On Training Children

I have some nuanced or maybe fence-sitting views about Applied Behaviour Analysis (ABA) that I'll try to sort out below. As a trustee, I went to a PD session in part about the WRDSB's use of ABA, which I questioned, and I'm currently taking a course with some material about Autism Spectrum Disorder (ASD) that I questioned. But this post is prompted by a new book, which I haven't read, that's been briefly and scathingly reviewed by Ann Memmott. I'm just interested in the anti-ABA arguments presented, which I'm seeing more and more:

Behold. Here it is. Our new reading material, the book entitled, Handbook of Applied Behavior Analysis for Children with Autism - Clinical Guide to Assessment and Treatment. Brand new. 2023. So, the new ABA, eh? Shall we take a look? . . . 

We start with their fascinating summary of autism:

"...difficulties with social initiation and responsiveness, reduced creative and imaginative play, interfering behaviors including inflexible adherence to routines, repetitive speech and atypical sensory reactions . . . a history of difficulties developing and maintaining friendships and relationships  . . . aggression and self-injurious behaviour and behaviours of deficit"

Then we are straight into saying how wonderful Lovaas is. Let's remind ourselves of Lovaas's methods...content warning. [from an interview in 1974]

Continuing,

"...clinical issues targeted by ABA include appropriate communication, social interactions..."

One should at this stage stop to be amazed at the entirely negative description of autistic people, the belief that ABA is clinical (clue, it's not a medical profession). 

The authors congratulate Romani and team (2016) for making three small children do meaningless tasks for an hour, by refusing them adult attention or their toys until they jolly well did the task. This, they say, proves ABA works. Mmm. 

Next, the authors tell us of the wonders of Athens & Vollmer (2010), I have the paper. In this experiment, children as young as 4 were made to perform meaningless tasks "4 to 16 times per day, 5 days per week." If the children did not Do As They Were Told, they were told off, loudly. If they did well, we are informed that they received, e.g. "hugs and tickles." I felt a little queasy. No, I am not making this up. Yes, this is a brand new book, 2023, the 'new ABA,' remember. 

They say ABA adults subjecting small children to punishment is fair because, for example, there's punishment of an adult being suspended from social media if they are too rude on there. Hands up all those who can think why that's not a good comparison. 

Moving past the pretence that a four year old should have adult-level abilities to control every aspect of their behaviour (!) . . . they say that a behaviour that 'competes with learning' is fair game for Punishment. Well, no. In another mind-boggling statement, the authors tell us about the study by Falcomata et al., (2007) claiming that punishing a young autistic person reduced a problem behaviour. But the actual study showed it was the relationship with the therapist that helped, not ABA. There's so much more, even in this one chapter of this huge volume. I think you get the idea, though. Throughout this chapter, autistic people are talked about as if we are experimental animals in a cage. 

New ABA. Just the same as the old ABA. Thank you for enduring the reading. 

One or two ABA fans elsewhere saying people should ignore this thread as, for example, ABA punishment isn't really a punishment, honest guv. Judge Rotenberg Center. It delivers intensely painful electric shocks to children. ABA. Any questions? And also I am not being balanced enough and need to say some nice things, said some man from the ABA industry. Perhaps he'd like me to smile more, eh.

ABA punishment isn't punishment, eh? Mmm. This same book, 2023, p. 30, mentions Lerman & Vorndran (2002) as a guide to punishers for ABA teams. And this is what those two wrote in that 2002 paper. Does the complaining person believe we can't feel pain or fear, perhaps?

 

Let's look at a recent informal poll of the autistic communities on here: Taking a precious item away and only allowing brief access to it if the person complies without question - that's standard ABA. 

So, a distressed autistic child...

And as the responsible adult, they reached for an electric shock button, a lemon juice squirter, a spray mist to spray the child in the face as if they were a 1970s dog trainer, or perhaps a painful restraint, eh? 

Define how ABA works. By claiming it is scientific and rational and gold standard, the ABA profession has continued 1980s treatment of children to the present day, almost entirely unquestioned. Quite a few of us are questioning it now. They're not happy." 

Bit of a similar rant about my Assessment textbook published just last year: In my class on Assessment we read about autism under a chapter on children, which completely ignores that it's also a condition in adults. They have concerns that little Steven "hates kindergarten and has few long-term friends." How many long-term friends does a NT kid have at age 4? It actually cites that ridiculous Wakefield study that says autism is caused by vaccines, giving it a platform it really doesn't deserve. The text later outlines the controversy about the study, but it starts with it rather than having a tiny "did you know" box in the corner to make people aware that it's garbage, rather than presenting it as legit, then adding that it's mired in some controversy. The text also gives the most negative view of this disorder: "extreme unresponsiveness to other people . . . highly rigid, repetitive behaviours . . . problems with closeness and empathy and restricted interests and activities . . . 1/3 never speak." Elsewhere it uses the "r-word," which just about blew me away. 

The text doesn't mention the three levels of severity beyond a box with the DSM-5 symptoms that lists them, and it might be the case that they are entirely focused on kids with level 3 ASD, who sometimes don't speak, but that is never clarified. 

