One of the most “annoying” stereotypes about ABA is that it’s robotic. BCBAs and therapists are portrayed as unemotional beings walking around with our clipboards watching with deadpan expressions as a toddler cries. Many of us find this description deeply offensive and launch into a pedantic explanation for how inaccurate that is. We will go on and on about how much we care about our learners, how we love them and would do anything for them. Maybe we’ll even go into how hard we burn ourselves out bending over backwards for the people we serve.
We’re not wrong, but if we’re still using techniques such as planned ignoring, edibles as reinforcers, and snatching comfort items to use as “motivators,” we’re definitely not right either.
Despite how we label our private events, there’s nothing in our outward behavior to show that there’s much empathy going on in there. And if others can’t measure it, it’s not important, right?
Sound familiar?
There’s been this conflation, especially among the Old Guard™, that the natural responses we have to children’s emotions– comforting, sympathy, hugs– are “giving attention” to “negative” behaviors and therefore need to be suppressed at all times. I know this is a fading practice and many BCBAs have thrown away this idea, myself included, but this is not a post for #NotMyABA, this is a post to highlight a method of practice still very much prevalent in the field.
This is what “they” are talking about– those mean autistic advocates who criticize ABA. And yes, it’s still happening, and yes, it’s damaging.
Function-Based Techniques and The Black and White Thinking that Sometimes Accompanies Them
“But what’s the function of the behavior?”
It’s the question we’re all taught to ask before doing anything, especially with a behavior we’re trying to reduce. It’s not an invalid question by any means, but it’s often seen as the Be-All-End-All of questions. Once we’ve answered that, we know everything we need to know about that behavior and thus, what to do about it.
The difference between future BCBAs in their first semester of grad school and their last semester seems to be whether or not the consequence is the only part of the ABC data that matters or if the antecedent is sometimes taken into account too. It’s disturbing to see how many practitioners never seem to get past that though, even multiple years post-grad.
It is maintained by attention, therefore we must remove that attention and boom! Problem solved! That’ll be $500. Attention seems to be the scariest of the functions as well, because many practitioners are very concerned about giving it to anything. We must not give attention to any behaviors other than smiling and complying otherwise we risk reinforcing inappropriate behaviors.
The definition of what behaviors should be addressed is disturbingly wishy-washy as well. Crying, screaming, and other extremely normal behaviors for young children are seen as somehow “inappropriate,” especially when said children have a developmental disability diagnosis. Although the sound of, say, a toddler crying triggers evolutionary responses in us, as adults, to comfort and do whatever we can to get that sound to stop, somehow ABA has better answers than our own instincts. Crying is meant to get our attention, which is always a bad thing, and therefore must never receive said attention. Only behaviors deemed appropriate for typically-developing adults, such as waiting patiently, saying “excuse me,” waiting for a pause in conversation, etc. are considered deserving of our attention… because these are things that all 3 year-olds do.
I’m often perplexed by the difference in reaction to my own behavior, even when I can figure out the function for itself. Sometimes I poke my spouse’s buttons, as I’m sure many of us do, just to get a rise out of ger. Sometimes those reactions escalate, and yet we continue because something about those reactions are reinforcing the shit out of our childish button-pushing. What about if I’m having a bad day and being unfairly snippy at people around me, or overreacting to something seemingly small?
If I had a diagnosis, would I have to have an outside expert come consult on the situation, determine the attention-maintained nature of this behavior, and then write up a behavior plan for me to be completely ignored in that situation? If I drop something and react irrationally (e.g. crying or screaming or even throwing something else), no one will be allowed to hug or comfort me because my reaction was inappropriate. I would need to calm down and pretend the small inconvenience didn’t bother me as much as it did before I would be entitled to any acknowledgement from other humans around me.
Would you like to be treated like that for having a bad moment? Why are our standards so high for a person’s behavior once they have a diagnosis?
