Is ABA Therapy Abuse?May 2, 2017 6:53 pm Leave your thoughts
Applied Behavior Analysis (ABA) has sometimes been mislabeled as “abusive” or ill-described as focusing too much on compliance or on creating “robots.” With the plethora of research supporting ABA as an effective therapy for people with Autism, these claims are surprising and disturbing. As a behavior analyst (BCBA), I had to ask myself why these misconceptions exist. Using years of interactions with families and children, discussions with other service-providers, and general discussion in the Autism community, I have come to identify four facets of ABA therapy that may be misunderstood by others.
Updated August 22, 2022
ABA therapy sessions can be very emotional, with highs and lows around a child’s rate of progress.
When beginning ABA therapy, there is often an initial increase in troublesome behaviors before substantial gains in more adaptive skills are achieved. This process holds especially true if a child has a long history of communicating through problematic behaviors.
Consider a child who is five-years’-old and has learned that hitting, flopping, crying, and whining gains him/her access to more preferred toys and affection from Mom and Dad. This means that when the child engages in these “tantrum” behaviors, he/she usually receives toys and/or attention during or immediately after the tantrum. An effective ABA program breaks this relationship by teaching the child that tantrum behaviors no longer pay off, while also teaching the child to communicate via sign, PECs, vocals, or even gestures. For a while, the child in our example will try harder to gain attention and toys through his/her old method of communication: tantrum behavior. This increase in problematic behavior is part of the learning process. The child learns that a) old behaviors are no longer effective, and b) new, more appropriate behaviors can serve the same need. There is usually a lag between learning these two contingencies where the child has not mastered new appropriate communication. This is why there is often a spike in problematic behaviors when beginning ABA therapy.
Watching your child struggle to learn new skills, and watching problem behavior increase, can be a very daunting task for parents. It’s never easy to see your child unhappy, but these frustrations must be worked through. As adults, we readily acknowledge that personal growth is often a painful process and that it is hard to abandon old habits in search of new abilities and learning. Think of your last great personal achievement. Was it difficult? Was it always enjoyable? Was it worth it in the end? If we allow ourselves to be uncomfortable and to grow into new people, we must allow the same process to happen with our kids. Children with Autism become adults with Autism, and we want our kids to be fully prepared for every aspect of life.
Emphasis on Compliance
A common complaint with ABA is that it teaches children to be too compliant and does not emphasize autonomy. However, a huge focus within ABA is early intervention, during which children tend to be the least autonomous due to their age. It’s also important to consider how we develop the skill of autonomy. Autonomy is a right of all people; however, complete autonomy without the skill to make decisions and the understanding of how those decisions affects one’s life is dangerous for the individual.
For example, I am an adult who is generally very compliant when asked to perform a task at work. My boss might ask me to create a report that I would rather delegate, but I understand the consequences of not following through with my responsibilities in this setting. In comparison, if a stranger asked me to do so something that I did not want to do, I would be much less likely to comply with this request because I understand that I am not obligated and—in some cases—compliance could put me in danger.
As adults, we are able to make complex discriminations about when to comply, when not to comply, and to what extent should we comply. These skills are highly verbal and involve a thorough understanding of settings, conditions, the roles of others, etc. ABA does not deny the importance of teaching children discriminatory abilities that effect greater autonomy; however, compliance is a prerequisite skill to these high-order discriminations.
Consistency in Approach
A third factor which may contribute to a skewed perspective of ABA relates specifically to the consistency of its approach. As discussed, ABA focuses on teaching children to follow directions (especially where health/safety is a concern) and be more compliant. For teaching to be successful, behavior analysts must be consistent with their expectations and must follow through with requests.
Consider this: You work for a company that has a policy regarding late arrival to work. If you are late more than once in a pay period, you receive a half-day’s suspension. You have been late to work several times in the current pay period, and you receive a suspension as a consequence. Later in the year, you are late to work for a couple consecutive days (due to oversleeping and being thoughtless), and you do not receive a suspension. You are now likely to push the policy a little further because you know there is inconsistency in its implementation, and you also may lose some respect for the person implementing the policy. Your behavior is no longer kept in-check by the system, and your job may be in jeopardy in the future. You also may have angry coworkers and disgruntled clients as a result of your own tardiness.
ABA practitioners avoid reinforcing negative behaviors by being consistent in their response to negative behaviors. Sometimes following through with requests or handling sticky situations may be time-consuming and may involve more intense problem behavior if the child is unhappy with the situation at hand; but ultimately, the consistency with which disruptive behavior is handled will determine the extent to which a child is successful functioning in his or her environment.
A Board Certified Behavior Analyst (BCBA), Board Certified assistant Behavior Analyst (BCaBA), and a Registered Behavior Technician (RBT) must earn and maintain qualifications to provide therapy to individuals. Their work is further regulated through the Behavior Analyst Certification Board (BACB) and bound to a code of ethical conduct and responsibility. This Board Certification is an internationally recognized credential.
Often, service-providers without certification from the BACB will refer to themselves as behavior therapists or behavior analysts. This is unfortunate because these providers—no matter how well-intentioned—lack the experience and credentials of a certified practitioner. Likewise, they lack the oversight and regulation of the Certification Board.
ABA therapy should always be delivered under the supervision of a BCBA. Sadly, this is not always the experience of families, and therapeutic techniques can be used that are called “ABA” but have no resemblance to what ABA is or does. When seeking ABA services, always ensure that your therapists and analysts have proper credentials, and know that you may make a complaint to the BACB at any time should you have concerns regarding your child’s therapy.
As the premier ABA provider in the Tampa Bay Area, BCOTB prides itself in its relationship with its clients and the community. We believe in open communication regarding who we are and what we do, and we value collaborative analysis with families and other disciplines. If you are considering us as an ABA provider, we invite you to schedule a complimentary meeting and facility tour with one of our Clinical Coordinators.
Check out our blog posts on What is ABA Therapy and BCOTB’S Guide to ABA Therapy: What you need to know when starting ABA!
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**BCOTB has been Tampa’s leading provider of pediatric ABA therapy since 2003. With four clinic locations throughout the Tampa Bay area, we know that our clinic is the right spot for your early learner! BCOTB focuses on in-clinic early intervention for children from birth to ten years old. BCOTB accepts most major insurances, including, but not limited to: Aetna, Anthem, Baycare, Beacon, BCBS, Cigna, CMS, Florida Blue, Humana, MHNet, Meritain Health, Magella Health, UnitedHealthcare, and TRICARE.**