Would You Accept This Behavior Towards a Non-Autistic Child?

abablog“Treat people as if they were what they ought to be and you help them to become what they are capable of being.”  

– Johann Wolfgang von Goethe

This is not only about autism. This is about any child who is in an autism or multiple disabilities classroom. It is about any child who is in an inclusive classroom and may or may not actually be included. Mostly it is about any child who has Complex Communication Needs (CCN) and the interventions that are used to teach and modify behavior.

When children leave in the morning, I think it’s reasonable that parents have expectations about their children’s school day experience. I think it’s reasonable to expect that a child will be treated kindly and respectfully and that the information he/she learns will be useful and functional.  I think that those expectations are reasonable for any child, regardless of disability.

There are three important points I need to make before I say any more. I’m switching between person -first language and identity-first language, so please know that it’s not my intention to offend if you prefer one over the other. Here’s an article about that.

Second, I am a speech-language pathologist with significant Augmentative and Alternative Communication (AAC) experience, and one of the creators of the Speak for Yourself AAC app. I have a passion for AAC and even more so for understanding and teaching the people who use it. I am not a Board Certified Behavior Analyst (BCBA), and I have not been “trained” to use Applied Behavior Analysis (ABA) or Discrete Trial Training (DTT). Here’s more information about ABA and DTT.

For anyone who is not familiar with these terms, ABA is the science devoted to the understanding and improvement of human behavior.  Discrete Trial Training is an intervention that uses that science to teach and change behavior utilizing punishment and reinforcement.  It is most frequently used with autistic children, but I’ve also seen it used with children who have CCN but do not have autism as a diagnosis. It is usually done one on one with an “ABA therapist” ( this can be an aide, BCBA, teacher, parent) and the student.  For the purposes of this post, I’m using the term “ABA therapist” to refer to the person who is working directly with a child and uses the science of behavior analysis in his/her therapeutic approach.  Here is an example of how DTT might be used to teach the color blue:

A blue, red, and yellow card are placed on the table in front of the child.

The ABA therapist says, “Touch blue.”

The child touches the red card.

The ABA therapist might say “No” or “try again” or they might say “touch blue” and move the child’s hand to the blue card.

The cards are then moved around and the ABA therapist says “Touch blue.”

Once the child gets it correct, he’s given “tokens,” praise, tickles, a high five or access to something he loves. When he gets it correct over a certain number of days with a certain number of trials, it’s expanded so that it can be generalized. For example, different color cars, crayons, or bears may be used and the child is told to “Touch blue” so he learns that blue is the color and can be applied to anything, not just that single blue card. Very detailed data is taken.

The “downfall” (in my opinion) is that sometimes a child’s progress depends on the ABA therapist’s ability to motivate the child. Blue cards are not very fun for most children. If the ABA therapist is not able to motivate the child, he could be working on that blue card for a very, very long time. Another “issue” is that teaching “verbal behavior” through a discrete trial approach is teaching a child to say something as a behavior in response to a specific demand rather than teaching communication in a flexible, naturalistic way.

This brings me to my third point. Like any field, there are excellent BCBAs who I have had the privilege to collaborate with and who have a rich understanding of the importance of communication and its correlation to a student’s behavior.  We receive e-mail from BCBAs who are searching for communication systems to help their clients have a voice to replace negative behaviors.  I have seen children learn skills using ABA strategies and then quickly generalize them into the “natural environment.” If you are one of the excellent, knowledgeable BCBA/ABA professionals who incorporate the evidence-based benefits of ABA and DTT into child-centered activities, you will most likely not be insulted by this post. If, when asked the question, “Would you accept this behavior toward a non-autistic child,” most people would say, “Yes!”…well then, I am not writing about you.

This is about the treatment of nonverbal children, who are treated and spoken to in ways that we would not tolerate, and we would not expect them to tolerate, if they were “typical.” It is about autistic children, who have difficulty with socialization, being isolated in cubicles or corners for the majority of their day with an adult drilling programs repeatedly. This is about reinforcing compliance over independence, and removing a child’s voice if he’s not saying what he’s supposed to say.  It is about “working through a behavior” and continuing to drill programs when a crying pre-schooler does not have a way to make his voice heard. This is about refusing to accept behavior towards a child with a disability that we would find unacceptable if the child was “typical.”  This is a plea to question what is being done with your child or client, and asking yourself a question that will define the expectations that others have for your child and ultimately, the expectations and value your child will place on himself/herself:

Would you accept this behavior towards a non-disabled child?

If your answer is “no,” as a parent or professional, then adjust your behavior. Require higher standards for your child, and refuse to allow anyone to minimize your child’s dignity in the name of “treatment.”  There is no evidence-based treatment that compromises the integrity of an individual.  Saying that a child with CCN is “simple and pleasant,” is not a compliment. It means that the child doesn’t have a way to argue. Saying that a child in a wheelchair, on a feeding tube, with no communication “loves to sit and watch the other kids run around,” means that the child doesn’t have a way to interact with his peers or classroom environment.  If someone says a child “needs hand over hand prompting for everything,” it means that people are physically moving that child to do whatever they want her to do…whether she wants to or not.

Would you accept that behavior towards a non-disabled child?

If you are going to make the if-a-child-is-diabetic-you-give-them-insulin-and-you-don’t-give-it-to-a-non-diabetic-child statement, let me be clear about what I’m saying.  I am saying that ABA and discrete trial training help children learn and generalize skills. I am saying that all children have a right to be able to communicate, including expressing individual preferences, arguing, and refusing an activity. I am saying that there are different approaches to every goal. If your goal is to get diabetic children to inject themselves with insulin, you explain it in a way they understand, let them try it in an orange until they’re comfortable, allow them to ask questions, and do whatever you can to make it less scary. I am saying that children with neurological issues that cause their body to work against them should be afforded the same understanding and compassion.

