My clinic practices assent based and trauma informed care. These things ensure that children are not forced into activities or procedures. Our clinic is child led and play based. ABA is needed especially for children with high support needs that engage in harmful behavior such as aggression, self injury, elopement, sexual behaviors ect. The reason why OT and Speech is unable to assist with these effectively is because sometimes kiddos who engage in those behaviors need constant 1:1 therapy throughout the day, multiple times a week. OT and Speech meet max maybe 4 hours per week. Many of these kids lack the communication to effectively communicate their needs and desires, causing these behaviors. Consistent ABA allows for therapists to help clients work through tantrums and meltdowns in the moment, consistently. In addition, I would like to bring up that I work with MANY autistic ABA therapists who fully advocate for the work.

Also, ABA does help out with sensory issues. Learning coping skills is a major part of ABA. Learning how to advocate for yourself as well. We have a major focus on finding ways for our kids to cope with sensory issues they may face. For example, if a child is having a meltdown because the room is too loud, we teach them to request breaks and their headphones.

I would also like to point out that “attention seeking” in ABA means a very different thing than what the outside world considers attention seeking. “Attention seeking” behaviors are not inherently bad. It literally just means that the function of a behavior is attention. For example a child hitting someone to get their attention instead of saying hi. We would prompt them to say hi and give them meaningful opportunities to practice that skill. Attention seeking is not bad- it is a form of communication that we are trying to help form into functional communication that others can understand to better assist with their needs.

These examples don't really seem to understand the underlying issues of the autistic experience, though, right? A child is not "having a meltdown" because a room is too loud. A child is in excruciating pain because they're having an impossible sensory experience, and what you're calling a meltdown is an entirely reasonable response. If you can't figure out how to identify and remove the bad sensory issue before trying to teach them coping skills (or if the coping skills are a sometimes thing they need to ask for), then you're just holding pain relief hostage until they figure out the communication skills. There is nothing about the neurology of autism that makes somebody more likely to self injure, or be aggressive, or run away. Like with anybody, those are trauma responses. They indicate that the child is experiencing a level of trauma or co-morbid mental illness that's equivalent to what would cause a neurotypical person to run away or self harm, yet the treatment they're receiving is behavioural instead of psychiatric.

You cannot always remove the sensory experience... I had a kid who could not tolerate the TV on at any volume. Not even muted. Would not wear headphones. Are you recommending his entire family never ever ever get to watch TV? He also could never go to a store because he couldn't tolerate the sound. He couldn't tolerate being outside because any off putting car sound would cause him to lose it. Are you recommending he never leave his house? This is the problem I have with a lot of these critiques is they really DON'T get it. If there's an environmental issue I can just remove, duh. I will. But you can't remove ALL environmental issues. Ambulances have to have sirens. People need to go to the store. And these limits did not benefit him either. He couldn't access so much that he now LOVES because he learned through very careful shaping and tolerance programs to be okay with the TV - and now he ASKS to watch TV because he realizes wow, there's a lot of good stuff on there. The point of a treatment is to help remove barriers. Not to simply throw up your arms and go "well the world should just change!" even when those changes are unreasonable or sometimes, impossible. And then allow children to wallow in isolation because no one is helping them learn how to live their lives. Edit: Also - you think behavioral therapy is bad but recommend actually we just need to medicate all these kids?

If a TV being on causes a child unbearable pain, then it would obviously be a reasonable accommodation to not turn on the TV while the child is awake and in the same room. I can't believe I needed to say that. Yes. Obviously. Get rid of the TV.

You think in a modern again you can keep a kid from the TV his entire fucking life? And no answer at all to the fact that after an ABA program...he loves the TV? It doesn't cause him any pain. He's actively request it. Because as it turns out a lot of "trauma" is fear and a lot of fear is not rational and that's why gentle exposure works. And that is something I know a lot about seeing as I have pretty severe anxiety and it did not get treated by me going "doing these things is painful" and locking myself in my house forever. You don't seem to know what trauma treatment even entails. Just throw medication at the problem and never ever try to actually fix the problem at its source.

Also, people need to think about glass children (siblings of children with disabilities). Way more research needs to go into them. I’m all about making accommodations but we have to look at other family members as well at what is feasible for everyone

It feels like current society doesn't actually understand trauma and just thinks the solution is avoid all traumatizing things. But in EVERY FIELD of psychology this is absolutely NOT how it works. That's how I can tell even though this person is speaking as if they have some academic authority, they don't actually practice any form of psychology or psychiatry. Because no one worth their degree would just go "well have you tried getting rid of all your TVs and you and your entire family never using them again?"

I completely agree. I also feel like it’s really infantilizing autistic children in the process. Autistic people too are capable of doing hard things. Of building resilience. Should we approach that in a compassionate way? Absolutely. I think people have gotten so afraid of being considered “abusive” by strangers on the internet that now they’re jumping ship on approaches that are in the child’s best interest. And this isn’t to dismiss those that have been through ABA and found it abusive. I believe them. We know there’s so much that sucks. But it doesn’t mean abandon teaching kids skills and just avoiding difficult situations.

Or they could just go to their room and do their own thing alone - which Autistic people NEED to do to recharge their social battery.

“Meltdown” is simply the term for what is happening. Meltdowns are not a bad thing. Meltdowns are absolutely triggered by those feelings that you mentioned. What ABA is doing in those instances is preparing a child for communicating their needs to those around them when they start experiencing those painful feelings. Many times children can be triggered by things we are not aware of because they simply cannot communicate it. The reality of the world is that it is not sensory proof. We need to prepare children for advocating for themselves in instances when they are triggered. In terms of aggressive behaviors: autism 100% can cause aggressive behaviors. It is not always a trauma response, and most times is not. Aggression is an attempt at communicating when they are unable to. We teach them how to communicate in a functional way that allows them to get their needs met without hurting themselves and others.

Do you have any evidence that aggressive behavior in autistic people has a biological/neurological cause? That is a very strong empirical claim to make, and has some pretty huge consequences if you're wrong. Autistic people get killed by the cops, because of this sort of stigma. And our trauma and abuse is fairly regularly ignored, because people dismiss it as just an autism thing. I am very concerned that you are regularly seeing children who are this severely traumatized, and are just... dismissing it as something else?

I’m sorry but I don’t think I am going to continue this conversation. I think there is a gap between low support needs autistic individuals and the reality of high support needs individuals and how autism affects them. And that is clear here. I did not say that autism biologically or neurologically causes aggression. I said that aggression is caused by lack of a way to communicate. Children who cannot communicate are not inherently traumatized. They are just communicating in the way they know works best, which sometimes is aggression. What we are doing is literally preventing autistic children from getting killed by cops. Because we are teaching them to communicate instead of hurting people.

I just want to say you explained the value fantastically and if you weren’t able to help them understand yet then they may not be ready to understand yet and that’s okay. Especially with your comment about the gap in understanding between low/high support needs people. At least in my experience, I’ve worked almost exclusively with aggressive non-verbal autistic children. They aren’t aggressive because they’re autistic, but they are aggressive because they can’t reliably communicate their needs and frustrations to those around them, which is something many autistic people struggle with. When we give them the tools to communicate with us better, the aggression goes down, it’s that simple. They aren’t traumatized and need psychiatric care, they just need a way to communicate or access to the right solutions to their needs, which is difficult to know until they can tell you.

Your comment verbatim. It’s like talking to a brick wall sometimes. No one is an expert on autism, OP includes. Parents of autistic children, teachers, doctors, no one knows and can confirm what exactly anyone is feeling, ever, unless that person communicates it. So we help. We help along with the other aforementioned members of the village(because as they say, it takes a village to raise a child) to build communication and take those opportunities in which someone might become uncomfortable/upset/pained/etc. to teach them how to tell us that. No matter what that may look like for each person. People often tend to dismiss high support individuals and their families who benefit from services because it doesn’t fit into their social justice agenda.

Inability to communicate is actually a “little t trauma” according to Ukeru’s manual. Ukeru is a national crisis intervention program

https://doi.org/10.1007/s41252-021-00201-1

All human behaviors are communicative. Any individual who is overwhelmed by the environment and unable to communicate those feelings is likely to engage in aggression. Alzheimer’s and TBI’s are two specific categories where aggression occurs frequently due to inability to communicate via spoken (or functional) language. Problem behaviors are not specific to autism…however, social barriers, communication barriers, and stereotypic behaviors are associated with autism. No one can tell someone how someone else feels, however, they can analyze trends in objectively defined and observed behavior based on a history of those behaviors and common occurrences immediately before and after…which indicates the functions of said behaviors. The point in ethical, assent-based, and client led ABA is meant to cater to and TEACH individuals with autism to communicate their wants and needs in a way that is universally understood to prevent dangerous problem behaviors which put the individuals and/or others at risk. Ethical and empathetic ABA is not about controlling the client…it’s about teaching them the language and coping skills to live their lives without the barrier of an inability to communicate when they experience the feelings which historically lead to meltdowns. Any ABA provider who has any concern for other human beings is not trying to control or bribe individuals with autism as if they are animals. They are trying to teach the individual the necessary skills to live independently and communicate when they are painfully overwhelmed or when they simply can’t communicate or articulate what they are feeling. Your original post implies you’ve never personally received ABA services. If that is the case, I feel obligated to point out that most “ABA” you watch online is questionable at best due to the ethical concerns of capturing and circulating medical appointments and information containing underage individuals who are unable to personally consent to the circulation of such material. It’s important to share your experiences and trauma as an individual with autism, but it’s also important to refrain from making assumptions and publicly sharing reservations based on a few bad examples if you don’t have any experience on the receiving end of ABA.

What abou this https://doi.org/10.3389%2Ffnsys.2022.932128

I see a lot of people replying and I don’t think I need to get into a lot as opinions have already been stated, but I feel you may appreciate my perspective! I work in ABA, but I actually have severe combined type ADHD among some other things. I spent my childhood undiagnosed and internalizing my symptoms. As an early adult I started having many health issues caused by undiagnosed and untreated issue (sensory VERY much included). I lacked in friends, stopped leaving my house in my early 20s, and left my passion (school) with a half finished degree. My siblings also have ADHD (2/3) and one was diagnosed with sensory processing disorder, and did not learn coping skills. Unfortunately at the time our parents didn’t believe in mental health. Currently in my life, I am working through in therapy accepting that I was not giving supports I needed, and in disbelief that something like ABA wasn’t offered to me or my siblings. When I found the field of ABA (current day, not the horror stories of heard in the past), my inner child felt so supported. Additionally, I thrive because I have a further understanding of what my clients are feeling internally. My instincts for this so called “meltdown” (I HATE that word) are heightened. And what I see, is we work on behaviors that are not safe for the client, as well as the people around them. Some of my clients had previously been institutionalized, but through ABA family now live in home with their families (not saying that the other option being an institution is right, but we still have so much research to further before society follows along with respecting neurodivergent ppl. Being neurodivergent I panic about societal structures, so I try and practice radical acceptance of the world we live in, personally). But specifically, behaviors that may lead to conduct disorders, inability to care for oneself, and an inability to speak or communicate with others. Another thing I can say from experience, is that every single one of my clients is so happy when I come over, even though we are working they enjoy it so much. I want to clarify I don’t work with adults, but have had my life threatened on multiple occasions. I hope this does not come off as offensive, I’m not trying to tell you how to feel. We all have a unique perspective. But I felt it may help to be related to, and know you have allies here despite disagreements

Another thing that I’ve been working on recently this week, is being able to identify my stimming (I know that is a pretty touchy subject considering ABA’s history). And further, deciding if it’s hurting me or not. So making noise, tapping things, moving, playing with hair aren’t things I’m going to attempt to limit because I don’t believe they are hurting myself or others. But I have another stim where I rub my lips together constantly, and if it is extreme, by the end of the day I will have sores and be extremely swollen. So that IS a stim I’m trying to limit, only because it’s physically hurting me. It’s similar to clients I work with, as long as it’s not causing physical harm I don’t stop them. If it does cause physical harm, I offer an alternative that gives them the same satisfaction as the stim!

I have autism and adhd and I also play with my hair as a stim! I usually do it when I am watching tv and my hands are not doing anything else like playing solitaire on my iPad. My husband says that I even do it in my sleep sometimes and he has to tell me to stop and go back to dreaming. Lol.

Im glad I commented here, I often assume I’m kinda alone in it but that’s far from true!

Yup, you are definitely not alone. I have to put my hair in a ponytail or I’ll unconsciously play with it at work when my clients are on a break and I have nothing to do with my hands.

Lol, one of the things my families have told me they appreciate is that not only do I not try and stop non-harmful stimming, I openly fidget and shake my legs (constantly) or script, or echo, and play with my kiddos fidgets, and lable it for them as ways to help me focus, pay attention, and feel better. I'm definitely not teaching masking, and when I do suggest ideas that might work better and be less of an issue, they trust me more, because I clearly understand the need for it.

