Last updated on November 26, 2023
Applied Behavior Analysis (ABA) is an ineffective family of “therapies” with a dark, disturbing origin, which I’ve written about several times. Notice that ABA is not named Applied Behavior Therapy. It’s not what I’d consider therapy and it isn’t really presented to parents and caregivers as therapy.
Mental health therapies help people identify the causes for emotions and behaviors they seek to change. A patient seeking mental health supports is unhappy or dissatisfied with something and seeks resolution or coping strategies. The process is patient-centered, helping that person achieve what is important to that individual. Merely treating symptoms doesn’t resolve the cause, it merely pushes the source of dissatisfaction aside.
Not everyone in need of help is able to seek help, and that’s especially true of children. However, that does not mean therapies should focus on the needs or desires of other people. The individual, the patient, should remain the focus of treatment.
ABA falls into the classic problem of behaviorism: it seeks to change observed behaviors. Behaviors in ABA include statements, so saying the right thing at the socially correct moment is a behavior.
All parents and teachers use some form of extrinsic rewards and penalties to foster “good” or “desirable” behaviors. Technically, even verbal praise is a reward for good behaviors.
However, ABA takes this natural reward-penalty model and takes it to extremes. For 20, 35, or even 40 hours a week an ABA therapist or “technician” might be with a child, rewarding and penalizing constantly. Most adults with 40-hour work weeks don’t “work” for 40 hours. Instead, we spend a lot of time mentally recharging. We stretch, we walk, we take mental breaks. But the children in ABA get penalized when not on task.
So, do behaviors change? Yes. Of course, they do. Non-stop monitoring will do that to a human. But, after ABA, is there a lasting change? Rarely. But, there might be post-traumatic stress disorder, anxiety, depression, and addiction.
Now, we have meta-analyses of ABA and other behavioral interventions suggesting these approaches don’t do much for the child.
Project AIM: Autism intervention meta-analysis for studies of young children.
Sandbank, M. et al. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychological Bulletin, 146(1), 1–29.We found that when study quality indicators were not taken into account, significant positive effects were found for behavioral, developmental, and NDBI intervention types. When effect size estimation was limited to studies with randomized controlled trial (RCT) designs, evidence of positive summary effects existed only for developmental and NDBI intervention types. This was also the case when outcomes measured by parent report were excluded. Finally, when effect estimation was limited to RCT designs and to outcomes for which there was no risk of detection bias, no intervention types showed significant effects on any outcome.
This meta-analysis demonstrates a depth often lacking within autism research projects, which is sadly why we need meta-analyses. Too many studies are small, causing distortions in the statistical findings.
In this comprehensive systematic review and meta-analysis of group design studies of nonpharmacological early interventions designed for young children with autism spectrum disorder (ASD), we report summary effects across 7 early intervention types (behavioral, developmental, naturalistic developmental behavioral intervention [NDBI], TEACCH, sensory-based, animal-assisted, and technology-based), and 15 outcome categories indexing core and related ASD symptoms. A total of 1,615 effect sizes were gathered from 130 independent participant samples. A total of 6,240 participants, who ranged in age from 0–8 years, are represented across the studies.
Parents are told, again and again, that ABA is the only therapy, treatment, or intervention for autism. It isn’t. And, it is no more effective than anything else, unless your goal is to make a child afraid of making mistakes.
The child in ABA experiences penalty after penalty, “aversive” (negative) consequences for being autistic.
My wife and I have tried various therapies and interventions for our daughters. None of them were productive. We’re now just doing our best to be supportive and caring at home.
I recommend reading the posts on ABA at NeuroClastic, where there are many informative blog posts explaining the problems with ABA.