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Dispelling the Myths About ABA and Service Providers Like Knospe-ABA

By Robert Schramm

ABA has become the preferred approach to Autism intervention throughout much of the world. However, in Germany and many other European countries, modern ABA is still considered a newer approach that is not very well known. Because of this lack of understanding about what ABA truly is and how it works to help educate children with Autism, there are some unusual myths and rumors about ABA that seem to persist without any rationality or support.

With this paper, I will discuss some of these Myths and hopefully help put them securely in the past where they belong once and for all.

Myth: “ABA is an experimental treatment and not scientifically demonstrated effective.”

This is the exact opposite of true. Of all the forms of therapy and education that are available for use with children with autism, ABA is the one that has the most scientific study and support for its principles, techniques and overall effectiveness. There are a dozen or more professional journals that are dedicated to the science of ABA, Autism intervention, and mental retardation that have published thousands of individual research findings and large group studies. Although there will always be a single study or two that was not able to show success of a specific intervention or program, an overwhelming percentage of the available research shows quite clearly that ABA is not only extremely effective for use with children with autism but also the most effective approach available for most children with behavior and learning difficulties. In fact, ABA is currently the only autism therapy recommended for long-term benefit by the United States Surgeon General. As a treatment for autism, Chapter Three of the Surgeon General’s report on Mental Health, 1999, states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.” What other therapy option can boast all of that?

Myth: “ABA does not teach how or why a child should do something. It only trains them to behave in a certain way.”

This Myth deals with the mistaken idea that in ABA programs children are not being taught to be independent thinkers but merely trained to react to stimuli. All learning has some aspect of rote memorization and practiced routine, whether you are in an ABA program, regular school classroom, Montessori school program, or simply learning from mom at home. There are always going to be things that a child is expected to do, “Just because Mom said so.” Additionally, there will always be behavior we choose without thinking. Humans are creatures of habit. When discussing “training,” one is generally talking about creating habits of behavior – things we do without thinking about them. However, this fact has nothing to do with ABA but rather how all people learn. Many of our behavior choices in life are reactions and habits. When it is time to brush your teeth you do not think about each of the behaviors used to make that happen (wetting the toothbrush, squeezing the toothpaste, raising your hand to your mouth etc.). These habits have all formed the way that they have because guided practice has led to success. Success then leads to repetition. It is true that ABA is very successful in breaking down seemingly simple tasks such as brushing teeth and teaching them in small steps to help a child find success where they might not otherwise. However, the premise that ABA is limited to only teaching this sort of memorized or habitual task is absolutely false.

 
Just like any form of teaching, a good ABA program needs to be designed to teach to all of the needs of the individual. This includes concepts such as complex language, social interaction, problem solving, flexible thinking, and theory of mind. Although, these skills are much more complex in nature, they are not immune to the same behavioral principles that guide all of our learning. The issue then becomes, “how creative and experienced is the person running the ABA program at addressing this sort of learning?” In the early days of ABA it is true that there was much less experience addressing these more complex learning processes. Thus, some early ABA programs may have been deficient. However, that was a result of the professional’s inexperience applying the principles and not problems with the principles themselves. The benefit of ABA is that it is a science and therefore progress made anywhere in the world is made available to all through the studies published in scientific journals. Over the past 40 years there have been an uncountable number of breakthroughs and experience gained addressing even the most complex human issues with the principles of ABA. With a qualified program that is up to date with the latest information and techniques available, there is little concern that you will find any type of learning that cannot be addressed in all of its complexity.
 
As a final point, it is important to remember that ABA is the science of what works. ABA is outcome oriented. A program is only successful if the learning goals that are targeted are being met on a frequent and consistent basis. Even if there was a method of teaching that contradicted our current understanding of the ABA principles, the fact that ABA is outcome-oriented would mean that the procedure would be recommended as long as it had been shown ethical and effective.
 