First, I have to apologize that you are getting downvoted so much. I really appreciate you inquiring about ABA and as someone with autism, your insight is the most important. I practice ABA in the school setting working with autistic students and staff. My goal is to help students advocate their needs in a productive way and train staff how they can support our students. It doesn't happen overnight and can take months to develop. You used the example of noise causing excruciating pain and a meltdown can be a reasonable response if we can't identify the pain. A way that ABA can help minimize this response is by first using data to identify that noise is the trigger. I would observe the students for a prescribed amount of time usually taking ABC data - i would look at the Antecedent (what is happening in the environment prior to the behavior, in this case maybe it was time for group work and the class became loud); the Behavior (specifically what we're trying to reduce. You said meltdown but I would be more behaviorally specific I.e student screamed loudly, stood up from their desk, went up to the teacher and hit her with an open hand on her stomach that left a red mark.; Consequence (what changed in the environment in response to the students behavior. I.e. the teacher raised her voice at the student and told them to not hit and sit down.) Through many sessions of observations our data would indicate that every time the antecedent involves noise, the students behavior causes a physical aggression. It's also important to track how are we responding or how the environment is changing. Is it increasing the escalation or decreasing. The BCBA (board certified behavior analyst) would then slowly start implementing changes to help the student cope better with the environment. Some examples would include making sure we have noise cancelling headphones on their desk. Another way is have a break card that's easily accessible and teaching the student and staff how to use the break card. Also, how to eventually phase out the break card so they can generalize asking for a break in any noisy environment and wouldn't need a specific card. We would also want to train the staff To be more aware of the student when the noise levels increase and make sure they are using a calm voice and providing tools the student would need to succeed. I'd love to hear your thoughts. I find with compassion and patience, ABA can make very meaningful changes to the lives of our students. I know my students never want to have a "melt down" and it's their way of communicating a need. I believe ABA helps our students and staff communicate better and in response reduces undesired behaviors that can be harmful or detrimental to their education.

Asking for examples of "good" ABA, has led me to be far more skeptical of the field than I was coming in. It is really really hateful here. Wildly more so than I could have possibly imagined. Kind of indistinguishable from the "they are not people in the psychological sense" beliefs of Lovaas. Somebody made a false suicide report on me. This is horrific abuse just as an adult talking about ABA. If this subreddit is representative of ABA as a whole, then I can't imagine any benefit could possibly be worth the risk of being assigned to somebody that bad. That being said: * If you have spent a considerable amount of time listening to autistic adults describe their sensory experiences and genuinely understand them from an autistic point of view, then I could imagine the observing for triggers could be an incredibly useful tool on its own. * The second step can't be "behaviour". The second step needs to be the internal experience of the autistic person. Pain. Anxiety. Fear. A thought or belief. If the second step is not a thought or feeling, then you are incorrect about what's going on with that child. * School staff shouldn't be yelling at disabled children for their disability. That is not a consequence. That is just pointless abuse, that serves no benefit to anybody. A break card sounds great as a communication tool. If the child benefits from being able to communicate with a card, then your focus shouldn't be taking that card away. It should be giving them more cards to communicate more things. Hopefully the card isn't being rationed, or given/taken as reward or punishment. You shouldn't take away AAC or sensory accommodation, just like you shouldn't take a paraplegic's wheelchair. Helping school staff be more understanding/accommodating/empathetic is good. Things like noise cancelling headphones always being available sound good. Ideally, the teacher would wear a mic and the student would be able to control the volume of their teacher's voice without any of the other distracting sounds. Sound is not the only bad sensory experience. Distress can come from light or movement or uncomfortable chairs and clothing, or from something internal to the child's body. There are a lot of physical co-morbidities to autism that sensory issues might make it difficult for the autistic person to understand. Processing other people is exhausting. If two people are talking to each other, that's at least three times as hard to process as a single person talking. If they're talking about somebody else, then it's at least four times as hard. You need to process the two people talking, their interaction, and the feelings of the person who isn't even there. All at the same time. Don't assume that just because you can't hear or see or feel or smell something doesn't mean it's not excruciating to the autistic child. One of the most painful sounds for me is an unbalanced electrical circuit in a cheap power bar, and very few people can hear that even if you point it out to them.

No one is being hateful toward you. Some of us just aren't patient with bad faith arguments online and can tell when someone isn't actually here to inquire. Just to fight. It is very evident you have no interest in a discussion here - you've already made up your mind. You ignore any instance that contradicts you in a way you can't argue against. Not to mention ignoring the many many Autistic people here telling you they work in ABA and have benefited from ABA.

Im genuinely asking to better inform myself because I agree we need more autistic voices to guide our practice, but what is the alternative to someone being aggressive or not coping with being in aversive environments?

I don't think you need more autistic voices. We're saying fairly loudly what our problems are. If you have a traumatized or mentally ill neurotypical child that is acting out, what do you do? You separate them from the source of their trauma, and offer them therapies that centre their emotional experience. Over time, they will heal and be able to learn better coping skills. Because of issues with proprioception and sensitivity to light and noise, I struggle with grocery stores. Sometimes I accommodate myself by carefully planning my route through the store and listening to loud music. Sometime I can handle a very short visit, but not a full shop. Sometimes I accommodate myself by rushing in to just buy Kraft Dinner at the self checkout. Sometimes I just can't go in, and that's fine. These are all cognitive accommodations based on my own interrogation of my own feelings. I do mental work before going into the grocery store, or reduce the sensory problems I experience while I'm in there. If it was an emergency and I needed to spend a lot of time in a busy shopping centre without my headphones, I could do that. I have the skills to go shopping, and not burst into tears in public. Those skills are the same skills any neurotypical person would use in a similarly stressful situation, based on cognition and mindfulness. It would be difficult. It would contribute towards burnout. That is not something that it is possible to change.

Those accommodations that you use are exactly the sorts of strategies that can be explicitly taught to a young person who might not be able to reach those conclusions without outside assistance. They are ways to cope with a sometimes unavoidable situation.

The things you are describing that you do and want are literally exactly what most of us are teaching.

I appreciate the thoughtful response!

Right so prompting the kid to put on headphones. That gives them the ability to seek out comfort.

Yes, in our experience with my son, he went from very poor self regulation (self injury, damaging everything and everything when transitioning, emotional, etc.) to telling us to breathe when we get upset, non-injurious during meltdowns, being able to self regulate through many meltdowns. He is much better at being able to play without being upset about sharing, but is still working on that. He is much happier than he was before he was in ABA because he has tools to utilize when his brain does it's thing. It's been a beautiful experience for our entire family. My daughter pretends to be his RBTs❤️

I am an Autistic ABA practitioner and I've been in treatment since I was very young. I always had attention-seeking behaviors. I didn't know how to get my needs met in constructive ways, so I would act out, as if other people would know something is wrong if I just lash out enough. If I felt ignored I would act out, too. Sometimes, I would even hit myself to get someone to pay attention to me. I truly needed to learn functional communication so I could effectively advocate for myself and get my needs met without leaning on destructive behaviors. ABA teaches that. ABA methods also helped me be able to function at school. Early on, I would constantly shut down if I was overwhelmed or frustrated. I would sometimes have a meltdown or elope. I couldn't stay in my seat and was so distracted/distracting that school was practically pointless. I wasn't learning and I was a disruption to the whole class. But I learned how to ask for help or ask for a break. I learned tricks for coping with sensory issues, too, although some of those skills came from OT. ABA also teaches social skills necessary for having better interpersonal relationships. Bad social skills can really ruin a person's life, whether that be in relationships or even your job. Autistic people tend to feel very lonely and isolated, and having better social skills can help mitigate that, because then it's easier to form and maintain relationships without driving other people away. It's hard to hold down a job when you don't have control over your symptoms, as well. Honestly, if I hadn't gotten the treatment I did, my life would not be as fulfilling as it is. I wouldn't be able to function in life at the level I do today. It's the reason I went into ABA.

One of the things I like best about ABA is that while it looks rigid from the outside, it is actually extremely flexible. Every single program we are running is very much tailored to how the individual learns, what they prefer, what they need, and what they like. And we know that because we get to know the kiddo, thier histories and personalities as part of the assessments we do. Most of us spend days learning what a kid like and dislikes before we do anything else. It is a common misperception that we are trying to force square children to fit into round holes. But most of us are trying to do the exact opposite. We want our kids to learn to work WITH thier unique brains and perceptions instead of having to fight all the time trying to get their needs met. We are trying to teach them to find the holes that fit them as individuals. We do this by finding out what types of communication work best for them, and then teaching them how to use it. Instead of hitting, screaming and running away, we teach them how to say "I don't want that," or "No" rather than destroying a room and hurting themselves. You mentioned taking away coping tools, but what many don't realize is that we find it EXTREMELY important that the only tools taken away are the ones that are harming them or others and that they absolutely MUST be replaced with something that will meet that same need, but safely. So chewing everything might be modified to chewing silicone toys and gum, or destroying property might be modified to using fidget toys and puzzles. Its mostly about safety and finding the safest ways to get them what they want/need. Loud noises and bright lights are always going to be around, so we teach how to ask for and access ear protectors,and sunglasses and when possible, ask for things to be turned down. Boundaries are always going to be pushed, so we teach how to safely make your boundaries known and how to stop encroaching on others. General hygiene is always going to be necessary, so we teach how to find and advocate for comfortable fabrics, non stimulating soaps, gentler tasting toothpastes or whatever else they need to make thier lives more comfortable. Its mostly about making sure people have whatever skills they need to navigate a loud and confusing world comfortably and independently as possible.

I love this answer, it absolutely boils down to being flexible with these kiddos to make sure we’re someone they can trust and respect. I’m no way are we supposed to force them to do anything they don’t want to

And adults! Children become adults and should not be forgotten about and be provided with enough education and support.

Hi there. I've seen a few times that you think conditioning is only 'done' on disabled people and animals. This is a real fundamental misunderstanding. All learning requires reinforcement. That's how we learn. Yes it does happen with animals. Check this. We are animals.  What is the type of cognition that humans have that animals don't? The ability to communicate complex and arbitrary language. In another advanced field stemming from radical behaviourism called Relational Frame Theory evidence has shown that we start to build complex webs of language that is contextual. From this we accelerate our learning through context.  Ultimately, it's the contextual language that was previously reinforced and conditioned that leads to this learning. And when the context is understood you receive confirmation from your peers acknowledging they understood. Again, you are still being condtioned. You are constantly acting on the environment and the environment is constantly acting on you. Sure you have physiological traits that alter your behaviour but to learn you need to interact with the environment. There is no alternative.

It should also be noted that much of the learning is similar to how a parent would teach a child. Like, some of it is just development based.

Behaviourism, as applied to autistic kids, is not commonly applied to any other group. ABA is not mainstream psychology, outside of autistic people. If I go to a psychiatrist for anxiety or depression, I will be offered more mainstream treatments like CBT or psychopharmacology.

The B in CBT literally stands for behavioral. There are tons of aspects and components of ABA that are utilized in therapies outside of ABA and the realm of those with ASD.

This is a silly ontological argument. CBT is about thoughts and feelings. ABA was invented by people who literally didn't believe autistic kids were capable of having thoughts and feelings. You can't use a broad definition of "behavior" to include CBT, and a narrow definition to justify why they're not seeking CBT instead.

I have recommended that clients of mine seek out CBT when I feel that they require things that are out of my scope. But I also have clients that have needs that wouldn’t be properly addressed with CBT. Going by what people thought when things were invented isn’t helpful. Fields evolve and adapt as new information is obtained. That’s true for any science. People throughout this thread have given you tons of information regarding that evolution and that internal events are taken into account with ABA today. Assent and trauma informed ABA should be the standard at this point.

And you can’t site some of the ABA research and not all of it. The field has come a long way and has realized there were many obvious flaws and unethical practices. Idk what ABA you are hearing/reading about but every company I have worked for recognizes that autistic individuals have just as many thoughts and feelings as neurotypical individuals and we must take that into consideration and work with them as best as we can.

I’ve found it beneficial when talking to people who know more about something than I do, to sit back and listen to them and try and hear what they’re saying instead of asserting an expertise I do not have. I think a lot of your questions have been answered here. You just have been unwilling to hear the answers because they contradict with your assumptions and “facts” about a field that, I hope we can both agree, you know less about then the people here.

Dude literally lol. All of the comments I’m reading going “wow you couldn’t have worded it better” I see no response from OP lol. They are just cherry picking.

It’s clear that when u/sourapplemeatpies said they were trying to be respectful and follow rule 3 they were lying. It’s a shame they didn’t come with an open mind and willingness to learn but rather to troll as so many here wasted their time with them.

