What Is ABA Therapy—and Why So Many Autistic People Are Speaking Out Against It

What’s inside this article: a clear breakdown of what ABA therapy is, why it’s controversial, what autistic adults say about it, what the research says, and what better, neuroaffirming alternatives exist instead.

If your child has just been diagnosed as autistic, you’ve probably heard this line: “ABA is the gold standard.“

ABA, or Applied Behavior Analysis, is still the most commonly recommended therapy for autistic children.

But it shouldn’t be. The data speaks for itself.

• 76% of kids who receive ABA don’t improve long-term.
• 9% actually regress.

Worse, many autistic adults who went through ABA say it caused trauma—and, in some cases, PTSD.

Let’s break down what ABA actually is, why it’s controversial, and what real alternatives exist to support your child without harm.

What Is ABA Therapy?

ABA is a behavior training system.

It uses external rewards and punishments to shape how a child acts.

It doesn’t look at why a child is doing something. It only looks at what they’re doing and how to stop it—or make it more “acceptable.”

The goal of ABA is to get autistic kids to look and act like non-autistic kids.

ABA strategies often include

• Repetitive tasks done over and over
• Reinforcement systems (if you do X, you get Y)
• Prompting and fading (physically guiding a child to perform an action, then reducing help)
• The Premack Principle (“First do something you dislike, then you get something you like”)

And it’s intense. Children are often in ABA for up to 40 hours a week—the equivalent of a full-time job.

Why Is ABA Controversial?

The answer is simple. ABA is controversial because its foundation is behavior compliance, not emotional development or communication.

ABA was developed by Ole Ivar Løvaas in the 1960s. He openly believed autistic children were broken and needed to be made “normal.”

While today’s programs say they’re more “positive,” the core goal is still the same:

Make the child act less autistic.

And that comes at a cost.

ABA’s Roots Are Linked to Conversion Therapy

Yes—Ole Ivar Løvaas, the founder of ABA, was directly involved in early gay conversion therapy.

In the 1970s, he collaborated with George Rekers, a Baptist minister and psychologist, on something called The “Feminine Boy Project” at UCLA.

One of the most well-known cases involved a child referred to as “Kraig.” His real name was Kirk Andrew Murphy.

He was just five years old at the time that the “therapy” began.

Kirk was punished for showing what the researchers called “feminine” behaviors. They used the same behaviorist principles as ABA:

• Positive reinforcement when he acted “masculine”
• Punishment or withdrawal of affection when he didn’t
• Tracking his behavior, shaping it, and pushing compliance

The stated goal was to prevent him from becoming gay or transgender.

As an adult, Kirk died by suicide. His family blamed the “therapy” for causing deep psychological harm that followed him for life.

Løvaas didn’t just help create the system. He defended it.

He referred to autistic and gender-nonconforming children as “not fully human.” He believed behavioral control could make them more “acceptable” to society.

These ideas weren’t just side-projects. They were part of the original blueprint for ABA.

This is especially important to recognize because research shows a strong link between autism and gender diversity.

• Around 7.4% of autistic individuals identify as gender-diverse—far higher than in the general population
• Transgender and gender-diverse people are 3 to 6 times more likely to be autistic compared to cisgender people

These identities overlap far more often than many people realize. That makes it even more critical that therapeutic approaches respect autonomy, identity, and consent—instead of trying to suppress difference.

Even if today’s practitioners say things have changed, the roots haven’t.

The principles—compliance, suppression, control—are still there.

And for many autistic people, that harm is still being passed down.

Autistic Adults Say ABA Was Traumatizing

Thousands of autistic adults have spoken about their experiences with ABA. Some say it made them feel unsafe. Others say it caused lasting psychological harm. Many have been diagnosed with PTSD.

“ABA taught me to ignore my own body. My meltdowns were punished. My joy was called ‘inappropriate.’ I learned to fake being someone else to be accepted.” — Autistic adult, via NeuroClastic

They weren’t allowed to stim.

They were forced to make eye contact, even when it hurt.

They were trained to say words they didn’t understand.

They were taught to suppress every sign of their autism.

