Is ABA therapy safe for my children?

A while ago I published a post on Instagram that said "When someone tells me that they don't like the ABA intervention because it is too rigid or uses rewards and punishments, I understand them, but I immediately explain how it works." Given its reception in the form of private messages and personal comments, I wanted to argue on the subject. I am also a mother, I have a little girl and this has deeply impacted my worldview, my emotions and my life. Now I see nuances in everything, I cry for any situation that involves an iota of emotion and I don't want my daughter or any child in general to feel afraid or sad for something that doesn't deserve it, much less for receiving therapy or learning that should be friendly and gradual to generate internal motivation (which we already know is the most important).

Applied Behavior Analysis (ABA) therapy is a widely used therapeutic approach to help children with autism spectrum disorders (ASD) and other developmental disorders. Over the years, there has been an ongoing debate about the safety and effectiveness of this therapy. And the truth is that behavioral science (ABA) has evolved a lot from its beginnings to what current practices are. ABA is a therapeutic approach based on behavior modification. It focuses on analyzing and understanding a child's behavior, breaking down these skills into smaller, more manageable steps that can be taught in parts and then integrated into a whole and learning is progressive. Positive reinforcement as well as antecedent interventions are also used to promote desired behaviors or skills among other strategies to teach and encourage desirable behaviors while reducing undesirable ones.

Our approach at NeuroDverse begins with respect for the person we deal with, as well as working on their needs to achieve the primary objective, that of helping our children to be autonomous and functional, increasing behaviors that are useful (such as communication, play, social and daily living skills) and decreasing those that are harmful or affect learning (inattention, rejection of tasks, aggression, etc.). The rewards we use are mostly natural.

When we take our children to a professional we assume that they know what they are doing and that this will be beneficial for our child, but unfortunately this is not always the case. As parents we want the best for our children, but many times we don't know what is best. How many stories have I heard of parents who lock themselves in the bathrooms to cry because they see their child being forced to do something they don't want to (probably can't) and displaying all kinds of behaviors (unsuccessfully) to get out of the situation. And don't think that I haven't seen results after this, many times these struggles work and that is the reason why they continue to be done (positive reinforcement but for those who practice it), but at what cost to the child???

From our point of view and based on research that demonstrates this, if a child is showing behaviors that indicate discomfort, it is neither okay nor respectful to continue with the ongoing intervention. Helping this child to regulate himself and find a way through play that makes sense to him and is able to acquire what he is being taught should be the response of a professional who works centered on the person.

As parents/caregivers we should always ask about the methods being used and what the ABA session will look like before starting, protecting the well-being of our child. Each family must advocate for what is most effective for their child, always evaluating the pros and cons of each intervention. Without forgetting that the primary intervention is what your child receives at home, from his family.

This is why I wanted to put together the following points, as a guide for parents looking for an approach that shows results while respecting the individuality of their children.

Before starting any ABA therapy ask your service provider:

• Are therapists certified by the BACB?

• What experience do you have in the field?

• If you don't have experience, what did you do before?

• Have you worked with children my son's age?

• Do you receive supervision from an analyst (BCBA), how often?

• What is the background of the BCBA?

• Is your interest in short- or long-term results?

• What does a session look like?

• Do you focus more on reducing behaviors or increasing skills?

• Do you use non-natural reinforcers?

• Do you work based on development milestones?

• What would I do when my child has a tantrum?

• Do you work guided by the child's interests or do you have a structured plan?

• How do you handle stereotypical behaviors?

• How do you handle behaviors that are mostly sensory?

• Can parents participate in the session?

In summary, ABA therapy is generally safe for children when implemented correctly by qualified, ethical, and empathetic professionals. It is important that parents are informed and actively participate in the therapeutic process. Every child is unique, and ABA therapy is an effective tool to help children with ASD develop skills and reach their full potential when carried out safely and focused on the child's well-being.