Last month, we shared part one of our blog, “The Truth about ABA Therapy” to clear up some of the common misconceptions about ABA and help families make informed decisions. In part two, we continue to address some criticisms that parents may hear about ABA therapy, and what they should actually see and expect from quality clinicians.
We want families to be empowered with accurate information so they can advocate for the best support and outcomes for their children.
“ABA is too intensive and will only work if my child has 40 hours a week of therapy.”
The reality: It’s true that early studies—like the one by Dr. Ivar Lovaas in 1987—recommended up to 40 hours of therapy per week. That number stuck around and led many to believe ABA is “all or nothing.” This can create unnecessary pressure and guilt for families who cannot commit to intensive programming due to work schedules, financial constraints, or other children’s needs.
It is true that ABA is a time-intensive therapy, and that best outcomes are often associated with more hours. The Council of Autism Service Providers (CASP) recently released a summary of the evidence supporting the benefits of early and intensive ABA treatment. However, ABA clinicians take an informed and individualized approach to how many hours they recommend for each child. They take into account what other quality educational and therapeutic activities a child has scheduled, family availability, and developmental and chronological age when recommending services.
Today’s ABA therapy takes a child-centered, play-based approach. Gone are the days of sitting at a table doing “work” for hours. 6+ hours a day doesn’t sound nearly as daunting when you consider that an ABA therapist can create learning opportunities during play time, while taking a walk, having a snack, relaxing with a book, as well as during more instructor-focused “work” times. As discussed during a recent family webinar, the number of quality learning opportunities impacts outcomes, and if families are seeing quality ABA therapy benefiting their child, why wouldn’t they want more of it?
“ABA is too rigid and won’t focus on what’s important to my family.”
The reality: It’s true- some early ABA practices weren’t very flexible. As a young behavior therapist, I taught all of the children I supported to do puzzles. For some kids, it worked out great. But I’ll always remember one boy who had no interest in puzzles, no matter how much I persisted. Looking back, I realize the error of my inexperienced ways and that flexibility in goals to meet a child and family’s needs and interests is necessary!
Behavior analysts do use standardized assessments to develop goals, and there are often common skills that many kids with autism need help learning such as communication, play, and social skills. But one of the hallmarks of ABA is its individualized approach. What goals are targeted and how they are taught should be built around your child’s unique strengths, interests, and your family’s values.
ABA focuses on increasing socially significant skills, and what matters most to you as a family should be a top priority. Share what is most important to your family with your BCBA. Your clinician should talk with you about how to best prioritize your family’s and child’s needs, and your input should be taken into consideration. My professor once told me a story about a family that wanted their child to learn to ride on a motorcycle. At first, she thought this seemed ridiculous, especially given everything else that the child needed to learn. But she quickly realized that riding motorcycles was an important family activity and being able to do that with his family would open him to new experiences, interactions, and learning. A green flag of quality ABA is ongoing collaboration with family members, so don’t hesitate to speak up about goals that matter to you and your family.
“ABA uses things like cookies and M&Ms to bribe kids and takes away their intrinsic motivation to learn.”
The reality: Positive reinforcement is a core principle of ABA, and it’s something we all use every day:
- A toddler giggles when Mom reacts to spilled juice—so he does it again.
- A student beams when praised for a correct answer—so she keeps raising her hand.
- You wear a certain outfit to parties because people compliment it.
As with many criticisms of ABA, there is some truth in how the interventions were implemented in its history. In the past, many therapists relied on rewards such as snacks without a full appreciation for children’s individualized preferences. Luckily, as our science and practice has evolved, so has our use of reinforcement. Behavior analysts use various types of assessments designed to identify a child’s specific interests, motivations, likes, and dislikes. Positive reinforcement is used thoughtfully to help motivate children to engage in positive behaviors.
In addition, while there are times that programmed additional reinforcers are needed to motivate children to practice important skills (what kid really wants to brush their teeth?!), choosing socially significant goals and teaching them in meaningful engaging ways minimizes the reliance on structured reinforcement schedules. For example, teaching a child to initiate play with peers results in the natural reinforcement of a social activity.
“ABA is ok for decreasing problem behaviors, but it isn’t helpful for things like making friends and communication skills.”
The reality: A significant misconception is that ABA therapy is only used to address challenging behaviors like tantrums, aggression, or self-injury. While ABA can certainly help with these issues when they occur, the vast majority of therapy time is actually spent teaching positive, functional skills that help children thrive. ABA therapists work extensively on communication skills, such as requesting items they want, or engaging in back-and-forth conversations. Social skills and play skills are another major focus—many children with autism need explicit instruction on how to engage with toys appropriately, play pretend games, or join in group activities with peers. Finally, academic readiness skills like following instructions, sitting for short periods, and completing simple tasks are also common targets. The goal is always to build positive behaviors and skills, with challenging behaviors often naturally decreasing as children gain better ways to communicate and interact with their world.
In addition, even when decreasing challenging behavior is part of someone’s ABA programming, there is a strong focus on increasing alternative replacement behaviors. For example, if a child begins to hit others when they are asked to do something like take a shower or brush their teeth, a behavior analyst will work on teaching the child to ask for help or a break and express frustration in a safer way.
“ABA therapy is only for young children and doesn’t work with older children or teenagers.”
The reality: Early intensive intervention can lead to significantly improved outcomes, but ABA principles can benefit people of all ages. Elementary-aged children regularly make significant progress in ABA programs, particularly in areas like social skills, academic readiness, and independence. The strategies simply shift to match your child’s developmental level and interests. Older children might work on conversation skills through board games, practice money skills at a pretend store, or learn organization strategies through fun sorting activities. In fact, ABA can be effective in teaching adults independent life skills like laundry, cooking, and shopping. The key is finding providers who understand how to make therapy engaging and age-appropriate. Remember, your child’s brain continues developing throughout childhood and beyond—it’s never too late to help them build new skills and reach their potential.
In summary, ABA therapy has evolved—and when done well, it’s collaborative, compassionate, and deeply personalized. High quality clinicians will:
- Involve you in goal-setting
- Respect your child’s interests and personality
- Use play and natural interactions to teach
