ABA Reform: Distinguishing Meaningful Change and “Neurodiversity Lite”
I’ve been doing some more thinking on that most controversial of controversial autism questions: ABA.
Right now, most neurodiversity advocates don’t trust the idea that any sort of ABA intervention could be a good thing, and why should they? Far too many ABA interventionists have been pointing to a few modest changes to their programs – like removing aversives1, or adding some cosmetic “neurodiversity lite” jargon – and claiming that this makes their programs adequate and ethical. But that’s not enough.
While I admit that the behaviour intervention field has made some progress over the last few decades, these modest changes are not nearly enough to satisfy many autistic advocates, and nor should they be. They don’t address deeper critiques: critiques of normalization, of power dynamics, of suppressing people’s autonomy and self-determination, and more. They don’t address fundamental concerns about making reward – even affection! – contingent on correct copying of neurotypical behaviour.
Obviously, the goal of intervention reform shouldn’t be, “Let’s make our programs somewhat less harmful” – the goal should be to do no harm at all.
But I do believe there are people in the ABA field – some of them autistic themselves, and some who are non-autistic allies – who are absolutely genuine and sincere in their efforts to reform the field and to provide support to young autistic people without causing any harm. The changes they are trying to make are broader and more comprehensive, not cosmetic. It’s not an inherent characteristic of ABA that it has to be conducted without empathy for the client, or that it has to be conducted in pursuit of normalization goals, or that it has to trample the client’s autonomy. I hope and believe these reform-minded interventionists can show us how ABA can be conducted with empathy, in pursuit of appropriate and neurodiversity-aligned goals, and in a way that encourages instead of trampling autonomy.
I think we should support the efforts of these reformers. There are some important forces – e.g., insurance mandates in the USA, the number of people who depend on ABA intervention for a living – that would make it easier to reform ABA than to replace it with some other kind of intervention.
But if we support ABA reform, how are we going to make it possible for families to know whether they are accessing a reformed intervention, one that would meet the expectations of neurodiversity advocates, or not? As I hinted before, “neurodiversity lite” jargon could be added to a traditional ABA program. How then would families be able to determine whether they will get (1) a progressive, neurodiversity movement-aligned program or (2) a traditional program with some progressive window dressing?
Perhaps somebody needs to set some standards for progressive, reformed ABA intervention and determine whether programs are meeting them?
A few months ago, some of my colleagues and I published a paper exploring how the naturalistic-developmental behaviour interventions, which are already some of the more progressive ABA interventions out there, could potentially be reformed further and brought into alignment with the demands of the neurodiversity movement.
I don’t think the suggestions in that paper should be enforced as standards – if the autistic community is ever to trust ABA professionals, ABA reformists would need to engage in dialogue with the autistic community and develop some standards everyone can agree on – but perhaps the suggestions in that paper could help serve as a basis for a discussion about standards.
Once standards are agreed on, presumably we’d then need some kind of agency to certify programs that meet them. Currently it seems like there’s not nearly enough interest in reform at mainstream ABA organizations, so perhaps the neurodiversity-aligned ABA interventionists would need to establish a new association in order to do this?
Whatever the logistics (and I’m sure they would be complicated – what I’m outlining here definitely couldn’t happen overnight!), it seems to me like setting clear, transparent, and rigorous standards may be the best way for the ABA field – or some subset thereof – to provide concrete assurances of its seriousness about reform. Community members should be able to trust that any intervention they access from certified providers would be delivered in a way that both autistic advocates and ABA professionals agree is empathetic, supportive, and non-harmful.
If there’s one thing ABA professionals ought to be good at, you’d think it should be setting goals and monitoring whether or not they’re being met. Let’s hope that ABA professionals will choose the right goals for themselves.
5 thoughts on “ABA Reform: Distinguishing Meaningful Change and “Neurodiversity Lite””
Thank you for writing this. There are several ABA professionals who are trying to create reform. There are so many variables and complexities to all that is wrong within this field, from the teaching and training, to the box behaviour science has put itself in, that it is derived from a branch of psychology, a field that for most part is focused on the individual, that is has failed to listen to autistic voices, that it continues to be lead by privileged, mostly white, mostly male academics, that it has failed to take into account people and families cultural context and other intersectional identities. And autistic BCBA’s, autistic and ND allies continue to speak up and out, to take a stand against organisations such as JRC and ABAI. The field of behaviour science isn’t about viewing things as behavioural challenges/disorders/problems, rather it was intended as a science lens through which to view all experiences, actions, biological and social at individual through to cultural and global behaviour. Humans being humans have in all their arrogance, privilege and ignorance gone ahead and applied behaviour science in a rigid, limited and prescribed way without collaboration, flexibility and compassion. Behaviour science, has I believe, a lot more to offer, it depends if we can get out of our own way though to utilise it more compassionately and effectively to create the kind of change our world needs.
I know ABA practitioners who are deeply invested in reform and I appreciate their efforts. But I don’t think they’re going to be successful. There *is* something inherent to ABA that makes it particularly ill-suited the needs of autistics, because autism is not behavioral disorder – it’s neurological. A behavioral lens isn’t useful for addressing any other neurological issue, so why would it be helpful here?
We don’t train people to behave as though they’re not having a migraine or reward them for having seizures at night instead of in the day. When I have heard autistic people talk about what actually causes them distress or interferes with their lives, they usually talk about neurological issues – sensory issues, executive dysfunction, motor loops, meltdowns. Sometimes they talk about comorbidities – EDS, CPTSD, GI issues, feeding issues, epilepsy, ADHD. And sometimes they talk about the challenges of living in a society that just doesn’t accommodate them. Very few of these issues respond in any way to “behavior modification,” and some respond quite negatively to it.
I know that some ABA practitioners are trying, and I hope that they will, in fact, do less harm. But right now, I don’t see a path forward for ABA to be genuinely valuable to autistic people.
Thank you for linking your article
Unfortunately, I don’t see this changing anytime soon. The UK Government recently refused to outlaw conversion ‘therapy’ for trans people, and that may be to avoid autistic self-advocates drawing the obvious parallel and saying, “Well, you banned it for them, so why not ban it for us?”