What is Ableism?
“Ableism is the discrimination of and social prejudice against people with disabilities based on the belief that typical abilities are superior. At its heart, ableism is rooted in the assumption that disabled people require ‘fixing’ and defines people by their disability. Like racism and sexism, ableism classifies entire groups of people as ‘less than,’ and includes harmful stereotypes, misconceptions, and generalizations of people with disabilities.” (Eisenmenger, 2019).
How does Anti-Ableism Impact ABA Therapy?
Ableism is a form of social prejudice that affects people across all different kinds of physical disabilities such as blindness or paraplegia (wheelchair users). In addition, ableism also affects people who have developmental disabilities such as individuals with Down’s Syndrome or autism spectrum disorders (ASD). As behavior analysts (BCBA), we are specialized in modifying behaviors. According to a survey from the Behavior Analyst Certification Board in 2021, over 70% of BCBAs service individuals with ASD (BACB, 2021). Developing and writing up ABA goals is one of the most important responsibilities of a BCBA. They help set the foundation and framework for the goals and skill building. When working on these goals, it is especially important to consider how the behavior analyst can develop a goal that is ethical and evidence based. But it is also crucial that the behavior analyst thinks with an anti-ableist mindset during this process.
The following includes some recommendations and considerations (in regards to thinking anti-ableist) when beginning the process of goal writing:
1. Don’t “teach to stop” repetitive behaviors
A common question that parents have asked me is, “how can I get him to stop stimming?” A common symptom of ASD is the presentation of repetitive (aka “stimming”) behaviors. Some common examples include: clapping hands repeatedly, echolalia (repeating sounds or words without any social context), and rocking back and forth. Repetitive behaviors such as these are not often dangerous to the self or others, and are often thought of as “self-regulatory” or “self-soothing” behaviors (Kapp, 2009). Because these behaviors tend to be thought of as “disruptive” or “bothersome” by others, it is important to consider this from an anti-ableist perspective.
My view on repetitive behaviors fully takes into consideration anti-ableism. I feel that regardless if a person has autism or not, we all have our own different versions of “self-soothing” behaviors. For me, when I am nervous I like to squeeze my hands together as hard as I can. I find that it helps me to soothe myself in moments of this kind of distress. On some days when I’m feeling really happy, I like to jump up and down and give hugs to all my loved ones. Think of it in this way when it comes to our kids with ASD! They have their own version of behaviors that calm them as well.
Instead of objectifying these kinds of repetitive behaviors to be subject to being treated through behavior modification, consider creating a behavior plan that educates yourself and the client’s family on why their child is exhibiting these behaviors. The behavior plan should never seek to eliminate these behaviors if these behaviors are indeed just for sensory processing reasons. At the very least, we can develop a behavior plan that can help teach the client how to control these impulses and behaviors depending on the time and place. For example, you can use stimulus discrimination teaching procedures to teach the client that they can jump and down and scream inside their bedroom with the door closed, but not in the living room.
2. Don’t ever underestimate the child’s abilities!
“I don’t think he can do that… He doesn’t even know how to read!” This was a comment from a parent that I worked with a long time ago. This was a case with a 7 year old boy who had non-verbal autism. We were discussing the idea of teaching him how to use a PECS on the iPad. At only 7 years old, this boy had a great set of skills: how to open up the browser and YouTube on the iPad, receptively identify things in videos, and even type on the keyboard for what he wants to watch!
A lot of times, parents will focus a lot on the negative things about their child when they have a disability. To consider this from an anti-ableist perspective, I always keep in mind that every child with a disability is capable of learning anything compared to a child without a disability. There will be without a doubt where you will hear discouraging comments as such, but just remember that the process of learning just might take some more time and a lot of patience. The right behavior analyst will keep this in consideration and never assume that their client is incapable of anything without even trying first!
3. Never force someone to change!
I strongly disagree with those who believe that, “ABA is coercive” or that we use ABA to “fix” or “change” their behavior or even “who they are.” It really pains me that there are some people who would agree with these beliefs! My job may be a BCBA most of the week, but my full-time job as a human being will always consider how others feel before myself. I do not think that any person with autism needs “fixing” or “changing.” Ultimately, human beings are subject to their own free will and decisions. This applies to our children that we work with as well. Before I decide to implement a goal, I always discuss it with the child first and then talk with the parents afterwards. By not doing this, it can seem coercive or that the child may feel like we are “changing” them. I want to make sure that they are aware and comfortable if the child wishes to work on the behavior in mind.
I bring the example of my friend’s 13 year old with ASD – “I want him to be outgoing. He is so antisocial! He needs to make more friends” she told me one day. The key words here are “want” and “needs”. It is the use of this kind of language that comes off as coercive or that her son needs “fixing.” Because one of the main features of ASD is an impairment in social-communication, my friend often assumes that the “anti-socialness” in her son is due to his ASD. However, I feel that this is not a problem that needs any fixing. Similar to my previous point, every human being is unique in their own special way. Some people are outgoing, and some are not.
I was able to quickly resonate with my friend how he feels because I am very similar to him in that regard. My ideal Friday night is spent at home with a scented candle lit, curled up with my partner and our pets, watching dumb sitcoms! Imagine how I would feel if someone told me that I needed to “change” that? Ultimately, our differences as human beings are not because we have something “wrong with us” like a disability!
4. Watch your language!
An article titled Avoiding Ableist Language: Suggestions for Autism Researcher recommends various considerations in an effort to reduce the use of ableist language. In their article, they describe language as a powerful means for shaping how people view autism. If researchers take steps to avoid ableist language, researchers, service providers, and society at large may become more accepting and accommodating of people with autism (Bottema-Beutel, 2021). The first section of their article shows a table of potentially ableist terms/discourse, and suggested alternative terms that are less ableist.
For example, words such as “challenging behavior” or “problem behavior” can potentially come across as ableist as it can seem like masking the child’s behavior. It is recommended that these terms be avoided all together and just simply describe what the behavior is and what it looks like. There are many more of these recommendations included in this article that are especially relevant to all ABA practitioners.
Kristen Bottema-Beutel, Steven K. Kapp, Jessica Nina Lester, Noah J. Sasson, and Brittany N. Hand.Avoiding Ableist Language: Suggestions for Autism Researchers.Autism in Adulthood.Mar 2021.18-29.http://doi.org/10.1089/aut.2020.0014
Written by Andrew Ng, BCBA, LBA