ASHA, Why Aren't You Listening?

The American Speech-Language-Hearing Association recently released an article titled “Building Working Relationships with Applied Behavior Analysts.” They continue to promote ABA therapy despite opposition from the autistic community and advocates like the SLP Neurodiversity Collective. I wrote my own response but haven't received a reply from the author of the article or ASHA. You can read my thoughts on Dr. Morgan's advice below.

Dear ASHA and Dr. Lindee Morgan:

I just received the April copy of the ASHA Leader. As an autistic SLP, it is disheartening to be part of an organization that is so out of touch with the people they claim to serve. I hope this is due to a lack of awareness, rather than an unwillingness to acknowledge the concerns held by autistic people. Whatever the reason, we feel unheard, misunderstood, and marginalized. I hope you are willing to change, for the sake of autistic people everywhere. The autistic community overwhelmingly opposes the use of ABA with autistic children, yet you continue to promote this harmful and ineffective practice by publishing articles such as “Building Working Relationships with Applied Behavior Analysts.” According to the Department of Defense Comprehensive Autism Care Demonstration Annual Report released in June 2019, most Tricare beneficiaries that received ABA for a six-month period, showed no improvement. It is unclear why you are promoting a practice that has so little benefit for the children forced to endure it. Autistic adults subjected to ABA as children often report experiences of trauma and psychological abuse at the hands of BCBAs and RBTs (yes, even the “good” therapists doing the “good & new” ABA). At the core of ABA, is ableism and forced compliance with little or no regard for the child’s autistic identity or emotional wellbeing. I would encourage you to familiarize yourself with the work of Stephen Porges, Mona Delahooke, Ross Greene, and Stuart Shanker (to name a few). I hope after reviewing their work you come to understand that “problem behavior” is not intentional and cannot be changed with the rewards and punishment used in ABA. “Problem behavior” is the brain and body’s physiological response to perceived threats, stress, trauma, or lagging skills. Behavior needs to be addressed within safe, compassionate, and meaningful relationships using co-regulatory approaches. Using rewards and punishment to manipulate a child does nothing to promote feelings of safety, build meaningful relationships, or teach skills necessary for emotional regulation and independent functioning. By promoting a practice that often forces eye contact and whole-body listening, attempts to extinguish stimming or other repetitive behaviors, and withholds special interests in order to force the child to act a certain way, you are telling the child that being autistic is wrong. You are telling them that their natural way of being is wrong. You are telling them that their discomfort (for example, when making eye contact), is not valid. You are telling them they must change who they are at their core if they want to be accepted by other people. But since they cannot change their autistic neurology, they learn to hide their true identities. They become ashamed of who they are. They cannot figure out why being them is so hard. They lose sight of who they really are because the mask they are wearing becomes too real. When autistic children are forced to do something they are uncomfortable with, you are teaching them that consent does not matter (what a dangerous thing to teach a child with a disability). I am sure many BCBAs and RBTs have good intentions and want to help the children they work with. However, uninformed good intentions continue to promote false narratives and harmful practices because they do nothing to address the real needs and concerns of actually autistic people. We are a very vocal community. We are passionate about our special interests. We need to stim. We need routine and repetition in this unpredictable and overwhelming world. We see nothing wrong with being autistic. We are a different form of normal, but the non-autistic world has pathologized us and wishes to “fix” us. ASHA and Dr. Morgan, you are not helping us as long as you continue to support ABA and ignore actually autistic voices. Maybe you do not use ABA principles in your practice, but you are guilty by association. Your perception of autism and how to help autistic people does not align with the real experiences and views of the autistic community. You are not helping us until you allow autistic adults to inform and guide your professional practice. You are not helping us until you take the time to learn from us and understand our needs and concerns. If you are ready to listen to the autistic community and their allies with an open mind, I’d recommend starting with the Autistic Self-Advocacy Network, Autism Inclusivity (an international, autistic-led Facebook group), #askingautistics on social media, and the SLP Neurodiversity Collective (though I know you have ignored the latter in the past). We are more than willing to educate others, but you must be willing to listen.

Kaylen Randall, MS, CCC-SLP

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