Betraying our own philosophy for “results”
I’m on about this a lot. The “radical” in radical behaviorism is the big deal that led to the creation of our field. We pride ourselves so much on it. It’s the idea that there are private events– entire environmental experiences that are only measureable to the person experiencing them. We are better than everyone else because we take this into account when we analyze behavior.
Except we don’t. When it’s brought up, we turn around and say “well we can’t measure that,” and continue to dismiss potentially damaging psychological effects in the name of science and behavior.
The Old Guard™ really likes to talk about the “results” when faced with criticism for ABA. It’s just another behavior too prevalent in our field that makes us sound robotic AF. People are telling us that our techniques cause trauma, and all we can say is “but it’s effective!” “It works!” “Look at the results!”
Yes, the results are what they are looking at, just not the results you want to acknowledge because We Can’t Measure That.
Emphasis on we– another thing we struggle with and then unironically try to “treat” in autistic people. We really struggle with accepting opinions from experts in fields other than our own. Psychology definitely has its flaws, but it’s been studying private events and coming up with ways to measure them for longer than ABA has existed. There are specific diagnostic criteria for specific disorders, including what we use to define autism and justify our services in insurance companies. When it comes to explaining why we’re necessary in the life of a young autistic child, suddenly it seems We Can Measure That.
And yes, I realize there are immense flaws with the DSM and that the criteria for autism are problematic and all defined by outward behaviors. That’s not the case for all mental disorders though and I’m pretty sure if we, as a field, started doubting the existence of things like schizophrenia and obsessive-compulsive disorder, it would not be well-received. So either we accept that psychology is creating adequate measurements for private events, or we stand by our insistence on observable and measurable, drop the radical from our behaviorism, and die on the hill of Mental Disorders are Fake. You can’t have it both ways.
Worshipping Measurement while misunderstanding it
This topic could be an article to itself, and I’ve already touched on a few aspects of it. Our love for data is one of our favorite aspects of our field, and yet it’s one of our biggest flaws. For all our love of data, we are not great at using it. Yes, we can tell you what those lines are doing and what the trends say about what we’re measuring, but there is precious little discussion about what we aren’t measuring.
That is how you analyze. That is the radical in radical behaviorism. It’s sometimes in the discussion of that journal article you read at 3am before your 8am class, but even then, it’s not enough. Even the most diligent of authors isn’t going to be able to call themself out on all of the confounds of their study. That’s where we, as other people, come in. That’s where other people and other fields come in.
Part of this issue is the idea that ABA has all of the answers and anyone else talking about behavior, especially autistic behavior, is just stupid. Their data doesn’t mean anything because it’s not measuring behavior. Our data is measuring behavior, therefore it’s measuring everything. It’s that circular logic we hate so much about mentalism.
The thing is, if all we’re measuring is the outward behavior, then we don’t have a full picture of our outcomes. Take feeding for example, a topic often heavily criticized as outside of a BCBA’s scope of practice. Yes, the learner is now consuming 5 different foods instead of 3, but what is their relationship like with food? How will these behaviors we’ve just reinforced affect them in the future? How will continuing this procedure affect their feelings around food? If we work on this “skill” for 2 weeks, what effects will we see a year from now? If we work on this “skill” for 6 months, what effects will we see a year from now?
And I’m not just talking about maintenance and generalization. Our data can show us how many specific foods the learner is eating, and even how long it’s taking them to eat, how often they try novel foods, etc.
What our data can’t show us is anxiety present at mealtimes, or difficulty eating on their own, with no one watching and instructing them on what to do.
The lack of data and ability to measure that does not negate its existence or importance. These need to be discussed when analyzing data, but the only way we’re going to be able to identify the potential unmeasurable outcomes is to look outside of ABA’s narrow scope.
Our Rule-Governed Behavior as Practitioners
As with most of our flaws, it comes down to training. As much as we like to think we are training our baby BCBAs to think critically and to analyze everything, what we end up doing, through a whole lot of flippant applications of reinforcement and punishment, is teach them to follow rigid rules about behavior. It isn’t just for reducing inappropriate behaviors either. Our principles of motivation, reinforcement, and how outward behavior looks dictates our decision-making and are used as tools to push out all other ideas.
