~Rumi

All day I think about it, then at night I say it. Where did I come from, and what am I supposed to be doing? I have no idea. My soul is from elsewhere, I'm sure of that. And I intend to end up there...Who looks out with my eyes? What is the soul? I cannot stop asking. If I could taste one sip of an answer, I could break out of this prison...I didn't come here of my own accord, and I can't leave that way. Whoever brought me here will have to take me home.

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18 October 2009

World Autism Interviews: Applied Behavior Analysis with Anonymous

You have to go to these institutes and just observe a full day to get a sense of the chaos around you. This chaos breeds hostility, poor judgement, and abuse. Imagine: six or more kids with six or more therapists sitting in a plain room with very colorful cube-like plastic furniture, and televisions on every table top. Different movies being played at different times for brief moments and then screaming from one corner, a full-on wrestling match in another, with six therapists each giving different demands and offering artificial praise. It is a lot of stimulation. -Anonymous

*Please note that this interview is not an attack against well-intentioned parents who use Applied Behavior Analysis. I personally know a few parents who employ ABA in the home and these parents are great people with their children's best interests at heart. ABA is, however, controversial and questionable.

Behavior analysis is a science that studies the behavior of people, as well as the behavior of animals. It is a science (though some note it as a pseudo-science) attempting to explain, predict, record, and understand behavior. Applied Behavior Analysis is used as a teaching tool for autistic children.

Some examples of controversies surrounding ABA: lack of autistic rights (ex: psychodynamic acceptance), misinformation surrounding ABA, discrepancies in the training of ABA practitioners despite the existence of a Behavior Analyst Certification Board, widespread misunderstanding of autistic behavior, et cetera.


Interview with Anonymous

E: What drew you into the field of Applied Behavior Analysis? What type of training did you receive, and what qualifications were required for you to be hired?

Anonymous: I took an Experimental Analysis Behavior course where I was exposed to Behaviorism. Toward the end of the term, my class completed an introduction to B.F. Skinner's Verbal Behavior. A guest speaker, the director of a language treatment clinic, visited my class to give a presentation. The director showed us how the theories we had studied applied to treating children with developmental disabilities. He spoke about his cases, mentioning that his clinic had over an 80% success rate. I was hooked, so I applied to intern. I loved playing with the children, as I related to them well, plus I had a knack for working with difficult children. I had just turned twenty-one years old, and this work gave me a way of understanding my own social interactions.

After graduating with a B.S. in Applied Psychology, I had to go through a one-week ABA training again, where materials from both my class and interning were reviewed. Additionally, there were trainings on how to respond to difficult behaviors by giving alternative demands, ignoring the behavior, et cetera. Assault training was also incorporated where we were taught combat moves for defense of both the children and ourselves. We also learned policies and protocols.

As far as qualifications, the only requirement was to possess a B.A. degree, preferably in psychology, social work, or another similar concentration.

E: How long did you work as an ABA therapist? Did you ever begin to have misgivings or second thoughts about this work?

Anonymous: I officially worked as a therapist for one year.

One day, I was sitting next to one of my favorite clients. He was the sweetest nonverbal foodie (he ate everything) who smiled often, and listened well. We had just gone through his set of verbal training programs, and we were having a relaxing break. He was stimming [ex: finger flicking/rippling, humming, rocking, spinning] on a musical toy and then he began hyper hand-flapping. My job was to click each hand flap and *reset* his hands every time. I sat back in realization and wondered to myself: is this treatment truly helping him to become independent? Will he be institutionalized for his entire life? Why does it matter if he hand flaps? Will he find love in his life?

During this rush of emotions, it was like I saw a film reel pass my eyes, and I could see my client sitting in a home twenty years into the future, having never been given an opportunity to grow to his full potential. He had been stunted by diagnosis after diagnosis, prescription after prescription, and treatment after treatment.

How do we expect to *socialize* someone if we never give them a chance to interact socially, and we treat them as if they are rehabilitated animals at a nature center of some sort?

I began to take on a new attitude regarding therapy. I changed the way I connected with the children I worked with, avoiding operationalized responses, unless I was being monitored. Though I utilized the philosophy I was trained in, I wanted mostly to make sure the kids were able to have fun, to feel love, and to have a chance to communicate with me in their own language. I formed real friendships with my clients.

Consistent environments are conducive to learning, but boredom hinders learning. I wanted to motivate learning, and not just prove learning to parents, insurance companies, and supervisors.

Due to the lack of joy in many of the children I saw, several of them exhibited depressive behaviors. There were few toys in the playrooms, and so I requested that new toys be purchased, especially since the center was charging exorbitant fees for treatments. Was there no person who could not stop to think about what those children wanted?

Some therapists assume they are great at knowing what children think because children's thoughts--in their minds--could be nothing more than simple.

E: Did you ever witness any incidents that you felt either violated human rights, or disregarded a client's, or an individual's, right to dignity?