They also say a potential cause of autism, beside vaccines, is "Theory of Mind" (i.e. people who are ASD don't quickly grasp what other people are thinking based on context and their face and gestures the way most NTs can). It's true that many people on the spectrum have theory of mind deficits, but how is that a cause of ASD and not just another symptom?? It might seem a minor point, but in psychology, it's a huge problem if the text confuses cause and effect.

It really sucks when professionals write books that paint people with a disorder in a negative light. It also ignores the reality that many therapists and educators are starting to refer to ASD and ADHD as a difference instead of a disorder. I prefer to think of it as a different culture. A woman with ASD wrote about living in Germany for a while, and it was as if her ASD didn't exist because everyone there spoke literally, without much expression, in very focused conversations, without the typical random chitchaty expectations. Check out this Tiktok for a sense of how we could improve things! (Link in case embedding doesn't work) 

@jeandanielodonncada Communicating with autistic people, social skills advice for allistics. Is this too much? #actuallyautistic #autismacceptance #allisticcommunication #socialskills #themediumplace #hyperlexia ♬ original sound - Jean-Daniel Ó Donncada

Or check out comedian Fern Brady, who said (at about 26 min), 

"You must have worked in some environment with that one person in the office that people think is weird. Often those people are autistic people, but people just don't know that's what it is. I see undiagnosed autistic people out and about all the time, and neurotypical people treat them so callously. If someone was struggling to speak English, we wouldn't treat them poorly, but if someone's not fluent in social skills, why do people feel like it's okay to treat them poorly? Not all neurotypical people do that, but I see it a lot, and it's bad when I see it. And people who like to think of themselves as left-leaning liberals, I think, "Why do you take what this person is doing in such bad faith?" It's quite painful to see you're not extending the kindness to someone, you know, giving them the gift of better intentions. You're treating them as if you're sort of expecting the worst from someone without being kind to them."

The Other Side of the Coin

However, here's the other side of ABA use that needs to be acknowledged. 

It's often very gentle and patient and can dramatically increase vocabulary and improve social relationships within the family. 

Furthermore, some of the behaviours in question aren't just annoying or disliked, but seriously harmful to the child or others. In that Romani study, the three children they were working with were "engaged in destructive behaviors." In some cases, kids are so destructive to themselves and others that some kind of  intervention is necessary, and sometimes that means the removal of a toy or speaking sternly and loudly. The goal of that study wasn't to get them to do an unnecessary task, but to get them to refrain from destructive behaviours for longer and longer periods of time by redirecting attention elsewhere. And it worked. 

The Athens & Vollmer study didn't do ABA, specifically, but looked at what happens when they use differential reinforcement of an alternative behaviour (DRA) as a way to extinguish and replace a harmful behaviour. Here's a list of the participants with behaviours to be replaced by the alternative behaviours (click it for easier reading): 

I completely oppose ABA techniques that are violent in any way, but not all training is necessarily harmful. If a mother has a violent 12-year-old, like Clark, possibly growing larger than she is, who is in the habit of hitting, kicking and scratching her when his needs are not met immediately and perfectly, then that's a problem that needs some kind of a solution. Although yelling isn't desirable, it's clearly favourable to restraints and institutionalization or just tolerating being beaten by your growing child. The study's intervention program involved sessions just 10 minutes long, but, yes 4-16 times/day for five days in a row. During the sessions, therapists had to be prepared to block hits to the head from the participants. They found that the quality (timing, duration, etc.) of the reinforcement had a significant effect on the ability of participants to choose the preferable behaviour more frequently. Imagine being Clark's mom, and after one week of interventions, the hitting and scratching decreased substantially? Also, the "hugs and tickles" were just for one participant. The reinforcements were very specific to each child, as they should be. 

Some cultures use frightening stories instead of raising their voice, but those stories were passed down for generations, and that technique is unlikely to work on a media-savvy 12-year-old living here.

The Falcomata experiment was not just to "reduce a problem behaviour," but to reduce a life-threatening behaviour as the single participant was obsessively eating random objects. And yes, the Judge Rotenberg Educational Center uses ABA and has been condemned for torture for using electric shocks on children. The place should be shut down, for sure. However, because one place uses ABA in a horrific way doesn't mean the principal behind ABA, i.e. training through operant conditioning (offering rewards for desirable behaviour and punishment for unwanted behaviour), is abhorrent and should be stopped.

Furthermore, how would it be remotely possible to stop people training others with operant conditioning?

We do it all the time. Any time someone says thank-you and gives lots of affection in hopes of increasing a behaviour (Sally did dishes!) or any time someone looks annoyed and turns away after an unwanted behaviour in hopes of decreasing the behaviour (Sally hit me), they're using operant conditioning to "train" someone to alter their behaviour. The difference between what we do day to day with our friends and family to make them aware of what we appreciate or not, and to help guide our interpersonal relationships, is that we often don't set out to do some training, and we don't track the behaviours to see if our response has the desired effect. But I can't imagine raising children, with ASD or not, to be capable of any useful interactions of any type without praising what's desirable and saying or doing something negative when they do something undesirable, even if that negative thing is just "That was a silly thing to do," or "That looks like it's not working for you." In operant conditioning-speak, a punishment is anything that reduces the frequency/duration of a behaviour; it's not necessarily painful or traumatizing. 

