What I saw at an ABA clinic

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I used to go to a social skills group that used the same building as an ABA clinic. I had to pass through the ABA part to get to my group. Some things I saw.

1.Kids stimmed. Nobody did stim suppression.
2.Kids smiled at lot. It seemed like therapists were using the kids’ interest to teach them. I witnessed one kid having a meltdown when another kid sang happy birthday too loudly.
3.Kids were either doing sensory stuff or learning life skills like brushing teeth, taking turns, etc.
4.Some kids used PECS or other communication methods.
5.The kids were mostly boys.

My conclusion: Is ABA right for everyone? No. Are there abusive ABA therapists in the world? Yes, they should fired. But overall, the method of modern ABA seems different or at least changing from the old ways.

I quit my social skills group because the other members were much younger than I was.

Bracing myself for some intense responses ...

This was also my experience being in an ABA clinic setting. I was there for sensory therapy, and the therapists were all young and super nice. I told the occupational therapist that I had a lot of trouble with indoor lighting, and she actually took me outside for therapy. The other kids I saw there were also all really happy. They were making lots of noise, but there was a "noisy" waiting room and a "quiet" one, so it was okay for the ones who couldn't handle it. Overall, I'd say that ABA therapy in my area is really good. There are, of course, bad therapists in the world, but I don't think that ABA itself is the problem. It can obviously be done right, if those happy kids are any indication (they were running to their therapists). I think that focusing our anger on ABA is actually really harmful in the long run, because even if you stop its use, you'll still have those bad therapists around who will definitely abuse whatever therapy they switch to, simply because they don't care if they're cruel to children in attempting to prevent unwanted behaviors.

Not all therapies labeled as ABA are bad. Some are called ABA in order to get funded because, according to some people, ABA is the only autism therapy that some institutions (such as states) are willing to fund.

It's only justifiable to get angry at harmful forms of ABA, as not all forms hurt autistic people.

I desperately need OT for light sensitivity but I can't find any services for adults. Did your "outdoor" indoor light therapy work? I'm opposed to ABA for children but given my desperation maybe I should look into it just for myself?

Exactly. “ABA” isn’t always what people think it is.

ABA therapy has changed a lot over the past 55 years. It works if it's done right. It works if the children are free to act naturally while learning essential skills.

I take it this thread is focusing on children and therapy, since ABA isn't done to adults, or at least shouldn't be. From the little I've read, been told by people including some other ASD people wiser than me, ABA's underlying goals have not changed. This is therapy created by the same as*hole who invented Queer Conversion therapy, so I don't see what possible positives there could be for anyone in using it. It's also advocated by Autism Speaks, the largest ASD interest group in the US at least, but they're a de facto hate group against people w/ASD, who try to "cure" them. You can't be cured of ASD b/c it isn't a disease and anyone who tries to do so either doesn't understand the neurological condition or doesn't want to. And if you're an adult, the only kind of therapy that's been proven to work is CBT. I presume there's some variation of that for children and I wouldn't recommend any parent consider that or anything else (if there is anything) that's holistic over ABA.

There is an expression lipstick on a pig. That is how I view most of the modern forms of ABA.

The modern ways of ABA are not nearly as abusive as the old shock em out of being autistic or gay techniques. Not as bad and not nearly as bad does not conflate to good. It is still teaching them to be too dependent on the approval of others. What has changed is they have learned to make compliance and manipulation both fun for the children and acceptable to squeamish parents. ABA is part of the larger problem of helicoptering and snowplowing parenting. ABA would never be so widely lauded in a society that actually wanted the rugged individualism it claims it wants.

Of course there are many ABA’rs with good intentions but as they say the road to hell is paved with good intentions.

I am really tired of hearing about how abusive or bad ABA’rs are imposters using the ABA label to cover their abuse and incompetence. Yes of course it is a real issue but it is an issue created by the people that have made ABA a monopoly ahem “gold standard”. If there is very little other way to get funding then by claiming you are an ABA therapist that is what people are going to do no matter what quack therapy they are actually practicing.

Yes it is a positive development that ABA is not nearly as bad as it once was. This happened because Autistic and other advocates exposed them. What I am seeing in the autistic community is growing excusing and accepting of a system with fundamentally flawed goals based fundamentally flawed way of looking at child rearing. This is the path backwards not forwards.

It seems that because of the advocates, the fundamentals of ABA have changed or are changing, though I realise I will not change your views on ABA with this post.

Note that the kids were all more on the severe side, so keeping eye contact during a conversation was probably was the least of their concerns. Again, the kids were doing sensory play and learning life skills. They were working on coping mechanisms and more independance. What about that is manipulation, conversion, etc? Even though the original was founded on manipulation, the fundamental missions can change as people realise their mistakes.

I guess you’re saying they’re doing those skills to please their therapists. That is a valid concern and why the kids should try different things if something isn’t working. The goal for any therapy is to apply those life skills to other areas of one’s lives for one’s own benefit, not to seek others’ approval.

If you are rewarding “good” behaviors you are indirectly teaching people to please others.