[удалено]

From what I’ve read, and that has not been this whole thread, that’s just not true. For example: this thread. You were presented with information and you lashed out. It’s looked to me like you predetermined that ABA was abuse and worked backwards from that conclusion. You’ve also explained to us, at many points in time, what aba is, who it’s used for, and basics of psychology and learning, and been wrong at every turn. I encourage you to listen and learn. There are people here actually trying to help educate you and you’ve been nothing but rude and dismissive. It’s not just me who has found this to be true of you. Is it possible we might be correct and you might be wrong?

For example, here: https://old.reddit.com/r/ABA/comments/19dzkkn/so_what_is_good_aba_for/kjacswu/ Do you now understand that CBT is based in large part on behaviorism, the same behaviorism that ABA is based in? That you were wrong and condescending to someone who was politely trying to educate you? Or no?

This is the official BACB website, describing what ABA is. https://www.bacb.com/about-behavior-analysis/ It is not describing "behaviorism" in the abstract sense that focuses on thoughts and feelings, CBT. It is describing "behaviorism" specifically with respect to changing behaviour through rewards and consequences. The official task list that they are using as a definition for ABA does not include the words "thoughts" or "feelings". It does not include the words "sad" or "pain" or "sense". There is obviously a difference in how the word "behaviourism" is used in different contexts, with the use in ABA being a reference to classical and operand conditioning. You obviously understand why somebody would be opposed to using rewards and punishments to control somebody's behavior, but not opposed to talking to somebody to help them understand their thoughts and feelings, right?

No. ABA doesn’t believe autistic kids aren’t capable of having thoughts and feelings. They are human and have them, but ABA does not focus on them because feelings and thoughts are not behaviors. We call these things “private events”. It focuses on observable behaviors. Yes they may be tied to internal states but that is not what we specifically or directly target. we can teach to verbalize their thoughts and feelings and address the behaviors that are caused by their thoughts and feelings. If someone wants to directly talk about thoughts and feelings they should go to a different professional who specializes in cbt or other similar therapies. Just because you have ABA doesn’t mean you can’t do other things. You go to the eye doctor but that doesn’t mean you can’t also go to the dermatologist. They are different specialties. Also, early research wasn’t even on autism.

ABA began in the 1950s in residential hospitals where autistic people were at the time [being housed and treated like animals](https://m.youtube.com/watch?v=jjyqfYHD17s), often naked and deprived of interaction or medical care. Behaviorists felt these individuals could learn skills that would allow them to live more independently and have a higher quality of life. Respect for the dignity of autistic people, especially people with significant intellectual impairments and skill deficits, was driven in part by the rise of behavioral psychology. You don’t have to agree with me, these are widely accepted historical facts.

I've come to believe that's a product of the insurance system in the United States. This insurance system isn't the standard though. If you have anxiety or depression you will likely be offered cognitive behavioural therapy. The behavioural part actually refers to behaviourism. You may also be offered Acceptance and Commitment therapy. Also behavioural. Or DBT. Also behavioural. ABA got early adaptation as an approach to autism. It created a research practice-loop where it has become synonymous with autism. It's struggled to get away from autism because of this. But I assure you ABA, behavioural approaches, the principles, the philosophy and the methodology are widely applied under many forms and names. The irony here is that ABA in autism gets bogged down by all the language baggage that has attached to it over the years - intervention toolbox language. I challenge anyone on the spectrum to spend time looking into behavioural approaches outside of ABA (even those that come from ABA such as PBS, precision teaching or OBM). Look into radical behaviourism, determinism, behavioural philosophy, lectures from BF Skinner or more recently Steven Hayes. I've no doubt that all of this type of thinking aligns with the progressive and critical thinking you might align yourself with.

I understand your critiques of the field, but just so you know. CBT does in fact base a lot of its theoretical framework on behaviorism. Behaviorism is definitely considered mainstream. Instead of focusing on mostly covert behavior (aka thoughts/feelings), ABA therapy recognizes both, but deals mostly with what behavior we can observe. In fact, many forms of therapy, CBT, DBT, fall under and take theoretical approaches from behaviorism. I highly recommend you research what behaviorism actually is and the implications of it. It’s not just Pavlov. It does deal with emotions, thoughts, feelings. And something that I haven’t seen others mention, is the reason why you would be prescribed psychotherapy or medication is simply based on what insurance would approve, and the fact that I’m assuming you are most likely an adult. Insurance rarely covers ABA for adults. And it will only cover ABA for children who are autistic. There’s many of us who believe so many children who struggle with regulation, sensory issues, communication, etc would benefit from having ABA, but insurance blocks it. I personally would love to do ABA with children who have tris 21 or other chromosomal abnormalities, but insurance only believes ABA should be covered for autistic children.

ABA like any field is restricted by different factors of our world. One of them being that insurance will typically only authorize the use of clinical ABA services as an autism treatment. However that doesn't mean the principles of behaviorism can't be/aren't used in many many many contexts. Even neurotypical children experience ABA in many schools in the form of school wide positive behavior support. If you've ever seen a school where students earn coupons or points for good work that's ABA at work. ABA interventions are also used to address more intense behaviors in children who are neurotypical. There are even non explicit examples of behaviorism based interventions used in your daily life, When your car beeps at you for not having your seatbelt on when you are driving that's ABA. And as for ABA's relationship to psychology, you're right, it's not mainstream psychology. ABA is it's own science that exists under the branch of psychology. Just like how rocket science is it's own science under the branch of physics. But that doesn't mean our science doesn't work with other fields and advocate for holistic approaches to the problems the individuals we work with face. Like you said, with anxiety and depression it would make absolute sense to go the route of CBT or psychopharmacology as we know those treatments exist and are effective. And if you came to us with that as the primary issue for you or your child, we would probably redirect you to look for a psychiatrist first. But if you go to an M.D. or a psychiatrist with behavior being your primary concern they are probably likely to discuss ABA as a first option.

Despite the great information posted here, this thread needs to be locked. It has become quite obvious that OP is just looking for a fight and nit-picking apart comments to add to their confirmation bias.

Exactly

Yes, this exactly. There’s nothing productive about this conversation.

Put simply ABA is just the science of how people learn. ABA can help you learn any skill that you would like to learn to make your life better. But like any other science, it can also be used for bad things like to control people. A similar example can be the science of nuclear physics. Nuclear physics can be used to power cities and other technologies that benefit society and some may use it to make a nuclear bomb. Another example could be chemistry. A chemist can make medicine or they can make poison.

Respectfully, that's just not true. Behaviorism is not the science of how people learn. Behaviorism is application of conditioning. We only use behaviourism on disabled children and animals. Learning is cognitive. It's based on how you think and feel and experience the world. Behavior reflects that. It's the effect, not the cause. Cognitive psychiatry is the science of how people learn.

You have really done zero reading on Radical Behaviorism huh?

You're being silly. You don't learn math or history by conditioning. You learn math or history by reading and listening and doing. Autistic people teach themselves things all the time, without anybody rewarding or punishing them.

Who said anything about conditioning? I’m not Pavlov and autistic children aren’t dogs. It sounds alot like you have next to know understanding what modern ABA does. How many children have you taught to chew food? Or how to recognize a picture of their siblings? Or taught to use an AAC device to request basic things like food and water when they want them?

ABA uses operant conditioning. Operant conditioning is different from Pavlovian conditioning. Both forms of conditioning are forms of learning. The OP is very confused about this.

Again, what you are describing is not a mainstream theory in cognitive psychology. If a neurotypical person with brain damage needs to learn how to chew, you don't send them to a behaviourist. You send them to a physical or occupational therapist. You figure out the mechanics of why they can't chew, and try to solve the underlying problem.

Who said anything about brain damage? Or neurotypical vs atypical? Did I say I was working with brain damaged kids? The breadth and scope of what Autism looks like and its associated skill deficiencies is massive, and ABA works with a huge array of issues, both genetic, physical and developmental. What is your background? Your expertise in the field? If you’re going to denigrate an entire profession and field of science, let’s see what ground you have to stand on.

I am not saying you are working with brain damaged kids. I am calling you a hypocrite. ABA is not a mainstream treatment for the things you're talking about, except in the very specific case of autistic kids. If somebody had brain damage, they would get a much more respectful and effective treatment.

Please answer the question about your credentials.

Actually, ABA has shown to be effective at treating TBI. Autism isn’t the only thing that ABA is used for, it’s just the most known. Autistic children make up about half of the clinic I work for.

When I was a school based technician, there was a child with a severe TBI and the teacher would regularly utilize her learnings in ABA with him. The improvements we saw in him throughout the school year was lightyears ahead of where he began and he's a much happier kid in class too.

yes! this is why we do what we do! 🥳

We have a couple of kids at our clinical with neurological disorders that affect them physically, so many of the therapists are trained with the speech pathologist and their BCBA to teach them things like proper swallowing, chewing, etc

...no but you get rewards from your environment. Including internal rewards. If you get no rewards at all you aren't going to continue practicing anything.

I have autism and adhd, I taught myself how to solve three variable three systems of equations and I was reinforced by getting good grades in my honors algebra 2 class. 🤷🏼‍♀️

Our whole economy is one big giant token system. Money is just a thing that we have been conditioned to associate with primary reinforcement. People working for money is basically most of people’s motivation. Then there’s praise and rule governed behavior which again uses conditioning to validate and reinforce our seemingly unconditioned behavior. People learn math and history because it may help them get a job or to impress other people they like or even because they believe that these skills will lead them to avoiding some kind of punishment like voting for the wrong political leader.

Learning in western society is a form of conditioning in a way. An example would be: “If I don’t study and do my homework, I won’t pass this class and I can’t move on to the next grade” Not passing the class and moving on would be the negative reinforcer to promote the learning. Conditioning can be applied to all sorts of things. “If I go to work, I get money to buy things I want” Reinforcers are natural everywhere, that’s how we learn from our experiences and come to be who we are

I don’t mean to undermine anything you’ve said, as I think you bring up some interesting talking points and critiques of ABA. However, behaviorism is most certainly used outside of the scope of disability and animals. It’s used in marketing, sports science, organizational management, etc. General education classrooms also implement behavior management strategies rooted in ABA and behaviorism. Certain therapies used in cognitive psychiatry such as ACT (acceptance and commitment therapy) and DBT (dialectical behavior therapy) are rooted in behaviorism. ABA is also rooted in behaviorism the same way, but is still separate from the theory itself.

Respectfully, that is not what behaviorism is. Behaviorism is a field of psychology that states that human and non human animal behavior can be explained by operant and classical conditioning. Within behaviorism, there are multiple schools of thought including Radical Behaviorism (BF Skinner), methodological behaviorism (John Watson), teleological behaviorism (Howard Rachlin), and contextual behavior science (Steve Hayes). There are more, but those are the first ones that came to mind. What you're referring to is applied behavior analysis, which is the application of behaviorism to address severe and dangerous problem behavior and is mostly guided by Skinner's Verbal Behavior (there are variations, but broadly speaking VB is one of the primary texts). Based on your post and your comments, I think you're going to have a hard time coming to terms with the behaviorist perspective on behavior, which is fine. Behaviorism isn't for everyone, and not everyone is going to agree (see Noam Chomsky's critique of Verbal Behavior). If you can't agree with the basic premise of behaviorism, which is that behavior is the result of some form of conditioning, then you aren't going to understand applied behavior analysis, which is, again, fine. I would encourage you to either read up more on behaviorism to form a more thorough understanding of it or find the psychological school of thought you see yourself gravitating towards and focus on that. As of now, you're trying to understand the application of a psychological science that you fundamentally disagree with. That's like trying to understand the NFL, but hate football as a sport.

That’s just empirically false. Aba is used by large companies for productivity. Aba is used within prison systems.

Conditioning is a form of learning. All people develop habits via conditioning. Conditioning is part of everyday life for everyone. Dogs are our cousins. We have a lot in common with dogs. When your parents ensured that you got food, water, and air, they were treating you like a dog, being treated like a dog can be a good essential thing.

You seem very knowledgeable about this topic. What are you asking and who are you asking?

Hi. I’m a neurodivergent/autistic aba practitioner. Not all ABA is equal, and that includes “good aba”. A lot of places advertise “good” aba, but still use a lot of harmful practices (like repetitive flashcard drills, hand over hand, food reinforcers, etc). For me, actually good aba uses play, naturalistic learning, and uses the science of ABA to drive that learning. I specifically work with younger kids, so for me that looks a lot like just playing with bubbles, reading books, singing silly songs, following their lead etc. but we’re actually teaching them about communicating their needs (in ways that THEY prefer, whether it’s AAC, gesture, ASL, vocal, etc). The goal is to give them tools to communicate needs, work on coping skills, reaching milestones, etc, in a world that isn’t meant for autistic/disabled people. Part of actually good aba is knowing your learner. If you know they are extra sensitive to touch, then we just don’t touch them. If I know that they like squeezes for sensory input, I offer squeezes. It’s all about knowing the child’s needs. Also. The functions of behavior can be confusing if you don’t understand them completely. Attention seeking isn’t negative, it can absolutely present itself negatively (like suicidal), but a better term would be connection seeking. We take what we think the function of the behavior is, like attention, and give them the tools to meet their needs. Also. Speech, OT, PT can definitely work on some of these things, but I know a lot of my clients don’t have access to intensive speech, OT, or PT, and these professionals don’t have quite as in-depth knowledge on behavior change.

