by Catherine Horton, MS, CCC-SLP, BCBA, CAGS
Clinical Director, Pyramid Education Consultants, USA

In recent months, controversial statements regarding the field of behavior analysis have become rampant in some circles. Some anti-behavioral proponents have gone so far as to indicate that Applied Behavior Analysis (ABA) is abusive. Others have publicly denounced the parenting skills of those who have sought out interventions that have behaviorally-based origins. The literature indicates that principles from the science of behavior analysis have been empirically validated and proven to be successful.  So, why the public outcry against a proven science?

Literature: There are two articles that are commonly cited containing misinformation related to the field of behavior analysis. One article argues that there has been an increased rate of Post-Traumatic Stress Symptoms (PTSS) related to the application of ABA (Kuperstein, 2018). However, Leaf et al. (2018) have done a superb job in their rebuttal to Kuperstein’s article urging readers to carefully review the original article as there are clear methodological and conceptual flaws. These issues include the use of leading questions, failure to confirm diagnoses of individuals participating in the study and unclear descriptions of the interventions. Further, a portion of respondents were recruited from social media…shouldn’t we all be a bit cautious about information that comes from outlets like Facebook?

Another recent article goes so far as to use the word “abuse” several times referring to practices that inaccurately relate to ABA (Sandoval-Norton and Shkedy, 2019). This article has led to another eloquent response from Gorycki et al. (2020) that debunks the five key principles cited in the original article. These principles include issues related to prompt dependency, effectiveness for learners with varying characteristics, outdated methodologies and long-term effectiveness. Finally, the review addresses the indication that ABA is “unethical and abusive”. It’s concerning that a group of professionals could possibly deem an entire science as “abusive” and equally concerning that this type of information would be supported by some and published. As mandated reporters, we are legally required to report instances of suspected abuse. In some cases, however, the term “abuse” is seemingly used to evoke the emotional reaction of the word rather than an accurate descriptor of observations. Further, using the term “abuse” in such a casual way is likely to undermine experiences of individuals who have, in fact, suffered abuse in various forms.

Application:  As with any intervention, professionals and caregivers may conceptualize the implementation of a strategy in slightly different ways. So is the case with the application of the science of behavior analysis. In our experience, we have observed programs that focus on 1:1 interaction with the learners and mass trials are common. Some learners will benefit from this type of structure and intensity. At other programs, teams apply the same concepts associated with the science of behavior analysis, but do so in a way that seems much more natural and relates to real-life opportunities and outcomes. At Pyramid we have always focused on implementation of a very functional approach to the application of behavior analysis. Dr. Andy Bondy developed the Pyramid Approach to Education (PAE) with this goal in mind. In fact, one of the questions we first pose to our teams is, “If you can teach your learner one thing right now that will make a positive significant impact in that learner’s life, what is that skill?” This question forms the basis for all our instructional planning and maintains the focus on teaching skills that will ultimately help increase our learner’s independence, communication and general happiness. In other words, we do not change behavior for the sake of changing behavior. Rather, we assist individuals to make changes that ultimately increase their overall quality of life. Furthermore, all stakeholders participate in the selection of what skills, deficits and challenging behaviors should be addressed- we do not tell others what they should be doing.

Information Delivery: Foxx (1996) described strategies to change the common perception that behavior analysts are often viewed as arrogant and abrasive. The field of behavior analysis is overflowing with terms that are either incomprehensible to those outside the field or terms that people in the general population view as negative. For instance, what do you think of when you hear the term consequence? Probably visions of your boss telling you something like, “There will be consequences for your behavior if you are late to work again!” However, in the field of behavior analysis, consequence is a neutral term that is used to describe what happens after any behavior.  These types of terms, as well as the superior way the words are sometimes used, are likely to be off-putting to those outside the field. The BACB Code of Ethics 3.04 reminds us to, “…explain assessment results using language and graphic displays of data that are reasonably understandable to the client.” Yet, twenty-five years after the recommendations from Foxx, the delivery of information to those outside the field continues to be problematic.

Summary: So, how do we resolve these problems? At Pyramid, we will continue to listen to individuals on the Autism Spectrum and review critical feedback. We will take into consideration the values, goals and dreams of the caregivers and professionals who devote their lives to improving learner outcomes as well to the learners themselves. We will continue to implement a functional, meaningful application of the science of behavior analysis.  We will use clear language, free of jargon, when we talk to caregivers and professionals outside the field of behavior analysis. Our interactions will continue to be sincere, empathetic and ethically sound. And, we will invite the individual and all important members on their team to engage in open dialogue. In sum, we will continue to apply the science of behavior analysis in such a way that leads our learners to become independent, productive and happy members of the community.

References:

Foxx, R. M. (1996). Translating the covenant: The behavior analyst as ambassador and translator. The Behavior Analyst, 19(2), 147–161. https://doi.org/10.1007/BF03393162

Gorycki, K., Rupple, P. & Zane, T. (2020). Is long-term ABA therapy abusive: A response to Sandoval-Norton and Shkedy, Cogent Psychology, 7:1, 1823615, DOI: 10.1080/23311908.2020.1823615

Kupferstein, H. (2018), “Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis”, Advances in Autism, Vol. 4 No. 1, pp. 19-29. DOI:10.1108/AIA-08-2017-0016

Leaf, J. B., Ross, R. K., Cihon, J. H., & Weiss, M. J. (2018). Evaluating Kupferstein’s claims of the relationship of behavior intervention to PTSS for individuals with autism. Advances in Autism, 4(3), 122–129. https:// doi.org/http://doi.10.1108/AIA-02-2018-0007

Sandoval-Norton, A. H., & Shkedy, G. (2019). How much compliance is too much compliance: Is long-term ABA therapy abuse? Cogent Psychology, 6(1), 1-8. https://doi.org/10.1080/23311908.2019.1641258

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