Does Applied Behavior Analysis Work for an Autistic Child With Lower Support Needs?

Understanding ABA, Its Utility, and Controversy

Applied behavior analysis (ABA) is often described as the "gold standard" in autism therapy. But it is not without controversy. Some people feel ABA techniques can be demeaning and, in many cases, cruel to the child.

This may particularly be the case for those termed “high-functioning,” now more appropriately called autistic people with lower support needs. Research suggests that ABA is beneficial for children who experience more intense autism traits.

Developmental play therapy is recommended in place of ABA for autistic children with lower support needs. This treatment focuses on interactivity, communication, and emotional growth, while ABA (as the name suggests) is focused almost exclusively on behavior.

This article discusses ABA for autistic people with lower support needs. It explains the concerns around using ABA therapy and other therapy options for autistic children with lower support needs.

Child and teacher looking at an illustration
KatarzynaBialasiewicz / Getty Images

Why No One Is "Beyond" Behavior Modification

Behaviorism, in itself, is simply a way to teach a desired behavior by ​offering rewards for compliance (or consequences for non-compliance, although negative reinforcement has gone out of style in recent years).

Parents and teachers use behavioral approaches when they say, "Just as soon as you finish your peas, you can have dessert," or "You can go out with your friends just as soon as you clean your room." Workplaces use behavioral techniques when they offer incentives for reaching specific goals.

Behavioral treatment is effective for many autistic children, particularly those with higher support needs. The goal of behavioral treatment is to help children catch up to the skill development level of neurotypical peers.

ABA therapy plans are individualized for each child's specific strengths and weaknesses. This means, in theory, that autistic children with lower support needs can also benefit from behavioral treatment. However, experts note that while some children with autism benefit from ABA, the treatment may not be appropriate for everyone. 

Why ABA May Not Be Right for Your Child

ABA therapy is not right for everyone. Many autistic individuals argue that applied behavior analysis damages their mental health and treats them as though they are a problem to be fixed.

A study of autistic adults found many remember traumatic events from ABA. Additionally, while they gained some benefits from ABA, they also reported suffering significant negative long-term consequences and consider it an unethical intervention.

Other reasons why ABA may not be right for your child include the setting and time commitment involved with treatment.

Autism Classrooms

ABA is often offered in the context of an "autism classroom" designed to serve children with relatively intense autism traits. Most children who spend their days in an "autism classroom" spend little or no time in the general education setting.

If you have a child with low support needs who is intellectually and behaviorally capable of learning in a general education classroom, the "autism classroom" is likely to be a poor fit.

Instead, autistic children with lower support needs may benefit from a one-on-one or shared classroom aide in the general education setting.

Real-World Settings

ABA may also be offered in a one-on-one setting. This can be very helpful for a child who is learning very basic skills or who is not yet able to engage with neurotypical peers on a playground or in another setting.

For a child with lower support needs, however, ABA should be offered in a "real world" setting. If ABA therapists are unable or unwilling to work with your child in a natural setting, ABA may be a poor fit.

Time Intensive

In addition, ABA therapy is intensive and offered for many hours a week—as many as 40 hours. At this level of intensity, it is difficult for a child to also take part in extracurricular activities like sports, scouts, or music lessons unless the ABA therapist attends with them.

If you have a child who is capable of taking part in typical activities, and ABA would make those activities impossible, ABA may be a poor choice.

How ABA Should Be Customized

There is little data available in peer-reviewed research articles to compare outcomes of behavioral treatment for autistic children with low and high support needs. In addition, there are few studies that compare the efficacy of different "brands" of ABA for different groups of children.

It is, however, possible to make some specific recommendations for customizing ABA for the needs of a child with low support needs.

The goal of behavioral treatment is to help children catch up to the skill level of neurotypically developing peers. Behavioral treatment can be modified to teach complex behaviors and social skills, such as:

  • Recognizing facial expressions and nonverbal behavior of others
  • Developing cooperative social behavior
  • Verbalizations of empathy
  • Conversing with peers on a variety of topics rather than a limited range of interests

Behavioral therapy may look very different between autistic kids with low and high support needs. In addition to one-on-one therapy, other behaviorally sound procedures such as incidental teaching, video modeling, and generalization in the natural environment may be more strongly emphasized.

Behavioral therapy attempts to help a child so that they can learn in less structured settings in the future (for example, in peer groups). Even in these less structured settings, the principles of ABA are often key to a child’s success.

Some of these principles include defining measurable behaviors for change, investigating the function of inappropriate behaviors, reinforcing appropriate behaviors, and measuring progress routinely.

Options Other than ABA

Many people with autism benefit from a multidisciplinary approach to care. Other therapies that may be beneficial include:

  • Developmental and play therapy
  • Educational interventions
  • Occupational therapy
  • Physical therapy
  • Sensory integration therapy
  • Speech therapy
  • Talk therapy (psychology)

Summary

ABA therapy is commonly recommended for children with autism. However, there is limited evidence to support its usefulness in autistics with lower support needs (formerly referred to as high-functioning autism). What’s more, many autistic adults consider the behaviorism techniques used in ABA to be harmful and unethical. 

ABA therapy plans are individualized to the child with the goal of helping children catch up to their neurotypical peers. In this regard, children with high support needs can benefit greatly from ABA therapy. Those who require less support, however, often aren’t far behind and may not get such noticeable results. 

Other reasons ABA therapy may not be a good fit for your child include the settings and time commitment involved. In-school ABA therapy is often provided in a separate “autism classroom,” but offers little or no time in a general education setting. Additionally, ABA requires several hours of treatment a week. This can make it difficult to participate in extracurricular activities your child enjoys.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Lisa Jo Rudy

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.