ABA Forces Masking—and That Hurts Long-Term

Masking is when autistic people hide their true feelings, needs, and behaviors to appear “normal.”

ABA teaches masking by design.

It rewards eye contact.

It punishes stimming.

It demands verbal communication, even if that’s not the person’s best communication method.

Over time, masking leads to serious mental health issues:

• Anxiety
• Depression
• Identity confusion
• Burnout
• Suicidality

A study in Autism in Adulthood (2020) found a strong link between masking and suicidal thoughts—especially among autistic people who had been through ABA.

ABA Is Everywhere—Not Just in Therapy

Even if your child isn’t in a formal ABA program, they may still be experiencing ABA-style behavior training.

It’s common in schools. Many behavior intervention plans (BIPs) use the same principles:

• Sticker charts
• Token economies
• Forced eye contact
• “First-Then” boards
• Ignoring “noncompliance”
• Removing sensory tools as punishment
• Withholding recess or preferred activities

These are all rooted in ABA thinking:

Change the behavior, no matter what it costs the child.

And that’s the problem.

It’s not support. It’s compliance training.

It doesn’t meet the child’s needs. It makes their needs invisible.

For autistic kids—especially those who can’t advocate for themselves—this can be traumatic, even if no one calls it ABA.

Examples of ABA Tactics That Cause Harm

Let’s break down a few techniques commonly used in ABA—and why they’re problematic.

1. The Premack Principle (“First do X, then you get Y”)

This is used constantly in ABA.

Example:

“First, clean your room, then you can play outside.”

“First, do this math sheet, then you get iPad time.”

At first glance, it seems like a normal parenting strategy—a simple way of communicating expectations and what to expect next. But in ABA, it’s applied to nearly everything.

Even basic needs like food, rest, or play.

Here’s the issue:

• It teaches that needs must be earned
• It undermines a child’s autonomy
• It can trigger shutdowns or meltdowns—especially for kids with limited communication.
• It makes every interaction feel like a transaction

For kids who already feel powerless, this strategy often backfires. Instead of motivating them, it adds pressure. They feel controlled, not supported.

This can cause resistance, anxiety, or complete shutdown. Especially for children with PDA.

And over time, it damages the relationship between adult and child.

2. Prompting and Fading

ABA often uses physical guidance—like moving a child’s hand to complete a task (e.g., stacking blocks, pointing to a picture).

This is called prompting.

Then they try to fade that help over time.

But here’s the problem:

Any physical contact with another person requires consent.

Children—especially those with communication challenges—may not be able to say no. But that doesn’t make it okay.

Prompting without clear consent teaches:

• Your body isn’t yours
• Adults are allowed to move or touch you without permission
• “No” doesn’t matter

It’s a violation of bodily autonomy.

There’s also weak evidence that this kind of prompting helps kids learn. A study in Physical & Occupational Therapy in Pediatrics (2016) suggests that modeling and play-based approaches may be more effective than physical manipulation in teaching new motor skills.

3. Withholding Play and Movement as Punishment

Movement, play, and exercise are critical for child development.

They support:

• Emotional regulation
• Sensory integration
• Cognitive growth
• Social interaction
• Language development

Yet in ABA, these are often used as rewards—or worse, taken away as punishment.

Example:

• “You can only go outside if you complete this task.”
• “You don’t get recess today because you weren’t compliant.”

This isn’t just unethical. It’s counterproductive.

It removes exactly the things that help kids feel calm, focused, and safe.

It punishes kids for needing movement.

And, it sets up a system where joy is only allowed after performance.

4. Compliance Over Safety

ABA teaches children to comply with adult instructions—no matter what.

That creates real danger.

Children who are trained to always say yes…

Who learn that adults can touch or move them without permission…

Who are taught that saying no means losing something they care about…

…are easier to manipulate, control, and abuse.

This is especially dangerous for children who:

• Don’t have reliable speech
• Rely on others to interpret their behavior
• Can’t easily tell a trusted adult when something bad has happened

Teaching obedience over autonomy puts children at risk.

The Research Isn’t on ABA’s Side

Let’s get specific.

A 2020 meta-analysis published in Psychological Bulletin by Sandbank et al. reviewed 150 studies on early interventions—including ABA.

