Recommended Reading: What is the ABA Reform Movement (ABA Haters Pt. II)?
You may be a caregiver, professional, teacher, or someone
simply interested in ABA as you read this.
Regardless of how connected you are to the ABA community,
you might not be aware of ABA Reform, what it is, why it is needed, and changes
that are being made, right now, in both large and small ways.
In case you are unaware, let me walk you through the ongoing
conversation a bit. It will help shed some light on why "Trauma Informed
ABA" is a thing, and why it’s a much-needed thing:
Both within and outside of the professional ABA community,
there are people who want to see ABA adapt, listen more to the very populations
we serve, reflect on our past (and sometimes current) practices, grow, learn,
and in general: Evolve. The way to bring about this change does differ, with
some people wanting ABA therapy to end/be abolished, some people wanting to see
wide, sweeping change at the top levels of the field, and other people
believing that practitioners doing their job differently everyday, in small and
impactful ways is how we accomplish change. Different people have different
perspectives, so it makes perfect sense to me that although many people are
talking about changing and improving ABA therapy, there is little consensus on
just how to do that.
So how does this connect to trauma informed ABA?
Trauma Informed ABA can be operationally defined as
recognizing that someone's history, lived experience through their own eyes,
and mistreatment or microaggressions has a direct impact on how they behave. It
is viewing someone through the context of who they are in the world, and how
they self-identify OR are identified or labeled by others. For
example, a history of abuse, crisis event, significant illness or injury, neglect, mistreatment, prejudice, misjudgment, or
social rejection, are all traumatic events that should influence how any
intervention or therapy is applied and carried out.
In a nutshell, trauma informed ABA is an intentional
decision to provide services and care in a highly personalized, unique,
person-respecting manner, and to recognize that we are all products of our
environment. For good, or for bad.
If you are an ABA professional, you may be thinking "Well....obviously.
I already do this in my practice". I'd invite you to dig a little deeper
and consider some of the strategies and techniques you implement through the
lens of your client (put yourself in their shoes).
For example, I've worked with many young children who have
been kicked out/asked to leave multiple daycares or preschool settings before I
ever met them. How did those experiences affect them? What must it have felt
like to be in a setting where you are excluded, not wanted, misjudged, and your
needs weren't met? What kind of interventions and consequences to problem
behavior were attempted before the facility realized they could not meet the
child's needs? How did those failed attempts at consequences make that child
feel? But here is the problem: for most of the clients I serve, I cannot
just ask them these questions. Even if they communicate by speaking, they
don't always have the vocabulary, cognitive understanding, or desire/motivation
to answer these kind of questions. And of course, asking someone's caregiver or
parent to speak on the client’s traumatic experience is not quite the same as
asking the person who lived through it. Is it starting to sink in now??
As ABA professionals, we must approach each client uniquely
and specifically, meaning we make little assumption from one client to the
next. We modify and tailor intervention to what the client needs and prefers,
not what we think is best or should happen. We collaborate with caregivers,
parents, and other professionals working with that client, and we design
intervention in a way that respects client dignity, autonomy, choice, and
again: preferences. If my client hates washing dishes, is it unethical to
utilize reinforcement to teach them this skill because their parents want them
to wash dishes? If my client has a meltdown in a public space, should I
immediately take them out to respect their dignity in that moment or is that
"reinforcing escape behaviors"? If my client is non-compliant, is physical
prompting necessary? How do I respond during a session when my client revokes
their assent? What about a client who is older or able to communicate, and
tells me they don’t want to receive ABA therapy. How should I respond? How do I
select treatment goals for a client who has no means to communicate? How do I
make sure I am embedding client choice? Is it ethical to create a Behavior Plan
for stereotypy? What about teaching play skills? Is this ethical or not?
These are not easy questions to answer, which is the whole
point.
For client A who has a very specific background, I may
answer these questions one way. But then with client B who has a history of
trauma, school refusal/aversion to authority figures, or past experiences with a
low-quality ABA provider, my answers could be completely different. And that is
how this should work, with the intervention package looking quite different
from one person to the next. That’s a GOOD thing.
If the care being
provided is individualized, focused on what is best for that individual
(and not just their caregivers/parents), and trauma informed, then the
intervention will ultimately be far more helpful, impactful, and SAFER/less
harmful to the individual receiving therapy services.
There's tons of valuable information, research, and
resources about trauma informed ABA (here is a massive list of resources). I
urge any ABA professional reading this to dig into this methodology and embed
it into the way you do your job. Listen to Autistics who speak about their life
experiences, meltdowns, sensory issues, and their daily challenges. I have
worked with many Autistic RBTs or BCBAs, and learned so much from them talking
about their own experiences as a child, in school, in therapy, as an adult, etc.
In order to gain new
perspective, you have to be willing to be wrong. Be willing to say
"Wow, I didn't know that", “I don’t know/I need to research
that further”, or "I never thought it about that way". This how we
learn.
There is a movement happening all around us, and while it
may have many differing voices, that does not negate the need for change. We
CAN do better at how we help our clients, how we listen to our clients
(especially those who do not communicate by speaking), and how we serve the
disabled community.
*Check out these great resources to learn more:
Trauma Informed Care for Behavior Analysts
'What is Trauma Informed ABA?'
A Perspective on Today's ABA (Dr Hanley)
ABA Provider Listening Pledge (video)
The Compatibility of ABA & Trauma Informed Practice
Examining Challenging Behaviors from a Trauma Lens
Parent perspective on the importance of listening to Autistic voices
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