Rethinking ABA: Compassion, Science, and the Path Forward

Scrolling through my non-toxic mama group the other day, I saw a post that made my heart sink. A mom was asking about ABA for her child, and instead of support, she was met with a flood of comments calling ABA ‘barbaric’ and ‘animalistic.’ It made me stop to think—how did we get here? How did a science-backed, compassionate field become so misunderstood?

As a BCBA, it is my job to rely on data, science, and empirically based interventions. As a mom, partner, and friend, I rely heavily on a holistic lifestyle that is as natural and non-toxic as possible. As someone who personally and professionally relies on holistic interventions, I have always had the viewpoint that ABA is holistic. Rather than referring a child to medical interventions as a first treatment, ABA assesses the environment to determine what changes we can make to target selected behaviors. This does not mean that I am trying to change the core of who a child is. This does not mean I am trying to create mini robots, and this certainly does not mean that I am looking to traumatize children in any way, shape, or form. In fact, I am trying to do the complete opposite. I am trying to support children and families in understanding and addressing behaviors that may be causing distress or creating barriers to their participation in meaningful activities—without seeking to suppress natural expressions of neurodivergence. I am trying to support children so that they can access friendships and community activities that they haven’t been able to previously. I am trying to create lifelong bonds and relationships that children look back on one day with appreciation.

I have many families that reach out for services and are so hesitant when they make that first phone call. They are looking for help, but have heard that ABA is “abusive” and “traumatic.” We often chat for a while and I allow them to ask as many questions as they need to. Most often, these families end up on board and willing to at least try services. Almost always, we end up with children, parents, and siblings who look forward to us showing up for ABA sessions. We receive pictures, hand-drawn cards, hugs, and heartfelt "I love yous" from the children we support. We get smiles and laughter. We get jumps on the trampoline, board games, and Lego towers. Do we also get “work” done? Absolutely. But, we do it in a way that works with the child. Sometimes we encounter situations that feel difficult, and we work with children to develop self-advocacy skills, emotional regulation strategies, and alternative ways to navigate those moments—always prioritizing their comfort and autonomy. We focus on family and client values, client preferences, and naturalistic teaching as much as we can. We create individualized treatment plans and interventions that are ever-changing to meet the needs of each child that we work with. And we truly LOVE what we do. The community that we have built is one of compassion and understanding. We value education, but more importantly we value the relationships that we have with our clients. So, when I read comments about how horrific ABA is, I wonder where we went wrong and what we can do to help people see how beneficial and supportive ABA can be. That ABA can involve collaboration, family support, and skill-building—without altering a child’s identity or causing harm.

Unfortunately, not everyone sees this. Just as there are 'bad' doctors, lawyers, and teachers, there are also 'bad' BCBAs and ABA agencies. There are absolutely agencies that I wouldn’t recommend and BCBA behavior that makes my skin crawl, but that’s true of any profession; it isn’t solely the ABA field. Furthermore, our field comes from a place of less ethical intervention and more intrusive support, but so do the fields of medicine and science. There are many medical treatments that are no longer used as science advances—and the field of ABA is no different. There are treatments and interventions that we used when I started in the field almost fifteen years ago, that I would NEVER use now. ABA has evolved significantly, and ethical practitioners today actively work to center client dignity, autonomy, and well-being. While past practices may have been more compliance-based, we now emphasize consent, collaboration, and a strengths-based approach. The field of medicine once relied on treatments like bloodletting and leeches—practices that we now recognize as outdated and ineffective. But as science advanced, so did medical care, with new knowledge shaping better, more ethical approaches. Can you imagine going to the doctor and refusing a treatment because at one time the medical field used such outdated practices even though the field has evolved to be far more effective? ABA has undergone a similar evolution, moving away from rigid, compliance-based methods toward compassionate, individualized, and evidence-based support. Just as we trust medicine to grow and improve, we should also acknowledge how ABA has progressed to better serve individuals with respect and dignity.

I’m certainly not saying that every person with an Autism diagnosis NEEDS ABA therapy, but I am also not saying that they don’t. I recognize that ABA is one option among many, and the best approach depends on each individual’s needs and preferences. Some children benefit most from occupational therapy, speech therapy, or other neurodiversity-affirming supports—and our role is to collaborate with families to find what works best for them. I truly believe the decision should be individualized for every person, and each family should choose what works best for them, but it saddens me that some families won’t even consider ABA because of misinformation. I’m not sure how we change that or what we can do to promote the positives in the field right now. In our small little slice of the pie, we focus on transparency, incorporating families and clients into treatment goals, and providing compassionate, highly individualized care that emphasizes values and trauma-informed approaches. I can only hope that the families we work with and the lives that we have touched will continue to grow and one day our clients will look back on their time with ABA based therapy with fondness. 

On that Facebook post, I self-identified as a “holistic BCBA”. Someone asked what I meant by that, and here’s how I explained it: “I am a practitioner who incorporates family and client values into treatment. I focus on naturalistic learning opportunities, and my interventions incorporate the whole child. I collaborate with other professionals to provide the highest level of care that I can. I recognize when ABA is an appropriate therapy for a child, and when it is not, I refer to other services that may be more appropriate. I blend science with a compassionate, flexible, and individualized approach to ensure that interventions are relevant, meaningful, respectful, and effective for each client that we work with.” Then I stopped to reflect—and in my opinion, most BCBAs I know take a very similar approach these days. This is more the norm than it isn’t, and I wish we could get more people to see that firsthand. For now, I will continue working within our little bubble while expanding our reach to get the word out and to show our community just how effective ABA can be while simultaneously embracing who each child is at their core.