ABA is not a therapy

 “My thinking is first and last and always for the sake of my doing.”

(James, 1890; Fiske, 1992; Gollwitzer & Bargh, 1996).

In an article “Early Treatment for Autism Is Critical, New Report Says” published by the New York Times, ABA providers are uncritically offered the platform to advertise their “therapy” without any dissenting opinions or critical insight.

It should be known to the New York Times and noted that ABA is also viewed critically from an academic perspective. Among other things, the study and evidence base is far from being as clear as it is presented in the article. The studies on ABA often have methodological shortcomings (for example, studies often include single case design or otherwise extremely small numbers of test subjects, no studies on long-term effects in relation to the satisfaction of the participants, no control groups…), and they are basically based on a misdefinition of autism as Elle Loughran has already aptly explained in her article “The Rampant Dehumanization of Autistic People.”

If one starts out from a wrong definition, nothing reasonable can come out of it (like when the medieval doctors used a wrong but coherent theory to explaine diseases as the results of winds, natural gases, and the four human humours: blood, phlegm, yellow bile, and black bile).

The minimum journalistic standards would have required a more balanced article. Instead, ABA is touted as a miracle cure, without any side effects. It’s not credible, even if you don’t know anything about ABA. A profound intervention in the nature of a child, without any reported on negative side effects? It smells like a snake oil salesman.

In Germany, ABA is still being viewed critically and is therefore not covered by health insurance companies. As autism is not considered curable, it logically cannot be cured therapeutically and therefore the ABA “therapy” cannot work by definition.

However, we are also flooded with fantasty-based articles and advertisements from institutes that offer this dressage at high prices. A miracle cure! No negative side effects whatsoever! Almost like magic! These are pied piper methods, and it’s completely nonsensical that The New York Times has published such an article. This would not be the first time – in 1971 the New York Times published a hymn of praise for the „healing“ of homosexuals: „the therapists report that they have helped between 25 and 50 per cent of all their homosexual patients – regardless of age or original motivation – to make a hetero sexual adjustment.”

I am not against supports, accommodations, or therapies– as in the field of speech therapy or psychological support in coping with stress, sleeping problems, etc. I am against ABA as as a “therapy,” because this “therapy” does not deserve the name therapy and uses methods of brainwashing and operant conditioning.

Quote from Dr. Levy from the New York Times article: “The most intense intervention is Applied Behavioral Analysis (A.B.A.), a program that addresses specific behaviors, identifying triggers and antecedents, and responding with rewards when a child behaves in the desired way.”

That rings a bell for me…

What is ABA? In a nutshell: ABA is based on the behaviourism that sees the human being as a blank page that can be filled with content or deleted at will. This school of thought came into disrepute in the 1970s because of its conversion therapies for homosexuals, and is now experiencing a cynical renaissance with ABA.

The use of ABA for the treatment of autism is critically evaluated in many parts of the world, because it is based on one of the darkest chapters of behaviourism: the experiments of Ole Ivar Lovaas, who tried to “cure” autistic children.

For Lovaas, autistic children were “only persons in the physical sense, but not a personality in the psychological sense.” He saw his task in constructing a person from their raw material. To achieve this goal, he used slaps and scare tactics. Although these are not always part of ABA treatment today (though electric skin shocks are still used at the Judge Rotenberg Center), ABA aims to change the behaviour of autistic children without learning the reasons for their behaviour. 

To achieve this, so-called “early therapies” are carried out on young children for at least 40 hours a week, an intensive working week. Typical characteristics of autism such as stimming or special interests that help autistic children cope and regulate their nervous system are prevented. Even when they claim it’s not, the aim is often that the child behaves as little like an autistic as possible to the outside world.

The training causes great harm on the psychologically, even if this is not immediately apparent. Basically, the use of ABA is a sign that the child is not accepted in its personality and identity, which is inextricable from autism. In order to experience this, one only has to ask autistic people who have experienced this treatment.

Some studies, such as those mentioned in the New York Times article, do confirm the effectiveness of ABA. Besides the methodological shortcomings mentioned above and also contrary studies that found no effects, “successes” are not surprising because ABA is classical conditioning: the effect of psychological manipulation that is empirically measurable.

Now, when studies find that autistic people can be successfully conditioned to behave inconspicuously and suppress their actual personality, successful conditioning is successful dressage, but not success in terms of the satisfaction of the individual, as is the case with other psychological therapies.

To put it succinctly: one can also force behaviour by means of torture, but I would not call therapy such a thing. ABA is about adapting the outwardly visible behaviour of a person to a defined system. The needs of the individual are put aside in favour of the sensitivities of the environment.

And this 40-hour weekly conditioning is best done with toddlers, according to the New York Times article which functions more like a commercial than credible journalism– just as Ole Ivar Lovaas trained homosexual boys in the 70s to say that they suddenly found only women attractive. Today, this thought makes our hair stand on end in horror. In the past, deaf children were forced to read lips, today they are (hopefully) taught sign language. Left-handed children had to write with their right hand. Today, left-handed children are no longer forced to deny their neurology and are of course allowed to write with their left hands.

In the past, the rule was: no matter what the child feels, the main thing is that it looks normal. Nothing else counted. The black box didn’t matter. The arrogance of the majority, the status quo, determined success. Fortunately, that has changed in many areas. But the voices of autistic people are still not being heard. Now, there is an aggressive push to bend even the youngest children into expensive ABA “therapies.”

In 20 years, the scientific community will be ashamed of this.

I am sure that ABA supporters will claim that I am exaggerating when I mention behaviorism and torture in one sentence– but it’s not very far off. Behaviorist methods were also used by psychologists and other professionals to develop torture methods for the C.I.A. (the psychologists involved called this “The Behaviour Management Plan”), which were used, for example, in Guantanamo Bay.

Radical behaviorist methods of classical conditioning should finally be put where they belong: on the garbage heap of history, and not be uncritically promoted by the New York Times.

Additional sources:

Fiske, S.T. (1992). Thinking is for doing: portraits of social cognition from daguerreotype to laserphoto. Journal of Personality and Social Psychology, 63(6), 877–889.

Gollwitzer, P.M. (1996). The Psychology of Action: Linking Cognition and Motivation to Behavior. New York

James, W. (1890). The principles of psychology. New York : Holt.

Picture: Bundesarchiv, B 145 Bild-F010223-0012 / Unterberg, Rolf / CC-BY-SA 3.0