I’m writing about this because I feel like I have spent a lot of time “professionally disagreeing” with BCBAs about language acquisition and intervention, especially when a child is nonverbal or limited verbally.

Here is an example of a conversation with my least favorite BCBA. We are talking about a preschooler who is nonverbal and using AAC:

Her: I think we need to add the word “airplane” to his app.

Me: Okay, does he love airplanes?

Her: (confused) No.

Me: (confused) Oh, is he going on an airplane soon?

Her: (confused) Uh, no.

Me: Why do you think we need to add the word airplane?

Her: Because it’s in his programming.

Me: Is he reading about airplanes?

Her: (annoyed) No.

Me: I don’t understand why it’s in his programming. What is he supposed to be able to do once he learns the word airplane?

Her: It’s on the list of words he’s supposed to learn expressively.

Me: Who put a word on the list that has no function in his life?

Her: (sigh). I just need to be able to check it off the list to say that he’s learned it.

Me: Can we put words on the “list” that he will use and be able to practice because it will be applicable to his life? I could go a lot of days without ever saying or hearing anyone else say the word “airplane.”

Her: The programming list is the list everyone uses. We can’t just change it for him.

Me: Can we get an airplane book or toy so that it means something?

Her: If you want. I just need him to be able to say the word on the app.

Me: Can I have a copy of the list?

Her: Well, what vocabulary do you think we should add to the device…and don’t say core vocabulary!

Me: Uh…are you kidding?

The list had various nouns that could be represented easily by pictures. Core vocabulary, the words we use in 80% of our everyday communication, are not easily represented by pictures.  It’s more difficult to teach core words because they can’t be concretely matched to a picture, but it also makes sense.  If someone was teaching your “typical” preschooler where Greece is on a map and he didn’t know the alphabet, would you say “I just trust the experts,” and be glad that he was being taught something? Or would you question the teacher because, even though knowing the location of Greece is… well…knowledge, it’s not exactly useful to your preschooler.  If something that your child or client is being taught doesn’t make sense, ask yourself,

Would you accept this behavior towards a non-disabled child?

If the answer is no, then it is not acceptable for a disabled child either.

That early BCBA conversation was followed by many other equally frustrating conversations. Here’s another example:

Her: He called the llama a dog.

Me: Well, that’s good. He’s overgeneralizing, which is great because that’s one way kids learn new words and expand their vocabulary. You know how kids call all men “Daddy” until they learn that “Daddy” is the name of their male parent. He’s calling the llama a dog because it’s a furry animal with four legs. He’s probably never heard anyone use the word llama so when he saw the llama he… By the way…How did he see a llama?

Her: It’s in his programming.

Me: Oh.

Her: Anyway, I think we need to close the word “dog” so that he can get the word llama right.

Me:  What would you do if your son was calling a llama a dog?

Her: I’d say, “It’s kind of like a dog, but it’s called a llama.”

Me: Can you just say that to (the student)?

Her: No, because (the student’s) not learning language typically.

Me: That’s because it’s not being taught to him typically.

abablogllama

If someone is teaching language to your child and they’re calling it “programming” or “training,” be wary. If you speak to children atypically, and they receive atypical language input, they will develop atypical language.  If a child is using AAC or verbally limited, it does not mean that you have to speak TO them differently. You can speak TO them as you would any child because that is part of presuming competence.  Sometimes you need to modify your language complexity for children with processing difficulties or re-word figurative language for the sake of comprehension, but keep your sentences grammatically correct and natural and your tone of voice age appropriate.  If you speak to children differently because they have a disability, you’re also giving them an abnormal model. When you meet these children in their later years, the effects of the “programming” is evident. Whether they’ve used AAC or not, if they’ve developed verbal speech, it is robotic and their sentences are frequently rote.  They are able to say a select number of sentences exactly as they were “programmed.”

The students I’ve known who began communicating using AAC and have been able to develop verbal speech with intonation and variation of language, were students who were in a naturalistic preschool setting, where they interacted with both typical and disabled peers. They were given the opportunity to communicate what they wanted. Sometimes the answer was “no,” but they were given the benefit of being heard.

Language is a dynamic web of emotion, interaction, and experience. To learn language is to learn that words are flexible and can be rearranged in an endless combination of expression, stories, explanations, and questions. It’s the experience of using words and watching people react to what you’re saying and responding in a way that makes it meaningful. Language is not learned in cubicles, seated at little tables facing walls. Language is not learned on two dimensional notecards through drill and repetition. Language is not optional, and it is not limited to words that are easily represented by pictures. It is not measured in pluses and minuses on data sheets. Language is not restricted to a few words or sentences that someone else has chosen to allow a child to access, because “the child is so low functioning.”

Would you accept this behavior toward a non-autistic child?

Language frames the way we see people and it defines our expectations of them.  If people are referred to as low functioning, less is expected of them and less opportunities to demonstrate their actual potential are provided.  Nonverbal students are at the mercy of the adults in their life to give them the language they need. If they are given a small, restricted vocabulary, they will only be able to use those words or sentences.  They have no way of telling the adults that there are words they want that are not included. Some students are not willing to prove themselves, and will not interact with a system that insults their ability. Imagine handing a high school student a four piece puzzle. He wouldn’t put it together to prove that he could. He might laugh and put it to the side or ignore it altogether. Allowing nonverbal children the potential to access a large, varied vocabulary gives them flexibility to find words that they have in their mind and tell you about THEIR interests. Language is power. When a child learns that, the possibilities are endless.

