Long-Term Effects Of ABA Therapy: ABA Is Not Abusive

Learn about the long-term effects of Applied Behavior Analysis (ABA) therapy. It’s not abusive.

steven zauderer
Steven Zauderer
January 11th, 2023

Positive Long-Term Effects of ABA Therapy - Why It’s Not Abusive

Although ABA therapy has been consistently evaluated as a recommended treatment for the autistic, some organizations and individuals have come to question its reliability and ethical approaches.

While there are claims that long-term ABA can have unwanted effects on autistic patients taking part in it, they often don't hold up to hard evidence when scrutinized. Therapists must adhere to stipulations that ensure negative consequences are minimized.

They're monitored by the BACB, or Behavior Analyst Certification Board, which serves to verify that behavior analysts follow protocols with everyone they interact with, including the parents of young autistic kids.

During long-term care for the autistic, some detractors of the therapy state that not enough courses are built around more than one skill set.

They also argue that therapists may not have adequate knowledge to properly handle children who experience symptoms of anxiety.

Therapists may be accused of conducting therapy sessions using methods that have no relevance to treating such symptoms.

These claims are false.All behavioral analysts are required to practice stipulations that are laid out to reduce the likelihood of severe reactions due to anxiety from autistic patients, including in the long term.

They must abide by ethical codes which are stipulated by the BACB. Therapists don't use practices that deviate from what they're trained and taught to do.

Treatments are crafted according to what a patient needs to make their behavior improve.

This can be motivated by the requests of parents or guardians, so long as it falls within the ethical standards of the BACB.

If a skill isn't learned in a sufficient amount of time by a patient, therapists aren't allowed to continue its use as per guidelines set by the BACB.

Stimulating Behavior

ABA therapists are also accused of having inadequate training to deal with the autistic and some of the behaviors they exhibit, such as stimulating reactions.

The research is clear that therapists provide needed social improvements to people on the spectrum.

This can lower or nearly eliminate behaviors shown to be antisocial or unwanted by parents and educators.

To do this, therapists must follow rules which allow them to help autistic individuals through their experiences.

The needs of every client can change. Therefore, therapists create new treatment plans that fall in line with their ethical obligations.

During this time, parents and guardians can ask that self-stimulation be reduced. Therapists can accede to the requests of parents in this situation, provided that doing so doesn't interfere with the patient's ability to learn and won't further impact their health.

ABA Doesn't Lead to PTSD

A frequently made claim concerning ABA therapy is that it can somehow lead the autistic to symptoms associated with PTSD, short for post-traumatic stress disorder.

Surveys are cited of patients diagnosed with PTSD after they turned 18. In one survey, the questions were made for researchers to see the severity of symptoms made known in several people.

Proponents of the study claimed that nearly half of the group showed PTSD symptoms.

Another claim made about this study is that patients would exhibit these symptoms about a month after having last visited the ABA clinic.

The truth is that the claims made were taken from a study that used a methodology that has since been discredited. Summaries made from such research have been discredited as well.

Contentious Behavioral Techniques

There are claims of ABA being unethical or not having enough variance in ideas to treat the autistic.

ABA therapy uses behavioral procedures to help drive the behaviors in autistic patients.

Numerous treatments are available through ABA to help them achieve this. To be specific, the contention is that ABA doesn't use enough courses for this purpose.

One issue with this claim is that some treatments are deemed ineffective for some, which can change between each individual.

ABA focuses on giving the best treatments possible, and with a high probability of working out well in favor of the patient.

Positive outcomes are made possible when the focus remains on the ABA course, not those which aren't closely related to treating the autistic.

Why Some People Think ABA Therapy Is Abusive/Bad + Why They’re Wrong

In the last century, what was once a relatively obscure way of treating various psychological disorders has now become a recommended treatment by healthcare professionals worldwide.

Advocacy for ABA therapy even reaches outside the world of psychology, having earned a name for itself among many government institutions in multiple countries.

A key component of ABA therapy is positive reinforcement, something that drives behaviors in the autistic that are preferred by the patient's parents, teachers, caretakers, and guardians.

