Introduction to Applied Behavior Analysis (ABA) Online Tutorial
	Module 9: Is an ABA Program Right for You? If you’ve liked what you’ve read so far in the tutorial, chances are you may be interested in starting an ABA program for your child, or using ABA strategies with your students. As much as I support ABA programs, I think it’s also important to look at the criticisms commonly associated with ABA for children with autism. These criticisms largely reflect personal opinions and preferences, rather than facts. However, they may be important to keep in mind when choosing whether to begin a formal ABA program for your child. Some (but not all) of the common criticisms of ABA are summarized in the following paragraphs. As you read these criticisms, please keep in mind that many of them don’t necessarily have to apply to an ABA program. You can use ABA methods in any number of ways, so you can definitely work around these issues if they concern you. In other words, don't let these criticisms turn you off to ABA. Often, using a play-based, naturalistic ABA method (such as PRT) automatically eliminates these issues. Rote or Robotic Responses. Some critics believe that ABA programs have a tendency to produce only rote or robotic responses. An example I’ve seen is an eight-year-old child who, when asked his age, still says that he’s five years old. He had been taught “five” as the “rote” answer to the question, “How old are you?” when he was five-years-old, and he didn’t have a conceptual understanding of the question. These types of issues are certainly possible in an ABA program (and should be watched out for), but a good ABA consultant should be able to help develop a program that addresses these issues. Again, this is an area where naturalistic or play-based ABA can be really helpful. Too Intense and Demanding. Another criticism is that an ABA program is too intense or demanding, particularly for a young child. With the recommended 20-40 hours per week of ABA intervention, I can see some point to this argument. It is important for a child to spend a significant amount of time just “being a kid.” However, with the increased use of naturalistic ABA interventions such as incidental teaching and PRT, ABA can be incorporated into a child’s typical daily activities. This way, you may not need so many hours spent in a highly-structured ABA setting, sitting at a table doing discrete trials for long periods of time. Naturalistic interventions don't really limit the hours of ABA (because the child is still getting ABA throughout the day). The ABA is just incorporated into the child's normal routines and favorite activities. It may make ABA feel less demanding because the child is doing ABA while playing, not just at a therapy table doing “work.” Please note that I believe traditional discrete trial instruction can be combined with naturalistic ABA strategies for a balanced program. Inappropriate Goals? Some critics take issue with an ABA program that seeks to make children with autism “indistinguishable from their peers” (a goal often associated with early ABA research). Groups such as the Autism Rights Movement sometimes oppose ABA programs that seek to eliminate what they consider to be harmless behaviors, such as hand-flapping, spinning, or rocking. They may consider these behaviors to be useful, as they may help a person with autism to calm down and regulate their sensory system. A parent and autism/inclusion blogger, Lisa Jo Rudy, describes this aspect of ABA as follows: “The goal of autism therapies and treatments, in my opinion, should be to help the individual with autism to become as fully human as they can be. Being ‘fully human’ means so much more than being typical. It means learning, loving, creating, imagining, laughing, playing, singing, being silly, having fun. The idea of valuing a human being on the basis of whether he is ‘indistinguishable from his typical peers’ is just plain terrifying.” I can see this point. However, I don’t believe that an ABA program has to be this way. Your ABA program can help your child develop valuable communication and social skills while still respecting him or her as a unique individual. When done well, ABA can use children's unique interests, gifts, and talents to help them develop their potential. I believe that naturalistic ABA can be particularly empowering for children with autism, as it allows them to learn communication skills that directly relate to their favorite activities and toys. Use of Aversives. In the past, some ABA intervention programs used “aversives” to reduce problem behavior. “Aversives” in this case refers to punishments such as slapping a child’s hand, shouting, or spraying water in a child’s face. Thankfully, the vast majority of ABA programs today do not use aversives, instead focusing on positive behavior supports. However, I have seen a few cases in the news in recent years where aversives have been used with children with autism. If you have concerns about this, talk to your ABA provider about their policy on the use of punishment and aversives to make sure it is consistent with your family’s values about that issue. Impact on Intrinsic Motivation. Alfie Kohn, in his book, Punished by Rewards: The Trouble with Gold Stars, Incentive Plans, A's, Praise, and Other Bribes states, "Do rewards motivate people? Absolutely. They motivate people to get rewards." Among Kohn’s criticisms of some behavior analysis procedures is that they focus on external (extrinsic) motivation and neglect intrinsic motivation. I've also heard this criticism from students in the college courses I've taught, and it's a very good point and a valid criticism. While it is true that providing reinforcement (rewards) such as a cookie or a token economy for correct responses is extrinsic, I believe that these types of rewards may be necessary for some students with autism who are not inherently rewarded by learning from a typical childhood environment. If use of extrinsic rewards (such as food treats) concerns you, I would again encourage you to look at naturalistic ABA, particularly PRT. With many naturalistic ABA methods, the use of treats and other "arbitrary" reinforcers isn't as common. These methods focus on following a child’s lead and using their natural interests for teaching. This makes learning more naturally reinforcing, which reduces the need for extrinsic rewards such as candy or praise. If you do use extrinsic rewards for your child, keep in mind that you might not always need to use them. As your child learns and progresses, these need for these external rewards can be reduced over time. Your ABA consultant can help you with a plan for reducing these rewards over time, if that works for your child. No matter which side of the debate you agree with, Punished by Rewards is an interesting read if you’d like to learn more about this topic. References ABA: rote? too demanding? useful? The Fathers Circle: Applied Behavior Analysis (ABA) Wikipedia: Autism Rights Movement Autism.About.com (September 28, 2011) Wikipedia: Lovaas Technique Next --> Module 10: ABA Resources