Sometimes when a child is having “negative behaviors” or “stimming” on her device, the decision will be made to remove the device, close the vocabulary, or ignore the child. When vocabulary or a device is removed from a child, her voice is silenced, her ability to express herself extinguished, and consequently her dignity is compromised.  Verbal children ask for the same things repeatedly. They talk when they’re supposed to be listening.  They get upset if the item they want is not available. Verbal children do not have to be concerned that someone will physically take their voice.  If you remove a nonverbal child’s device, you’re taking advantage of her disability and forcing her to rely on the only form of communication she has…behavior.

Would you accept this behavior towards a non-disabled child?

If the answer is no, then maybe you should have a conversation with your child’s BCBA about whose behavior actually needs to be modified.

****Special thanks to Brian Young, MA., M.Ed., BCBA, co-founder of Pinnacle Counseling Center, for taking the time to “fact check” this article, and also for being one of the professionals who integrates his ABA knowledge into functional, client centered clinical applications.****


Comments

63 responses to “Would You Accept This Behavior Towards a Non-Autistic Child?”

  1. Thank you very much for this. I have extended family with autism, so I read a LOT of blogs, facebook pages, etc., that are either autistic-friendly or written by autistic people. There are many stories of PTSD from autistic adults who underwent the the type of non-person-respectful procedures you speak of. It seems like common sense to me that we should teach children what they NEED, not what is easier for us to teach. But that’s not always the case. And the thinking that children and/or the disabled are “less than” is prevalent in society. Compliance training is incredibly dangerous for our children – it leads to easy abuse, and should NEVER be a goal in and of itself.

    Thank you very much for speaking out on this. Please feel free to visit my blog to links to the various autistic blogs/autistic-friendly facebook pages, or ping me directly if you like.

  2. DUSYA LYUBOVSKAYA Avatar
    DUSYA LYUBOVSKAYA

    I made a similiar point at North Eastern University where I was giving a presentation about Autism and other issues !

    Although the subject was restraint , I explained that nobody would do this to a non autistic child as it was against children rights .

    So I said ; If you would never restraint a non autistic child , Then why on earth would you do that to an autistic child ? !

    1. Birra-li Law Avatar
      Birra-li Law

      Birra-li Law

      How do you suggest you would keep a child from harming themselves and others when they are violent? Would you just leave them to it?

      1. If they’re legitimately being violent to themselves or others, yes, I could see restraining. However, if an NT child were doing the same, I could see it then, too. The point being made is that restraint is often abused by caretakers who are not giving the child a chance to react. I have become non-verbal during meltdowns, and I am a 34 year old High Functioning Autistic woman. I don’t need restraining, just because I cannot speak during those times…

  3. I am autistic and thirty-five years old. If anything, I was speaking earlier than normie-expectations. I could read at a university level before I started school. And I am here to tell you that there is not one thing that was done to me when I was a boy that I would ever tolerate being done to a child, normie or otherwise.

    When a man who is 35 keeps telling his mother that he would go back in time and vote for Hitler to ensure the murder of one of the teachers he went to school with at age ten, you know that something is horribly wrong with the education system. Hatred of schoolteachers is not an extreme reaction in my eyes. It is norm de rigeur.

    And they have only themselves, or representatives thereof, to blame for that.

    1. I’m right there with you. 34 HFA. My second grade teacher deserves a gunshot between her eyes.

    2. Ocean lover Avatar
      Ocean lover

      Bless you! I thought it was just me! I feel exactly the way you do! Thank you for your article and confirming I’m on the right path in the way I work with my students.

  4. EXCELLENT!!!

  5. Excellent post… I’ve never sent my son to any kind of “formal” therapy because of the inherent cruelty I’ve seen in the videos of it. If a child isn’t enjoying learning the skills they need to learn, then it’s up to us to adjust our way of teaching, not punish them instead. Accommodation is frequently seen as a bad thing, when, in fact, it’s just changing something that isn’t working, and probably never will work without harming the child. If something “seems” cruel, then it probably is, and you should not do it. It doesn’t matter whether the child is autistic, or not.

    One of my favorite quotes: “It’s easier to build up a child than to repair an adult. Your words and actions have power in your child’s life, use them wisely.”

  6. As a fellow SLP who has also fought this good fight for years, thank you!! Your article is informative, interesting, and easily applicable to anyone who interacts and works with nonverbal and minimally verbal children. I applaud your advocacy!

  7. Stephanie Avatar
    Stephanie

    There are good BCBA’s and not great BCBA’s ….. a BCBA is to think about the individual child and what that child needs and utilize ABA that way for the child. Some do, some struggle. The system of special education is exhausting ….. people – parents, BCBA’s, speech therapists, special education directors – can fall into the traps of the system or not fall. Some personalities maintain not falling far better and some personalities fall as a standard. My son would not know what he does if it were not for ABA. Yet, I have had to understand and supervise how it is being used for him.

    1. I’m curious. Is your son verbal? Is he able to reliable communicate his thoughts on this to you?

  8. I am an SLP and BCBA and could not agree more with what you have written. However, sadly there are many in our own field with whom I have had this argument. I have sat in many IEPs and argued with other SLPs about the need for core vocabulary. How can we expect professionals from other fields to understand when our fellow SLPs do not?