Myth: “ABA just uses food and toys to bribe kids into doing things. “
 
One of the most misunderstood concepts of ABA is the value and importance of Reinforcement. ABA is a Reinforcement based science. We understand that, in life, the things we do that are followed by positive changes in our environment are most often the things we choose to do again. This “success leading to repetition” is what creates our behavior patterns and ultimately helps us to determine the kind of people we are to become. Reinforcement is defined as any change in the environment after a behavior that increases the likelihood of that behavior recurring under similar circumstances. The fact that Reinforcement is defined as occurring after a behavior shows that the terms “Bribe” and “Reinforcement” are not synonymous. Bribes involve saying to someone, “If you do this, I will give you this.” Bribes are dependent on a negotiation before the behavior occurs. Since Reinforcement occurs only after a behavior is completed, they are not one in the same. In fact, most ABA programs teach that the use of “If, Then,” statements are often contrary to good teaching.
 
Additionally, there is nothing in the definition of Reinforcement that dictates what reinforcement is or can be. It only dictates when reinforcement occurs and what it does for a behavior. The actual stimulus that serves as reinforcement should not and cannot be determined by the ABA program developer. Instead, reinforcement is always determined by what actually does increase future behavior.
 
In general, some forms of food, access to items, physical or mental stimulation, attention, praise, and self-satisfaction act as the reinforcement for most everything we do. We eat because it tastes good and/or to nourish our bodies, read books because it stimulates our brains in positive ways and tend to be nice to others because it gives us some combination of attention, praise and self-satisfaction. The same things are true for children with autism but to differing degrees. Our job is not to judge what acts as reinforcement, but to work hard to uncover what it is that works as reinforcement. Once identified, we can help the environment present those stimuli to the child after behavior choices we want to see reoccur and not after behavior that has been deemed inappropriate, less effective or ultimately harmful to the child’s future.
 
The truth is that Reinforcement is what guides us all in our behavior choices. Parental Praise, school grades, financial payment and a sense of accomplishment are all forms of Reinforcement that guide us through our daily behavior choices. But, how many of these things actually work to help a child with autism make better behavior choices? Depending on the child, it is quite possible that none of these higher-level stimuli support behavior change. That leaves us with only lower level items to work with at the start of a program. Food, physical play, music, videos, and toys are often good early reinforcers that help a child to learn important new skills. But, as important as it is to identify what currently works as reinforcement for a child, it is just as important to increase the amount and level of reinforcement meaningful to the child. Luckily the science of ABA and the advancements of the Verbal Behavior research in ABA have given us many very successful tools to help us do just that.
 
Myth: “There is only one kind of ABA.”
 
It is true that there is only one science of ABA, but that does not mean that there is only one kind of ABA and that all ABA programs are the same. It is common for people to see an ABA program or hear about a single recommendation of a single child’s program and assume that all ABA is done this way or recommends this technique. Nothing could be further from the truth. ABA is nothing more than an understanding of why people make the choices that they do and an application of this understanding to help a child make better choices. Because no two individuals (with or without autism) are alike, no two ABA programs should look the same. Everything done in an ABA program has to take into account the individual needs and desires of the child who is being helped. It has to be implemented and assessed objectively to determine if the desired results are occurring in a timely manner, and it needs to be altered to represent what is determined to be most successful for that individual. The goal of any good ABA program is to understand what works best for the child and apply those teaching techniques in comprehensive ways. This is done to address all of the potential deficits that can come with autism. If you have looked into ABA at all you might have heard of Lovaas programming, Verbal Behavior, Pivotal Response Training, German Verhaltens Therapy and many other forms of ABA that have been developed to help children with autism. The truth is each of these approaches is ABA because they all take into account the behavioral principles. The difference is in how the principles are being applied and what the focus of the intervention is. Some forms of ABA might be better for some children and other forms better for others. Regardless, just deciding to put your child in an ABA program is not enough. You need to consider the background and training of the specific service provider to see that qualified individuals run it. You also need to determine if the service provider offers the approach to ABA that most suits your belief system and your child’s specific needs. (Note: Knospe-ABA offers programs that focus on the Verbal Behavior Approach to ABA)
 
Myth: “ABA is a specialized Autism Therapy and is not useful for children with other diagnosis.”
 
