Negative views of ABA are not new, in fact there have been negative views since ABA began. Changes have occurred within removing practices such as electric shock therapy. Forcing someone to continue to take part in a therapy practice that is causing them stress and harm is against the code of ethics, and conforming to social normative is not the end goal of ABA. Board certified behavioral analysts (BCBA’s), must be aware of what is going on with the client. There are assessments conducted before any intervention is implemented. The BCBA, BCaBA (Board certified assistant behavioral analyst) and RBT (registered behavioral technician) use the assessment(s) to ensure that they are within their scope of practice before rendering services to someone (Behavior Analyst Certification Board, 2022.) Assent-withdraw is when someone resists or protests participating in a service, this can be done verbally or in non-verbal communication and is a focus for ABA therapists, so that the client is not being forced to participate in interventions, goals or activities that cause them distress in any form. Though there have been changes implemented, there are still negative views and statements made regarding ABA therapy. The neurodiversity affirming movement is an advocacy for ASD individuals. This movement is positive in many ways. The movement does not entirely agree with ABA therapy.
Applied behavioral analysis (ABA) is a scientific approach based on principles of behavior to identify environmental factors that influence social behavior. The method is used to teach basic communication skills, increase positive social interaction, promote development in daily living and self-help skills(Yu et al., 2020.) Neurodivergent individuals diagnosed with autism spectrum disorder (ASD) benefit from these therapies. Many studies were conducted providing information supporting the positive results that occur during and after ABA therapies.
The BACB, a non-profit corporation established in 1998, oversees the certification needs identified by behavior analysts, governments, and consumers of behavior-analytic services (ABOUT the BACB, n.d.) In the BACB code of ethics for Behavioral Analysis, there are guidelines that must be adhered to. Including making sure the services being rendered are client based. The services provided are to do no harm (Behavior Analyst Certification Board, 2022.) A case-by-case basis is something that is strictly followed when individuals are provided ABA therapy.
The Neurodiversity affirming movement began in the 1960’s and continued to expand and bring light to wants and needs of autistic individuals. This movement aims to shift how autistic experience is viewed in many settings (Pewett, 2023.) Through this movement there have been comments made that ABA is harming and not listening to the individual that is being rendered services. ABA is perceived as a “treatment” to Autism, a way to rid the person of the diagnosis (Kapp, 2020.) ABA is not to treat the diagnosis, but to support the individual recognizing they are more than their thought and behavior. To be in the moment they are in now and to work through the feelings they are having, rather than attempt to control, escape or avoid the situation (Kelly & Kelly, 2021.) To assist in a better life and understanding how to accomplish this life is what ABA does. Neurodivergent affirming practices want to support individuals, which is congruent with the therapies provided in ABA.
Neurodiverse affirming practices is not a negative, but there are aspects to ABA that they are viewed in a negative light, when it is not what ABA actually does. ABA is not a harmful therapy and there is not any intervention that someone is forced to participate in. Listening actively, making sure that the individual knows they are safe in this place and with the people there is a key to their success and the therapist’s success. To see the individual thrive, grow and learn how to be more than their thoughts and behavior, is what ABA is about. Being able to function in society, as themselves, but with the skills to do so. To have the skills to function in society, sometimes intervention is what is needed. For example, socialization is hard for neurodivergent children. Structured play can assist in this skill set. Though the neurodivergent affirming practices agree that play therapy is important, they also believe that if a child does not want to interact with people, they should not have to. Again, conforming to social norms is not what services through ABA are about, it is about giving guidance and teaching what is needed in life. Point of view: if you are unable to interact with people due to social skill deficits, how are you to get a job? Structured play as a child can assist in building these skills that set the foundation for success later in life.
It is understandable that this field of therapy is not for everyone. However, the more knowledge that is shared regarding services, the more people can understand that this therapy is used in a positive manner, never to harm or cause traumatic experiences. Being aware of all that is occurring, keeping up with the data and how the individual is reacting to the interventions is always being done. Conducting different assessments to ensure that the interest of the individual is being used to help reinforce their learning and participation, happens in each session. This field is not a right and wrong field it is an effective or not effective. If it is effective for one individual but not the other, that’s alright too. Working with the individual and the family to find what will help is continuous. Communication is key and things in this world is ever changing. One thing may work on Monday but not on Friday and that is alright. This therapy will fit the individuals needs, not the therapies need.
References:
ABOUT THE BACB. (n.d.). Behavior Analyst Certification Board. https://www.bacb.com/about/
Behavior Analyst Certification Board. (2022). Ethics code for behavior analysts. https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119-a.pdf
Dallman, A. R., Williams, K. L., & Villa, L. (2022). Neurodiversity-Affirming Practices are a Moral Imperative for Occupational Therapy. The Open Journal of Occupational Therapy, 10(2), 1–9. https://doi.org/10.15453/2168-6408.1937
Elbeltagi, R., Al-Beltagi, M., Saeed, N. K., & Alhawamdeh, R. (2023). Play therapy in children with autism: Its role, implications, and limitations. World Journal of Clinical Pediatrics, 12(1), 1–22. https://doi.org/10.5409/wjcp.v12.i1.1
Graber, A., & Graber, J. (2023, March 2). Applied Behavior Analysis and the Abolitionist Neurodiversity Critique: An Ethical Analysis. Behavior Analysis in Practice. https://doi.org/10.1007/s40617-023-00780-6
Hart Barnett, J. (2018). Three Evidence-Based Strategies that Support Social Skills and Play Among Young Children with Autism Spectrum Disorders. Early Childhood Education Journal, 46(6), 665–672. https://doi.org/10.1007/s10643-018-0911-0
Kapp, S. (2020). PDF.js viewer. Library.oapen.org. https://library.oapen.org/viewer/web/viewer.html?file=/bitstream/handle/20.500.12657/23177/1006976.pdf?sequence=1&isAllowed=y
Kelly, A. D., & Kelly, M. E. (2021). Acceptance and Commitment Training in Applied Behavior Analysis: Where Have You Been All My Life? Behavior Analysis in Practice. https://doi.org/10.1007/s40617-021-00587-3
Lerner, M. D., Gurba, A., & Gassner, D. L. (2023). A framework for neurodiversity-affirming interventions for autistic individuals. Journal of Consulting and Clinical Psychology, 91(9), 503–504. https://doi.org/10.1037/ccp0000839
Linstead, E., Dixon, D. R., Hong, E., Burns, C. O., French, R., Novack, M. N., & Granpeesheh, D. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational Psychiatry, 7(9), e1234–e1234. https://doi.org/10.1038/tp.2017.207
Palwasha Najeeb, & Quadt, L. (2024). Autistic well-being: A scoping review of scientific studies from a neurodiversity-affirmative perspective. Neurodiversity, 2. https://doi.org/10.1177/27546330241233088
Pewett, A. (2023). Behavior Analyst Supervision Through a Neurodiversity-Affirming Lens: An Examination of Practitioner Knowledge and Future Directions. Vanderbilt.edu. http://hdl.handle.net/1803/18286
Rey, N. (2022, March 18). The Neurodiversity Movement: Reframing Autism, Reconceptualizing Normality, and Reimagining Treatment – ProQuest. Www.proquest.com. https://www.proquest.com/openview/443d0064eeeaf2943612f36e3b7f62ff/1?pq-origsite=gscholar&cbl=18750&diss=y
Yu, Q., Li, E., Li, L., & Liang, W. (2020). Efficacy of Interventions Based on Applied Behavior Analysis for Autism Spectrum Disorder: A Meta-Analysis. Psychiatry Investigation, 17(5), 432–443. https://doi.org/10.30773/pi.2019.0229