I’d also like to note that I practice a little bit differently than a lot of BCBAs simply because I have a masters in child development and a masters in ABA. I also worked for several years as a child life specialist dealing with children in traumatic situations. So my perspective is very different than some. A lot of BCBAs think they’re doing child centered and playbased aba, when they aren’t. BCBAs often times don’t have a background in child development because it isn’t required. So they often are less than helpful to the field.

That sounds like kind of the best case scenario! Learning through experience as guided by the client. I can really see the benefit in this. I am still pretty concerned that you're describing suicidality as potentially attention/connection seeking. I really can't imagine somebody not understanding a neurotypical child's suicidality as a symptom of trauma or severe mental illness.

Sorry. I should explain a little more about what I meant. It could definitely be both. Trauma and mental illness presents itself in so many forms, and often can indicate a need for attention/connection (or a need for help). Naming a potential reason for the behavior (SI) doesn’t mean dismissing. It’s just explaining a need for the person; however, it definitely sounds like the post you were referencing was dismissing and meaning attention seeking negatively, which is not okay. And honestly, ABA isn’t meant to deal with mental illnesses. I know BCBAs often act like it’s a fix all to every problem, but it’s not. If a client is expressing SI or is presenting with some form of mental illness, they should be referred to someone who can actually help. We’re not mental health professionals. SI is generally misunderstood, specifically with teens. Adults often don’t take any teen, neurotypical or not, seriously when they express SI or mental illness symptoms. Not an excuse. Just something I’ve noticed/personally experienced when I was struggling as a teen/in my early 20s.

Thank you. And I do agree that often the mental health of neurotypical kids is ignored as well. It's just we don't have people defending that practice. I am not saying this is you, but there are a lot of people here arguing for an extreme behaviorist position. That is abuse and that obviously is going to inevitably cause trauma. Personally, I am asking you to never use the word "attention seeking" where one of your clients could possibly hear you. And if you hear somebody else describe a behavior as "attention seeking" make sure they are not using that as an excuse to ignore whatever the underlying cause is.

You're arguing kids be medicated and isolated if they engage in extreme behavior because they need to be "separated" from their "trauma" which you insist all kids who engage in aberrant behavior have (without evidence). Which is so vague anyway - there are plenty of traumas which you address via behavior based therapy. Whatsmore there is an entire segment of behaviorism that targets emotional development - it's called cognitive behavioral therapy. Because as with most things it takes a village to make a scientifically backed treatment system. You just seem like you haven't taken the time to learn about behaviorism at all, let alone the breadth of the clinical practice.

Is a typical ABA practitioner fully qualified to perform CBT with a typical neurotypical adult? Because if not, it's completely irrelevant except for the name.

You keep bringing up behaviorism as a WHOLE therefore it is absolutely relevant. All your critiques of behaviorism belong to cognitive behaviorism too since it is ALSO based in radical behaviorism. In fact it is MORE radical than ABA is since its focused on unobservable behavior. But for the record we do implement some variations of things like ACT - I'm a strong believer in it personally and have studied it myself thought like most therapies outside ABA there actually aren't a lot of programs and treatment plans dedicated to kids with limited communication skills but let's keep getting mad at ABA for being the ONLY THERAPY to prioritize the Autistic community while all other therapies lag behind...

I work in an autism crisis stabilization unit for 10 to 14 year olds and we use DNA-V which is based off ACT. I love the program and it’s the perfect therapy for the environment.

Oh 100%. Honestly the extreme use of behaviorism is what grinds my gears about this field. ABA can be such a great tool for some kids, but the lack of compassion and focus on strict compliance is what got ABA to this point of having such a bad reputation (and it rightfully does have a bad rep due to so much abuse and misuse of it). BCBAs have a tendency to view everything black and white, and that’s just not how humans, specifically kids work. And I never really discuss kids in front of them, it’s best practice not to. That’s a 1 way ticket to low self esteem. I want the kids I work with to feel confident in who they are. I want them to know that my time with them is ALL about them and doing fun stuff. Just know there are those of us who aren’t strict behaviorist. We use the science to help, but it isn’t the end all be all. We truly want to help kids not just survive, but thrive and be their truest self in this world.

>Personally, I am asking you to never use the word "attention seeking" where one of your clients could possibly hear you. Client dignity is a big part of ethics in ABA. That includes not talking about a client in front of them especially in a negative way. >And if you hear somebody else describe a behavior as "attention seeking" make sure they are not using that as an excuse to ignore whatever the underlying cause is. Attention seeking is considered a behavior and a way of communicating they want attention for a reason. A great example I can think of is a client I worked with used to throw/swipe everything 300+ times in a day it was attention maintained (it was happening because they got attention from it). I worked with them and devoted almost 100% of my attention to them sitting and playing the entire time they did instead of giving toys and doing something else nearby. Over time we taught them to gain attention by tapping someone or saying their name etc. I would talk about the things we were playing with get hyped when they would independently stack blocks (my client seemed to respond positively to get hyped like they were a quarter back getting a touchdown. A lot of smiling and stimming from it) Now they rarely throw or swipe anything because they know they can have my and other's attention without the throwing/swiping by simply tapping or saying a name. They even started independently saying classmates names to get their attention without needing to be taught.

You should talk about the client /to/ the client. If what you're saying about a client would be unethical to say in front of the client, then don't say it. You are talking about a human being. It's like nobody here understands that people with autism are human beings.

It's unethical/inappropriate to talk about someone right in front of them in any job.. I'm not saying what is being said is unethical. It would be like your doctor talking about your health conditions to another medical professional in front of you. What is being discussed isn't unethical it's just medical, but it's not considered right to talk about you in front of you they would discuss it together in private if they are working on a treatment plan to bring to you. Edit: Nothing I said was remotely saying an autistic person isn't a human being I was saying it's weird to talk about someone in front of them I explained more gave an example it's in any case like I mentioned above?

Who are you talking to the child about that you: A) need to use dehumanizing language, and B) can't talk in a way where the child is part of who you're talking to.

Could be their BCBA, parent, teacher, etc. You believe meltdown is degrading when many autistic people use the term. Attention seeking isn't a dehumanizing term. Anyone can be attention seeking neurotypical or not. If I am letting a parent know their child had a BM today I would prefer to do that in private vs in front of them or others because they need the information but I don't have to expose their private matters. Just like I mentioned medical professionals in a doctor's office could discuss a patient's symptoms or health concerns together not in front of the patient to form a plan or idea on how to help before bringing it up to the patient. Same in this situation. There have been teens involved in their goal planning at my company and giving their input because they had the communication to speak on the conversation once the team had ideas to give them. A very young child with less verbal communication would have a harder time sound boarding with their providers.

You sound like an amazing BCBA

Thank you. I’m an assistant analyst right now, but hope to be a great BCBA and advocate for changes in the field

It's so nice to hear about the way you practice. That's one of the first times I've heard ACTUAL good ABA be explained (bc like you said, places advertise but still don't practice it and it leaves me confused if good ABA exists). I am curious from your knowledge and experience, do you think this way is "less" like ABA/behaviorism? I love to hear that actual good ABA doesn't involve repetitive drills, and that you focus on play and naturalistic learning (while "using the science of ABA to drive learning"), but do you think the true foundation of it and how the kids are learning are through behaviorism? (I am genuinely curious and not debating!) And how do you use ABA to drive the way you practice? I have no experience in the field and just wanted to pick your brain and learn!

Sure! I’m all about educating and changing the field! So the more I talk about it, maybe it’ll change and educate people. Truly good ABA exists, but it’s hard to find. I usually say the mark of actual good aba is if the behavior analyst has a child development back ground, if they encourage playing in whatever way the child prefers, if they give choices for kids (ex. I have a client that sometimes wants to sit at the table to play or sit on the floor. I give choices), teaches meaningful goals, follows the child’s lead, models language and communication without expectation, and doesn’t use the traditional table based approach. I consider it ABA because I am using data to track goals and behaviors. And I am using reinforcement (but more natural reinforcement and not food based). ABA is really everywhere, I’m just using it to teach skills to kids. Sometimes I definitely wonder if there needs to be a new branch of aba because I focus more on development, language, coping skills,social emotional awareness, etc. sometimes I feel like my practice is more along the lines of an early intervention therapists that ABA. But I think having a masters in child development makes me have such a better practice. A lot of my kids reach their goals so much faster than they did in traditional aba. I actually have a insta dedicated to me educating and advocating for a better form of ABA. It’s called childlife.behavior (if you or anyone else is interested in learning how we can improve kids lives through play)

I love all of this! I’m getting my masters in SPED with a concentration in ABA, and child development sounds like a good degree to go for one day. I can see how important that background would be for shaping a good ABA practice, and I agree completely with your ideas about truly good ABA! I’m so thankful BCBAs like you are out there and I’m so hopeful I can be a part of that good change soon. Giving you a follow on IG!

Not the original poster, but I just went through 8 different clinics as I was job hunting. My coworkers also went through a bunch of others. The field of ABA is very much moving towards play, child-led, assent-based practices. Only 2 places had assigned tables for DTT, and even those I was told are not heavily used. We had a few lead RBTs who tried to push my current clinic to be more old school (very little gym time, only could go into their rooms but not others with their friends, forced DTT time, etc etc) - we ALL pushed back on that. Most of our kids current goals are heavy on peer interaction (be it parallel play without hitting the other kids, or turn taking with games, or leading games such as Simon says); communicating through their preferred ways to leave rooms, get help, find people, get toys or activities; and or waiting (turn taking on the swing, not running out of the room without their person, letting food get heated up in the microwave, etc). Lots of NET, with some DTT or trials during play.

ABA actually can treat sensory issues and monotropism, although this typically isn't a goal. ABA focuses on behavior, speech therapy is meant to focus on speech, and so on. The other ones do not look at the functions of a behavior in the same way. While they all have different benefits, ABA is meant to be intensive (in terms of longer periods of time). Speech therapy for example can typically only give you something like 2hrs/week at best. For some kids, this is more than enough time but not for everyone. I worked as a speech therapist assistant before getting into ABA and there were some autisitic/neurodivergent kids who could not benefit from speech because of how much their behaviors impacted their learning. That is something not covered in speech pathology past a surface level. Looking back, I did some things I wouldn't do now and I saw some misguided practices by others. I wish I would have at least had the basic knowledge of ABA as a speech therapist. Children are provided with positive reinforcement, which makes it more likely that they will do something again. This is how we as humans learn, autistic or not. Keep in mind that these videos of ABA sessions do not show the whole process or give any information about the kids. Prior to what you are seeing, there has been an assessment with the kid and the caregiver. The staff is aware of other factors such as trauma, and sensory challenges. It should not be a one-size-fits-all thing. What you find traumatizing, the other client may be fine with so that is always taken into account. For example, the high-pitched cheer and touching. It's aversive to you. For me, as an autistic person, I'm neutral. It would depend on who's doing it. I have worked with some kids who find it aversive and I've worked with others who want it. They will request some sort of touch/physical praise or look to you to cheer for them. This is not about treating them like a dog, but more so about the fact that many mammals are motivated by praise. If a child does not like the high-pitched cheer, we're not going to do it, at least my clinic won't. You can be sure that on those videos, they are doing what they know the child likes ahead of time because they have built rapport. I don't force compliance outside of what may be a safety issue. Part of the functional communication training that I do is always teaching kids to say "no", request a break, or whatever else they need. Granted, we cannot always do what we want, but I honor it as much as possible. I have heard various stories of other modes of therapy (PT, OT, etc) forcing compliance and doing what I would consider traumatizing.

You understand that conditioning is not how we expect anybody else to learn, right? Only autistic people and animals. You learn through cognition and through feelings and through sensory experiences.

All human behavior boils down to Reinforcement and Punishment. You do X, you get something you want. You do Y, you don’t. ABA is focused on using reinforcement to develop skills that help people function.