Just like it’s a rule that behavior works in this way or that, it is a rule that we can’t use mentalism to guide our decision-making– mentalism being a catch-all term for pretty much anything we can’t measure in another organism. While there’s some benefit to this rule when discussing our results or even just having a nerdy conversation at the bar at a convention, it’s a crutch in applied practice that keeps us from further analyzing our own techniques and the effects they could be having on our learners.
It also puts the focus on the techniques themselves without providing the tools needed to really understand the why. Sure, we can explain why these techniques work, but too many of us can’t explain any deeper than that and, once again, the argument quickly becomes circular.
For this thing, we should use differential reinforcement.
Why is it differential reinforcement?
Because we’re reinforcing one behavior and not another.
Why does it work?
Because it’s maintained by attention, so this behavior gets attention, that one doesn’t.
But why is this specific protocol you put in place for this learner effective?
Because it’s differential reinforcement.
Nevermind the other complexities of what’s motivating to that learner, the whys, the learning history, etc. The surface-level understanding is enough. The worst part is that it gets reinforced for the practitioner because much of the time, these copy-and-paste procedures and treatment plans produce the expected results. Parents are happy, graphs are pretty, everyone goes on their merry way.
It’s the kids who don’t fit the very specific type of learning and behavior patterns that respond to that that throw these practitioners through a loop. They’ve tried every tool in their toolbox, but nothing’s working. It’s especially jarring when the learner calls you out on your own technique, literally scolding you and laying out the exact contingencies you tried to put in place but assumed they wouldn’t notice. There, the therapists freeze and look at the BCBA for guidance, but the BCBA has none because that was never part of the plan. It’s off-script from the rules they were taught.
By the way, this works very well for any other unwanted interactions based on scripts. Got people at your door trying to prosthelytize? Throw some lesser-known Bible facts their way. It’s not in their script, they don’t have a response, so they go away. Got someone trying to sell you something you don’t want? Tell them something completely off-the-wall about your life that negates the need for that new Thingamajig. It doesn’t even need to be true, it just needs to be out of their prescribed stimulus class.
“Sorry, that time-share won’t work for me because I’m a vampire.”
Somehow we think it’s less funny when it happens to us, but I’ve got news for you: It’s still funny.
Professional Distance from Too Far Away
Professional distance: Avoiding becoming emotionally involved with a patient/subject/client in order to ensure our decisions remain objective. It’s a controversial topic especially in human services and there are valid points on both sides. On the one hand, getting too close to something absolutely clouds your judgement. It’s why a heart surgeon wouldn’t be allowed to perform life-saving surgery on their own child. The emotions attached to that heart would affect the surgeon’s ability to think, to even apply their own knowledge, especially if something starts to go awry. It’s why you see so many BCBAs who are also parents lamenting their own behavior on forums– how all of their training seems to go out the window when it’s their own kids.
On the other hand, bedside manner is important, and many people can tell when a person is pretending to care. There’s a certain coldness to it that makes us uncomfortable, like an emotional uncanny valley. Not to mention, if you have no emotional investment whatsoever, it’s going to affect your motivation and ability to properly care for that person. Even if you’re fascinated by the science and getting to the bottom of the problem, there’s still going to be a certain disregard for that human’s comfort and wellbeing during all of this.
So where’s the balance? Well, I would argue it’s closer to the emotional side than many would find comfort with. If we shut off our emotional reactions and stifle the natural urge to respond a certain way, we may be cutting off necessary connections that keep us from doing harm. We need to be aware of emotional needs and the roles they play in healthy development.
Failing to give attention to a crying infant is well-known to be detrimental to that infant’s development. People lose custody of their children for this. Yet somehow once that infant becomes a toddler and starts to develop speech, this idea goes out the window and we are to cut off these reactions without warning.
Almost like a sudden change in environment, a well-known cause of trauma, especially in developing brains.
