Therapist Neurodiversity Collective opposes the use of ABA treatment and/or restraint and seclusion to “manage” a person’s external distressed behaviors (aggressive, destructive, self-injurious, meltdown, and “non-compliant”). TNDC believes the use of ABA and restraint and seclusion are unethical, dehumanizing, trauma-inducing behavior management techniques that have immediate and long-term negative and even detrimental mental health and well-being outcomes.
Restraint is never therapeutic!
If a person has no way to functionally communicate at the moment, or if they are minimally or non-speaking, at all, how else do they communicate that they are
- anxious?
- upset?
- distressed?
- afraid?
- frustrated
- overwhelmed?
- in pain?
- being harmed?
- in crisis?
- experiencing trauma?
Dehumanizing human behavior is inhumane.
There are more trauma-informed, empathetic ways to approach a person’s distressed behavior instead of manipulating or extinguishing it for the convenience of others. Who does ABA actually help? Does ABA help the neurodivergent person who is exhibiting external behavior, or does ABA just make life easier for the people around them?
Instead of “fixing” a person’s distressed behavior by manipulating or extinguishing it with rewards and punishment, try to figure out the reasons behind their surface behaviors and fix those.
- Does the person have an effective and robust method of communication, including alternatives to spoken language, even if the person demonstrates the ability to produce spoken language?
- Is it possible that they are in pain, or ill and need medical attention?
- Are their sensory needs being met, or are they experiencing sensory overwhelm?
- Are there any changes in their environment, or problems with their immediate environment?
- Did someone ignore their protest (self-advocacy attempts) or fail to get consent for physical contact?
- Is someone harming them or bullying them?
- behaviors and responses?
There are better ways to approach distressed human behaviors than with behavior plans, compliance-based goals, and rewards and punishments.
Trauma-Informed Resources for Distressed Surface Behaviors
“Trauma Clashes: How to Stay Calm When Someone is Melting Down” – Thinking Person’s Guide to Autism, December 23, 2022
“Autism Checklist of Doom” – Thinking Person’s Guide to Autism, January 15, 2022
“Autism and The Myths around Violence” – Ann’s Autism Blog, September 2021
“When Autistic Kids Destroy Things: Insights and Advice” – Thinking Person’s Guide to Autism, June 18, 2020
“Autism and Behaviorism, New Research Adds to an Already Compelling Case Against ABA” – Alfie Kohn, January 21, 2020
“Behaviour Analysis, The Autistic Way” – Thinking Person’s Guide to Autism, Ann Memmott PGC, May 30, 2019
“If Not ABA, Then What?” – Thinking Person’s Guide to Autism, Maxfield Sparrow, April 7, 2017
“Autistic Insights on Meltdowns, Aggression, and Self-Injury” – Thinking Person’s Guide to Autism, Brent White and Lindsey Anderson, November 21, 2016
“Understanding Autism, Aggression, and Self-Injury: Medical Approaches and Best Support Practices” – Thinking Person’s Guide to Autism, Clarissa Kripke, MD, FAAFP, August 16, 2016
“Autism: Brain event, not nastiness. An example for parents.” – Ann’s Autism Blog, July 4, 2016
“A checklist for identifying sources of aggression” – We are Like your Child, May 11, 2014
“Self-Injurious Behaviors” ~ Let’s Discuss” – Emma’s Hope Book, ‘Living Being Autistic’, February 5, 2013
“The problem with behaviorism” – Alliance Against Seclusion and Restraint, Beth Tolly
“For Whose Benefit?: Evidence, Ethics, and Effectiveness of Autism Interventions” – White Paper – Autistic Self Advocacy Network
“For Whose Benefit?: Evidence, Ethics, and Effectiveness of Autism Interventions” – Easy Read Edition – Autistic Self Advocacy Network
(The following Links are to United States’ Amazon website. Therapist Neurodiversity Collective has no financial affiliation with the authors or Amazon)
Research
Treating self-injurious behaviors in autism spectrum disorder
Gary Shkedy, Dalia Shkedy & Aileen H. Sandoval-Norton | Luca Cerniglia (Reviewing editor) (2019) 01 Nov 2019. Journal Cogent Psychology Volume 6, 2019 – Issue 1. 6:1, DOI: 10.1080/23311908.2019.1682766
“Self-injurious behavior is a cry for help.” “ABA therapists use an FBA to look at both the antecedent and the consequence of SIBs (self-injurious behaviors) in order to hypothesize the function of SIBs. It is unclear why one would assume such an assessment/analysis would also be appropriate to assess the thoughts, feelings, and other internal processes that often determine the function of self-injurious behaviors (especially since we know this is the case for SIBs in the non-autistic population). Instead of approaching these SIBs and understanding them the way we understand SIBs in other populations, we have misapplied an FBA in an attempt to measure SIBs despite the fact that it cannot measure such a construct. This makes the assessment unscientific and methodologically flawed.”
How much compliance is too much compliance: Is long-term ABA therapy abuse?
Aileen Herlinda Sandoval-Norton & Gary Shkedy | Jacqueline Ann Rushby (Reviewing editor) (2019) How much compliance is too much compliance: Is long-term ABA therapy abuse?, Cogent Psychology, 6:1, DOI: 10.1080/23311908.2019.1641258
“Serious issues with the application of ABA to autistic students, specifically “lower functioning” and nonverbal ones, are discussed, especially with regard to lack of current and longitudinal scientific testing and research with respect to these individuals. These effects and the trauma that occurs resultantly are categorized as abuse. Finally, drivers of the expanded usage of ABA within the autistic community despite a lack of efficacy are also discussed, such as a potential current market size as large as $17 billion annually and the deficiency of variety in techniques used by the psychologists and behavior technicians who utilize ABA…”