  9. Very interesting and common sense. Do you see this as an approach similar to the concepts of DRI and RDI used be OTs? They also have battles with some ABA therapists over rote vs more natural reciprocal learning

  10. Lindsey Walters Avatar
    Lindsey Walters

    Great article! I have some questions I’m hoping you could answer. How do you recommend teaching core vocabulary to a non-verbal or limited verbal child? Also, what does it look like for you when you are working with a child? I realize this won’t always look the same, but if you could give me an example of how you’d work with someone, as apposed to sitting at a table drilling them. Thank you!

  11. This is an incredible article. I got my masters as an SLP but had a TBI just before my CFY. After becoming a patient in cog rehab, I left the field because of the insistence on building up my core skills, my discrete skills, my pencil tapping skills. Any protests I made in therapy were decidedly unconventional for a “typical” adult because I wasn’t typical, and they were ignored. I was not allowed to pursue the social communication goals I had for myself but instead did trials that the SLP could easily track data on. But when this is done to a young person whose means of communication are controlled by adults around them (as you wrote about), it is immeasurably damaging. I could drop out and find another way to do my goals. That’s not an option for a child.

    1. Wow! Thank you for sharing your experience…sheds amazing light on this subject!

    2. Wow, Cheryl, your story is incredible! Thank you for sharing, and I’m glad you were able to find a way to your goals.

  12. Cristina Stiles Avatar
    Cristina Stiles

    Wonderful article! There are always going to be those who think their knowledge is the end all be all. What a detriment to the children, families and professionals they work with. I am an SLP now but was an ABA therapist trained by a Ph.D BCBA prior to becoming an SLP. I am so grateful for what I know now. Keep working on educating that ABA therapist. They don’t know what you know. I spent part of my weekend teaching a large group of ABA and support staff about core vocabulary. I feel so lucky to have had the opportunity to speak to some open-minded professionals this weekend. I could see the light bulbs turn on! I have also certainly have faced the opposite. Thank you for this article.

    1. Cristina, those moments where the light bulb goes on are incredible. I love seeing it happen when I’m presenting, and I love when I’m in an audience and have those moments myself!:)
      It sounds like you have a great mix of experience! Thank so much for reading and commenting!

  13. Karen Mulvey Avatar
    Karen Mulvey

    I found your article so thought provoking and helpful. Thank you.

    1. Thank you for taking the time to read it, Karen!

  14. Thank you for your bold convictions and well-written article! I am an MT-BC (board-certified music therapist) and have been urging parents, teachers, ABA professionals, and others to consider these same points for some time now. It saddens me to see so many consider discrete-trial training and verbal behavior training the “evidence-based” choice for non-verbal children with autism. We now have so much evidence that non-verbal children, who, once approached from a presumed competence approach, are now communicating through AAC or supported typing, found ABA training to be “maddening” and “humiliating torture”. These children deserve humanistic and relational approaches to learning, just as any other typically developing child would.

    I also was glad to see you mention the body issues that come with ASD. I’ve had so many non-verbal children with autism who communicate differently tell me that they have a “broken body” or their “body won’t do what I’m thinking”. They also comment that their teachers, parents, ABA therapists “don’t think I have a brain because of my body issues.” We must start recognizing the movement differences of autism and realize that so many of these individuals are cognitively intact, but are trapped in bodies that don’t allow them to independently communicate what they know and understand. They should not be punished for this, but supported to reached their highest potentials!

    1. Thank you for sharing, Casey! I’ve also heard the nightmare stories that autistic adults tell about their experiences as children.

  15. Bravo! Thank you for writing such a thorough analysis of what goes on in some therapies. Once people start where the child is and work with that (and maybe try to see things from their perspective instead of “training them like a dog”) – well, that’s all just basic respect of a human being and you can’t go wrong with that.

  16. Linda Berry Avatar
    Linda Berry

    Casey keep on doing what you do so well, I will back you any way that I can. I agree that this is an awesome article. Thanks for sharing it with me.

  17. I am an Autistic adult, and I am now a speech assistant. If a child is going to learn language, they need to be INTERESTED in what they are learning, however they are learning the language.

    I ran my nephew’s early intervention program myself (he was diagnosed with severe Autism at 16 months and 4 years of age). I spent weeks trying to find something that interested him. Dinosaurs were a no go, as were cars, rocketships, nature documentaries… but I noticed that when the rocket took off, or the asteroid smashed into Earth he was interested for that time. He liked explosions. Enter the VOLCANO. Immediate interest, and he learned words like lava and magma before he knew yes vs no. I also used DIR/Floortime with him, he was GF/CF/SF, etc, and did very well in a study on a multivitamin designed for Autistic people (which I also take, and the diet worked wonders for me as an adult).

    If a special interest can be used, it is a WONDERFUL way to teach language. I focus with my clients on things that they find interesting, whether that be animals, foods, toys… but also things that they are likely to see (regrettably not applicable to my nephew’s volcanoes). And, more importantly, the clinic that I work in has a playground, a bunch of different toy stations, swings, and rooms we can withdraw into AFTER they get sensory stimulation many of them need. If we’re working on social language, I can bring them out and we can interact with other therapists and children, with me right next to them to help guide them. It’s a very natural setting compared to most of the clinics I’ve seen, and has components of what children will see in their work and home lives.

  18. Mary Jo Quarry Avatar
    Mary Jo Quarry

    Thank you for writing this. It is heart-warming that the ABA folks where I live are finally getting on board, if reluctantly, with the idea of visuals and AAC as tools for communication, rather
    than insisting that non-verbal children are “withholding communication.”