A lot of this distance seems to come from ABA’s roots, beginning with rats and pigeons in a lab and culminating with Lovaas’ mission to make disabled children appear as normal as possible. It’s easy for some people to remove all concern for animals in a lab, especially when said people are of the (incorrect) belief that such animals do not feel pain or suffering. The core of that belief is that such sensations are reserved for humans and humans only. Thus, something that is sub-human.
Like disabled people.
Source: https://the-art-of-autism.com/damage-over-generations-quotes-by-major-influencers-in-autism
Most people will not simply ignore seeing another human suffering. There have been enough social experiments to document that. As such, it seems safe to assume that most people would agree that the world would be a better place if we showed more compassion and understanding towards each other. Whatever that means to the individuals stating it, we are far less likely to blow up a city if we know the names and hobbies of everyone in it. Studies have even shown that just giving something a name or a personality makes people have emotional reactions to those objects as if they were alive (Ball 2012, Smilek et al. 2009, Inagaki & Hatano 1987, Carriere 2007). Such animism has been studied recently in autistics as well as people with synesthesia, a not-uncommon comorbidity with autism.
The Rigidity Issue
It’s a common joke among BCBAs that many of the “big names” in our field show signs of autism. Many of the BCBA-Ds who are the most prolific publishers and researchers in the field are described as socially awkward and failing to properly respond to social cues when put in social situations, such as at professional conventions. Perhaps there’s a reason for that though, an effect of spending decades upon decades in the experimental analysis of behavior.
When met with criticism, the field as a whole tends to stick to repetitive– dare I say scripted– responses as I described above. We fall back on our interpretation of things as we understand it and reject with varying levels of aggression any other interpretation. When our interpretation is challenged or criticized, we tend to discount the knowledge and opinions of those who criticize us.
We’ve even gone so far as to actively attack people who publicly oppose ABA all in the name of “but science!”
Yet we spit out research every year addressing these as “core deficits” of autism.
Maybe we should examine our own deficits in perspective-taking.
In looking through research on the same topic across different fields, ABA frequently stands alone in its interpretation of anything. Yet somehow this doesn’t register to us as a “the-whole-world’s-crazy-except-me” argument.
If everyone is telling you you’re wrong, the correct and acceptable response is not to dig your heels in. When presented with evidence that we are wrong, it is not good science to stick your fingers in your ears and walk away. This is how we’ve ended up with a rapidly-mutating global pandemic.
If people within your own field are telling you there are better ways, and your response is to block their ability to communicate with the field, you are no longer a field, you are a cult.
Resources
Ball, D.W. (2016). Toward a sociology of toys: Inanimate objects, socialization, and the demography of the doll world. The sociological quarterly, 8(4), 447-458. doi: 10.1111/j.1533-8525.1967.tb01081.x
Bohn, K. (2019, Dec 9). The empathy option: The science of how and why we choose to be empathetic. Penn State News. https://www.psu.edu/news/research/story/empathy-option-science-how-and-why-we-choose-be-empathetic/
Carrier, J., Malcolmson, K., Eller, M., Kwan, D., Reynolds, M., & Smilek, D. (2007). Personifying inanimate objects in synaestesia. Journal of vision, 7(9), 532. doi: 10.1167/7.9.532
Inagaki, K. & Hatano, G. (1987). Young children’s spontaneous personification as analogy. Child development, 58(4), 1013-1020. doi:10.2307/1130542
Smilek, D., Malcolmson, K.A., Carriere, J.S.A., Eller, M., Kwan, D., & Reynolds, M. (2007). When “3” is a jerk and “E” is king: Personifying inanimate objects in synesthesia, Journal of cognitive neuropsychology, 19(6), 981-992. doi:10.1162/jocn.2007.19.6.981
White, R.C. & Remington, A. (2019). Object personification in autism: This paper will be very sad if you don’t read it. Autism: The international journal of research and practice, 23(4),1042-1045. doi: 10.1177/1362361318793408