ABA AND AUTISM: A NECESSARY CRITIQUE

In my clinical practice with children on the autism spectrum, I have observed a growing concern within the scientific community regarding the negative implications of interventions based on ABA (Applied Behaviour Analysis), a model that has been widely adopted and, until recently, considered the “gold standard” in the management of developmental disorders.

This approach is rooted in a behaviourist, structured and intensive logic that aims to shape the child’s behaviour

to conform to socially accepted standards through techniques of positive and negative reinforcement.

Spontaneous behaviours, such as stimming or other expressive modes typical of neurodivergence, are therefore inhibited in favour of adherence to neurotypical models.

What is deemed “functional” is decided by the adult, while the child’s internal experience is marginalised, often resulting in psycho-emotional distress that may manifest as anxiety, loss of self-esteem, feelings of inadequacy or worthlessness, and in more severe cases, symptoms related to depressive disorders, social avoidance behaviours and, in some situations, suicidal ideation.

This type of psychopathological outcome has been particularly described by autistic adults who underwent ABA interventions during childhood. They highlight how the emphasis on “normative” behaviour can lead to a form of masking (camouflaging) with long-term detrimental effects on mental health, ultimately undermining the principle of respect for personal integrity and hindering the development of self-determination.

Valid alternatives to ABA include approaches such as DIR/Floortime, the TEACCH model, relational pedagogy and neuroaffirmative practices. These do not forgo educational structure but adopt a profoundly different perspective in which the aim is not to “correct” the child, but to support them in discovering and expressing their own uniqueness.

To reflect critically on ABA is our responsibility.

It means promoting an ethical, clinical and pedagogical evolution in which neurodiversity is not seen as a problem to be solved, but as a human condition to be embraced and supported.

- 𝐷𝑟. 𝐷𝑒𝑏𝑜𝑟𝑎 𝐶𝑎𝑝𝑢𝑡𝑜

𝑆𝑝𝑒𝑐𝑖𝑎𝑙𝑖𝑠𝑡 𝑖𝑛 𝑃𝑠𝑦𝑐ℎ𝑜 E𝑚𝑜𝑡𝑖𝑜𝑛𝑎𝑙 𝐷𝑒𝑣𝑒𝑙𝑜𝑝𝑚𝑒𝑛𝑡