  19. Heather S Avatar
    Heather S

    I am an BCABA, and I think you made some great points. The thing is that Behavioral therapists should be following the Verbal Behavior method as opposed to Lovvas, therefore, what you have mentioned should be taken place. Motivation is the heart of ABA. You cannot shape behavior without it. Also, VB focuses on the function of communication. It is pointless to teach a child to read and write the word drink without first teaching to label and request for a drink. They need to be able to communicate their wants and needs before considering teaching the form of communication/ academic portion. The majority of behavior is caused by inability to communication. Also, if they cannot communicate what they want, then how can we know what motivates them? An intensive method, DTT, is generally needed to teach difficult skills and to maintain skills. BUT AFTER every skill, it must be generalized in the natural environment. Our kids have difficulty doing so. We generally have to teach and link every step.
    For example:
    A picture of an apple is called an apple and a-p-p-l-e spells apple. The the 3d version of an apple is the same as the 2d version, and a green apple is also considered an apple like the red version. We often have to teach that the apple in the classroom is the same as the ones in the grocery store. AND it is still an apple when a different person is present and asks what it is.
    This is just the beginning. The kids then have to learn about features, functions, and class and to receptively identify the item and expressively label it.
    If you get a chance look up:
    Verbal behavior, Mark Sundberg, and VB Mapp.
    Good work!

  20. Heather S- The problem I find with your view on the need for a behavioral approach to these children is that you are making assumptions about these children that may not be true. When you say, ” It is pointless to teach a child to read and write the word drink without first teaching to label and request for a drink.”, you are assuming the child is incompetent-unable to understand that a drink is a drink or and apple is an apple. I urge you to consider the movement differences of autism and the related research. It sheds light on possibilities that these children do not respond in a typical way, not because they don’t care to or don’t know what’s being ssked of them, but because their bodies and brains are not working together in an integrated way and they are physically unable to respond. Since I started approaching these kids from an assumption of competence and an understanding of their movement difference, my work has focused on building their confidence and helping them neurologically integrate. It has made all the difference. I promise these kids are in there and cognitively intact. They just need help being found and supported to use their bodies functionally to move…to communicate…to live.

    1. Heather D Avatar
      Heather D

      Behaviorist a do not work off assumption. Behavior Analysis is considered a natural science the same as biology. We do not assume, there must be empirical, objective data before we make decisions. Every child receives a very detailed assessment to find deficits. And yes we support the fact that these deficits are due to autism and miscommunication in the brain. That is why we teach each step and then generalize. Essentially, we are teaching their brain how to learn. Each child is completely different and we design intervention specifically for each child. Children that are capable of learning without DTT then DTT should not be required. I can tell you I use it with my son for math facts and sight words and it has increased fluency greatly. It’s flash cards. If a child is not physically capable of talking we teach sign, pecs, and/or Proloquo. We have received many iPads for children through grants. At the center I work at, every classroom is equipped with an iPad and Proloquo. We have 2 Speech therapist on staff that see each child and create their programs regarding speech. I have one student that cannot physically stick his tongue out. We do not try to replace speech or OT, but there some skills related that we do work on. When I stated that it is pointless to teach academics if a child cannot request is to get across that we do teach the skills the need as opposed to skills that should be taught later.

      Please keep the communication coming. I would be happy to supply with with answers. If you would like my email I will gladly give it to you. I am excited that you are trying to find the answers instead of just writing ABA off. I am here to help not to be a jerk. 🙂

      1. Marissa K. Avatar
        Marissa K.

        Heather, you state that behaviorists do not work off assumptions. You also state that our children have difficulty with generalizing in the natural environment. Truly, not all children with an ASD diagnosis have this difficulty. What empirical and objective data is taken to determine the existence of this difficulty? I am concerned that it is really an assumption made based on the person having been labeled with the diagnosis.

  21. Elizabeth A. Avatar
    Elizabeth A.

    Discrete trials almost never use punishment; learning happens through differential reinforcement (correct answers get acknowledged and rewarded, incorrect answers are ignored). However, most ethical and talented BCBAs and ABA providers use some form of errorless learning, which has a huge body of research to support it. Echoing what Heather said, ABA is a science that is highly individualized and tailored to the needs of each student.

    It is unfortunate that you do not have a good relationship with your child’s BCBA; however, this does not mean that she is representative of the science! Like any other field, there are good and not-so-good practitioners. I really didn’t like a doctor I had two visits with in high school, but rather than write off the whole discipline of medicine, I started seeing a different doctor who made me feel more comfortable. Perhaps there is another BCBA near you who is more creative and can adapt his or her strategies better to your child’s needs. I wish you the best of luck.

  22. […] Let’s remember to be careful how we talk to, and about our child when they can hear us. Here’s another good post to help remind us how we should treat our kids, and how we should expect others to treat them: Would You Accept This Behavior Toward a Non-Autistic Child? […]

  23. […] Therapists take away children’s communication outlets because children are “stimming” on them when in reality, they are babbling and playing with language. […]

  24. […] Emma’s Hope Book adds a great perspective on ABA therapy as well. Another post that is worth considering: Would You Accept This Behavior Toward a Non-Autistic Child? […]

  25. […] article, Would You Accept This Behavior Towards a Non-Autistic Child takes a look at how we treat those on the Spectrum. I highly suggest reading it and taking a look at […]

  26. I kept my son out of the system altogether. No therapy. I’m a stay-at-home-mom, so I taught him & I allow him to be his quirky, wonderful self. I am strongly opposed to ABA therapy, and think it is borderline child abuse, and in some cases IS child abuse. Yes; would it be acceptable to treat a “normal” child this way? No!!!! Stop treating Autism like a disease that needs to be cured, folks! Help the child as much as you can to develop life skills in a gentle way, but don’t try to force them to “conform” to the neat, little clone box the world has made. Rant done. 😉 Great article.

