The ABA controversy

This has nothing to do with a Swedish pop group of the 1970s, but with the controversial treatment of autism in children Applied Behaviour Analysis or ABA. I’m writing now because I almost had a meltdown in church after the service. Then later that week #TodayInABA started appearing in my Twitter feed. Such as this from @the SapergianCom:

In trauma spectrum counseling, we taught survivors how abusers use intermittent rewards to cause the Vulnerable to be addicted to the validation of the abusers– same principle as slot machines, lottery tickets, and ABA. – @the SapergianCom:

The controversy seems to be between adults who have autism who are saying ABA is abusive and the parents of autistic children who find that ABA therapy makes parenting easier. But autistic children grow up to be

There are differences in the way autistic people and neurotypical people will work together. Neurotypicals tend to sit across a desk and will talk whilst working often giving clues to each other through eye contact. Autistic people would tend to work side by side, avoiding eye contact. I have heard that ABA tends to be done face to face across a table with eye contact demanded. To an autistic person, eye contact can be physically painful.

ABA claims great results. But children with autism make improvements as they grow up anyway and the claims of ABA therapy include these improvements. The claims of ABA are exaggerated. What ABA does is reward good outcomes and punish bad outcomes. A big problem with this is that meltdowns are often seen as bad outcomes. An autistic child is seen in meltdown being made to finish a task by an ABA therapist in Chris Packham’s BBC documentary Aspergers and me. To understand why this was bad practice you have to understand meltdowns. Meltdowns can look like big temper tantrums. But they are anything but. They are a reaction to mental overload. In my case, I cannot switch off noise. In a room where people are having a lot of conversations around me, I am hearing all the conversations, the words of someone walking past can overwhelm the conversation I am having. In a party in someone’s house, I am the one in the corridor having a quiet conversation with one or two people rather than in the room where everything is going on. This is at best tiring, it can be overwhelming. I also have problems with bright light and particularly with flickering light.

Meltdowns are not normal behaviour for people with autism, they happen because the person’s brain is being totally overwhelmed. Unlike the child in Packham’s documentary what is actually needed is a quiet place away from mental stimuli. Being made to finish tasks makes things worse, not better. Therapy such as that given the boy can make what looks like an improvement, but it is just acting. The autistic person will start acting like a non-autistic person, which is the desired outcome for the therapist and often for the parent, who is going along with what the therapist says, believing that is the right thing. this short vimeo is prety accurate in showing what sensory overload feels like:

You deal with meltdowns and shutdowns by changing the environment, not the person. The meltdown is due to the environment being overwhelming. In that case you need to move to somewhere safe and less overwhelming.

Ann Memmott is an autism consultant and is Vice Chair of All Party Parliamentary Group for Autism – Advisory Board. She is not only well qualified in Autism, but has autism herself, and has brought up her own autistic children. She says:

Because yes, we can enforce a child sitting on a chair and looking at a teacher. We can enforce ignoring pain, discomfort, anxiety. We can enforce staying in environments that are overwhelming. We can enforce staring-at-eyes, which switches off hearing. None of that is success. – Ann Memmott on Twitter.

I have left some discussion groups on autism on the interwebs because of the assumption that autistic adults are somehow against the parents of autistic children, we don’t know how difficult it is they say. But we do know. Many autistic adults are also, or have been, the parents of autistic children. Autistic parents, we are with you, we know what it is like, we have been there. But there is a knee jerk reaction from some of us. Some have been traumatised through having been through ABA therapy and know that in the long term what they have been through is harmful. They cannot stand to see someone being abused in the way that they have been in the name of therapy.

But not all that is called ABA therapy is bad. In places where funding is given to ABA therapy the name is used in for financial reasons. Not all that is called ABA is actual ABA. On the other hand, if a parent is told to withdraw love from their child until she has achieved her goal, as some of the more extreme forms of ABA do, then alarm bells should be ringing.

-o0o-

Information in after this blog was written:

60 autistic children received various early interventions, up to 25+ hours a week. The result – no difference in the rate of improvement of abilities. Autistic kids naturally develop skills.

https://link.springer.com/article/10.1007/s10803-019-04138-2

 

 

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