My Thoughts on ABA

I just realized that I have never given my personal viewpoint on the current poster child of autism therapy, Applied Behavior Analysis. I think this is mostly because I know that I have strong feelings about the subject, and because I was usually surrounded by proponents of ABA and didn’t want to rock the boat. Now removed from it for about a year, I can talk about it more freely and without the anxiety the environment gave me. Please understand that this is my personal opinion, grown from my personal experiences in the ABA field.

I worked at an ABA-centered organization for a few years, so my thoughts do not come from a lack of exposure. The organization actually started out with a different model (and one of my preferred models), the Early Start Denver Model. Then, as Kaiser became more involved due to funding, the organization started to shift gears quickly. I gave it a chance, I really did. I listened to its proponents (some of which are/were friends of mine), got trained in several aspects of ABA, and created treatment plans based on it.

And I eventually hated every second of it.

Okay, hate is a strong word. Let’s see…each day that I worked there took a tiny piece of my soul away. Yikes, that sounded worse. It was true for me, though. Let me break down the reasons why I tried and eventually decided ABA was not for me or most of my clients:

  1. The obsession with fixing what isn’t broken. This is the basis of nearly every issue I have with ABA in general. I have never heard so many references to fixing someone as I have in that field. It is problem-focused almost to an extreme in some cases, and much of my training was solution-focused. That led to an instant clashing of values. I don’t believe autistic people are broken, they just have a different experience with the world.
  2. The therapist/interventionist/analyst is the expert. Um…no. A former boss of mine (who was deep in the rabbit hole of ABA) actually said of our clients’ families, “They’ll listen to us…we’re the experts.” Before I could stop myself, I blurted, “No, we’re not. The client is actually the first expert of themselves, then the parents are a very close second…we’re around third.” That boss and I butted heads from then on. Yes, I’ve studied a lot about autism, and I’ve had many autistic clients. Guess what, though? “If you’ve met one autistic person…you’ve met one autistic person.” In other words, we aren’t experts at all. Guides, maybe. Advisors, perhaps. Experts on autism? Not even close.
  3. Disregard/dismissal of any other approach. I may not be a fan of ABA, but I still respect it as a discipline and a psychological approach (even though quite a few of its supporters don’t want it associated with psychology because I guess psychology isn’t considered a true science…as I sit here with my two science degrees in psychology and counseling). Sadly, the other approaches, some of which I have seen work very well with clients, were met with almost mocking ridicule during my ABA experience. The often-repeated reason was that ABA is “evidence-based” and basically everyone else isn’t. This is a sad catch-22 to me: no funding is given to other approaches to give them an evidence base, and more is going to ABA because it is evidence-based. Good luck getting off that carousel right now. Also, the testimonies I see arising from the adult autistic community suggest that the psychological harm being done by some of the execution of ABA is real, and those voices are largely being ignored by the ABA community (at least to me).
  4. It simply does not fit me or my beliefs with regards to autism. Again, this is all my opinion, based on my experiences with the ABA approach. I don’t agree with the approach in general, and that’s fine. We can agree to disagree. What bothers me is the absolute takeover of ABA (along with “cure seeking”) in the autism world. Actually, it scares me. I have never seen such a monopoly occur in a field (except maybe Apple and the iPod), and when monopolies occur, innovation can be stifled. I have seen colleagues with amazing ideas get shot down repeatedly in ABA-centered organizations, their insights rendered mute. Then these same organizations wonder why they can’t keep solid employees.

Look at it this way: say you need to see a therapist. You got to your HMO doctor to ask for a referral, and they’re happy to give you a list. You notice that everyone on the list is a psychoanalyst. You say, “Um, this is great and all, but I really wanted a cognitive-behavioral therapist.” The doctor replies, “Nope, this is all we have.” You go to your insurance company, and get the same response. You have to choose a psychoanalyst because that is all that is offered. Your chances of getting anything out of those sessions just dropped significantly before you even walked through the door because you didn’t get to choose for yourself. Welcome to the current state of the autism treatment world.

This is what led to my difficult decision to work on the fringe of the field, so to speak. My work is now more developmental in nature, and with a much younger client base. My methods of building trust and a relationship first and foremost, of making the sessions fun and engaging, and involving the family whenever I can have not changed. I am much more happy here. Again, I am not to the point of chanting “down with ABA” (at least not yet); I think all of the different approaches can work in harmony.  However, there needs to be some additional educating to some of ABA’s followers on working with the autistic population, and other approaches need the opportunity to shine again without being shunned by the majority. Yes, ABA is now the majority approach. The ABA field can no longer use the “we’re the underdog” excuse.

No, you’re not. You’re the monopoly now.

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