  27. usethebrainsgodgiveyou Avatar
    usethebrainsgodgiveyou

    In earlier days, there was a portion of Catherine Maurices’ book “Behavioral Intervention for Young People with Autism” that had a long curricululm of singular words beginning from easiest to more difficult. I used the words to present non-noun language to my son for 1-2 hours a day. I NEVER made him look at me or be seat ready. It was a savings of $60,000 at the time. ONE HOUR A DAY… Five, not 40 a week!
    This makes me so sad this wonderful page had to be made. Trust your instincts, mama’s. Don’t let others tell you how to raise your children.

    1. I totally agree with you here – my boy started with 1hr per day after school.
      Only during summer holidays we had more – we needed help with toilet training as well.
      3hrs of careful quality training per day can make more than forced 8.

      On the other hand… we have to be wise and think that other children may have much more “serious” behavioural needs than “singular words”.
      There can be children where more intensive behavioural intervention is needed.
      For example, for a child with excessive self-harming agressive behaviour (I saw a boy, bless him) “singular words” are not his priority…
      I’d say such a child might need intensive behaviour intervention and 1hr/day wouldn’t change anything.

  28. usethebrainsgodgiveyou Avatar
    usethebrainsgodgiveyou

    OOPS…I forgot to mention I presented those words visually or kinesthetically…the way Benno learned. Thanks.

  29. This is one of the most amazing articles I ever read. The fact that it is written by a speech therapist makes it even more powerful. I am a mom of two boys with autism, one is minimally verbal and the other rarely verbal. I have watched therapists with my kids following DDT aiming for no errors out of 10 trials….its rediculous. Why would a child want to answer the same question 10 times?! Would you try that with a typical kid? Try it and they would look at you like ” What’s wrong with you I already answered that?”. Yet…therapist think it is an ok way to use with autistic kids…well it is not! You are just insulting their intelligence. My kids do so much better work with me at home because I know what they are capable of and respect their brains. Unfortuantely , many therapists and even educators choose not to believe me when I tell them of the things my boys can do at home, simply because they can not get them to do simpler things. Well autistic kids are cognitively intact…they are very smart…their problem is communicating how smart they are…and if you as an educator or therapist are unable to get that out of them then you are the problem and not them. Some special educators were wonderful and managed to improve the work at school which made it more challenging and guess what? My older son is now doing better work with the more difficult goals just becuase the former ones were way too easy and insulting. Please take a moment and think…if that was your child , would you make the effort or not?
    And for those therapists defending ABA… Maybe it is good if you can apply it the right way…not by assuming a child does not understand something or its fuction just because he does not speak!! The best thing I was able to give my kids was to talk to them just like talking to anyone else and most importantly respecting their amazing mental abilities which am sorry to say not many of their therapists did.

    1. Thank you for sharing your experience! It’s exciting to read that you see and appreciate your sons are cognitively intact. This is too often not the case. We are taught to trust what we see… behavior, as an assessment of what a child knows or doesn’t know. We are doing some exciting work with non-verbal and non-reliably verbal students related to the brain-body disconnect and movement differences that make it difficult for them to reliably show what they know. We are hosting a conference on April 17th in Evansville, IN if you are interested. The conference title is “Rethinking Autism” and it will feature the stars of the documentary, Wretches & Jabberers, along with Marilyn Chadwick, a speech/language pathologist who recognizes the importance of presuming competence and the role of rhythm in supporting improved functional and reliable movement. Visit our website for more information: http://www.optimalrhythms . com Follow the tag #RethinkAutism for related articles and information.

  30. I obviously made a mistake, most possibly emotion… last year was obviously 2014.
    We started last summer when he was still “not ready” to do anything.
    G

  31. This is rooted – deeply – in the unconscious of the (self-righteous) Normal population.

    Much of what occurs in the ‘mind’ of most Norms happens ‘on autopilot’, that is apart from conscious awareness – and without conscious effort. More, the bulk of this capacity is *not* conventionally learned.

    In fact, it is characterized as ***innate*** (U. Frith and others).

    Yes, folk psychology ( which includes theory-of-mind) is ‘more or less instinctual’ in the vast majority of people; and it is by ***this*** precise means that we (autists) are seen apart from the whole of humanity as ‘lesser beings / devils/ aliens / changelings’.

    If you are familiar with the unspoken hierarchy of disabilities, you know that autists (of all possible types of expression) are at its bottom.

    That, as is usual for Normie disinformation, is a lie.

    All Norms *instinctually* see ***all*** autists as socially dead – and, to the dominance-obsessed Normal mind, is indeed ‘the worst place in hell’. (If there were a worse place than that of Satan in Inferno, it would be ours, according to the instinctuall apprehension of Normies.)

    This means that autists can only be one of two things to Normies: either ‘non-romanticised outlaws’, or compliant slaves. Neither category has anything remotely close to rights, and both live and die at the whims of their betters.

    This is why ‘90% of autistic interventions amount to compliance training’. (Namely, slaves must do their master’s will.) This is why our suffering is ignored. It is why we are excluded in toto from all life – why no one dares provide real help (and those who think to do so are punished). This is why those killing us are openly excused (and covertly applauded).

