What are some alternatives to ABA therapy

ABA - Applied Behavior Analysisdispute around Autism therapy

When it comes to the autism therapy ABA, different opinions clash. Some call ABA dangerous. Others say the method is very helpful for many children. An overview.

We got a lot of reactions to the interview with Marlies Hübner, herself an autistic person. She criticized the so-called Applied Behavior Analysis, ABA for short, as "a dangerous thing". Some agreed, others said this look was too brief. We took this as an opportunity to answer the most important questions about ABA:

What is the dispute about?

The dispute is actually about two questions. At one point, the method is specifically criticized. The modern variant of ABA therapy uses reward effects to influence the behavior of autistic children. For Marlis Hübner and other critics, this is a manipulative and overwhelming practice - for parents and children. According to the criticism, no consideration is given to personality.

"The white sheet is then rewritten as desired. In short, this means: Autistic behaviors are trained through drill"

And that leads directly to the second, very fundamental question that was also discussed on Facebook: Should one even try to change autistic children, to adapt them to society, so to speak?

The crux of the matter is that there is a very broad spectrum of autistic disorders. For example, there are people in whom autism, such as "Asperger's Syndrome", is only diagnosed in adulthood. Likewise, there are children who are so developed with autism that they have extreme difficulty communicating or even harm themselves. "This is a huge burden for the parents," says DRadio knowledge reporter Volkart Wildermuth, who spoke to parents and therapists.

For many parents, Volkarth Wildermuth describes, therapies are an important help for their children. Ultimately, it is about enabling the child to have a more independent life, easier contact with their peers, and attending school.

Similar approaches, according to which autistic children are treated, add up under the ABA label. It is about children who show abnormalities in three areas: problems in communication, in social behavior and a tendency to constant repetition. Of course, there are forms that can be differently stressful. Therapy can begin as early as two years of age.

The underlying concept comes from behaviorism, which basically assumes that a child can be shaped at will. The first ABA treatments were carried out by the psychologist Ole Ivar Lovaas in the 1960s and, in order to encourage certain behavior, used punishments in addition to rewards - including light electric shocks. Although this is now considered obsolete, some methods of behaviorism are still used in behavior therapy.

How is the therapy going today?

At the beginning of today's ABA therapy, the goal is broken down into many small steps that the child can manage relatively easily. This should avoid frustrations and bring a quick sense of achievement. The modern variant of ABA uses rewards to influence the behavior of autistic children, such as having a cookie or spending time with their favorite toy. From the basic principle as parents encourage their children.

With children from the autistic area, this is usually slower and requires a lot of repetition. This means that specialized therapists and the parents themselves work with the child between 20 and 40 hours a week.

What are the results of the therapy success?

There are already many scientific studies on ABA. A study evaluation, under the auspices of the Federal Ministry of Health, came to the conclusion in 2009 that although there is still a lot of data missing, according to previous studies "improvements in cognitive and functional areas can be achieved". Current results from a pilot project at the Bremen Institute for Autism Research are also expected to be available soon.

New results also open up other ways: Perhaps the behavioral therapeutic approaches do not have to be applied as intensively as before. At the University of Frankfurt, Professor Christine Freitag was able to demonstrate clear effects with just two hours a week.

And how does the discussion continue?

Various associations and parent groups have already commented on the topic. There are local applications demanding that ABA no longer be financially supported. The Federal Autism Association has also issued a comprehensive statement on the subject. There are several sensitive points that come together in the discussion, which is why the dispute is carried on again and again emotionally: How far are parents allowed to and how far must parents support their child? At what price is behavior changed? And last but not least, the question is again: How can a person be in our society?

There is no objective answer to right and wrong. Children with autism are very different, so different ways of helping them can be useful. There are also different ABA providers who implement the method differently. But one direction from the discussion is also: It is about the children accepting that they should be supported in their own development, but not really changed. This should be possible without the parents or the children being judged.