Is ABA Therapy Harmful? Understanding Behaviour Support Therapies
Updated: 6 days ago
The terms used to describe support for challenging behaviour are numerous and often confusing. Behaviour Therapy, ABA Therapy, Positive Behaviour Support (PBS), and Naturalistic Developmental Behavioural Intervention (NDBI) are frequently misunderstood as distinctly different therapies.
Since the introduction of Applied Behaviour Analysis (ABA), various names for behaviour interventions have emerged in response to policy and cultural changes. However, any evidence-based therapy aimed at managing behaviour is rooted in ABA, as it is the scientific study of behaviour and learning.
Some claim that Behaviour Therapy, PBS and NDBI are more ethical, child-centred alternatives to ABA. This misconception moves focus away from the real issue: ethical practice. Whether ABA is harmful depends on whether therapists centre the client in decisions about their behaviour change.
Let’s examine some common myths.
Myth: ABA uses punishment, while PBS only uses reinforcement.
Truth: PBS does not label withholding a reward until an appropriate behaviour is displayed as punishment, yet it functions the same. It is the same punishment, also known as 'response-cost' used in ABA to ensure unsafe behaviours are not rewarded, which in turn reduces the chance of the unsafe behaviour occurring again.
Example: If a learner wants a toy but engages in negative behaviour such as hitting, the therapist may withhold access to the toy (a response-cost) until the learner communicates safely and appropriately, such as asking for it.
As in PBS, reinforcement strategies are central to ABA. Both approaches emphasise the use of positive reinforcement to strengthen desirable behaviours. B. F. Skinner, the father of ABA, stated the goal for behaviourists clearly: "We feel free when we are [working for] positive reinforcement. We don't feel free when we are being coerced or threatened with punishment".
Myth: ABA focuses on reducing negative behaviours, while PBS focuses on teaching positive ones.
Truth: All interventions based on behavioural principles begin with understanding why a behaviour is occurring, then teach alternative, positive behaviours that serve the same function. This arises from the principle that all behaviour serves a purpose, and to reduce challenging behaviour, we need to teach more appropriate behaviours for the learner to get what they want.
Example: If a learner is hitting others because they don’t know how to verbally communicate their needs, ABA practitioners will teach the child appropriate communication such as requesting and more complex negotiation skills, in order to reduce their need to communicate by hitting.
At Spectra, every behaviour reduction goal is targeted alongside a minimum of 2-3 behaviour increase goals. We also ensure the burden is not solely on the learner. We aim to better accommodate the needs of the learner by adapting their environment, and providing coaching to better support caregivers.
Myth: ABA makes kids sit at a table and do repetitive, meaningless tasks, while Behaviour Therapy and NDBI are play-based and enjoyable for kids.
Truth: The effectiveness of ABA is not dependent on one method of teaching, but on adapting to the preferences and needs of each learner. At Spectra, we take a play-based approach to ensure learning is enjoyable. Our CBA builds programs based around the child's everyday environment, using familiar people, activities, and belongings as opportunities for learning and natural reinforcement.
Structured tasks are provided when appropriate, as some learners initially require a controlled environment to acquire skills. We also ensure learners are able to communicate their consent to a task and request a break, empowering them to be active participants in their learning.
Example: If a learner has a goal of practising colour identification, we might initially introduce the task in a structured format, such as matching coloured cards. The same skill is then developed and maintained during play and naturalistic settings, such as finding a requested colour while drawing.
ABA is a flexible approach, and while it may involve structured tasks, we at Spectra are committed to aligning our practices with the learner's needs and preferences. We are committed to promoting a life-long love for learning, by making our therapy sessions fun and meaningful for each learner.
Truth: ABA services have caused and can cause immediate and long-term harm to vulnerable individuals, who are often children and people with limited communication skills.
I have thus far defended ABA as a science, and described how Spectra honours compassionate ABA services. This does not exclude the reality of the real harm that has and can occur using behavioural science. Excessive and cruel uses of punishment, rigid compliance training, suppression of harmless behaviours, and practices that restrict an individual's choice and freedom have occurred under the name of ABA. Such practices cause physical and psychological harm. By undermining autonomy and self-advocacy, it can traumatise and worsen the vulnerability of the individuals that present for therapy.
No service nor provider, whether they are school teachers or play therapists, are ethical by definition of their role. Ethics is a practice. Beyond ethical codes and marketing, it is the conduct of any person providing a service that identifies whether their care is compassionate and effective.
The differences between ABA and other behaviour therapies often lie in terminology. While some approaches frame their approach differently, they too apply the principles and evidence-based strategies of ABA. Ethical behaviour change is thus not about rejecting the principles of ABA, but ensuring it is applied in a compassionate and client-centred manner.
At Spectra, we proudly deliver ABA therapy within a strengths-based, play-focused framework that aligns with the needs and preferences of each learner. Our goal is not to make learners “normal” but to equip them with the skills to confidently express themselves and navigate their environment.
