Concerns About ABA-Based Intervention: An Evaluation and Recommendations.
Justin B Leaf, Joseph H Cihon, Ronald Leaf and 6 others
PMID 34132968WHAT IT FOUND
This paper argues that while historical ABA used aversive procedures, modern practice is largely reinforcement-based.
It acknowledges valid concerns about goal selection and social validity, but claims evidence for abuse or trauma is weak. It recommends collaborative goal-setting and avoiding rigid protocols.
Key findings
01The authors state that historical use of aversive procedures like electric shock by Lovaas was for life-threatening self-injury, not repetitive behaviors, and that these are no longer standard in ABA.
02The review admits that autistics are often not included in goal selection in published research, and that social validity measures are inconsistently reported.
03The authors argue that claims linking ABA to PTSD are based on studies with methodological limitations, and that current data does not reliably support ABA causing PTSD, anxiety, or depression.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a position paper by proponents of ABA, which may introduce bias in how criticisms are interpreted. It does not present new empirical data, so its conclusions rely on the authors' interpretation of existing literature. The definition of ABA used is broad, which may obscure specific issues in discrete trial training (DTT) versus other behavioral approaches.
Declared interests
The authors state that they are board certified behavior analysts, psychologists, parents, and autistics/individuals with ASD, all of whom support neurodiversity and ABA practice. No specific financial conflicts of interest or funding sources are disclosed in the provided text.
The easy way to misread this
Do not interpret this paper as evidence that ABA is safe or effective for all patients, nor as a refutation of patient experiences of harm. This is an argument by ABA practitioners defending their field's evolution; it does not provide new clinical trial data. A therapist should not use this to dismiss a patient's report of distress from behavioral interventions.