You teach independence by giving them as much independence and freedom of choice as possible. 25 to 40 hours a week of ABA plus reinforcement at home is recommended. If you manage or schedule their life 24/7 you are not giving them time to learn from their mistakes, learn what works for them, basically figure out who they are. I do not see this fundamental problem with ABA and beyond changing.

Even those that seem on the severe side mature. Autistic people mature because they are people and most people mature. Putting poo on the walls, banging things, horrific meltdowns etc etc would be most peoples definition of severe. I am describing Temple Grandin, John Elder Robison(creator-of equipment for the rock group KISS, author of several books). Would you say a person who the public schools threw out after second grade not because he was violent but because they could not get through to him because he was in his own world is not mild? That is me, 15 years later I was graduating college. What the three of us have in common was we had no ABA or any services at all, we were raised what they call “free range” style today. Would it have been better if I had some help? Yes. Is free range good child rearing for every child? No. The 1960s style of child rearing had its fundamental flaws too.

A child is an individual not a set of good and bad behaviors. There is no one system for all but increasingly because of the ABA monopoly it is becoming that way.

So that's why I grew up to be a people-pleaser!

Just kidding! But I am concerned that children who receive ABA therapy don't know how to say "no" because they aren't allowed to during treatment. They'll grow up only knowing how to please others and not do what's right for themselves.

The therapy I received in that clinic was more often strategy-based rather than integration therapy (that is, guided exposure), so I can't say. I didn't have integration therapy long-term because my mom thought it was pseudoscience. But since then, I've started CBT, and I've actually found it more useful. I have comorbids like GAD, and you can't really treat sensory issues without addressing them, too. The first therapist I went to actually urged me to find someone who could help me with both because treating one without the other is less effective. Well qualified psychologists can use CBT sessions to address all of your issues (including SPD), helping you come up with strategies and plans that you can implement on your own, too. My CBT focuses on building my tolerance for sensory input and breaking routine by various means (including exposure) and improving social skills. I've made great progress with it in both areas.

Thank you. I do have a new psychotherapist who specialises in ASD. She recommended that I seek OT for SPD but I know she is also qualified to implement CBT approaches in our sessions. I hope it will help. I'm virtually house-bound because of light sensitivity which causes depression, anxiety, nausea and migraines (plus a multitude of other sensory disorders).

Other things besides ABA rewards “good behavior”. Parents often use a reward system when teaching kids to use the toilet. The point of teaching anything is that people will start doing those skills for themselves and not to please others. If they don’t, then obviously a different method needs to be used.

It’s great you and other severe autistics figured those skills out on your own as you got older. Some people don’t and need intervention to achieve those skills. What I saw seems very child-led. For example, if the kids wanted a different activity, or wanted to take a break instead, it happened.

ABA as a monopoly is bad, since it is not effective for everyone. However, it seems like more and more people see there are other interventions for autism, like OT and RDI, so I don’t think ABA will be a monopoly.

After seeing sessions, I concluded that while ABA, like everything, else has flaws, and definitely should not be the only option, ABA nowadays is also not necessarily the “big bad wolf” I read about. Especially if it resembles what I saw at the clinic.

You are correct in that “bribing” children goes beyond ABA. It goes well beyond toilet training. It’s overuse is a problem. It is one reason younger people have higher rates of anxiety, depression, and generally seem to be more fragile. Another reason is the micromanaging of their lives. IRL everybody does not win a trophy, there are setbacks and bumps and bruises.

My whole point is that I have never been severe, I just presented in some ways that would be perceived that way today. If I was severe I never would have figured most things out. We figured some stuff out because we were given the opportunities to do so. Go to school, make sure your homework was done, and be home for dinner was as far as parental scheduling went. I think a lot of kids today are being trained for things they can figure out on their own.

Speech therapies, Occupational therapies are given in addition but ABA is the core treatment. If you are a Autism parent it is hard to avoid. Prefer another behavioral treatment, be prepared to pay for it all, uproot your family(not good for routine averse autistic children) and take a chance on some unproven treatments. ABA is the “gold standard” so it is much harder for researchers to get the money they need and the prestige they want if they go in another direction. If you can’t afford that homeschooling is the other option which most parents are not qualified to do especially for atypical children.

Maybe someday ABA won’t be a monopoly but the trend is ABA proponents friend. Right now the emphasis is on early as possible diagnosis for earliest intervention which usually means ABA. IMHO the unstated goal for early intervention is to interrupt or intercept autistic brain wiring at the earliest stages of life when natural brain wiring is at its most rapid. It is too politically incorrect to say that. Maybe the idea that letting kids be kids can be put in a museum somewhere maybe next to the removed Confederate statues museum(sarcasm).

Last edited by ASPartOfMe on 21 Apr 2019, 11:04 am, edited 1 time in total.

Not everything called ABA is ABA remember, it's to the point it's basically gambling because so many things call themselves ABA only to be covered by insurance, doesn't change the 50% coming out with PTSD.
https://www.emeraldinsight.com/doi/abs/ ... -2017-0016