Tag Archives: ABA

Thoughts on Autism and Behavior Modification

As I said yesterday, autism sucks sometiems. This doesn’t mean it needs to be eradicated. Then again, not eradicating it doesn’t mean not pursuing treatment for its bothersome symptoms. I would pursue treatment for certain symptoms even in an ideal society. For example, I take medication for irritability and anxiety and see no reason not to.

Where it gets trickier is when I’m forced by circumstances to pursue treatment, and others dictate what kind of treatment I get. I may legally be an adult, but I am not in a position to live without supports, which in essence creates a power dynamic in which my staff largely determine whhih of my symptoms get treated and how. Behavior modification is staff’s favorite treatment modality, and even though originally, behaviorists tended to include the environment in their assessments of behaviors, B-mod has largely gone down to ignoring and/or punishing “negative” behaviors and sometimes rewarding “positive” ones.

I put these two between scare quotes because, what is perceived to be a positive or negative behavior, is not always (or rather, is rarely) objective, and even when a behavior is by most perceived to be positive or negative, the way it’s handled may still vary depending on people’s perceptions of what is behind said behavior (which, I might say, the original behaviorists didn’t care about). For example, as long as I’m not acting out aggressively towards others (which icnludes mild verbal aggression), I can exhibit as much self-directed violence as I need to. I assume the idea behind this is that I’m borderline and borderlines need to be responsible for their own behavior and its consequences. I’ve had people seemingly more annoyed at the fact that they had to take care of my physcal wounds than concerned at the fact that I’d inflicted them.

Now we’ve moved past the times when cognitions, emotions etc. didn’t exist. Lay behaviorists (ie. most staff) have taken just what they want out of behaviorism. I remember in 2008 my diagnosing psychologist recommended a functional bheavioral assessment on my meltdowns. This includes close observation of behavior, antecedents and consequences, in order to hopefully find the stimuli that trigger the aggressive response. Now I’ve not yet figured out what I think of this, but I never got to, since such an assessment never took place. The staff introduced seclusion, used it as a threat when I became even slightly irritable, noticed that made my behaviors decrease and decided this was the cure.

Now let me tell you: autistics have as much emotion, cognition and sensation as neurotypicals, we just experience it differently. If you wouldn’t want to be subjected to harsh behaviorism yourself, then don’t subject an autistic to it. If you want to eradicate a behavior, observe its situational context closely and consider how you would respond in this situation. Is the autistic perhaps trying to communicate the same that you would in this situation, only using a different modality? Are they perhaps responding to sensory overload the same you would, only experiencing this overload differently than you would? If so, consider meeting the autistic’s needs beofre you attempt to modify their hehavior. If you want to modify their behavior anyway, consider whether you would want your preferred B-mod method used on yourself. I think everyone who has the power to seclude, restrain or tranquillize another person, needs to have expierenced it themselves first. Lastly, don’t assume that just because the autistic isn’t displaying behavior that annoys you, it means that they’re coping fine.

Appearing Indistinguishable vs. Being Yourself

Neurodivergent K wrote an interesting post on the tyranny of indistinguishability. I think I have quoted one of this blogger’s posts before, on the same topic, but this one again has interesitng points.

Unlike what people believing in the indistinguishability logic assume, it’s not like, once you’ve reached this goal,, you’ll always continue to appear indistinguishable. In the preemie sphere, people often talk about catch-up, when in fact a lot of preemies do not just have developmental delays, but developmental differences as well. Same with autistics, but more so: all autistics are not just delayed (in fact, I’d argue against the idea that we’re delayed at all), but rather different. Suppose that an autistic, who we shall name Joey, started early Lovaas-style ABA at age three, and, he being a pretty good student, reached the goal of indistinguishability by age six. Now I know that ABA proponents often argue that autism will not go away by age six, and some even argue for ABA for adults. I reckon that if it were truly effective in its aim of indistinguisability, it’d not be needed for life. Anyway, Joey makes for a pretty average-appearing first-grader thanks to his ABA. So the government decides to cut his services (I will get to this later) and he is mainstreamed. Joey performs on grade level in first grade, even though it takes him more effort to complete his schoolwork. Effort doesn’t count, and Joey continues his schooling in second and third grade. Once he reaches fourth grade, his teachers and parents notice he is lagging behind. Bring in the ABA therapist again and make him appear indistinguishable again?

Autism parents who advocate lifelong ABA would say yes. I and other autistic advocates say no. After all, as Neurodivergent says, you can appear like a crappy excuse for an NT or you can be the best person you can be. Besides, effort does matter to the autistic. Suppose Joey is restarted in ABA and, through his fa├žade of indistinguishability, slides through middle and high school, or so it appears. His parents don’t care about effort, so even though he is increasingly depressed and exhausted, he is pushed until graduation. Then he leaves his parents’ home and goes to college, where he crashes and suffers major depression, anxiety and other mental health symptoms. These are so severe that he needs to quit college and ends up on disability.

This story is not mine – I was not involved in Lovaas therapy and was not diagnosed till adulthood. I was, however, similar to Joey and other autistics in that normalcy was expected of me. Effort can’t be seen and the people around me likely didn’t realize how much it cost me to appear like a lousy NT. I am still trying to find out how to be my best self.