to think that ABA is bad because of their own personal definition of terms used in ABA. What this causes is a misunderstanding based on different ways of looking at terminology and not realizing what these scientific words look like in practice. You might hear, “I think the idea of punishment is bad,” “I think Extinction sounds horrible,” “Isn’t reinforcement just bribing kids to work for food?”

Punishment, like reinforcement, can take many forms and can be used in many different ways. Every single one of the anti-ABA people who have ever lived have used ABA procedures that would be considered the scientific definition of Punishment, Extinction and Reinforcement. And they do it every single day of their lives. Every one of them uses Punishment and extinction every single day. These are just labels for the possible consequences that follow all behavior. They use these consequences with their sons and daughters with autism, as they use them with their typical children, and likely their spouses, friends, and work colleagues, as well. ABA is not a foreign idea. It is merely a way to label and categorize what we all experience as we interact with each other and the environment we live in. Not liking a term or not understanding it, does not stop someone from using it. What it does, is not allow them to know when they are using it and therefore robs them of being able to determine if and when it would be best to used in supporting learning and growth. Often they end up using them inadvertently to support more increasingly inappropriate and eventually dangerous behavior instead and then lable this inappropriate or dangerous behavior just part of “being autistic.”

The final group are people who think that any concerted effort to affect the lives of people with autism is inherently anti-autism and disrespectful to the individuality of those diagnosed as such. When you factor in the common misunderstandings about ABA and then see that ABA is often billed (incorrectly) as “autism specific therapy” you can understand how easily ABA becomes a natural target for neuro-diversity advocates. These people would argue that autism is a normal part of human variance and that people with autism should be respected and treated as if they are okay just the way that they are. As an ABA/VB provider, I agree with this 100% and suggest that ABA for Autism’s sake is never a good idea. ABA should not be used to stop anyone from being who they are. It should be used to educate and elevate the skill level of those who are not learning successful ways to live happier and more independent lives. Is it true that some behavior labelled as autistic becomes less prevalent over time for some children in ABA programs? Absolutely! But, that is a result of ineffective or non-beneficial behavior being replaced by the child who begins to choose to use more effective and beneficial behavior as it is consistently shown to be more effective to help them achieve their own goals. My biggest problem with this group of the Anti-ABA activists is not that they are wrong. Everyone should be respected and loved for who they are. But, as a teacher, I never believed that loving someone for who they are should ever be used as an excuse to avoid the responsibility of trying to help them live a happier and more successful life. The fact that someone may not learn the same way or learn at the same rate, is not a good enough reason to refuse to teach them. We all deserve an education and as long as that education takes into account individual differences and is focused on the motivation of the person being educated, we as a society have a responsibility to improve our teaching methods to help everyone live happier and more successful lives. Whether they be easy to teach or hard, whether they have a diagnosis or not.

“If a child can’t learn the way we teach, maybe we should teach the way they learn.” — The philosophy of ABA.