Alternatives to ABA therapy, as well as PTMB, PBIS, and all of its cousins
Alternatives to ABA Therapy
There is a significant gap in the knowledge
Learning one’s child is Autistic can bring about so many different emotions and reactions. One common experience is feeling very lost and not knowing what to do, or where to go for support.
If a parent has never (knowingly) met an Autistic person before, their understanding of autism is likely limited to stereotypical representations in popular media.
Often psychologists, doctors, and other clinicians have a generic handout — perhaps a pamphlet, or printed sheet with a list of resources, resources which that professional has likely not checked out for themselves.
It’s difficult enough to find a professional who understands autism, it’s even more challenging to find a clinician who is neurodiversity-affirming, meaning they do not operate with a pathologizing view of autism.
Too often, the clinician provides the diagnosis, gives a deficits-based description of autism, then hands the parent a printout and encourages them to start contacting therapists right away. The most commonly recommended therapy is applied behaviour analysis (ABA).
In brief, ABA is very similar to dog training. There are particular goal behaviours, behaviours which are usually unnatural and uncomfortable for the Autistic child, behaviours which are intended to make them appear less Autistic.
The ABA practitioner uses rewards and consequences to “shape” those behaviours, essentially training the Autistic child to try and behave more like neurotypical children.
Why would clinicians recommend ABA if it’s harmful?
There are a few reasons. One, this is how they are trained. They are trained using a deficits model, and they are taught that ABA is the “gold standard” of treatment for autism (yes, they use the word treatment, as though autism were an illness, rather than a neurotype).
Secondly, the ABA industry is too large and too well funded to leave much room for other, more person-centred, approaches. It’s ubiquitous, pervasive, and inescapable for anyone in the Autistic community.
Most clinicians have no idea what they are actually recommending when they encourage parents to enrol their children in countless hours of ABA and behaviourism-based therapies.
Those clinicians, and those unsuspecting parents, have no idea of the harm these therapies have caused many Autistic children, trauma which has lasted well into adulthood for many.
I understand parents what to do what’s best for their children. When we are in a very vulnerable place, feeling completely lost, not knowing what to do next, we rely on those experts to give us good advice.
We expect they will have our children’s best interests at heart — and they may — unfortunately, they often make these recommendations with very limited knowledge about what they are actually suggesting.
I want to offer a variety of alternatives to ABA therapy which are more child-centred and respectful of your child’s individuality and autonomy. If you have received similar advice to that mentioned above, and it doesn’t sit right with you, I promise there are better options.
I will name some of them here.
I’ll list common challenges caregivers experience when caring for Autistic children — and the hardships those children are experiencing — and list some alternative options for pursuing support.
Emotional dysregulation
- Occupational therapy (OT) to improve interoception and learn emotional regulation strategies.
- Counselling to further develop co-regulation and self-regulation strategies.
Challenging behaviours
- Parent/caregiver education to help the adults in the person’s life better understand Autism and Autistic needs.
- Dig down to find the underlying causes of challenging behaviours and address those instead of the surface behaviours.
Sensory issues
- Occupational therapy (OT) to help identify the sensory issues and offer strategies for management.
- Provide tools and accommodations for the person’s sensory needs.
Communication
- Offer, teach, and engage with various modes of communication.
- This may include speech, text, AAC, sign language, writing, body language, art — whatever best meet’s the individual’s needs.
Love & acceptance
Love and accept your child for exactly who they are right now.
Listen to Autistics!
When Autistic people are trying to express how and why ABA is harmful, or trying to share their personal experiences, listen.
Our lived experiences are more valuable than textbooks written by neurotypical academics.
How do you find Autistic adults to learn from?
There are a lot of resources out there created by Autistic adults, so please investigate those before asking for Autistics to give you free emotional labour — some people are more than happy to, whereas for others this can be emotionally and psychologically draining.
Some helpful resources:
- Online support groups — I highly recommend choosing the ones run by Autistics, where Autistic experiences are centred, and allistic (non-Autistic) members are there to learn, not talk over Autistics.
- Social media pages run by Autistic self-advocates. Again, the idea is for allistics to follow, read, and learn.
- Books about autism, preferably those written by Autistic parents of Autistic children. I promise, there are a lot more than you may think! There are also many parenting books written by both Autistic and allistic authors which are child-centred and support our children’s autonomy.
- The Autistic community. Check for local Autistic meet-ups or supportive and affirming organizations. It’s so important for Autistic children to meet Autistic adults, and for Autistic children to have neurodivergent friends.
Community is also incredibly important for parents. This journey can feel very lonely sometimes, and finding other parents who get it is invaluable.
© Jillian Enright, Neurodiversity MB
You can find this list in the form of a free handout, alongside many other printable resources, available for purchase on my website.
Related Articles
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“I Think My Child Might Be Autistic Or ADHD… What Do I Do?”
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Learn more
The Significance Of The Neurodiversity Movement
My Favourite Books About Autism
References
Ashburn, M., & Edwards, J. (2023). I Will Die On This Hill: Autistic adults, autism parents, and the children who deserve a better world. Jessica Kingsley Publishers.
Broderick, A. (2022). The Autism Industrial Complex: How branding, marketing, and capital investment turned autism into big business. Myers Education Press.
Neurodiversity-related Terminology
