ABA Therapy: Some Ethical Considerations 

I love that. It’s good that you’re familiarizing yourself with the ethical considerations of our field, and representing neurodiversity within it. Your attitude should be the attitude of all ABA clinicians! Best of luck to you.

Hi Tom, I am not whom you asked the question from but I just liked your question so thought I jump in and give an answer in what's in my thought process but also saying that I might be wrong. The way I see it is from a parents perspective. As parents we have a an unstoppable variable that is time, time that is ticking and there is no way to go back and try again. Also, as parents of autistic children we are in parents support groups where we see children and teens in the whole spectrum from ones with very high support needs to very low support needs. In our mind we would like to bring our kids in the low support needs band when they grow up because with no disrespect, we see the families of high needs children struggling with mental health, and even the high needs child or adult really struggling because they cannot communicate their wants and needs. Thus we see what "no or very little" intervention can potentially result in. In order to get it right first time and the only chance we have is to then look at scientific evidence of what may or may not work to improve our child's and in turn our quality of life. We have one shot, one opportunity (quoting Eminem) . The current scientific research shows ABA is the most effective early intervention. I get where you are coming from about anxiety and depression etc. I am in many parents groups where children with ASC have very high anxiety (without ABA) and this is thus ancedotal that ABA causes anxiety because there is plenty of anxiety without it in ASC. I agree that the bacb ethical guidelines are a bit thin, and I agree that these have to be beefed up. It is thus even more important for parents to be fully informed and involved and thus videos like this really help and empower those who are on the fence

Hi, sorry it took me a few days to respond! I wanted to make sure to provide a well-thought-out response, as you did. Thank you so much for taking the time to watch my video and give your perspective. The more that autistic people are involved in these discussions, the better. Your feedback as someone from outside the United States is also important because ABA is predominantly focused in the United States. I’m not sure about the research base on mental illness and history of ABA services, but if there is a lack of research in this area, I’d consider that an opportunity for research instead of an indication that ABA directly causes anxiety and depression. As Taimur Khan (the other commenter) said, and as I’ve observed in my own practice, anxiety and depression are often comorbid with ASD, so while poorly implemented or downright abusive practices within ABA would be a factor here, it does not indicate a problem inherent to ABA. Speaking from personal experience, ABA has enhanced social integration for many of my clients, although this is not necessarily the case for all given that so many variables play a role in this, and that “social integration” requires an operational definition. Would you mind sharing which journals you searched on this topic? Also, where can I find the source indicating that 97% of autistic adults who have experienced ABA support its ban? I’d love to learn more about the details of their experiences, as well as when they received ABA, how old they were, how long they received it, what service delivery models (e.g. center-based, home-based) were used, and which procedures used in their ABA services caused them to support such a ban. As for the Code of Ethics, the following is stated on page 5: “The standards included in the Code are not meant to be exhaustive, as it is impossible to predict every situation that might constitute an ethics violation. Therefore, the absence of a particular behavior or type of conduct from the Code standards does not indicate that such behavior or conduct is ethical or unethical.” Perhaps it should include position statements on specific restrictive procedures, punishment procedures, and behaviors on the part of the practitioner which may cause harm. One thing I want to emphasize is that the autistic adults with critical views toward ABA have the ability to communicate those views, and many people on the spectrum do not. I don’t feel it’s fair for others who do not know the individual client to speak on their behalf about what is best for them. The main objective of ABA is to empower the client, and this very often involves teaching the learner to communicate what they want, what they do not want, and how they feel. Many times throughout my career, I have witnessed ABA being the one and only therapy that enables our clients with autism to do this, as it is the science of learning. ABA, like every other caring profession, is always evolving. Never perfect, but always striving for perfection. As I said in my video, most BCBAs have this mindset, but just as we should be savvy in evaluating the quality of services provided by medical doctors, dentists, teachers, etc., we should be equally savvy in evaluating the quality of services provided by behavior analysts. Doing this makes more sense than simply banning a highly beneficial service; to do so would be similar to banning surgeons from practicing because of methods used decades ago which caused harm, or because of a few current surgeons getting into trouble for malpractice. The whole point of this video is to better inform the community and reduce the risk of harm while maximizing the benefits of ABA, which are quite remarkable. Client assent and dignity, as well as maximum involvement of the client in treatment decisions, are paramount in ensuring that benefits outweigh risks. Thank you again for taking the time to watch and share your thoughts, especially in such a kind way.