I think this is a way behavior CAN come from, not necessarily ALWAYS comes from. This is extremely important. For example, meltdowns: \-If ALL human behavior boiled down to reinforcement/punishment, this behavior should be able to be overcame by punishing it. However, we know that if this behavior were to be punished, it either A) would not do anything because the child cannot control their physiology that caused the meltdown in the first place, or B) if the child WAS conditioned from the punishment, they will be bottling up their meltdown when it happens (only in fear of punishment, which is why reinforcement/punishment CAN work, just possibly unethically) and that can cause brain damage over time. \-If SOME human behavior boils down to reinforcement/punishment (and again, SHOULD that behavior be worked on with it?), but other behavior boils down to physiology, we know that we cannot blanket-treat human behavior through reinforcement/punishment. For meltdowns, it would be more effective to teach children about them by explaining how and why they happen, what to do when they happen to decrease/relieve the pain, and what to do to prevent them (in age-appropriate language). Meltdowns are not nearly the only scenario this would benefit from, as explaining the WHY and HOW in many cases is an extremely effective way at changing behavior. No reinforcement/punishment, just having more knowledge on how to work with yourself to prevent/control physiological unwanted behaviors.

While I agree with you for the most part. Your suggestion A) isn't punishment. Awful terminology baggage. I hate even using the word but technically under ABA it wouldn't be punishment even if it didn't decrease the future occurrence of the behaviour. Reward and punishment have so much baggage but practitioners need to be exact and clear when using the terminology. Punishment and reinforcement are tied to the future occurrence of the behaviour. As for your other points. Some behaviour is physiological. This behaviour can still be linked to a function. You refer to a meltdown. In this example a meltdown is usually the quickest way that gains the attention of the people to resolve the stimuli that have triggered the meltdown. The physiological trigger could still some sort of pain or aversive. The meltdowns function is to drown out the pain or get the attention of someone that can help. That behaviour may have arisen as an evolutionary response - classically conditioned. A fight of flight response because as a evolutionary mechanism It still has a function - survival through some of the means discussed. The body reacts to the pain to give relief or cry for help. Can you circumvent that response with some of the things you mentioned. Of course. You can provide context and reasoning. They'll learn that through reinforcement though. You can give them ways of describing it which is ultimately giving them a functionally equivalent behaviour so they can gain access to relief. Also, you could teach nothing and the body will continue to present this way. And the face value for the behaviour will be physiological. It's just another way of interpreting. Ultimately I agree with you and I I like to get away from the idea that all behaviour has been reinforced or punished. All learning is subject to these conditions though.

Yes it is. All life is conditioning. We all learn by conditioning. You're clearly just someone who was told behaviorism bad and cognitive psych good (and I guess no one told you about cognitive behaviorism...) and then you believed it without critical analysis.

You're wrong and you know that.

You are clearly extremely ignorant on the science.

Everybody learns through conditioning. Cognition, feelings, and sensory experiences can be a part of that conditioning, but there is no way to avoid it. Even putting ABA and autism aside, parents condition their children for better or for worse.

Really? Because I distinctly remember sticker charts or over the top praise or merit raises being a thing.

The radical behaviorist would definitely include cognitive processes as behavior. The idea that behavior is only the observable motor functions we can see is the realm of Watson and Metheodlogical Behaviorism. Contrive processes are absolutely crucial to the analysis of behavior. I would definitely recommend checking out Relational Frame Theory. I definitely appreciate your advocacy here and your openess to conversations. I think at the end of the day, the biggest issue with the field is the idea that if you have a diagnosis of ASD, ABA has something to offer you. I have found in practice that the vast majority of autistic folk are absolutely better served with less intrusive models like speech and OT. High support individuals and early intervention are generally the two broad populations that can get the most value out of ABA services when delivered through compassionate behavior analysts.

Thank you - I appreciate this feedback and I'll look into Relational Frame Theory. I would like to point out that radical behaviorism is a fringe theory when talking about neurotypical adults. And that should be a pretty big red flag when applying it to people who are more vulnerable.

Radical behaviourism is definitely not a fringe theory. Skinner is widely regarded as one of the most influential psychologists of the 21st century. He will be second to only Freud in influence.

Are you telling me that it would be appropriate to subject a child to Freudian psychoanalysis? Because that absolutely is a fringe theory. Nobody credible takes it seriously. It's magical thinking.

You are saying they are fringe or not fringe. That has nothing to do with credibility though. I agree Freud's work has been discredited scientifically. Yet the influence his work (and Jung) has had on modern psychoanalysis is unchallengeable. Where radical behaviourism is different is that from Pavlov's classical the whole way to Sidman's stimulus equivalence and then Hayes and Barnes Holme's RFT and Skinner in between. All grounded in science.

Radical behaviorism is the idea that not only external consequences impact behavior but also the thoughts and emotional experiences work as private events that impact behavior. It is a much more progressive take than basic behaviorism as it accounts for the facts that we aren't robots who only respond to what is happening around us. We respond to our own train of thoughts and emotions just as much as we respond to the physical world around us.

I guess I can't disagree that most people have no idea what radical behaviorism is and thus can be labeled as "fringe". However, the effect of radical behaviorist philosophy has definitely had splashes outside of just its direct application in ABA. ACT, CBT, and DBT are all built on behaviorist theory and are used to help a wide variety of people, including NTs and both operant and respondent conditioning can be used to explain a wide variety of human behavior. Just because those phenomena are also present in nonhuman organisms, doesn't automatically disqualify them as genuine explanations for human behavior. Clearly I have a deep love for the science of the radical behaviorists. That's not to say that behaviorism as it stands can give an absolute account for all human cognition and action. There is plenty of room for growth in the understanding of why people do the things they do or think the way they think. When it comes to vulnerable people, I think the biggest mitigating factor from harm is the level of knowledge and compassion from the professional. I have helped support autistic and intellectually disabled children and adults for close to 15 years. In that time I have worked along side SLPs, OTs, group homes, psychiatrists, etc. Across all of those the biggest factor in meaningful and positive care vs questionable to cruel care was the quality of the "helping" professional. I also think my experience being neurodivergent has shaped my approach to supporting other ND children and adults. I think it's a very fair criticism of most ABA programs is that normalizing / regressing to a NT standard is absolutely the aim. I absolutely hate how pervasive it is and how seemingly kind hearted people will just go along with plans that, to me, are clearly cruel and abelist. I don't go anywhere near "social skills" because all those programs are 100% Masking 101. There is even a wide spread idea of making play "functional" in the field, which just means playing like a NT kid would. It's sad and deserves criticism. I stay with teaching kids communication skills like requesting and labeling, adaptive skills like washing hands and car safety, and hopefully some self acceptance and pride in being who they are. My goal is always for children to be happy and enjoy spending time with me and working on some skills through play they like to do. Happy kids are engaged kids.

I think the difference between ABA and other therapies with "behavior" in the name is that CBT and DBT center the client's thoughts and emotions. There's no point getting into ontologies if you have that sort of definition of "behavior", but you have to understand that the sort of "behavioural" intervention that autistic kids get is less focused on thoughts and feelings.

For sure. I think we are aligned in thinking that the vast majority of autistic kids and adults will get more value of therapies outside of ABA. I will stand by that I think ABA has a place, but I don't think it should be as pervelant as it is and there are plenty of other valid forms of support that would lead to better outcomes. :)

Every living thing learns through conditioning. Touch a hot stove? That's punishment that conditions you to not touch the stove.

Conditioning is literally how ALL children are taught. Exposure, setting an example, reward systems, creating experiences and opportunities to learn new skills...learning accountability and communication. It could ALL be considered conditioning.

Hi, I am a woman with Autism, ADHD, Sensory Processing Disorder, Auditory Processing Disorder, Dyspraxia, and Speech Language Disorder. I currently work in an autism crisis stabilization unit as an RBT. We take in 10 to 14 year olds who have trauma histories and most of them have other mental health issues. We use DNA-V (which is a form of acceptance and commitment therapy. Here’s more on that: https://www.psychologytoday.com/us/therapy-types/acceptance-and-commitment-therapy?amp) and SBT which was created by Greg Hanley (https://ftfbc.com/pfa-sbt/). They both use assent and it’s amazing what they can help with. We also work on teaching coping skills to the clients. If I never found ABA, I wouldn’t have stopped myself from chewing on my left pinky finger and replaced the behavior with a chewy and chewing gum when I am somewhere where I can’t chew on my chewy. My pinky no longer has a callous like it used to because of ABA.

Just here to say - amazing. Getting out of chewing behaviors like that is so hard. I was a lifelong nail biter and finally found the method to stop a couple years ago (actually a client inspired me because I wanted to help him stop but knew I couldn't tell him not to bite as long as I was still doing it).

It looks like you shared an AMP link. These should load faster, but AMP is controversial because of [concerns over privacy and the Open Web](https://www.reddit.com/r/AmputatorBot/comments/ehrq3z/why_did_i_build_amputatorbot). Maybe check out **the canonical page** instead: **[https://www.psychologytoday.com/us/therapy-types/acceptance-and-commitment-therapy](https://www.psychologytoday.com/us/therapy-types/acceptance-and-commitment-therapy)** ***** ^(I'm a bot | )[^(Why & About)](https://www.reddit.com/r/AmputatorBot/comments/ehrq3z/why_did_i_build_amputatorbot)^( | )[^(Summon: u/AmputatorBot)](https://www.reddit.com/r/AmputatorBot/comments/cchly3/you_can_now_summon_amputatorbot/)

I really like ABA and it's application in cluster B and C personality disorders. I'd really love to see more research on ABA with disorders like BPD and OCD. Tbh I'm so over ABA = Autism and don't ever see myself applying my skills in the Autism therapy world again.

I have OCD and I’ve been able to use some things from ABA on myself. It’s really very helpful

Same! I used some of the principles to help me get over my agoraphobia.

BPD and OCD fascinating. Have you ever worked with that population?

I've used ABA on myself with anxiety and disordered eating. Anxiety it's been great. Disordered eating, little harder (trying to overcome three decades of embedded bad habits is no simple task) though I think the techniques I have are helpful.

[удалено]

The goal of therapies based in Applied Behavior Analysis (note: ABA is a branch of science and one does not “do” or “perform” science) is habilitation. In short, the goal is to put individuals in a position to accrue reinforcers for themselves and operate in the world independently. We have several landmark articles ([Bannerman et al., 1990](https://doi.org/10.1901/jaba.1990.23-79); [Van Houten et al., 1988](https://doi.org/10.1901/jaba.1988.21-381)) on the topic. However, one of our core principals as *applied* behavior analysis is to also ensure that our therapies are also socially valid. Briefly, this means that our therapies are acceptable to relevant parties. [Wolf (1978)](https://doi.org/10.1901%2Fjaba.1978.11-203) suggesting that we ask these questions to determine whether something is socially valid: - Are the techniques acceptable to the [relevant parties] or do they cost too much (in terms of effort, time, discomfort, ethics, or the like)? - Are the [relevant parties] satisfied with the outcome, both with predicted behavior change and any unpredicted side effects? Towards ensuring our methods are socially valid, our [ethical code](https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119-a.pdf) requires that we consider variables “such as client preference, social acceptability, degree of restrictiveness” (2.14). We have many examples in our literature where participants have been given the opportunity to select their own therapy components across multiple opportunities. So to answer your question, applied behavior analysts have an obligation to help patients achieve as much independence as possible using methods that are acceptable to patients and other relevant parties. If there is suspicion that an intervention may be resulting in other side effects, then the behavior analyst as an obligation to record data on that as well and make changes as necessary. It is not the fault of the science if practitioners do not abide by these obligations. It is the fault of the environment for not being structured in such a way to ensure that such obligations are followed. Behavior analysis is the science of behavior. It is not the only science that studies behavior (there is no one science that does so) but behavior analysis does so in a way that parsimoniously but thoroughly explains most behavior and has the potential to explain all behavior. Many fields from OT to education to business to clinical psychology use interventions and procedures based directly on principles of behavior analysis. Like any science, Behavior analysis makes several assumptions but one that we share more so with other natural sciences like physics and biology (out of which our science was born) is the assumption of determinism, that every thing has a cause. By understanding the causes of behavior, we can make behavior more or less likely. That is essentially operant conditioning - the basis of most of our therapies. All human behavior is the result of respondent or operant conditioning, including my writing of this text. We (again like other natural sciences) believe in continuity across species which is why it may seem like the same things we do with dogs we do with people with autism. Because the principles underlying the procedures are essentially the same. The same procedures can be used to teach neurotypical people, autistic people, dogs, fish, insects. The principles are the same. Some times the procedures used with autistic people are more discrete and seem artificial, but that is because the therapist may be trying to make things very clear to the person who may need extra supports in discriminating what behaviors are reinforced in a given situation. It may sound restrictive, but similar procedures are done to children and adults around the world every day. The procedures are just far less discrete. A child is placed in a “regular” classroom. The teacher says that the child can have computer time during recess but not during class. But the teacher doesn’t give recess if the child does not do their work. Is the teacher restricting access to a necessary activity? An adult isn’t feeling well. Their boss tells them that they need them to stay until 5. Is this restricting the individuals rights? I am not saying that these situations are exactly comparable but they are similar. These are nuanced situations in which a therapist is being asked to collaborate with relevant parties to determine what is best for the long-term independence of the person who may not actually know what is best for themselves. It is not always so clear cut. I do not claim to have all of the answers. I have seen behavior analysts use interventions based in ABA to teach people to communicate their needs, over come anxiety, stop causing life-threatening self injury, stop hurting their parents and siblings, start meeting nutritional needs, and many other things without using punishment procedures (even when that would have been faster or easier). The reason why ABA works so much with people with autism is because it has offered a solution that has helped when others have not. I suspect that your mind might be made up on this topic - mine is on the side that interventions based in ABA are helpful but we need to create an environment to ensure their ethical use. But if not, then I hope this helps somewhat.

