Is ABA Therapy Harmful?

There is a heated debate within the autism community about Applied Behavioral Analysis (ABA) therapy, its benefits versus negative effects with some people questioning, “Is ABA therapy harmful?” To start, it is important to know what ABA therapy is and what it looks like.

ABA therapy helps people understand the behaviors associated with the autistic child by using a scientific approach that focuses on how best to acknowledge and change specific behaviors, environmental factors, and the best learning style for the individual. It is an individualized approach to a broad spectrum of people.

There are numerous ways that ABA services are used when pinpointing certain behaviors of the autistic kids that are receiving the services. Depending on the area and what is available, ABA services can also help people with autism spectrum disorders receive more services like occupational therapy, speech therapy, assistive technology, and more.

An important note for parents and caregivers is that an ABA provider has been specifically trained in ways that use positive reinforcement to help with problem behaviors. There are certifications that must be met and educational standards that all staff must have for ABA services.

In this article we are going to talk about what ABA therapy is, what it does, the pros, as well as the cons of these services. It is up to the parents and/or caregivers to use their discretion while reading this article and figuring out if these services would benefit their children with autism and what they should know about these services moving forward.

Autism Parenting Magazine doesn’t solely represent or support any services or claims in this article. The purpose of this article is to discuss ABA services and the debate surrounding these services.

Is ABA therapy a good choice for children with autism spectrum disorder?

There have been a number of studies and research conducted that has shown how effective ABA therapy can be for autistic people based on the behavior analytic principles. These include how effective different aspects of ABA therapy can be like behavioral skills training, extinction, and functional communication can be.

These skills that are built can be done with a 1:1 ratio of behavior technician to client or in a group setting. It is dependent on what the autistic person, Board Certified Behavior Analyst (BCBA) and parent and/or caregiver have decided on for goals and what the therapy sessions focus on.

These services have been evaluated and discussed for the effectiveness that ABA therapy and the behavioral interventions have on autistic people. Applied behavior analysis and other evidence-based practices have been endorsed and recognized as methods that have proven to be beneficial for a lot of people that have been diagnosed with autism spectrum disorder.

Although these studies have been proven to be beneficial for a portion of the autistic community, it by no means states that it is beneficial for all autistic people. As with any treatment, therapy, and service there is a certain level of discernment that should be taken and questions asked that are related to the individual that may be receiving the services.

There are doctors, professionals, and other parents that can help answer any questions that families and individuals may have in relation to someone receiving or showing interest in receiving ABA and other services and therapies. There is no one size fits all intervention, treatment, therapy, etc. that will cover all needs and potential growth areas for every autistic person.

What are some benefits of ABA therapy?

Since there is an array of behaviors and skills that ABA therapy can help with, such as self injurious behavior and social skills, and more. How well applied behavior analysis benefits a person with autism would be based on the drive and skill level of the individual, support of family, and an understanding and welcoming community.

An ABA technician works alongside the person with autism, their family and/or caregiver, and a BCBA to create goals and an outline of what services are available and how therapy sessions will work based on goals and ambitions.

Some of the things that most ABA therapists might do during a session includes, but is not limited to:

• Set up goals and plan for sessions with the autistic person and their parents and/or caregivers;
• Identify, monitor, and track both problem behaviors and appropriate behavior and how the sessions are progressing towards set goals;
• Evaluate current system and decide whether alterations are needed to follow the goals that were set;
• Work on and teach skills based on overall goals and progress;
• Assess and determine the progress of therapy and whether more interventions are needed.

These exercises during sessions can help build an individual’s skills set and alter problem behaviors that were noted at the beginning of services. As the sessions progress, the ultimate goals and positive behavior could include:

• Increased focus in daily and educational duties;
• Improved communication and social skills;
• Potential decrease in self injurious behaviors;
• Expand opportunities for social interactions with those around the individual;
• Lessen problem behaviors, such as tantrums, meltdowns, etc.

Does applied behavior analysis really work?

As with any therapy or treatment, success is very individual and based on the person and whether or not they have the support and resources they need to continue what they have learned and apply it in an everyday occurrence. If someone lives in a community that is understanding that they are learning new skills and allow the person the time they need to accomplish tasks then that can be a big help.

Also, having a family that is active with the sessions and knows what the individual is working on and can create a working schedule or ways to incorporate what they have learned at home, school, work, etc. Sometimes support can be overlooked and without it the autistic person really won’t have the opportunity they need to test out and see how their new skills will be beneficial and work in their day to day tasks.

What are some cons of ABA therapy?

There have been autistic self advocates, organizations, and other members of the autism community that have disagreed with ABA services. There are some that even consider some of the treatments abusive in nature, especially after some of the practices are held over differing periods of time.

Although there has been evidence provided from different sources related to how effective ABA services can be, there are still autism and neurodiverse activists that disagree and vocalize concerns over the practices.

Some of the concerns include:

• The displeasure of how mental health and neurodiversity were handled during certain historical events and experimentations;
• Current procedures and interventions that are carried out over lengths of time that can hurt and alter the individual’s overall personality and uniqueness;
• Unrealistic and unnecessary goal setting for individuals such as eliminating stimming behavior and forcing eye contact which can alter the person’s ability to cope and take away a part of their individuality;
• Not acknowledging potential trauma and how some therapies can trigger individuals that have experienced trauma;
• Take a look at how early intervention and recommendations for children with autism to attend lengthy weekly hours in ABA therapy (up to 40 hours a week), is too much and more realistic goals set;
• Not allowing the person with autism to be an active member in the goals setting and session planning.

Ways to acknowledge concerns and move forward with ABA therapy

There have been many different concerns over how ABA practices are done and there are professionals that are coming up with ways to acknowledge these concerns.

Moving forward with ABA and acknowledging concerns:

• There should be no predetermined amount of weekly hours that all children should meet, rather looking at it through the individual child’s development and ability at the time of diagnosis;
• Using more positive reinforcement in sessions to teach skills and help curb problem behaviors such as biting and tantrums;
• ABA practices should continue to adapt and improve as more is learned about individuals and what works best for the individual;
• Treat the individual as an individual;
• Always take claims of abuse seriously and seek out the correct authorities for the matter at hand;
• Allow the autistic person to be an active member in their goals setting and session planning, this will help them become better autistic self advocates.

In conclusion

In this article, we have discussed both sides of ABA therapy. There have been both pros and cons discussed and possible ways to acknowledge the cons moving forward.

One thing to always remember is that all autistic kids and adults are unique. There is never a therapy that will work for everyone. Therapies need to acknowledge the individual, their strengths, and areas where some skill-building could be beneficial.

When discussing and choosing a provider, it is important to also know that along with the individual and their support system, the quality of the ABA provider needs to be considered. There are both excellent and poor ABA providers and due diligence, research, and talking with your child’s doctor and other families can help with the decision-making process.

References

Cihon, J., Khosrowshahi, D., Leaf, J., Leaf, R., Liu, N., McEachin, J., Russell, N., Shapiro, S. & Unumb, L. (2021). Concerns About ABA-Based Intervention: An Evaluation and Recommendations. https://link.springer.com/article/10.1007/s10803-021-05137-y

Dreyfus, A., Hendricks, D. & Palko, S. Autism Q & A: What is Applied Behavior Analysis? https://vcuautismcenter.org/resources/factsheets/printView.cfm/982

Elfer, E. (2022). ABA Therapy for Autism. https://www.autismparentingmagazine.com/aba-therapy-for-autism/