Positive reinforcement is frequently used during courses since it allows patients to acknowledge and heighten their social abilities.

At the same time, this lowers behaviors that can be damaging to their psychological development, such as tantrums or panic attacks.

But even with all of its recommendations and accolades, ABA remains heavily critiqued. One primary area of concern for critics is how methods are practiced by behavioral analysts.

Discrete trial training, for example, is used during courses but originally wasn't focused on positive reinforcement in the early days of the therapy during the mid-20th century.

Instead of positive reinforcement, punishments were common at the time, including electric shock.

Today, ABA therapy and DTT are entirely safe for the autistic, using no form of physical punishment to drive behaviors in clients.

The methods used so many years ago have long been discontinued and replaced with more effective and non-damaging ways of promoting positive reinforcement.

Hard on Children, Little Enthusiasm

The repetitive nature of some ABA courses has led to accusations of the treatment being too difficult or demanding on children.

It's usually accompanied by claims of being redundant to addressing their learning disabilities. Oftentimes, such complaints are based on stereotypes made about ABA in general.

In this area, therapists might be seen as difficult and even incapable of understanding.

However, a trip to nearly any ABA clinic reveals the exact opposite. Therapists are generally energetic and fun for clients to be around, regardless of their age.

Although some therapists aren't as gregarious as most, this shouldn't be taken as a widespread personality trait among them all. Just as individuals have different personalities, so do therapists.

Poor training can sometimes be the source for therapists that show a lack of enthusiasm in their teaching.

Additionally, since DTT is seen in the reduced practice in many clinics, children usually won't find themselves bored during therapy sessions, something that can allow both therapists and clients to better engage with one another.

Scheduling Issues

Long-term ABA isn’t a quick solution to autism. Treatment can last for months to years. ABA therapy is sometimes thought of as too long and drawn out, conflicting with the schedules of parents.

Although 40 hours a week is the most ABA therapy children can receive per week, the average number of hours children receive ABA per week is much lower.

Unless the treatment specifically calls for longer hours in session, autistic children are often scheduled for weekly visits totaling between 10 and 20 hours.

When symptoms are severe, clients need more time to reduce patterns of unwanted behavior. Yet once those symptoms are no longer present or significantly lowered, they too can have therapy hours shortened.

Too Much Effort Spent on Reducing Behaviors

This is commonly brought up among critics. The issue by some is that ABA therapy attempts to reduce a child's characteristics, and how they interact with the world, instead of building from it.

Such critics accuse therapists of taking away their patient’s characteristics for the sake of ostensible improvements, to the degree where they become indistinguishable from the rest of their peers.

Teaching a child that their uniqueness is wrong is thought by some to potentially lead to further problems later in their childhood, such as self-esteem or even more social anxiety.

Critics have attempted to link these charges to the neurodevelopment in autistic children.

The ultimate goals of ABA therapy are to alter the way an autistic individual thinks about certain situations, those which can produce desirable or unwanted behavior.

Changes are done through the use of environmental factors, such as the setting in the layout of the room in which therapy sessions are conducted.

Every person's individuality is taken into account, where courses can be predicted according to the specific needs of a child or requirements made by parents.

If a child learns differently from others or shows a behavior in a way that doesn't promote self-harm, discretion can be used by the therapist for positive reinforcement.

Does ABA Therapy Work Long Term?

The research conducted by approximately two dozen institutions shows long-term ABA therapy can be successful in treating people with autism.

When the fundamentals of modern ABA treatment are implemented in the treatment, patients have a high rate of success, regardless of its extent.

To be clear, long-term therapy typically involves courses that are at least 40 hours a week and span over a period between one and three years.

In all studies, patients exhibited exceptional improvements in their ability to speak, and understand language, and social interactions.

There was little change in the rate of success between adults and children. Although short ABA sessions are good for some, the long term is where the treatment shows the greatest area of improvement among autistic of every age.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639250/
  2. https://link.springer.com/article/10.1007/s41252-021-00201-1
  3. https://childmind.org/article/controversy-around-applied-behavior-analysis/
steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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