    Ultimately, this is why Normdom and the autist are in a constant state of war- where any and all desperate means are sanctioned so as to ‘liberate’ us from the hell of our supposed ‘prison’ – where Normal Slavemasters see ‘Autism’ as a separate entity, and the changeling before them as an impostor. While this is horrible to the Normal mind, (and a lie) – the truth would be immeasurably worse.

    Be thankful for the Normals’ capacity for self-deception. Without it, we would most likely be put in ‘death-camps’ in *very* short order – if we were ***lucky***.

    My stronger impression is that there would be a rash of the worst mob-style lynchings yet documented, and OUR necks would be the ones being stretched.

  32. I absolutely love this post. I was recently told by a BCBA that I am “just a speech therapist” so therefore do not know enough to apply programming for the children that he serves, or to discuss accomodations or modifications when things are not progressing and behavior is increasing. I was also told, by the same BCBA, that AAC was not “evidence based practice” nor is the use of visuals. Those letters behind his name do NOT make him the expert that he thinks he is, and that the autism world has given him the power of. Very frustrating, when all we want as therapists and autism consultants are to encourage the absolute most out of each and every child we serve, in the best way we can possibly do that. Thanks for your article, and I will reference it frequently:)

    1. usethebrainsgodgiveyou Avatar
      usethebrainsgodgiveyou

      Deena….I am with you. AAC and visuals are the best practices. Look at the thousands of hours this young man had of “therapy” that was of no help. https://www.youtube.com/watch?v=evjbx9_RiMY&feature=youtu.be

      I taught my “mildly autistic” son language via visual cues. He got nouns, it was just the verbs, adverbs, prepositions, etc. I taught him 1-2 hours a day at age 3 for one year only. It was a slow process, he didn’t immediately catch up, but at age 18 his verbal IQ was —-from a low of 79 at age 3, a somewhat more encouraging 126 at age 18. Different, definitely not less. He went through pages and pages of prepositions at age 14, but just didn’t get them until I found a woman who presented them visually. Put the rabbit ______ the box. If the word made sense, ie, “in”, “around”, “beside”, etc, the word was a preposition. Magic? No….teaching a child the way they learn.

      Somewhat ironically, I did use the BCBA bible at the time, Catherine Maurices’s “Behavioral Intervention for Young Children with Autism”—I used the curriculum to present language, and marked off each word as Ben seemed to use it with understanding. I never made him look at me or be table ready, the initial behavioral. I don’t think it is right to work against free will in any child. Raise a child up in the way he should go…not “train” a child up. But that’s just me. I’m a rebel.

  33. […] Would you accept this behavior toward a non-autistic child? I first read about this in the article, Would You Accept this Behavior Towards a Non-Autistic Child? It’s not a new concept, it’s something we should all think about when it comes to our […]

  34. Heidi Dutterer Avatar
    Heidi Dutterer

    Love this – exactly how I feel.

  35. […] Would You Accept This Behaviour Towards a Non-Autistic Child? by Heidi LoStracco, one of the speech therapists behind the terrific AAC app, Speak for Yourself. This post is especially good when it gives examples of how ABA “programming” often does not support the goal of helping disabled children to learn to communicate. […]

  36. […] people disregard our internal experiences, they may justify treatments for autistic kids that they wouldn’t for neurotypical kids, including compliance training that […]

  37. I couldn’t agree more with all of your points about presuming competence, treating verbally limited children with dignity, respect and equality, treating them no differently than NT kids, never taking away their voice for any reason, letting them learn naturally and not by rote repetition and drills etc. My only concern with this post is the idea that SLPs believe this about verbally limited children more often than BCBAs do. I think it fully depends on the individual practitioner. I’ve dealt with many special education teachers, SLPs, BCBAs, OTs – while running an inclusive program for Boston public schools and the past 4 years for my verbally limited son – and I’ve met too many practitioners with all kinds of initials after their names who treat verbally limited children horribly, expect nothing of them, have little expectation of them, interact with them as if they’re eternally 2 years old, etc. It doesn’t matter one bit what kind of therapist they are, if they are decent human beings who respect all children, they can do great work with what they know to create child-centric respectful healthy educational experiences and if they are not decent people, they use their position to treat the most vulnerable children in the most horrible ways. I’ve sadly seen plenty of both. I’m grateful for people with your point of view but from my experience it’s more a result of who you are as a person and not because you’re a SLP. In your experience, the BCBAs have been the worst offenders. Whereas in my experience, the SLPs I’ve dealt with have been by far the worst offenders in their disrespect and disregard of verbally limited students’ abilities.

  38. Stephanie Hack Avatar
    Stephanie Hack

    Thank you, thank you, thank you! I have a soon-to-be-six year old with autism who is just starting to talk. He’s been in ST four days a week for four years (since before he was diagnosed), OT, PT, aqua, HIPPO, hyperbarics, and the list goes on. Yes, I’ve tried everything to get him to talk more. He has such amazing qualities – he’s loving, sweet, compassionate, empathetic, social, loves playing with kids, and aside from SPD and less than 50 word vocabulary, he seems perfectly typical to me. Maybe I’m just used to his behavior and love him so much that I overlook it – because others do not. I have been told many times that I need to get my hyperactive kid under control – yes, by strangers. So, I’m assuming the only way to do that is ABA. But I’m a natural development fan. I don’t believe in having the child’s natural development cycle and style interrupted by society’s (0r my) need to rush it along. That said, he does have to learn how to behave in society. You can see my dilemma. I also sent him to an “ABA school” for three weeks but he became so depressed so quickly that I pulled him out. Come to find out they were spraying the kids in the face with apple cider vinegar (explains the burns on his face – I thought they were sunburns). Needlesstosay, it took months for him to get back to his normal self and he still has severe separation anxiety six months later. So what do I do? What do I do? I am trying to teach him to behave and talk outside of his typical therapies but I’m not an expert. All I can do is love him unconditionally and that doesn’t seem to be enough. He’s so smart and so sweet. What do I do? I’ll move anywhere (and can) for the right place for my child. Please help me.

