The Truth About ABA Therapy: Best Alternatives for Autistic Kids
By Vanessa Palomera, MA, LMFT Published August 12, 2024
As both a child therapist and a mother to a neurodivergent child, my journey through the world of therapies has been both personal and professional. When my child was first diagnosed with Autism Spectrum Disorder (ASD), I, was introduced to Applied Behavior Analysis (ABA) as the “gold standard” of autism treatment. However, as I explored this therapy through my work, I began to question its efficacy and ethical implications. Today, I want to explain why I don’t recommend ABA therapy and explore alternative treatment options.
Why ABA Therapy is Controversial
1. Historical Context and Ethical Concerns
ABA therapy originated from behaviorism, a framework that focuses on modifying observable behaviors through reinforcement and punishment. Developed by Dr. Ivar Lovaas in the 1960s, ABA methods included techniques such as electric shocks and other punitive measures. Although modern ABA has moved away from these practices, the historical legacy of such methods still raises significant ethical concerns.
In my practice, I have encountered several adults who underwent ABA therapy as children and continue to carry emotional scars from the experience. They describe feeling as though they were being trained to “act normal” rather than being accepted for who they are. As a mother, the thought of my child undergoing a similar experience is heartbreaking.
2. Emotional and Psychological Impact of ABA Therapy
A major criticism of ABA is its focus on compliance and behavior modification without addressing the child’s emotional well-being. The therapy often teaches children to “mask” their autistic traits to conform to societal norms. This approach can lead to long-term psychological effects, including anxiety, depression, and a loss of identity.
For instance, I worked with a young client who had been in ABA therapy for years. Although he learned to suppress his stimming behaviors in public, he displayed anxiety at home, where he felt safe enough to express his feelings. His parents were concerned that the therapy was teaching him to hide his autism rather than helping him embrace it.
3. Lack of Generalization and Long-Term Effectiveness
Research indicates that while ABA can teach specific skills or behaviors, these learned behaviors often do not generalize to other contexts.
I have seen this with children I have worked with. They may excel at certain tasks in a one-on-one setting but become overwhelmed in more dynamic, real-world situations. It became evident with the children I worked with that ABA was addressing surface-level behaviors without helping the children develop the deeper skills needed to navigate the world.
4. The Autistic Self-Advocacy Movement
Many autistic adults who have experienced ABA therapy speak out against it, advocating for more compassionate and individualized approaches. They argue that ABA prioritizes the comfort of neurotypical people over the well-being of the autistic individual at the expense of their health.
As both a therapist and a mother, I find these voices compelling. They remind us that our goal shouldn’t be to force neurodivergent individuals to fit into a neurotypical mold but to support them in life as they are.
Alternatives to ABA Therapy
Given these concerns, I have recommended alternative therapies that I believe align better with the needs of neurodivergent children. These therapies focus on building relationships, enhancing communication, and supporting emotional regulation without trying to “fix” or change the child.
1.DIR/Floortime
DIR/Floortime is a developmental approach that emphasizes emotional and relational development. It encourages children to engage in play and social interaction based on their interests and developmental level. This approach can be transformative for children. Instead of trying to suppress Their unique ways of interacting with the world, DIR Floortime meets them where they are and helps them build connections in a natural, enjoyable way.
2. Social Communication, Emotional Regulation, and Transactional Support (SCERTS)
The SCERTS model focuses on improving social communication and emotional regulation. It involves collaboration among parents, educators, and therapists to support the child in their everyday environments. I appreciate SCERTS for its emphasis on the child’s autonomy and emotional well-being, which I’ve found crucial for long-term success and happiness.
3. Relationship Development Intervention (RDI)
RDI is a parent-led approach that helps children develop flexible thinking and problem-solving skills. Unlike other autism therapies, RDI focuses on building relationships and emotional connections. It helps children learn how to share experiences and understand other people’s feelings. The process happens gradually, using everyday situations to teach kids how to interact with others and adjust to different social settings. Through RDI, I’ve seen children become more confident in handling social situations without feeling like they have to follow strict rules.
4. Occupational Therapy (OT) and Sensory Integration
Occupational therapy, when focused on sensory integration, helps children develop the skills needed for daily living and manage sensory sensitivities. For my child, OT has been invaluable in teaching self-care skills and improving physical/motor skills, making activities less overwhelming. It has also given us the tools to reduce her sensory sensitivities and manage when she is sensory overloaded.
5. Speech and Language Therapy
Speech and language therapy can be highly effective in helping neurodivergent children develop communication skills, both verbal and non-verbal. Unlike ABA, which focuses on rote learning, speech therapy can be tailored to the child’s communication style, supporting them in expressing themselves authentically.
6. Parent Coaching
One of the most powerful alternatives to traditional therapies like ABA is parent coaching. As a therapist and mother, I have found that empowering parents with the tools to support their children at home can lead to profound and lasting changes.
Parent coaching involves teaching parents techniques such as sensory integration skills, nervous system regulation, mindfulness and other strategies to create a supportive environment for their child to thrive. For example, parents can implement sensory diets or schedules to meet their sensory needs and keep their nervous system regulated. In addition, parents can learn to recognize when their child is becoming overwhelmed and implement calming techniques like deep breathing.
In my own home, mindfulness and sensory-related strategies have become a cornerstone of how we navigate challenging moments. On some days, when my child starts to feel overstimulated, we pause together, take deep breaths, and engage in grounding exercises. Most days, we incorporate sensory regulation strategies such as deep pressure, heavy work, and vestibular input. These practices help regulate her nervous system and prevent meltdowns, creating a more peaceful environment for our entire family.
Parent coaching focuses on building a strong emotional connection between parent and child, which is crucial for the child’s development. By understanding their child’s sensory needs and communication style, parents can better support their child’s emotional regulation and social engagement. This approach not only helps the child thrive but also strengthens the parent-child bond.
If you are interested in help and tips on how to navigate your and your child’s day-to-day with ease and minimal tears, reach out for a free consultation. We have two therapists, including myself, who have personal and professional experience helping parents and their children with higher support needs.
If you have any questions before scheduling, feel free to contact us and we will get back to you within 24 hours.
Conclusion: There Are Better Alternatives to ABA Therapy
As both a therapist and a mother, I cannot stress enough the importance of considering the whole child when choosing a therapy. While ABA may work for some, the potential emotional and psychological costs are too significant to ignore. Instead, I advocate for therapies that prioritize the child’s well-being, autonomy, and happiness.
Ultimately, the goal of any therapy should not be to change who a child is but to support them in becoming the best version of themselves—on their own terms. As parents and professionals, we owe it to our children to choose paths that honor their individuality and nurture their unique strengths.