Anonymous: There were times when I witnessed a therapist become fed up with a particularly difficult client, and this therapist would pinch the nipples to get him to stop the annoying behavior. The nipple pinching method was shown to me by my closest colleague. Pinching was a common method of abuse I witnessed. Pinching is easy to do, as well as difficult to observe; we were all so hands-on with the children.

E: Thank you, Anonymous, for your interview.

Further reading:



10 comments:

  1. This comment has been removed by a blog administrator.

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  2. This is really interesting, Elesia!

    (And thank you, Anonymous, for your willingness to talk about your questions and doubts publicly like this; that takes a lot of courage).

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  3. Thank you for your support Lindsay!

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  4. Great interview !
    I knew that ABA's ultimate goal was to make autistic children "indistinguishable from their peers" but I had no idea it went so far as forbidding autistic children to flap their hands...
    I would like to know : what's your opinion about using ABA to prevent harmful behaviours (such as aggression or self-injury) ? Do you think it can be useful in those cases ? If not, what would you suggest instead ?

    (I am asking those questions to every reader who opposes to ABA, not to a specific person)

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  5. Oktarin: That was Lovaas's goal. It is emphatically not the goal of ABA (which, being a science, doesn't have goals beyond understanding). I will admit that many, if not most, who practice based on ABA have that sort of goal, but again -- not the goal of ABA itself.

    Elesia: I'm rather surprised you haven't asked me for an interview of this sort. :-) Good interview, though.

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  6. The playroom is where a child’s imagination grows. And the Child Desks where it prospers. Well, I believe in having utility-based Kids Playroom Furniture at home.

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  7. Intriguing stuff you write about. Thinking of publishing any new feeds to your blog ?

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  8. Hello everyone, I am a BCBA who has been working in the field working with special needs children for over 7 years. The field of ABA like any other discipline has evolved over the years. The early years of DTT intervention specifically with children with Autism was indeed very structured, rigid, robotic even. Keep in mind that ABA is not synonymous with DTT (which is what it sounds like was done by person in the interview) or any other teaching methodology. They are under the umbrella of ABA. ABA is the science of Behavior. Behavior is everything that we do. Understanding the principals of ABA allow you to understand how to identify the functions or reason for occurring behaviors. We identify which are strengths and areas of deficit. The areas of deficit are targeted for replacement (such as the hand flapping talked about in interview) not denial. We want to teach the child how to do that behavior (if safe) in an appropriate manner that is socially appropriate. for instance with hand flapping playing drums, basketball, etc. The end goal is to make significant improvement that persons life that is socially significant. Meaning we want him to replace that (only if doing excessively to the point is interrupting his life) behavior to be able to be accepted by society. Most kids don't understand why a child would hand flap. So giving him an appropriate alternative gives him/her a chance to adapt and learn to play. Play is huge to make friends. As you can practice having conversations, rules, sharing , and turn taking. Today ABA is done in the natural environment where the child is such as home, community, school, etc) not so much clinic setting unless there is a study or individual needs intervention in such a setting (dangerous behavior such as head banging, pinching,etc).

    Hope this helps

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  9. One more thing I am the same BCBA that commented above. For any parents looking at how ABA interventions may be done with children with Autism please look up Pivotal Response Training/Teaching (PRT which was born out of the weakness of traditional DTT which as has also evolved today), also please look up Natural Environment Training (NET). And remember ABA when it comes to parents is about helping you understand when and where to apply simple techniques to increase appropriate (skills) behaviors and decrease inappropriate behaviors. We want to aid children be independent. We don't want teach things that in the end wont improve there day. Please take the above with a grain of salt. The person speaking did not have extensive background in ABA, he took a course not a degree. And he shared his experience which I don't want take away from but that is not the norm. Please take a look at the teaching methodologies mentioned above. Keep in mind we have helped thousands of children learn to speak, reduce inappropriate behaviors, taught parents how manage behaviors, and taught families how to communicate. ABA techniques are used in a variety of fields sales/marketing, politics, social policies, companies (to monitor performance, safety, etc). ABA is simple and the comments contrary to this is stated by persons with limited understanding of the field and our purpose. Having said this its important for people to question was is true and what is not. Be careful of where you information comes from and who is stating the information. Please look at various reputable sources always to verify information. Hope this helps
    Thank you

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  10. Last comment: Same BCBA from above. I could not help but comment on the pinching by "therapist" (which is not appropriate without a licensed. This person was not licensed from information given. Pinching and or any physical punishment is in NO WAY allowed,, promoted, or even legal with any reputable company that practices ABA today. Those persons if observed by parent, other staff, or supervisors would be reported! That does not and should Never occur!! If this was a practice of a clinic, it most certainly was eons ago. Unfortunately the beginnings of most fields (physicians, psychologist, dentistry, etc) all had experimental phases. But this is not where the field is today. If whoever interviewed the above person is still in contact with the interviewee it would be good to get additional information. If this is a clinic that is doing this today these people are not practicing ABA, and should be reported.

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