Disclaimer: We are biased against ABA.

Here is my brother and his puppy who wasn’t responding well to typical dog training.  He hired a dog ABA consultant to support him in training his dog.  The first ABA technique is eye contact for both dog and humans.  Here we have the 3-step process that is core to ABA intervention:

  1. Antecedent (A): This is the event or situation that occurs immediately before the behaviour. Antecedents set the stage for behaviour to occur. They can include specific environmental conditions, verbal cues, or other triggers.  In this situation, the cue is “look at me” with the finger.
  2. Behavior (B): This is the observable and measurable action or response exhibited by an individual. It’s the specific behaviour that is the focus of analysis and intervention in ABA. In this situation, the desired outcome is eye contact from the dog.
  3. Consequence (C): This is the event or stimulus that follows the behaviour. Consequences can influence the likelihood of the behaviour occurring again in the future. Positive consequences (reinforcement) increase the likelihood of the behaviour, while negative consequences (punishment) decrease it. In this case, it is a delicious treat.

Here is a write-up from the ABA experts themselves on behavioural training. 

For human children, more sophisticated techniques may be used.  Some ABA clinics replace the dog treat with smarties.  Some momentarily withhold fun.  Some would gasp loudly to elicit attention to gain eye contact.  If you see an autistic child gasping a lot like everything is super exciting and surprising, this is why.  There is an ABA clinic in Vancouver that uses a dog clicker. When my SLP friend and I heard of the last one, we both cried. 

Some ABA approaches are more discrete with behaviour manipulation and for an example, this is “Natural Environment Teaching (NET)” and the below is an example how they compel a child to say goodbye by not allowing them to leave until they uttered those words.

 

The child isn’t learning to say “goodbye” here. The child already knows how to utter the words “goodbye” but they are not doing it at a socially desirable time. The logic here is that “the child needed to be trained through repetition to say goodbye when prompted.  The child may be reluctant at first so we will motivate and compel”.  I find all this rather inhumane.

Why are we training eye contact? Why are we spending expensive therapy dollars training a kid to say “goodbye”? 

Both behaviours are important to neurotypical people. They get a lot of information from other people’s face and uses different visual gaze to communicate with each other.   So neurotypical experts thought, “To fix autism is to make autistic people have eye contact.”  Neurotypical people also interpret not saying goodbye as rude, “so if the kid is going to make it out in the real world, he has to be polite.”

However, both eye contact and saying goodbyes are not scientifically relevant developmental behaviours.  They are just cultural norms.  People from different culture uses visual reference differently, and some culture interprets direct eye contact as disrespectful. Even in Western culture, there are a lot of social nuances with eye contact.  A young autistic man who has “successfully” been trained in eye contact may inadvertently cause discomfort and misunderstanding by intensely and closely gawking at young women in public, even though he may only intend to be “polite”. Unfortunately, this does happen quite a lot.

Within the neurodiversity-affirming framework, behavioural training that focuses on training neurotypical social behaviours is considered ableist. Rather, we prefer Dr. Milton’s double empathy problem approach that autistic communication is effective amongst autistic people and the problem lies in the miscommunication between neurodivergent and neurotypical people.

 Here is more updated research on the problems of ABA and behavioural modification for autistic children.

At Cherish Clinic, we have explicitly anti-behaviouralism.  We definitely do not enforce eye contact or neurotypical greeting routines. For eye contact, we would advocate that looking at someone’s face and eyes can be very uncomfortable and may get in the way of processing thoughts and language.  There are many other ways we can show that we are paying attention and get information from other people without having to eyeball someone.