Special Needs Therapies: Applied Behavior Analysis

One of the more common special needs therapies for children with autism is ABA or applied behavior analysis.  According to its proponents, it is the only therapy with proven results at improving the behavior of autistic children and should be used extensively with all such children in all aspects of their life.  They recommend 40 or more hours per week of their rigorous, repetitive activities, at a rate of around $100 per hour (which insurance will usually not cover).  No deviation from their accepted practices is allowed outside of therapy time either.  Only then, they will tell you, can your child be saved from a life of isolation and despair.

Let’s just say my results varied.  I think I know why, so I’ll try to explain it to you.  In seeing how this form of therapy failed Deborah, I learned a great deal about how to work with her and hopefully other children with special needs.  Maybe those thousands of dollars were worth it after all.  At least that’s the positive way to look at it.

ABA is, of course, based on the psychology of behaviorism developed by BF Skinner.  Its essential claim is that your mind/soul/personality is really nothing more than a summary of your collected actions.   Put most simply, you are what you do.  Furthermore, what you do is determined by the laws of cause and effect–or stimulus and response in another way of saying it.  In order to teach autistic children to behave more like other children, therefore, they set up a whole series of extremely isolated activities for children to do and reward them when they get it right.  When they get it right often enough, they move on to more advanced activities.  Every trial is recorded and the child’s progress is shown on a chart.  It’s extremely mechanical and many have referred to this technique as dog training.  The point is to change the behavior in order to change the person.

For Deborah, her therapist was focused on verbal behavior, since Deborah wasn’t talking at the age of 7.  Deborah would be shown a flash card with a picture on it and was expected to name what she saw.  If she got it right, she would be rewarded with a small piece of cookie or something else she liked.  If she got it wrong, no reward and the teacher would say the word for her.  If she resisted, tried to do something else or otherwise acted up, the therapist would grimly “maintain the demand” at all costs and above all, not let Deborah get what she wanted.   After 20 or so pictures, they would move on to another equally artificial activity, like moving a body part on command.  The goal was to get her to do what they wanted with fewer and fewer rewards.  A normal session would run an hour and a half at a time at least, and the therapist preferred two hours.  Ideally, Deborah would have been subject to this method for 40 or more hours a week.  Fortunately for her, we couldn’t afford that.  Unfortunately for me, I had to listen to them telling me that the reason Deborah wasn’t improving was that I wasn’t trying hard enough at home, wasn’t getting her to therapy often enough, and wasn’t able to force the school district to adopt their methods.

I saw things differently after a while.  Deborah’s behavior at these sessions became increasingly disruptive.  I would watch from behind a one way mirror.  Slowly, it dawned on me what I was seeing.  My 8 year old, supposedly mentally retarded child, had figured out their system of behaviors and counter behaviors and was using it against them.  The therapist was so well-trained in her technique that you could count on what her response to any particular action would be.  If Deborah tried to escape, she would block her with her body.  If Deborah appeared to be trying to get attention, she’d turn her face away.  If Deborah would throw those blasted index cards on the floor, the therapist would stand there pointing at the cards until Deborah would pick them up again.  Since doing their mindless activities was boring, Deborah had found her own way to have fun and exercise control in a situation where she was supposed to have no power and simply obey.  Way to go, Deborah!  That’s the American way.  Set my people free!

I saw clearly the basic flaw in their teaching methods.  Because they believed there is nothing but behavior to a person, just getting the right behavior was all they focused on.  But people actually care about a lot more than behavior and have more depth to them.  If you are going to teach someone, you must be doing an activity that makes sense to them and that they find interesting or otherwise meaningful.  It has to relate to the rest of their lives.  Without that essential interest, you are fighting a losing battle.  The real trick with an autistic child is finding a common interest.  I’ll have more to say on that subject, because it can be the hardest thing to do.




© 2013, Margaret. All rights reserved.