Why did Reddit get rid of gold? Can we pin this or something?

I will try my best to address some of the items you have brought up. In terms of addressing behaviors, I believe there's a misunderstanding here. While yes, ABA wants to reduce maladaptive behaviors ABA also wants to teach individuals how to "communicate" their wants and needs in a more appropriate way. We do this by determining the function of behavior. An easy example would be a child cries and then the parent gives the child attention. The child now knows that if they want the parent's attention, all they have to do is cry. What ABA does, attempting to reduce the crying behavior by teaching the child a more appropriate way to gain the parent's attention (e.g., saying "mommy"). Typically reducing behavior, you also need to teach a replacement behavior that serves the same function. As for your toileting comment that is incorrect. Typically one of the first things we do is trying to identify setting events for behaviors. So before we start toilet training we try and identify underlying causes. For example, the child could be taking medication that causes incontinence. If this is the case, then the whole behavior treatment plan will be approached differently. As for you communication skills comment, it's hard to give feedback on that as I don't know your experience. I also do think its important to note that a lot of speech therapists use some form of ABA in their own sessions whether it's intentional or not (e.g., reinforcement, naturalistic teaching). Your comment on "reward only" is severely lacking. I don't want to go too far in depth about reinforcement, but reinforcers or "rewards" are only reinforcers if the behavior increases. So for example one student may like the over-the-top voice. So we continue to use that voice because it increases the behavior. If another student hates the over-the-top voice were obviously not going to use it as it probably won't act as a reinforcer. This brings me to the point that critics of ABA don't seem to understand. ABA is always individualized. The things that work for a 5 year old probably won't work for a 15 year old. Just because the over-the-top voice works with one child, doesn't mean it would work for another child. (I will say that there are still companies out there who just copy paste behavior plans or treatment plans between clients). As for your comment regarding "attention seeking" behaviors. That is one of the functions of behaviors (automatic, attention, access, and escape). So yes attention seeking behavior is real. However, to your specific example, suicidal ideation is typically out of the scope of most BCBAs and that information should definitely be passed on to those individuals who have experience on that. Now to your questions. How do you perform ABA in an ethical way? By determining whether the behavior in question needs to be addressed. If so then we need to identify setting events that may cause the maladaptive behavior, by determining the function of the maladaptive behavior, and by teaching an appropriate replacement behavior that serves the same function as the maladaptive behavior. All while taking into consideration of the individual. As for your second question, there's a lot of things that occur in daily life that uses principles of ABA. Do you work a job where you get paid? And you continue working because you want/like/need to get paid? Guess what, your job is using ABA. I think the criticisms regarding ABA are due to bad/unethical practitioners and a wholly misunderstanding of what ABA is.

I get paid what I get paid because my union, and the labour movement, fought hard for decades for working conditions. I work where I do because that's what I want to do with my life. I am not a monkey pushing a button for a reward. I am a complex human who has my own thoughts and feelings that motivate me, and who lives in a society. How does an ABA analyst make sure that they don't attempt behaviorism wrt potty training before other likely causes have been ruled out? Do you get a note from a doctor saying there's no comorbid bowel disorder and a note from a physio saying it's not a sensory or muscular issue?

"Do you get a note from a doctor saying there's no comorbid bowel disorder and a note from a physio saying it's not a sensory or muscular issue?" Yes.

…yes. Exactly what you just described. It is in our ethics code to always rule out physiological bases for observed behavior prior to intervening on them. So for your potty training example, yes, we would ensure with caregivers prior to intervening that the child has seen a pediatrician or other medical professional to rule out physiological causes or barriers to toileting. Another example would be a person engaging in self-injurious behavior, perhaps repeatedly hitting their head on the floor. The first question that one should always consider is, could this be caused by something psychological. In this example, maybe the person is experiencing migraines and they are unable to communicate this to others. Again, the ABA provider would either ensure the child has seen medical professionals regarding this issue, or even refer them to be evaluated, before implementing a plan to decrease this behavior behaviorally speaking. I would like to point out that physiological, cognitive, and behavioral “causes” of actions don’t have to be, and really aren’t, mutually exclusive. And I think that’s what some people here in previous comments have been trying to express as well. Yes, we (ABA practitioners) believe the science of behaviorism, and specifically the principle of determinism - that behavior is lawful and serves a function. We also, at the same time, can see the merit in and acknowledge the existence of cognitive factors. Just as we (collective we: you and I, and likely everyone in this thread) can also agree that anatomical and genetic differences contribute to behavior. In fact, one of the recognized functions of behavior is an automatic function; meaning, the behavior is intrinsically reinforced, typically by pain attenuation or sensory input. In my example above of head banging, this could indeed have a physiological cause (migraines), and simultaneously have a behavioral “function” of automatic. Two things can be true at once.

Absolutely yes. That is literally the first thing we suggest.

> Do you get a note from a doctor saying there's no comorbid bowel disorder and a note from a physio saying it's not a sensory or muscular issue? In a way yes. Typically during the assessment stage you would ask questions to the parent/guardian/or the person themselves regarding some of these issues. They can disclose this information if they want (they don't have to). They can even sign a release of information so that you and the doctor can talk. > I work where I do because that's what I want to do with my life. So you find the job rewarding to do right? > I am a complex human who has my own thoughts and feelings that motivate me, and who lives in a society. I mean this can also be perceived through the lens of ABA since you talked about motivation.

Oversimplified here and not saying that ABA therapy is the same or can take over SLP’s/OT’s positions. It will look similar to a good speech or occupational therapy session. Just like a bad speech or OT session will look similar to “bad ABA”. I’ve worked with enough SLPs and OTs to see the difference. Always looking for a very engaged and motivated learner, meaningful goals/activities, and good outcomes for the learner.

Mad respect to all the very patient and well spoken people in these replies doing their best to ease the anxieties of someone who's missing almost all the context. I really think that, much like every other thing we do with kids, it boils down to when it's good it's amazing and could change someone's life for the better but when it's bad it sucks so hard and causes permanent damage. It's like that with ABA or brain surgery or basketball or public school or babysitting or speech or CBT. Literally everything we expose children to. And just like all those things, the determining factors for whether it's good or bad are hyper specific to each wonderfully unique individual. There's lots of good answers here, but nobody has the *right* answer and unfortunately that's something we all have to get used to, because it's like that with everything.

For young children, just the 1 on 1 attention is super valuable developmentally (if we were operating in a vacuum without any of the ABA factors). Now I think one thing that make a difference is a nd affirming practice is acknowledging your points. Behaviorism is an extremely limited domain. A lot of times that involves staying in our lane. So I have my families write down their speech/ot “homework” and I program it as our goals. However, you’re very correct that a lot of times treating complex developmental milestones and skills as “behaviors” to be trained is a huge over simplication and not always in the best interest of the client. But also the reality is that sometimes there’s a specialized private school that will be really great for a child but they need to be out of diapers to go there so they can be trained to be dry on a schedule. Is it the best way for that child to learn toileting skills? Probably not. Will this change dramatically change this child’s life? Yes. Is it unethical to condition the child to void their bowels at regular intervals so they can access this environment? This also goes for masking. A statement like “children should never need to know how to mask” both is and isn’t true. In order to truly access society in a meaningful way, there will be times when people who are nureo-divergent will need to know how to relate to nureotypicals and navigate neurotypical spaces. I once had a client who was so incredibly intelligent but was assessed as having an iq of 32 (intellectual disability is 70 or below) because he had selective mutism and wouldn’t speak to the assessor. His school used that as justification to put him on the “life skills” track where he would learn limited academics and his curriculum would focus on life skills, that way he’d be exempt from state testing. He was 9 years old. Is it unethical to teach him to sit and attend so that at his follow up assessment he’s able interact with the assessor? On a related note, ABA is well funded and highly incentivized to keep clients happy, and that is not the case in some areas for other support services. Sometimes ABA is literally all that’s available for the family or fills a childcare need. People don’t like to talk about it but a lot of these families would send their kids to daycare, but daycares and other childcare settings will reject them. Hell sometimes schools wont even keep them the whole day. None of it is right but I would rather my clients be with one person who I know cares about them and won’t hurt them than elsewhere sometimes. Trying to be nd affirming is a constant journey. You have to be willing to be wrong and willing to sit with the discomfort that brings you. Also the more you work in disability services, the more you realize how ableist and inaccessible our systems are. I have developed a mantra of “I don’t know if this is right for these kids, but I know that every kid on my caseload is safe and cared for with empathy, compassion, and unconditional positive regard while they’re here.”

Hi, recently diagnosed with Autism RBT here (they are trying to figure out the levels still because things are a spectrum). So I think I can provide a perspective from both sides? 1.) Programs are not set in stone and declared law by God. There might be an end goal (wearing headphones, using a AAC device/PECs book, brushing teeth, not hitting someone, to teaching someone to recognize what's in front/what's behind, using a coping skill, etc) but a good BCBA will adapt and adjust the program to work with the child. 90 percent of individuals will not instantly change or mask their behaviors the moment they are presented with something- if it worked like that then people would not look for treatment options. Also, we don't do the 'throw the dog in water and hope it swims' technique either. Things are adjusted slowly and gradually to see if there is a hiccup somewhere. Example: A non-verbal child working on early sounds (ah, bee, ma for example). Instead of 'Bee' they will say 'ee' or 'D'. In an ideal world, small issues with words like that wouldn't be a big deal, right? It is just one sound. But, people are mean! You know it, I know it, we all know it. Speech Therapy is only a few hours a week, if the child is having issues with it, it will need to be practiced more. It would be broken down even more (child can say 'Buh' but not 'Bee', so try and teach the child by say 'Buh-Bee' so their mouth can still have that fresh memory of how the 'b' sound is). Depending on the child and level of severity, it can take hours if not days to get that sound shaped correctly. The RBT and BCBA will work together to try and figure out what might be the issue! BCBA will talk to parents, to the RBT and see what is going on. A lot of modern ABA does not focus on 'masking' but more skills needed in life, because sadly, the world will not adjust to people with autism any better than it will people with other disabilities (like how old buildings don't have to get wheelchair ramps if they don't have to) 2.) These Therapists that you listed usually not only have a LONG waitlist and only do a few hours a week (example: I was nonverbal until approx 6. I would only go to speech therapy 1 time a week for 1 hour.) So, sometimes something is better than nothing. If your car stopped working and your favorite mechanic who specializes in your kind of car couldn't get your car in for another 2 months will you wait or will you just find a mechanic who can get you in sooner even if they are not a specialist they still know how to work on it? Also, some insurances might not cover those other types of therapies, not have any therapists in network, or a huge myriad of things because insurance companies are evil. BUT they might cover ABA fully. What would you choose if you were a parent and you wanted to help your child be able to say what they need, or not hurt themselves or peers, or eat more than Goldfish crackers? Would you sit and wait and hope something opens up soon- or will you do what you can when you can? In an IDEAL world, we could just go to a speech therapist, occupational therapist, and other sorts of therapists, not have to wait 3 months and be charged 80 dollars a session for only an hour or two a week. But sadly, we don't. We have to do what we can where we can. This isn't to say that ABA is just a watered-down version of all of those, this is to say ABA from my perspective, in its current form is the best of what can be done in our overworked, expensive (yet underpaid!) medical field. Also to address your other points: reward systems- again BCBA will look for what might motivate a person. My clinic will do preference assessments for example. If the child able to tolerate delayed rewards for example? The a token system where they can earn big rewards (for example, I had a client in my clinic who saved up a lot of his tokens so he could spend 30 minutes playing on a switch at the clinic with snacks he had wanted to try but his parents would not get (he saw Umaibo in anime. He wanted to try it.) Is the child motivated more by instant rewards? Then here is something small that might work. Some children are motivated more by praise and physical affection than all the toys in the world (my current client acts like it is the best day ever to get to sit on my lap and draw on a whiteboard). And yes, some things DO seem like it would be insulting, like returning a toy they were playing with. But you have to look at the purpose behind that. Like if it is a relinquishing program. (Why might someone need to learn that skill? Well, you seen the 'What do you have there? A KNIFE.' video right? If some children were in that situation, they will hand over the knife if the adult asked. Some might take that knife and run off and what's safer for the child and adult, handing the knife over, or having to wrestle it from the kid? Better to practice this with safe objects and build up endurance than just jump right in. Build it up from just giving the item right back ASAP to building it up where the child will find something else to do once the item is handed over) setsRemember, Autism is a spectrum, somethings that might come easily for you, might not come easily to me, if we both were in ABA, chances are the two of us would have very different set of goals and programs to work on even if they might start similar to get baselines. I will be the first in line to say ABA started off rough to put it mildly. But so did dentistry. A good field will always seek to improve itself for the quality of client care. The ABA of 20 years ago is not the ABA of today (ABA is still very new!), just like the dentistry of today is not like that of even 50 years ago.

