Monday, December 03, 2007

If I'd Had ABA

[Note: ABA stands for Applied Behavioral Analysis, a common therapy for autism that has some serious ethical concerns associated with it.]



I've been reading a commenting on a book about ABA treatment for autism, that I got free in a conference. I have also worked as an volunteer in an ABA program, and been the recipient of treatment from my teachers which differed from ABA mainly in being less effective at reaching the intended goals. (For example, they never grasped that being sent home from school when I misbehaved wasn't an effective punishment - it must be time-out from reinforcement, not time-out from constant conflict, in order to be a punishment.)

My autism was diagnosable around when I was 6 or 7 years old. (However, I wasn't actually diagnosed until I was 15.) Here's my suspicion of what would've occurred if I had received ABA therapy at that young age.

I would've been considered seriously non-compliant. My instinctive reaction to someone trying to control me is to fight them on almost everything. I even developed an aversion to using a tissue to blow my nose because it was so incredibly important to my teachers.

They would've put me on a program to encourage compliance. What they generally do, according to my book and the head of the program I volunteered at, is to increase rewards and start giving orders that are very likely to be followed. I would most likely have resisted those, developed an aversion to whatever rewards they did and refuse to obey any command of theirs even if it was something I wanted to do. If they told me to eat some chocolate I might've even refused, or if I obeyed it would be despite their command. (And I'd feel bad about it afterwards.)

If it was a reward that was only available when I complied - as is recommended - then I'd definitely get an aversion to the reward. In my mind, it would be linked to the power struggles. So anything I actually liked about it would probably be neutralized by them using it to reward me. This has happened with things the school got me to do, like skating. I used to enjoy skating before I went to school, but after a few times skating with my school I hated it.

If they followed the ethical standards laid down for ABA, I doubt they'd have ever gotten me to comply more than rarely. Letting them control would've felt worse than missing out on the rewards. If they used painful aversives, maybe they could have broken me. And I use the term 'broken' advisedly - it would've been the same psychological thing as breaking someone in torture. Indeed, ABA with painful aversives (such as the Judge Rotenberg Center does) is pretty much indistinguishable from torture. The few times I gave in, I held out in my mind, thinking intensely to myself about how much I disagreed and feeling very helpless and angry and disgusted. It was awful.

There might have been moments that were good. Moments where they seemed to become a different person from the one constantly pressuring me to comply. I know I was not myself when I worked in ABA. I had a fake persona of 'ABA therapist'. Some people say ABA makes kids robotic - I think the therapists are more robotic than the kids. (Ironically, behaviorism has no way to explain the behavior of behaviorists.) If the therapist ever let his/her mask down, I'd probably have treated them like two distinct people - the ABA therapist and whoever they really were, who'd probably be a nicer person, at least from my perspective.

Certainly ABA would not have helped me. But I'd have been lucky, because I would be more myself than most autistics who get ABA end up. I'm an idealist and a rebel, like Kestrel in The Wind Singer. Kestrel rebelled against the rigid rules of her town Aramanth, I rebelled against the rigid rules of my school. Neither of us bend - we stay rigid unless it's strong enough to break us. People say it's better to bend than break, but those who bend are damaged more by mild abuse. Those who don't bend until they break are less damaged by anything which isn't strong enough to break them, but more damaged if they are broken.

However, ABA generally requires parental consent. My parents were a major source of strength for me because they stood by my right to be myself, and didn't want the teachers to change me into their mold. So had I been diagnosed younger, I still might not have gotten ABA because I doubt my parents would have accepted their opinion that I had a problem. (After all, they didn't when my principal said I was AS when I was 12.) But if they had, I'd have known my parents agreed to this. I'd have known it was their choice. I might not have resisted then - after all, it's much harder to write off your parent than your teacher.

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