By Isabella Rosario
The Daily Iowan published an article last week about three UI students’ software startup, ABAL Therapeutics. The founders aim to make expensive and time-consuming Applied Behavior Analysis therapy more accessible for autistic children through an app. The app will most likely alleviate financial burdens of traditional analysis from autistic children and their families, and the benefits of that should not be undermined. However, the proliferation of that behavior analysis itself is a consequence that deserves its own analysis.
The therapy was developed in the 1960s by Ivar Lovaas with the goal of making autistic people “normal.” Early such therapists would often shout at, strike, or even electrically shock children who displayed typically autistic behaviors, such as rocking back and forth or using echolalia. And while the methods of the therapy have changed in the last 50 years, their intention to make autistic children “indistinguishable from their peers” remains paramount. As stated in the DI article, exercises are drilled for 20 to 30 hours a week “until these [behaviors] become automatic responses for the child.”
Autism is a disability, but it’s not a disease to be treated. Autistic people often suffer from certain comorbid conditions — dyspraxia, social anxiety disorder, sensory processing disorder, etc. — that can lower their quality of life if not treated. But behavior-analysis therapy does not focus on improving gross motor control, relieving social anxiety, or regulating the sensory stress of living in a loud, bright, neurotypical world. Nor does it seek to give autistic people a voice through improving speech or teaching nonverbal communication.
The therapy is purely based on improving “socially significant” behavior, i.e., forcing eye contact and eradicating stims like hand flapping and rocking — the latter of which is especially counterintuitive, as it helps autistic people self-regulate with positive sensory input.
Many autistic people who underwent the therapy as children continue to suffer with its effects as adults. According to a survey from the Autistic Self Advocacy Network, one respondent said, “[The therapy] resulted in corrosive damage to self-esteem and shame about who I really am. No effort was made to show me or to explain the role of sensory overload in issues like meltdowns, shutdowns, etc.” Another respondent said that because they were forced to stop flapping their hands in class, they would chew the inside of their cheek until it bled. Even more disturbing, punishments given through the therapy teach autistic people they can’t say no, making them more vulnerable to coercion and abuse.
The therapy is heavily pushed on the parents of autistic children who are just trying to do what’s best for their kids. And as the therapy has evolved over the years, some variations of it have begun to focus on more than just “table readiness.” However, ABAL Therapeutics fully intends to align with “traditional ABA methodology of ‘prompt, reward, repeat” skill training.’
Teaching autistic children that their natural behaviors are something to be fixed is just as harmful in tablet form. While I applaud the startup’s mission to make help accessible, I strongly urge them to reconsider if making this problematic therapy more available is really worth the costs.
Listening to autistic advocates, it’s not.