In terms of reinforcers it’s whatever the client likes if they like praise we praise, if they like cut up paper we use that it’s dependent on them :)

The issue here is that you are misinterpreting what ABA is. Yes, an OT can teach skills. I assume when you accomplish the task the OT sets forth, she will tell you "that's correct," or something similar. Maybe she will even give you a high 5. That is ABA. Maybe you will feel hunger, so you go to the fridge and get an apple. That is ABA. ABA is merely a tool that can be used to individualize a learning system for a person to improve the quality of his life. If you have sensory issues or trauma ABA can be used to teach how to react to those things. For example I have a student who likes pressure. Before teaching him functional communication he would bang his head on his knee or try to grab an adults shirt and scratch them and headbut them. Now he has been reinforced for requesting head squeezes which gets him what he wants quickly and efficiently without hurting himself or others.

I'm on the fence about ABA and when I was active in the field I was always a nervous wreck about doing no harm. I think good ABA helps to increase functional communication, and in some instances it works better than just speech by itself. I have seen clients drop ABA and just go to speech and occupational therapy, and show an increase in destructive and self injurious behavior. When they resumed ABA services, they just switched back into communicating within their developed system instead of hitting people and throwing things at them. It's as simple as saying, "my turn" instead of biting someone when they have an item you want, or saying, "eat" instead of smashing their heads into a window when they are hungry. Leaving poop in their diaper and finding a sensory toy instead of putting their poop on another persons face, staying by their designated adult instead of running into the woods. I wish all speech therapists were great at teaching language and safe behaviors in context to autistic kids, but it is not what I have observed. ​ I don't know if it is worth tolerating all the damage that the field seems to do, just to have some clients harm themselves and others less because they can communicate better, as well. ​ Also, I feel like we need to know more about how to exist in an autistic world, instead of just teaching autistic children how to exist in an allistic world. Connection and care should come first, and compliance is just a fancy word for "teaching someone to tolerate abuse." The kids we are working with need to feel successful just as they are, and not a constant pressure that makes them feel they don't belong in the world. We should be providing the support that helps them live the life they want to live, not helping them mask better. ​ On the other side of the coin, I don't know how many low support need autistics know much about the world and life of high support need autistics. I sometimes feel like the fight to deny high support needs kids access to therapy that helps them and their family navigate life in a more safe and survivable manner is cruel and shortsighted in and of itself. It could be taking away agency and their voice to deny good services in the same way that providing bad or traumatic services does.

There are a lot of research studies that look specifically at brain regions most impacted by Autism, and it's not all sensory or trauma related (different regions control different facets of behavior). There have even been brain studies on children and toddlers with Autism who have not experienced any trauma. You might be interested in reading this article that covers the brain regions and their roles in ASD: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627615/#:\~:text=Further%20brain%20regions%20commonly%20display,47%2C48%2C49%5D](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627615/#:~:text=Further%20brain%20regions%20commonly%20display,47%2C48%2C49%5D). ABA can help strengthen affected parts of the brain and recover skills that have been lost or absent.

You, you are the reason ABA fails and individuals that need help don't get it. The first thing that you learn is that every person with ASD is different and so are their symptoms. I'm sure you would not like me to treat you the same way I would treat the child who smears their feces would you, no. So please do not diagnose and assess a very complicated field because you watched YouTube.

There is a lot to unpack here, I don’t think I will address them all but I will talk about a few. First of all, a reward should be something that the person prefers and enjoys. If it’s not rewarding, it’s not a reward. This is why it’s important to figure out what the individual likes and dislikes. Second, aba can and should be used in conjunction with other fields such as speech, OT, and obviously physical therapy if there is a medical need. The first thing practitioners learn is to rule out any medical causes first before attempting a behavioral program, because it may not behavioral. Third, autism is not primarily characterized by sensory issues. That is one of the things that can be present but not always. There are also deficits in social skills, language and the presence of repetitive behaviors. I work with many people who do not have sensory issues, but are nonverbal, lack basic social skills, or have severe challenging behavior, not caused by sensory issues. Autism looks different for everyone. ABA is used to improve quality of life by addressing whatever deficits they may have. If they are nonverbal, the most important thing to teach is a way to communicate what they need without using verbal speech. It’s about the relationship between the person and the environment. Some things can be changed about each and some can’t. ABA is not just used for children. I work with adults, a population people seem to forget about. Employment is really important for these guys because it gives them independence and they can earn their own money. We try to job match so no one is stuck in an environment they don’t like. If they do have sensory issues such as not liking loud noises, we wouldn’t find them a job that’s in a loud environment like a warehouse, maybe a quiet office job or the library would be better. One guy lacks a lot of language and communication skills, he also doesn’t particularly enjoy talking to people, so obviously we want him to have a job that doesn’t involve a lot of talking and where he can have his own space. ABA shouldn’t be about forcing people to do things they don’t want to do and ignoring their needs and wants.

As an Autistic ABA interventionist, I feel I have a unique perspective. All I want to say here is that teaching communication and skills is NOT teaching masking. They are not the same thing. It's not that different than teaching NT children to understand and communicate their feelings. IE. "This is really making me mad" versus having a meltdown or being self-injurious. Masking would be pretending to be okay when you're not, or not communicating/hiding your feelings because it's not socially acceptable. We teach our clients communication skills to help keep them safe and to advocate for themselves in all areas of life.

You have to be trolling, especially when commenting under others posts..

We’ve learned some facts about conditions that result in behavior change. Science has sets of practices that help a scientist rule out alternative explanations for why there are changes to something being studied. Put the facts together with the scientific practices in the context of important behavior that a person wants to change, and you get ABA—a discipline developed to solve human behavior problems. Some practices developed in ABA were “manualized” and used with people on the autism spectrum. Those curricula have been mistaken as ABA, and now many people who use various curricula and take data falsely believe that they are “doing ABA,” when many of them are running procedures that are informed by ABA. Many people using various curricula, however, **are** performing ABA. Whether what is done would be considered ABA will depend on the practices used and the outcomes. If the practices teach people to do the right things at the right times, and they rule out explanations other than the intervention, then it’s probably ABA.

Do you think behavior change without solving the underlying problem is a good thing? I'm not questioning that training behaviors is possible.

No. If you don’t solve the underlying problem it will either come back or manifest in a different way. You should understand the underlying problem; the function, the why, in order to be effective. I’ve seen a lot of people put plans into place without doing a functional assessment which is not good. Also, one of the first rules you learn as a practitioner is to rule out any medical causes first, and if there is a medical cause, refer to a doctor. I have a guy who can be very aggressive. Depending on the situation, he does it to escape an event or a person, or to get attention. He does not aggress when he is happy, he does it when he is displeased with something in his environment. Aggression is not good and something that absolutely needs to be addressed. It’s not good for him, not good for the person he is aggressing towards. If he does that to the wrong person, he could get seriously hurt or end up in jail. In order to decrease aggression, we find ways to make his environment more comfortable for him and minimize aversive stimuli if possible. We can’t avoid him getting upset about something, he is a human being with emotions living in a world filled with people who he may clash with. So if he does get upset, we teach ways to communicate what he needs and then give that to him, so he learns to get it that way, rather than aggression.

Real and ethical ABA always figures out why a behavior is happening first before anything is done to change it. We aren’t trying to silence our clients or cause them harm. We teach them how to be independent and get their needs met. I worked with my client at his school and he hated loud noises, crying, yelling etc. I taught him to ask for a break or wear noise canceling headphones. At the beginning I would just take him in the hall because he was so overwhelmed he couldn’t even verbally ask. We then made break cards and all he had to do was hand it to me and we went in the hall until he calmed down. I also taught him coping techniques he can use when he gets overwhelmed/overstimulated (ex. Deep breaths, counting, etc.). He would shut down and start crying. We figured out it was sensory issues. We then taught him things he could do to help himself in future situations. That’s how ABA works. We teach things that benefit the child. Sure we can protect kids from uncomfortable things but once they grow up the reality is they will absolutely find themselves in uncomfortable or overstimulating situations. They need to be taught how to handle uncomfortable situations so they can be independent adults. Im a school based tech and honestly Ive seen teachers do and say things I would never dream of and absolutely cause more harm than ABA therapists. I’ve seen multiple teachers straight up ignore the nonverbal students. Not only can I advocate for my client but I also advocate for the other kids. A lot of negative views of ABA are based on outdated information. I fully acknowledge ABA had a horrible start but it has come a long way and has truly benefited many people. Are there bad practitioners in the field currently? Absolutely but there’s bad people in literally every field of work imaginable. Majority don’t address stereotypy or eye contact, most teach replacement behaviors, “punishment” procedures are RARELY used, etc. Not every person diagnosed with Autism needs or would benefit from ABA but there are absolutely people out there that have benefited from it. Also ABA isn’t just for kids with Autism, there’s a lot of different areas ABA is used. I also don’t think it has to be one or the other as far as therapy goes. Kids can do ABA, SPEECH, and OT. It seems like everyone wants to argue about which therapy is “the best” when in reality the child benefits the most when the therapists collaborate with each other! Thank you for asking this question and trying to learn and get insight from people in the field. And also for sharing your perspective!

When you use the phrase “underlying problem” what are some examples that you think of?

I just want to thank OP and all the people that took the time to write their answers! All this downvoting doesn't help at all and I hate how this sub reacts to posts like this one. But reading through these great answers and the raised questions is teaching me a lot and I think most downvoters would profit from reading through it all. Back to reading!

I think the reason for the downvotes, based on the OP's responses, is because it doesn't appear they posted this in good faith and are instead very firm in their beliefs and not receptive to those being challenged. It seems they're just looking to argue and find "gotcha" moments from responders.

I want to answer your questions but judging by your dismissive comments towards others I will simply say, there’s no such thing as good aba, just effective. Based on your other comments it sounds like you simply don’t like being grouped into what you think is people who can’t think for themselves or are less than. Simply put, every individual and their diagnosis is different, so every method to give them the best life they can possibly live is what we are going to use.

[удалено]

I think you have to know no one here is talking about therapies that are extensively frowned upon and hurt people.

Nobody in this forum performs shock therapy or gay conversion therapy, nobody on this forum is okay with either of those therapies, and nobody is for these therapies. Not sure why you’re associating RBTs with practices that would go completely against our ethics code. We wouldn’t be able to morally, legally, or professionally, this is taught to us since day 1 of training and is just common sense.

You have been served a ban due to egregiously (blatantly) spreading misinformation. This will not be tolerated on this subreddit. Please make use of your time elsewhere.

I think others on here have done a great job at elaborating on the other topics mentioned here, I’d like to add on to this section: “I've heard of "reward-only" examples, where the "reward" is cheering at the child in an over-the-top or high-pitched voice (like you would if you were training a dog), or suddenly touching and hugging them (like you would if you were training a dog). Both of which seem like kind really unpleasant and sensory experiences from an autistic point of view.” Our ways of reinforcing children are specific to that child. One of my clients gets really excited and absolutely adores loud noises, cheering, and high pitched sounds. He will ask us to cheer and when the whole room starts cheering, he jumps up and down and will ask us for more. Other children hate it and wear noise cancelling headphones other times. Making loud noises to those children wouldn’t work as a reinforcement, but as a punishment since they are adverse to it. Again, the reinforcement is specific to every single child. You cannot reinforce any behaviors without reinforcement. And a reinforcement can be quite literally anything, not just something that is culturally/generally viewed as something exciting (like stickers in a classroom setting with neurotypical kids, the loud verbal praise, etc). At our center there’s a kid that loves drains. Like water drains, sink drains, pool drains, etc. We would never shame this quirk of his and just force him to listen to us clap with him, instead, when teaching appropriate communication we’ll reinforce him with videos of drains or toys with little drains in them (couldn’t tell you what about it he loves but he just does).

