February 26, 2024

Growing up in Texas, Tiffany Hammond was teased for how she spoke: she talked too softly, in monotone, paused too long between words, and didn’t talk to others. She tried to fit in by taking on other kids’ interests, but eventually tried to get away from the noise and negativity in her head by taking an overdose of Tylenol. When her mother brought her to doctors, she was diagnosed with Asperger’s syndrome and prescribed Paxil. At twelve, she began therapy aimed at helping her build skills and habits that other autistic people possess but she lacked. Hammond aged out of incentives after two years of therapy and was reinforced by praise from her therapists.Hammond currently has two autistic sons and discovered that her older son’s teachers believed in using ABA for their son when traditional therapies did not work. They were willing to “figure out” their son with the ABA approach. However, she stopped treatment after just a few sessions because she was uncomfortable with the approach, which she felt was like treating her son like a pet. Social media posts condemning the practice often carry the hashtag #ABAIsAbuse. The American Medical Association recently removed explicit reference to A.B.A. from its statement of support for autism treatments due to criticism from autistic self-advocates.A.B.A. is the only autism intervention that is approved by insurers and Medicaid in all fifty states. It aims to build skills and habits that autistic individuals may not have by breaking tasks down into small steps and reinforcing desired behaviors through repetition and rewards, which may take the form of candy or extra time with a favorite toy. It is widely recommended for autistic people who exhibit dangerous behaviors or who need to acquire basic skills. However, the practice has come under increasingly vehement criticism from members of the neurodiversity movement, who believe that it cruelly pathologizes autistic behavior. They say that its rewards for compliance are dehumanizing and compare A.B.A. to conversion therapy. Others say that this criticism obscures the good work that A.B.A. therapy can do.