Features common to all ABA-based approaches are:

1. the objective measurement of behavior,
2. use of procedures based on scientifically established principles of behavior, and
3. precise control of the environment to allow for the objective evaluation of outcomes.

To look at something “analytically,” one must put aside prejudices and observe with objectivity to find concrete evidence. Science and medicine use data-compilation and hard evidence to come to a logical conclusion.

Recently, The Kennedy Krieger institute pieced together studies from all around the medical field with results showing  a “demonstrated improvement” in those who underwent ABA therapy.

Here are a few excerpts.

The Association for Science in Autism Treatment (ASAT) found that “…ABA is effective in increasing behaviors and teaching new skills….ABA is effective in reducing problem behavior…and also indicates that, when implemented intensively (more than 20 hours per week) and early in life (beginning prior to the age of 4 years), ABA may produce large gains in development and reductions in the need for special services.”

Another excerpt

National Autism Center’s National Standards Report (2009) noted that behavioral interventions based on ABA were found to have an established level of evidence to support their use. Examples include behavioral packages, antecedent packages, comprehensive behavioral treatment for young children, modeling, schedules, pivotal response training, and self-management packages.”

This excerpt is from Autism Speaks.

We are finding more solid evidence, based on higher quality studies, that these early intensive behavioral interventions can be effective for young children on the autism spectrum, especially related to their cognitive and language skills,” says lead author Amy Weitlauf, a clinical psychologist with the Vanderbilt [University] Kennedy Center. (The Vanderbilt Kennedy Center is part of the Autism Speaks Autism Treatment Network.)”

Autism Speaks states that “ABA is widely recognized as a safe and effective treatment for autism”; and “Behavior analysis is a scientifically validated approach to understanding behavior and how it is affected by the environment.”

So “scientific evidence” has found that many people who underwent ABA treatment had positive developmental progress over time.

But is that the “whole story?” Was the well-being of the subject taken into account when the benchmarks of “success” were measured? Did all those gains come at the expense of emotional distress for the individual, as we have seen in my recent post?

In many cases, we cannot ask the individual.

The findings suggest that early intervention plays a key developmental role in those with autism. So most of those who are referred to ABA are parents with young children on the Autism Spectrum.

To answer this question, we need to ask parents about their children’s reaction to ABA.

Would loving parents knowingly or unknowingly “abuse” their children? One would hope the answer is “no.”

In fact, I have found that most parents who put their children through ABA have said that the therapy has been extremely beneficial to both them and their children.

You don’t need to look far in any autism parent support group to see how popular ABA has become (at least in the US) and the posts from parents are almost always overwhelmingly positive. Here are some examples from a community forum about how ABA has helped their kids:

From one parent:

ABA helped where all other therapies failed.  ABA taught my child to speak, read, ask for what she wants, potty train, point, swing, walk up and down stairs. The biggest impact is it helps her learn. It’s hard to explain but it’s giving her the skills to help her in the classroom. It’s hard to list all the ways it’s helped but I highly recommend it. But it important that you pick a great ABA therapist.  One that’s right for your child specifically. My therapist knew we needed an implementor that incorporated music, was high energy, fun and positive.  She does not respond well to a bootcamp type of interaction. If at all possible, home therapy before or in addition to school therapy would be great.  

Another parent writes:

My kids love ABA. If they don’t go they get upset. They love their therapists, play with tons of kids, have loads of fun, and have made insane amounts of progress. Do your research and find a good center, they are out there.” 

Still another one writes:

Our therapists use play based ABA and for the most part they follow his lead. They take breaks where my son can run around or hop on his trampoline during his sessions. They color with crayons, they use water paints, they play with stickers and play doh. He has fun and enjoys it. 

When he started ABA he couldn’t point, couldn’t sign, and his receptive and expressive speech was dramatically behind. He can how point to express wants and needs. He also uses signs for “all done” and “help.” I now know his receptive speech has increased because I can say “where is X?” And he’ll point to X. This has been a real game changer for us, as he’s finally expressing wants and needs. We’ve seen a huge reduction in behaviors like aggression and head banging (which is gone). 

I credit ABA for these improvements.

What they are describing doesn’t sound like the controlling, forced-compliance abuse that was described previously as ABA. This almost seems like a completely different therapy.

And, apparently that assessment may be correct.

I have read in various forums that ABA has become so popular in the US, that many insurance companies will only cover “ABA” as an autism intervention and other alternative therapies are not covered, depending on where you live.

So some companies are offering “ABA” to get coverage for their clients, but the actual service they provide is not considered “true” ABA as has been defined. It could be any number of different therapies being packaged as “ABA.”

Bear in mind, that is what is being said in some community forums, but I could not find any actual documentation to support that.

In the end, it all boils down to “what is right for you.” You need to do your own research. Not all therapists are “abusive.” Not all ABA you may be offered is even considered “ABA” by some.

You may have a therapist who understands exactly the needs of your child, doesn’t use any kind of aversives and let’s them dictate how they want to engage. You may have a therapist who doesn’t use “enforcers” or a “reward system.” You may actually have a “good” ABA therapist and have a FANTASTIC experience as some parents have noted.

Some would say that, if that were the case, “it simply wouldn’t be ‘ABA’ ” and maybe that is technically true. But if you were avoiding ABA based on the label alone, you would forego the possibility of a “fantastic” experience for your child simply because of what the therapy was labeled.

Some would choose to do ABA in the hopes that they find one of those “good” therapists. Others would not chance ABA out of fear of the “bad ones.”

As a parent, you must be our child’s biggest advocate. You must do what feels right for you.

A trustworthy friend of mine has a daughter who went through 12 weeks of ABA and came out with a better, clearer understanding of the expectations around her. She went from “biting and hitting” with limited communication at the beginning, to being able to communicate effectively—and as a result, the aggressive behaviors nearly vanished within 12 weeks.

She claimed it was a result of the ABA her daughter received. It could have turned out to be a bad experience, but it turned out to be great. At least for them.

And maybe her progress wasn’t a result of “ABA.” Maybe it wasn’t “real” ABA. Maybe she had a “floortime” version. Maybe it was just natural development, or just a really good therapist. But here’s the thing.

I don’t care what “label” it was. I don’t care. It was exactly what she needed at the time.

If my friend hadn’t at least tried it, she may not have seen the same success or have the tools to maintain that level of success with something different.

Could they have also had success using a different therapy? Perhaps. But who is to say that they would have had a “good” therapist using a different form of therapy?