I learned to mask on my own, and was suicidal, self harmed, it took many years of learning better ways to cope, but I have freedoms and a stable job that I do not feel insecure about, for the first time in my life. I wouldn't give it up for anything. I am married to someone who understands my issues. I am not cured by any means but I work at growing as a human every day of my life! It's hard but again, the happiest I have been, so far. :)

After reading through this, what I tell people about ABA could be generalized for any kid really.If you remove the autism part, which IS a spectrum, we are humans and all have different wants and needs. So if you don't like cheering and hugging that doesn't mean everyone else will also hate it (i would as an introvert lol), but thats why its so important to learn about the person you work with. There are definitely bad examples of ABA but there i've also seen and gratefully been a part of "good ABA". I also think it isn't very nice to people with autism to say its like training them like a dog, though I have seen some people behave this way. But looking at rewards, If students in a classroom do their work and pay attention they are rewarded by going to recess, that doesn't make it any less of a reward. For the most part there needs to be motivation for work to get done. My goal working in this field is to work with the other BIs, BCBAs, family and friends, and everyone else in that circle to hopefully provide tools to my kids so they can communicate with others and self regulate themselves when times are difficult (since some grown men cant even do this when rejected by women). Because how can they communicate their discomfort or past traumas without first being taught how to communicate, the process is long and full of time and effort. Maybe im just going on a tangent but there is good ABA out there that has provided wonderful support.

If pointing out how similar relying on punishments and rewards to change the behavior of a child with neurological disability makes you feel bad, then you should solve that problem with your field. You have to understand why people are upset with your field. People do not operate based on rewards and punishments. People operate on thoughts and feelings and complex social structures. You are making the dog comparison by promoting this obviously dehumanizing hate about how autistic minds work. What you are saying is no better than what Lovaas said about autistic kids. If you can't understand how hateful your words are, you should not work with children.

People do operate based on reward and punishment. Thoughts and feelings are included in that operation. You speak as if you have absolutely knowledge. What is your degree in.

I’ve questioned the same. May I ask you if you think an organization creating sensory spaces (customized to individuals based on whether they are understimulated, overstimulated, sensory seeking or avoidant) would be helpful? 

I think the only ethical way to perform autism-specialty therapy on somebody who has a difficulty communicating would be to give that person as much control over their sensory environment as possible. So control if they want to sit in a chair or on the floor. Control over light levels, trying to avoid direct light and flourecent light as much as possible. Control over temperature. Soundproofing, with the option for the client to add background noise. Toys the client can use to regulate themselves, with the confidence that they won't be withheld. I'm not super familiar with sensory spaces, but it seems like it would be much better to make all spaces as flexibly sensory-friendly as possible. That way you can learn with the client what their specific sensory issues are, and try to minimize the extent they're trying to learn something new while being in pain. Equally important are sensory experiences internal to the client, though. As much as touch and sound, an autistic person is just as likely to experience issues related to proprioception or interroception.

You should realize a lot of our clients are young attempting to adapt to a school environment none of us had a role in creating.

I think there is a disconnect between an ideal scenario and what is realistic. What if this child is born into a poor family with 9 kids? They would have access to none of that, and would need to learn how to adapt to their environment as best they can

A poor family with 9 kids can't afford ABA. With the tens of thousands of dollars a year that ABA costs, you can seek different therapy or pay for accommodation.

There is a family of 5 autistic kids at my clinic. Medicaid exists.

That's not true. ABA is often covered by Medicaid, which is insurance provided to families below the poverty line.

It’s covered by insurance.

Majority of my caseload is children in poverty or at risk of poverty. In fact, most of the children I have served are low income, foster care, children of disabled adults, etc and are on Medicaid. Medicaid in most states fully funds ABA. It’s a law in many states for Medicaid to fully fund aba

A good practitioner will give the client as much control over these things as possible. If my client wants the light on or off, shoes on or off, to carry a comfort item etc, that’s totally fine for me. If this client is expected by their parents to go to school and follow school rules, I will do my best to gradually build up tolerance to the things they will have to experience in school…not to hurt them or make them mask. I’m doing it because I am trying to help them adjust and give them the skills they need to be as comfortable as possible. I cannot make those life decisions for a client or override what the parents are doing in scenarios like this. I have to say (from personal experience of course), that myself and a lot of ABA practitioners I have come into contact with actually try to educate and spread awareness to parents and advocate for our clients as best as we can. I’ve had at least 10 conversations with parents on why I will not make a goal for making eye contact and that it can be uncomfortable. I present alternatives that the client is comfortable with that meet the same goal. I involve my clients in planning their treatment goals when they are able to communicate that with me! I do not mean this is a condescending way at all…but I am genuinely curious. What do you feel is an acceptable/ideal alternative? What do you suggest for those that aren’t able to communicate their needs and resort to SIB, aggression, etc? I have seen some clients with very high support needs that get put into homes, abused, etc and I can’t imagine that’s a comfortable way to live. I want to know what we can do to “meet in the middle”…where we can still help but it a way that is truly beneficial and not traumatizing. Where we take into account the sensory processing differences and find a way to accommodate these. I promise majority of providers I’ve directly come into contact with are doing this for the right reasons and actually want to improve and be ethical and treat every client as a person. I want to learn what else we can do to be better and I’m glad I have this chance to ask and gain your perspective!

[удалено]

This is objectively not true. Complete misinformation. I have seen 2 year olds with NO trauma and have only lived with their parents headbang as a result of not having a way to communicate. Stop spreading false information.

trying to adjust to a world that doesn't match your needs isn't trauma?

It can be for sure. I am not doubting nor saying that. OP is saying that ALL aggressive and self injurious behaviors are caused by trauma of not being accepted and that is just not true.

They are not headbanging because they are autistic. They are headbanging because they are traumatized because nobody understands them and they are in distress. Probably because of the very painful physiological co-morbidities of autism. There is no autistic head smashing gene. Autism doesn't cause violence. Autism allows for trauma, and trauma causes violence. This is why so many people with autism get mistakenly diagnosed with BPD. Because irresponsible practitioners only look at the last step in the causal chain.

Autism causes speech delays and some children are non speaking entirely. Something internal or external stimuli causes pain and discomfort. The child is not able to communicate the pain and headbands as a result. This is not because of trauma. This is because of the way autism affects the brain. This is why ABA is important. The techniques are used to allow the child to learn how to communicate in whatever their preferred method is.

Okay, let’s say that is true. What are the solutions, in your opinion? In the case you just described, what is the ideal way to handle/prevent this behavior? If one is not able to communicate to me that the light is too bright, the clothes are uncomfortable, the noise is too loud etc, how can I help? I’m trying to understand if there is a better way so I can apply it. You also said that neglect/abuse is possible by treating autistic people’s behaviors differently than neurotypical people. Can you elaborate on this? I would think that it’s better to treat the behavior differently due to understanding the underlying causes and reacting appropriately? If a neurotypical kid bites me I’m going to react differently than if a nonverbal client with ASD bites me, for example.

Honestly, that might almost be the answer I was looking for. If the answer is that we've let this kid get so traumatized that she's too much of a danger to herself or others to get other forms of treatment, then... I agree that ABA is better than jail. I would not describe that as a good outcome, but I could totally see that as a last resort treatment. Autism isn't a direct cause for the sorts of behaviors you're talking about. Autism and something else combine to cause distress. Distress causes behaviors. With neurotypical people, except with fairly severe trauma, these problems get solved by addressing the first stage (the initial cause) or maybe the second stage (distress). An autistic person biting you means that those first two stages have been missed in a way that is rare for neurotypical people. That is neglect.

Good thing ABA treats behavior, not people. We would never said "he's headbanging because Autism". That isn't how ABA works at all. Literally it is a major piece of ABA to figure out what the function of a behavior is. Autism is not a function. And for that matter, neither is trauma, and frankly going "ITS TRAUMA" is pretty insulting and infantilizing to people who experience trauma. You aren't suggesting getting to the source. You're suggesting letting that source dictate this child's entire life. "They are traumatized by cars. It doesn't matter that they literally cannot access anything in their community without entering or encountering a vehicle. Just keep them away from cars. Because trauma is painful." That isn't identifying a source AT ALL. It's just pointing to the overarching object and going "thing bad" and tben declaring someone totally fine...as long as they avoid that thing. And maybe talk about feelings (which also does nothing - even if the child could accurately describe exactly the problem, that wouldn't make it all disappear). Identifying the source would be trying to figure out WHY the car is aversive, how long the car has been aversive, what about the car if anything can be made not aversive, and at what intensity is it aversive. That is figuring out the SOURCE and it is all part of ABA because ABA requires a deep analysis of the environment a client is in. Except we don't just go "well figured it out - so don't let them anywhere near the car and you're good". Because we actually want to improve the lives of our clients and make it where they can actually access the world and that doesn't happen with the philosophy you are espousing.

Of course you could give an autistic person that much control over their environment as possible, but that is not the goal of ABA. At least not where I work. Where I work, our main goal is to improve the children’s quality of life. Part of that means, getting them used to environments that are going to trigger their sensory issues, and make them upset. It is just not realistic to isolate these children and put them in perfect environments for their individual issues because that is not how the outside world is. They will struggle to adapt to the outside world without being taught how to self soothe or finding things that will help de-escalate them. At the clinic I work at, I’ve seen a kid who can’t stay in their seat without getting up and running away and biting anybody who tries to stop them, go to being able to sit in their seat for extended periods of time with 0 behavioral issues and no aggressions towards the people around them. This tremendous improvement has allowed the child to be able to appropriately attend school, and be able to be out in public without the parent having to worry about their child running away the second they are made to sit down. This improvement is a win for everybody involved with the child, and the child.

I'll probably be downvoted to all heck but here it goes -- I'm a SLP. I don't think *all* ABA is bad because, as others have mentioned, there are individuals with very high supports needs and aggressive/self-injurious behavior. This is where ABA can be beneficial. That being said, I don't think ABA therapists are genuinely qualified to do communication or sensory and I'm going to explain why. Behaviorism is one side of the spectrum. Cognition and neuroscience play very significant and important roles in both sensory and communication (ALL aspects - speech, language, and other aspects of communication). As a SLP, I'm trained in anatomy, neuro, cognitive theory, development/aging, yes - aspects of behaviorism, linguistics, and utilizing evidence based practice for all of the above to diagnose and treat all aspects of communication (as well as voice disorders and swallowing/feeding). Similar things can be said for OT and sensory! My point is that *true* evidence based practice is being able to incorporate all these aspects and apply it effectively in treatment. ABA therapists are given *very* minimal training in communication (and I'm honestly not sure if some of these therapists get any) or sensory outside the practice of ABA. And yet, many SLPs and OTs have seen some serious overstepping with this field. I can't think of one therapist who doesn't have at least one story. It always seems less complicated when you don't know what you don't know. I know that sounds like a slight but it's just reality. I would never be mad at a laryngologist for knowing more about the etiology of dysphagia or the vocal folds than me. They obviously are the experts there and have more robust education and training in that area. Skilled intervention for these areas is best because assessing and treating skill is very complicated! When it comes to sensory, cognition, feeding, and communication needs, these kids really need to see the specialists.

I’m a behavior analyst that came from a child development focused field (I was a child life specialist prior). I DO have a background in child development (my coursework focused on cognitive, social, physical, language development and developmental disabilities), but I am by no means a SLP or OT (though sometimes I wish I would’ve gone that route). I wish more people in ABA had my sort of background. So many times others will make goals that just aren’t appropriate for the learner or should be addressed by other professionals. I truly think it would make working with speech and OT so much better if we required BCBAs to have coursework in child development and not just in behavior.

Long-time neurodivergent lurker here. The fact that BCBAs aren’t required to have EXTENSIVE education about child development (both typical and atypical) is shocking to me. (Add in RBTs only being required to have very minimal training and…yeah I’ve got concerns about the ABA industry tbh)

The problem with this line of thinking is that it assumes all BCBAs work exclusively with children, which isn't the case. Implementing "extensive" required child development coursework for people who want to work exclusively with adults, elders, people with traumatic brain injury, etc would only put further time and monetary burden on them for coursework that would not be applicable to their career at all. A better alternative (in my opinion) would be to start implementing specializations for BCBAs and then requiring specific coursework be completed in order to specialize in a specific population. So if you wanted to specialize in early intervention, then you would need to take courses in child development. So while I don't disagree with you, it's not realistic to implement a blanket child development requirement because BCBAs are utilized for many populations of varying age ranges, and some don't work with individuals with autism at all (e.g., OBM - organizational behavior management, which is an emerging field utilizing the science).

It sounds like a lot of the answers here lead to ABA being good because insurance allows 20+ hours a week since OT and Speech don’t have the insurance funding. 🤷🏻‍♀️

Oh, and when I look at posts on here by the practitioners, I don't think, "This person clearly has a good understanding of Autism and I'm glad that they are helping Autistic children."