Here’s what they found:

• Most studies had serious risk of bias
• Improvements were small to non-existent
• Quality of life gains were not demonstrated
• In many cases, children regressed after ABA

“There is insufficient evidence to support the claim that ABA improves meaningful long-term outcomes.” — Sandbank et al., 2020

The U.S. Department of Defense reviewed its own TRICARE data in 2021 and made a similar call. After analyzing 4,000+ children receiving ABA, it concluded: “No consistent evidence that ABA improves core symptoms or adaptive functioning.”

They stopped promoting ABA as the default autism treatment for military families.

But What If My Child Has High Support Needs?

If your child:

• Is non-speaking
• Struggles with daily tasks
• Melts down easily
• Has aggressive or self-injurious behaviors
• Has limited independence

You’re probably feeling desperate for help. And maybe ABA is the only thing the doctors or school system offered you.

We get that.

You’re not wrong for wanting support.

You’re not a bad parent for considering what you were told would help.

You’re just trying to do right by your child.

But ABA isn’t your only option. And it’s definitely not your best one.

What Actually Helps: Occupational Therapy (OT)

Occupational therapy helps kids do the things that matter in real life.

• Dressing
• Brushing teeth
• Using the bathroom
• Coping with sensory input
• Handling frustration
• Communicating in ways that work for them

OT is collaborative. It doesn’t demand eye contact. It doesn’t suppress stimming. It doesn’t rely on punishments or bribes.

And unlike ABA, it supports development—without sacrificing autonomy.

Why OT is better:

• It’s evidence-based
• It’s trauma-informed
• It helps kids learn without forcing masking
• It supports the whole family
• It respects consent and emotional safety

A review in The American Journal of Occupational Therapy (2018) found that OT, especially sensory-based approaches, significantly improved:

• Goal attainment
• Engagement in daily life
• Family satisfaction with care

No therapy will solve everything overnight. But the right support can make your child’s world easier to navigate—without erasing who they are.

Alternatives to ABA

If you want your child to learn, grow, and feel safe, look for:

• Occupational therapy (OT) with sensory integration or developmental focus
• Speech-language therapy that supports augmentative and alternative communication (AAC)
• Child-led therapy that centers on relationships, not compliance
• Neurodiversity-affirming professionals who work with your child, not against them
• Parent coaching rooted in connection and emotional co-regulation

What Your Child Needs Isn’t Compliance

They need:

• Safety
• Autonomy
• Support
• Connection
• Acceptance

Autism is not a behavior problem.

It’s not something to fix or train out of your child.

You don’t have to choose between doing nothing and putting your kid in 40 hours of behavior therapy.

There are better options.

Better outcomes.

Better futures.

Let’s stop forcing autistic kids to look “normal”—and start helping them feel safe being themselves.

Sources:

• Sutapa, P., Pratama, K. W., Rosly, M. M., Syed Ali, S. K., & Karakauki, M. (2021). Improving Motor Skills in Early Childhood through Goal-Oriented Play Activity. Children, 8(11), 994. https://doi.org/10.3390/children8110994
• Leaf, J. B., Cihon, J. H., Leaf, R., McEachin, J., Liu, N., Russell, N., Unumb, L., Shapiro, S., & Khosrowshahi, D. (2021). Concerns About ABA-Based Intervention: An Evaluation and Recommendations. Journal of Autism and Developmental Disorders, 52(6), 2838. https://doi.org/10.1007/s10803-021-05137-y
• Sandbank M, Bottema-Beutel K, Crowley LaPoint S, Feldman JI, Barrett DJ, Caldwell N, Dunham K, Crank J, Albarran S, Woynaroski T. Autism intervention meta-analysis of early childhood studies (Project AIM): updated systematic review and secondary analysis. BMJ. 2023 Nov 14;383:e076733. doi: 10.1136/bmj-2023-076733. PMID: 37963634; PMCID: PMC10644209.
• Schaaf RC, Dumont RL, Arbesman M, May-Benson TA. Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review. Am J Occup Ther. 2018 Jan/Feb;72(1):7201190010p1-7201190010p10. doi: 10.5014/ajot.2018.028431. PMID: 29280711.

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