Neurodiversity-affirming therapy: Dozens of neurodiversity-affirming therapy goals and best practice resources for ally SLPs and OTs.
“And, at the end of the day, that’s what a lot of therapy “influencers” are after: exploiting vulnerable families to benefit their own bottom line and their online image. And it’s time that professionals and parents begin talking about it and pushing back.”
1/24/2022, by Nicole Lobsey, Certified Practicing Speech Pathologist Like most health and education fields, Speech Pathology is a heavily ableist field. Speech Pathology practices are based on: Assessment against neurotypical […]
At the beginning of the evaluation, Adam appeared to enjoy playing with zoo animals with mom and the therapist. He laughed and smiled readily and paired gleeful, albeit, infrequent, babbling with gestures like pointing and guiding his mom’s hands to the toys he wanted her to play with. However, after a few misunderstandings in which neither mom nor the therapist could figure out what Adam was gesturing for them to do, Adam became highly frustrated and emotionally dysregulated. He threw himself to the floor and, in between sobs, began to bang his forehead on the floor repeatedly. His mother was worried that this self-injurious behavior had started happening more and more frequently in recent weeks.
ABA providers will tell you to break your child, to reward your child for eating food, to re-present food your child has spit out or vomited, to restrain your child in a chair and do not let them leave the chair. There are better ways.
When children have trouble eating, it can be incredibly stressful for parents. But you’re not alone! There are qualified professionals waiting to help you and your child.
And let’s talk about considerable ethical and financial conflicts of interest with this paper and its authors, shall we?
Reader, every single author of this paper is trained in ABA, (three of them are actually BCBAs), so clearly each author has a vested financial interest in duping people into believing that ABA is “Neurodiversity Approved”.
(It’s always about the $$$.)
Performative Neurodiversity – the appropriation and watering down of a Human Rights Movement for profit
What are some signs that you’ve wasted your money on a neurodiversity-lite product, book, or class?
Through the pairing procedure, children begin to learn that doing things that feel good to them (e.g. autistic play, stimming, etc.) are less valuable than the things that make the therapist feel good (i.e. neurotypical play, compliance). They learn to ignore their feelings of distress when confronted with a task they find aversive and mask their distress to please their caregivers. They become motivated by the praise they receive when they “do the thing” and become reliant on external reinforcement rather than intrinsic motivation, regardless of how much they are suffering.
“First Do No Harm”: How SLPs Who Ignore Coregulation Reduce Children’s Access to Authentic Communication
Many speech-language pathologists do not think of sensory, emotional, or cognitive regulation as a part of their area of practice. In actuality, though, all communication originates from the need for regulation, and it is impossible to support a child’s communication skills or language development without understanding and supporting their regulation needs.
Through the guise of play, I often contrived stressful and frustrating situations and placed consistent demands on very small children. For instance, one of my kid’s goals was something like this: The client will engage in 3 turn taking exchanges by relinquishing to their play partner, waiting while their play partner takes a turn, and then requesting a turn with ___ # of prompts.
I am used to my stuttering and I wish everyone else would get used to it too. My reactions and my feelings about stuttering are relative to how you, the listener, react. I am only uncomfortable because you are uncomfortable. I am uncomfortable FOR you.
Rebuttal to critique of “ABA is NOT Effective: So says the Latest Report from the Department of Defense”
“The DoD/TRICARE report isn’t a study in any real sense of that word.” This is FALSE. In fact, they included 3794 participants who had received at least 18 months of ABA services; 2,183 from the eastern region of the United States, and a replication in the western region of the United States with 1,611 participants. As such it is not merely the largest study of the effectiveness of ABA, it is the only large-scale test of ABA . And they determined that ABA services do not meet the TRICARE hierarchy of evidence standard for medical and proven care..
With 3,794 participants, this is the largest study ever conducted of ABA effectiveness. The 31-page report entitled, “The Department of Defense Comprehensive Autism Care Demonstration Annual Report 2020” concluded that “ABA services are not working.”
Our autistic female students are constantly mimicking and copying behaviors of peers so they can hide their autism. We, as clinicians, teach them to do this because we were taught that autism must be hidden and masked through the therapy we provide. We are licensed, credentialed ableists, “therapizing: our autistic students to learn to be in a constant state of making in order to be acceptable, to be worthy, to be liked.
“Good job!” is a phrase used frequently during treatment sessions with autistic children. What message does a child receive from hearing, “Good Job!”? We hope they hear our interest, encouragement and approval. However, when “Good Job!” becomes a habit, is it still successful in conveying this meaning? Or, does it simply signal that the adult is in control, with specific goals in mind and is directing the child towards those behaviors, regardless of the child’s intention? Can frequent “Good Job!” responses undermine a child’s initiative, creativity and broader learning? Does it interfere with a more robust engagement?
Why Perspective-Taking and Neurodiversity Acceptance? (Part 2 of “Training” Social Skills is Dehumanizing: The One with the Therapy Goals)
Wasted years upon years of endlessly drilling autistic children and adolescents to memorize and parrot “appropriate” rote phrases for specific social situations will not lead to their peers perceiving them as more likable. Social skills training is not a “cure” for autism despite what the ABA industry would like for us all to believe. All “social skills training’ does is to teach autistic people how to mask their autism. And the potential harms of masking (exhaustion, anxiety, depression, frustration, decreased self-esteem suicidal ideation) are significant.
Now let’s talk about one of the recent episodes, “The Reckoning.” There’s a loving montage of a character Kuiil rehabbing a droid, named IG-11, who’d been killed. Kuiil rebuilt the droid from scratch after “Its neural network was almost completely gone.” He had to piece IG-11 together, which may be a little beyond our day-to-day job, but the recovery process is certainly something many of us speech-language pathologists have participated in.
PECS® uses Operant Conditioning, which is a behavior technique that can be used to target and increase a behavior by pairing performance of the target behavior with a positive or rewarding outcome. Per Andy Bondy, inventor of PECS, “Skinner’s analysis of Verbal Behavior forms the basis for teaching particular skills at specific points in the training sequence and also provides guidelines for how best to design the teaching strategies.” PECS uses picture-based prompting and reinforcement tied to error correction in order to teach language skills. The method allows the trainer to artificially cause frustration through the withholding of highly desired objects or food until the targeted behavior is achieved, even if the communicator becomes upset or angry. It is not a natural or nice way to teach language.
Dictating how a neurodivergent person is expected to communicate in specific social situations takes away their self-determination. Training people as one trains animals is appalling. SLP Neurodiversity Collective believes in respecting the authentic social communication of all people, rather than compelling compliance for neurotypical expectations through a system of rewards and punishments.