On Freedom and Childhood Development

Parents quoted in article about children on the spectrum said recently, 

"The therapy, with its structured reward system, seemed coercive to him. He didn't want to see his child become anyone other than who they were. We like their autistic self. We like that they get hyper-focused on stuff. . . . ABA encourages 'masking,' or changing one's behavior to appear more neurotypical. . . . When you make a child repeat something over and over, that's abusive. . . . Training kids with rewards to do things that other people want them to do--some of which they may not be comfortable with--sets them up for future abuse."

We have a funny notion of freedom around children: they should be free to be who they are. 

But who people are is in part a creation of their upbringing. If we do nothing, have no reaction to children's behaviour because we want them to be fully themselves without any input from us, then they will not develop in any way. They might even lose their minds. It's our role as parents, educators, mental health professions, and human beings to let children know what gets our approval -- hopefully what works in society -- and what doesn't. 

Whatever parents, teachers, and peers favour and enjoy in a person will increase when that delight is clearly indicated. 

The people we care about more will have more of an effect. If a kid tells an offensive joke and his classmates laugh every time, he'll start to be the offensive-joke-teller, and the teacher will try to undo that behaviour with detentions, but the punishment of detentions is nothing compared to the reward of having students think you're funny. Some educators have learned to get the class on board if they hope to have any change on the behaviour. That's how operant condition is in place, already, throughout our society with neurotypical kids.  

Teaching uses operant conditioning. Huge debates are in play around which rewards should be used for better learning. Some think kids can learn to love learning enough that it's its own reward. I was like that as a kid, possibly a product of childhood science experiments with my dad. But I lean the other way on this one because I think many kids just want to get on with things. "Tell me what I need to do to pass the course and get out of here." They need marks as a reward. It isn't ideal, but it is what it is.

The punishers we use is what's clearly changed over the years. I was spanked, but I had my own kids sit on a step and sometimes, if they were really out of control, sit in their room for a bit to cool down. Now even that is seen as barbaric in some circles. It's isolating them and that can feel bad. 

But it's supposed to feel bad so they stop hitting their sister! 

Ideally, a calm and clear and loving conversation is what we hope will be enough to alter a behaviour. But if that doesn't work, and our little monkey keeps disobeying the rule about running into the road, and is unknowingly risking their life in a quest for independence, then something more has to happen to make it the boundaries clear. "It hurts your sister when you hit her with a stick," is the first step, but if it's the only step, and the behaviour continues, then she might be black and blue before it ends. This is Cartman's mom's tactic, and it's negligent.

I was the type of parent who never said "no," but instead said "ta ta." Same thing, really, except, knowing that whatever you say will be played back to you times a million, it's far nicer to hear "ta ta" than "no" on repeat. But somehow it's seen as morally superior, which is interesting. I was also very good at clear expectations. If we were going to the store, I'd make sure we all ate first, and then we'd have a little chat just before going in about keeping hands on your belly (especially an art gallery or glasswares store) and about what we're buying, so there will be no demands for anything that's not on our list, and that, if they can't manage themselves today, then we'd have to leave. 

Just one time, with a full cart, the kids started losing it, begging and pleading for junk and toys and everything they saw, and we all left. I felt it was more important to make it clear that my expectations mean something that to have my shopping finished for the week. If you state a consequence, but it never happens, then they'll know you don't mean business, and then it often has to escalate. I apologized to the closest employee, and we deserted our cart and went home empty-handed. They were a dream every single time after that. No yelling or arguing were ever necessary, just clear consequences that I established based on a prior agreement with them. 

Most kids can be very reasonable when expectations are clear and when their basic needs (mainly eating and sleeping well) have been met, and they really don't need much in the way of punishers. But some kids need more overt training of behaviours to be able to live in society, to be in a classroom and go to the store and live with their family. Sometimes it's never possible, and some kids have to be sent to live in group homes or institutions for the sake of the rest of the family. BUT, sometimes it IS possible with some help. And ABA, or operant conditioning, can work and can be done without it being torturous for the children. 

The School Board

On to the school board. On April 4th, I asked several superintendents about ABA after speakers at a Special Education information meeting for trustees mentioned their program,  

"Could I get information on the ABA training? It comes with some controversy now, despite how well it can work, and despite how often operant conditioning is naturally in use in our day-to-day lives. I'm mainly wondering what type of rewards/punishers are advised and typically used. Specifics can help if I get a call about it."

A week later, one reached out to say they'd get back to me. I never heard anything further, but I did resign in May, so it looks like my concerns as a random citizen are not important to them. I have a specialist in Spec Ed, taught in schools for 31 years, and then did a brief stint as a trustee, all at the same board, and I have no idea what the school board's ABA practice looks like. Hoping for the best!