    1. Dear Stephanie, spraying kids has *NOTHING* to do with ABA of 2016.
      Please read what I wrote above:
      https://speakforyourself.org/2014/02/22/accept-behavior-towards-non-autistic-child/#comment-15841

      Leaving an autistic child to “learn naturally” is – in my humble opinion – completely wrong. How about leaving all children illiterate and smelling of their own excrements in their oversized nappies? There are autistic adults like that.
      You need to take the bull by its horns, otherwise “Mr. Autism” teaches your child 24/7 what *not* to do.
      As long as you know that your child is capable, ABA done properly and wisely *can* help.

      My son has been doing VB-ABA (Verbal Behaviour approach to ABA) for ~2 years and it’s working great.
      If you have the time, watch carefully Schramm’s 12 videos, play and re-play until you understand perfectly what he means:
      https://www.youtube.com/watch?v=t6bPnjukgXA

      I’m not an affiliate or anything, I don’t care if it’s called ABA or BUBBA, but to have the guts to extract what’s best from behavioural science and create a *method* of teaching that works with any human being (including autistic) – is respectful.
      That’s why I suggest Schramm’s method – he is first and foremost – a teacher.

      Kindest thoughts,
      George

    2. Stephanie, I love that you trusted your gut and you are looking for therapies that will naturally support HIS development, not what others believe is right for him. I know your son is smart and I firmly believe that a child’s difficulties with speech typically have absolutely nothing to do with a cognition problem or a behavior problem. I’d love to share some research with you about the movement differences in autism that make it so difficult for these types of kids to show/tell us what they know. At Optimal Rhythms, Inc in Evansville, Indiana, we have developed accommodations and supports that are helping these kids of kids regulate in their sensorimotor system and emotionally. They are finally developing reliable communication and their families are thrilled. We are hosting the 2016 Rethinking Autism Conference on April 1-2. I encourage you to consider joining us to hear the research behind our approach. You will not be disappointed! We also have a school – ACCESS Academy. Visit us at www optimal rhythms dot org!

  39. Mina Lewis Avatar
    Mina Lewis

    I am a HAB therapist for a large organization and I just had this disagreement with the clinical supervisor. It’s annoying as all get out!!!! I completely agree with you. First she insisted I demonstrate his potty skills even though we just went before she arrived. I end up with a child that is (and never does) kicking and screaming and holding the door frame insisting physically that he does not want to go and I have a supervisor scolding me as I try to tell her that it isn’t right what she is doing and he normally is happy to go potty with me trying to tell me that I have a NON COMPLIANT child ok his training issue and I want to go tell her to go jump in a lake. Then I get the same therapist telling me when I tell her my ” student” can land for hundreds of items insist that we work on one at a time. I tried to tell her that the issue is not the Manding which I know ( (because I am there every day). It is that he says “yant “instead of “want” and I ask if I can work on that because he manga for hundreds of items already and she takes me back to one. Then when I sit him down to test him before we begin (I don’t have his attention song start the trial again because I can tell by the toss he is not with me. She basically cuts me off and says he can’t do it and conversation is over. I was so annoyed I was ready to quit. I have a granddaughter that has autism and I have never seen such an ego trip as this gal. All I can say is get yourself a good team that respects the other members of the team cuz this gal is requesting that I bring up a little robot rain man at her request and I refuse to do it. It’s so disrespectful to his brain. Her ” heaven forbid we learn out of order in her data book” attitude is making me rethink this job I absolutely love and he children who are learning well with me!

  40. Noncompliant RBT Avatar
    Noncompliant RBT

    This a good article with legitimate criticisms of how ABA is practiced with kids who have disabilities. There needs to be more articles like this.

    I have two comments. The first is that I think it’s very strange how people are okay with operant conditioning as long as it’s not intentional. If a parent teaches their kid (disabled or not) to scream when they want something by reliably giving that child what they want when they hear the scream, then that’s fine and gives the child autonomy. Even though that child will have tremendous trouble interacting with the natural environment that doesn’t tolerate screaming. Even though constant screaming is unhealthy for the child’s throat. But if I intentionally withhold what the child wants until they scream gently, then a squeal, then a grunt, then a syllable, then the item’s name, then “item please” over a period of a few months that’s some kind of cruel child torture that “controls” the child unduly. I’m curious why intentional operant conditioning is seen as so damaging when unintentional and often harmful/dysfunctional operant conditioning is tolerable. There is an underlying assumption that cold, unfeeling operational conditioning is being used on kids with autism and neurotypical kids get some warm loving “relational” or “developmental” teaching. That’s not the case. The operant conditioning neurotypical kids receive is just not explicit.

    My other comment is I’m very glad my parents didn’t restrict my vocabulary to words “relevant” to my life. It’s ok to learn the word airplane, be shown pictures of airplanes, be given airplane models and even go see an airplane even if it’s not relevant.

  41. […] I think usually the best thing to do is to alternate between “autistic” and “person with autism”, and explain why you’re doing that. Here’s an example of an article written by a speech language pathologist that does that well. […]

  42. […] article by an SLP, “Would you accept this behavior toward a non-autistic child?” is a piece that I think uses both terms in a clearly respectful […]

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