The truth is, ABA is a science that was theorized and developed long before there was any thought of applying it to Autism Spectrum Disorder. ABA is used the world round to help all kinds of people overcome all kinds of social and behavioral problems, such as quitting smoking, personality disorders, relationship counseling, obsessive compulsive disorders, and many other common human issues. Behavioral principles only began being used for children with autism in the late 1960’s and 1970’s. Although the techniques were basic and not very comprehensive at the time, experiment and study has made ABA a valuable tool for autism intervention as well as other maladies. In addition to scientific Journals such as “The Journal of Applied Behavior Analysis” (JABA) and “The Behavior Analyst Today” (BAT), studies supporting ABA intervention are being published in many scientific journals such as “The Journal of Autism and Developmental Disabilities,” “The Journal of Mental Retardation,” “The Journal of Early and Intensive Behavioral Intervention” (JEIBI) and “ The Journal of Speech and Language and Applied Behavior Analysis”. Studies are available that support the use of ABA programming with children affected by any number of different disabilities including Downs Syndrome, Cerebral Paulsey, Emotional Disorders, General Developmental Delay, etc.
 
Myth: “ABA service providers pressure parents into signing long and expensive contracts.”
 
I cannot comment on any other ABA providers, as I do not know their business practices. But, I can tell you that Knospe-ABA has never signed a service contract with a family.
 
 
 
Myth: ABA service providers like Knospe-ABA sell you false hope by telling you they can cure your child of autism.
 
Hope is something that all parents of children with autism are desperately seeking as they see a life that they had planned for their child changing drastically in front of their eyes. The loss of hope that is associated with families of children with autism can be devastating. It is often the response of professionals who have been unable to find meaningful success for children with autism in their own careers to try to ease parents away from having hope. This is meant to prepare the parent for what the professional sees to be the family’s new “reality.” However, the truth is, a parent either has hope for a better life for his child or he is hopeless to provide his child with a better life. It is my belief that encouraging families to give up on their hope for a better life for their kids should be considered the real problem. Nobody knows what is or is not possible in the education of any child. We only know what we have learned and what we have seen. To say that a child cannot learn just because the individual saying it does not know how to teach that child is just plain wrong. I, for one, will never take part in the act of stealing hope away from a parent who will need all of their strength and determination to find the best possible path for their child and family.
 
At the same time, it is important to not “sell” hope that is unfounded. Unfortunately, talk of amazing breakthroughs and magical cures for Autism have been sold to parents for as long as there has been a disorder called Autism. Regardless, it remains important to refute the “old world” belief that nothing can be done for a child simply because he was given a diagnosis. The trick to appropriately supporting families of children with Autism is to let hope build naturally through progress and success. We need to focus our time and energy looking for all of the things that can be done instead of trying to predict what cannot be done. We then need to work hard at what we can do every day and watch as the progress begins to lead to a more successful life for child and family.
 
I want to make this very clear. Nobody at Knospe-ABA has ever made the statement that Autism can be cured. As it stands, we currently do not know the exact cause or causes of Autism. Without that knowledge, how can anyone say that the cause has been removed? Curing Autism is not a goal of Knospe-ABA. Educating children with Autism to their fullest potential is our only goal. The best way to achieve this is to make systematic progress toward each and every important goal day by day. When this is done well, research and our experience shows us that children with Autism are capable of much more than was previously believed. Not with tricks or magic but through hard work, it is often possible to completely change the type of life a child with Autism can ultimately live. Children with early and intensive Behavioral intervention are more likely to learn to communicate with spoken language, are more capable of staying in their local schools, remaining with their families or living independent adult lives. 
 
A final note for professionals:

Knospe-ABA is a very professional friendly service provider. We have no secrets and no desire to compete with other institutions. We are happy to share our information and programs with others. We give “in-house” trainings to institutions and Introductory and advance workshops to individuals who want to know what ABA can offer to improve the lives of Germany’s children. Please, feel free to contact us about any questions you might have concerning the science of ABA and we will do our very best to give you all the help and information we can.