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Is ABA Therapy Safe for Children?

June 3, 2021 |

by Dr. Jacob Boney
a woman watches over a little boy in a teaching environment

When considering something new for your child, safety is always one of the first things a parent needs to be assured of. This is especially true of beginning new therapies. ABA therapy has somewhat of a long history, so it’s no surprise that some people might have some misconceptions about it. It’s always a good idea to practice caution, and a good starting point is researching “Is ABA therapy safe?” and how it can be an effective therapy for your child.

Many parents worry about their child being stressed, overwhelmed, or forced to do things they are not ready for. It is normal to have questions, and seeking information is the first step to making sure therapy feels safe and supportive.

Why Parents Ask About ABA Safety

We have received many questions regarding whether or not ABA therapy is a safe method of treatment. While ABA therapy might have a past of being excessive, with the right provider, ABA is a safe and beneficial option for therapy.

Parents often want examples of what “safe and beneficial” looks like. Safe ABA means that children are encouraged and motivated, not punished or forced, and that therapy goals are designed around what the child can realistically achieve.

Where ABA Therapy Came From

This is a question that Dr. Boney was eager to address because a lot of parents have these same misgivings without expressing them. Unfortunately, some of these concerns may be true about some providers, and some of it was much more true in the past. Historically, ABA was used to treat patients in mental institutes and hospitals, and a lot of that treatment focused on behavior reduction, which relied mainly on punishment procedures. Because of that, ABA got a bad reputation for being overly aversive and punishment-based.

Parents may find it helpful to know that modern ABA is almost unrecognizable compared to its early implementations. While the old reputation focused on reducing behavior through aversive methods, today’s therapy emphasizes teaching new skills in ways that respect the child’s feelings and autonomy.

In the old days, behavior therapy basically focused on decreasing undesired behavior. Today, there is an ethical protocol called the “fair pair rule”, which requires that for every behavior that you decrease, you are ethically required to create a behavior to increase. That shifts the focus to increasing behaviors with reinforcement-based procedures.

How Modern ABA Has Changed

In the past 20 years or so, ABA has made a big shift toward being more function-based and more reinforcement-based. Currently, ABA is ethically required to do functional assessments and to use evidence-based practices. However, it is true that some of these things did happen in the past and there may be some providers today that are not totally aligned with function and reinforcement based methods. This may, in large part, be due to the rapid growth of ABA in the last few years. The number of licensees in the state of Arizona, where Dr. Boney practices, has tripled almost every year. With that kind of growth, there can be a dilution of quality in providers.

Many families notice a difference immediately. Children engage more willingly in sessions, therapy becomes playful, and data collection happens without distress. Knowing the history helps parents feel more confident asking the right questions and observing whether their child’s sessions are supportive and enjoyable.

All of that said, quality ABA is nothing like what has just been described. It is not abusive. It is not restrictive. It is not punishment-based. That is not what quality ABA therapy looks like, and if that is the kind of therapy that your child is receiving, parents are advised to stop that treatment immediately, and look for a quality provider.

Parents should feel empowered to speak up if their child seems upset, stressed, or withdrawn during sessions. A good therapist will respond quickly, adjust techniques, and ensure learning happens in a positive environment.

What Makes ABA Therapy Safe

ABA is data-based. Treatment is monitored very closely, on a daily basis. Because of this, whether something is or is not working will be known very quickly.  Data is critical, and, because it is taken so meticulously and monitored it so closely, we can make finely-tuned adjustments in a very responsive way. Dr. Boney strongly believes that if a child is spending sessions crying or upset, they are not learning and are not going to make much progress. The program and treatment and teaching methodswould need to be shifted quickly. With that said, Scottsdale Pediatric Behavioral Services strongly believes in treating children in a safe and effective way, and ABA therapy is one of those safe ways for the following reasons.

Here are practical ways parents can see that ABA is safe in action:

  • Children are smiling, engaged, or showing curiosity during sessions
  • Breaks are frequent and tailored to the child’s needs
  • Reinforcement is motivating and enjoyable
  • Adjustments to teaching strategies are made quickly if a child struggles

ABA is regulated

ABA is now well regulated. The current licensure system regulates and monitors the way ABA is practiced. This ensures and maintains a very high standard of practice.

ABA must be effective. There has to be a simultaneous increase in adaptive behavior and decrease in maladaptive behavior. Both must occur at the same time or good ABA is not happening.

ABA is efficient

Competent behavior analysts have specific decision protocols. This means that a specific action is called for after a certain number of things are recorded. For example, after an overall descending five data points, you are probably going to stop a program and make an adjustment or utilize what’s called a tactic. Decision protocols are extremely critical. They ensure that a change is made quickly so that they do not continue to do what is not working. This crucial component of ABA makes it much more safe and effective.

The focus on functional analysis has changed ABA treatment in the past 20 years and allows us to identify the function of problem behavior much more quickly and efficiently. An even more recent modification, called synthesized functional analysis, makes the process even quicker and more humane, as well as safer and more efficient. This has led to very specific, tailored, function-based treatment.

ABA is fun

ABA should be fun, engaging and extremely helpful for your child. Children who are in a good mood, happy and looking forward to their therapy sessions get far more benefit from treatment. This is one of the reasons that ABA is safe, because making sure children are happy and naturally motivated is key to acquiring good data, which will more quickly lead to successful treatment.

Parents can observe whether therapy is fun by noticing if children want to go to sessions, show interest in activities, or smile and laugh during tasks. Fun therapy does not mean frivolous therapy. It means learning is embedded in activities the child enjoys.

ABA is well-researched

Ethical guidelines require that the least restrictive interventions be utilized.

Behavior analysts are required to get ongoing training. Constant research is taking place in behavior analysis, and we are required to utilize that research and the latest evidence-based practices to benefit our patients in the safest, efficient and ethical way. ABA is growing because it is effective. There is only one treatment that is approved by most insurance companies as one of the most evidence-based ways to work with children who have significant behavioral issues and developmental delays. That is ABA therapy.

Parents should develop a good relationship with their child’s therapist and not hesitate to seek information from them. Ask questions. Any competent provider should provide you with similar information so that you are confident that ABA is safe for your child.

ABA Therapy at Scottsdale Pediatric Behavioral Services

Utilizing evidence-based practices and the scientific principles of Applied Behavior Analysis, the Scottsdale Pediatric Behavioral Services team provides assessment, treatment, and consultation for a wide range of behavioral issues. We work with a variety of children, families, schools, hospitals, mental health agencies, and local community organizations to provide these services.

If you are exploring ABA for your child, you are not alone. It is normal to have questions and concerns about safety and effectiveness. Scottsdale Pediatric Behavioral Services welcomes conversations with parents, offers transparent explanations, and works closely with families to make therapy both safe and enjoyable.

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