Applied Behavior Analysis and Autism: Misapplication of Proven Science | Spectrum


Yev Veverka

Teaching AssociateUniversity of Washington

I had been working in the Applied Behavior Analysis (ABA) field for nearly a decade when my own daughter was diagnosed with autism at age 4. At this time, she was having several tantrums a day, turning over furniture, hurting herself, and acting aggressively towards her. cadet. She had trouble communicating, and my husband and I felt like we were letting her down as parents. I had a baby at the time, was pregnant with my third and desperately needed help. ABA seemed the obvious next step for our daughter and our family. I knew I shouldn’t analyze his behavior myself, regardless of my background: I needed an objective assessment from someone outside our circle.

While exploring the area as a parent, I came across a recommendation to join the group”ask me i’m autisticon Facebook. I filled out membership questions, explaining that I’m a Board Certified Behavior Analyst (BCBA) and a parent, and that I hoped to learn more from the autism community. group admin messaged me to say that the group does not allow behavior analysts unless they are willing to consider leaving the ABA field I was told that members would be uncomfortable with my presence in the group, given my profession. I found other pockets of criticism online, where ABA was described as abusive and traumatic. This was not the area that I knew and loved, and not the way I thought I was practicing and teaching others to practice.

I felt confused and defensive. Still, I continued my search for ABA services for my daughter. I contacted several agencies in my area. Some had long waiting lists due to staffing issues. Some have not taken my insurance. Others only had slots available in the middle of the day when our daughter was in kindergarten and my husband and I were at work. I was discouraged by the lack of compassion in these responses, and some agencies never responded at all.

We eventually found a place with one of the largest ABA service providers in the country. We thought we only needed home support, but their model required our daughter to come to the clinic for most of her services. We gave in, thinking something was better than nothing. Yet access to actual services was extremely slow: we began paperwork and insurance authorizations in November, and our first day of services was the following May.

Our experience did not improve from there. No one asked what led us to seek services. No one asked us what our goals were. Instead, my daughter was assessed on a set of generic skills, and she had to work on tasks that we didn’t find important, such as matching and labeling. We felt that more time was spent checking the boxes required for insurance reimbursement than creating personalized services for our daughter and her family. Months after receiving services—and nine months after beginning to work with the agency—we still didn’t have a plan for the behaviors we were most concerned about.

The agency also seemed to be struggling with the staff. When a new behavior tech showed up at my house, I asked her how long she had been in the field. She told me it was her first day. After our first three weeks with the agency, and just when my daughter seemed to be getting comfortable, they changed her behavior technicians.

I came across the field of ABA by chance, when I was taking an introductory course as an undergraduate student. I was matched with the family of a 3 year old receiving ABA services and watched in amazement as he learned new skills. He replaced his punching, kicking, and screaming with functional communication, such as being able to ask for objects, write down favorite activities, and ask for help. I fell in love with behavioral science. I found a job to train as a behavior technician and I continued my studies until I became BCBA. Since then, I have worked as a home and school consultant, clinical director, and educator at the University of Washington in Seattle.

The services my family received were not what I knew the ABA could do. The very nature of ABA requires that it be individualized. It is intended to be applied towards meaningful goals for the individual and the family. We received standardized services based on assessments we made on a computer. Now that was enough to make me doubt the job I had been doing for 10 years, and we took our daughter out of the agency.

I couldn’t believe, however, that there was something inherently wrong with this natural science. Behavioral science is welcome in a myriad of other fields. Companies use it to increase the number of employees job performance and presence. The health and fitness industry uses it to build balanced diet and exercise habits. ABA principles have been used to increase the use of seatbeltto help patients comply medical protocols and to boost recycling. I myself apply the principles to increase my water consumption, do my household chores and accomplish my professional tasks.

I started thinking about applying ABA principles to my daughter’s environment based on my own training. We started using it in our parenting and support strategies built into her school day. We focused on his communication skills. Over time, her fear of school lessened, her aggression lessened considerably, and she was happier than she had been in years.

Along the way, I rediscovered my love for Applied Behavior Analysis as a science. Still, there’s no denying that something’s wrong with his current application, and I’m not the only one who realizes it. A colleague and I formed the Coalition for Applied Behavior Analysis Reform, and it gained hundreds of members in a matter of weeks. Collectively, we recognize that we need to change the application of our science so that it is client-centered, neurodiversity-affirming, and equitable. Customer services should focus on the individual instead of using cookie-cutter approaches to save money. Services should be offered to clients in daycares, schools and homes, rather than forcing clients to spend hours in clinics. Services should be reimbursed, sure, but assessments and support plans shouldn’t be written just to appease insurance companies. Those in the field need ongoing education and training, and we need to improve the coaching of early-career behavior technicians and BCBAs. And, for some, we need to listen to autistic voices and honestly hear their criticisms.

I still have days where I wonder if I should just walk off the pitch. It can be exhausting to fight for reform in the field while advocating for science to outside critics. I’m staying because I think it’s worth fighting for. I am convinced that science can be applied in ways that improve the quality of life of the people we serve. My daughter is almost 10 now; she is a courageous and creative child. We continue to integrate ABA principles into the daily lives of all members of our family. Recently, we applied ABA to help our children overcome sibling rivalry, participate in family chores, and make dental visits less aversive. The current application of ABA in autism is flawed, and the the companies behind are troubled. But its delivery can be reformed and improved without abandoning science.

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