ABA (applied behavior analysis) has been the gold standard of therapies for autism for decades, but more and more professionals are now realizing that ABA might not be as effective as it was once thought to be. Not only that, but newer research has found that behavior therapy is actually harmful to neurodivergent people.
If you’re looking for a more compassionate and respectful type of speech therapy (that gets real results), read on to learn about some non-ABA techniques you can use with your autistic speech therapy clients.
Related: The Dangers of Behavior Therapies
5 Non-ABA Speech Language Pathology Techniques
Therapies for autism shouldn’t be about making someone ‘less autistic.’ It should be about giving someone the things they need to have a higher quality of life. Therapies are useful. They can help an autistic person with the things they might struggle with, like communication, social interactions and other life skills. But ABA is more harmful than helpful.
Most techniques for working with autistic clients in speech therapy are ABA-based, but there are several non-ABA options available.
1. Use a Strength-Based Therapy Model
ABA focuses on an individual’s deficits – their ‘problematic’ or non-neurotypical behaviors. The whole point of behavior therapies for autism is to change undesirable neurodivergent behaviors, like being nonverbal or avoiding eye contact.
A strength-based model focuses instead on the individual’s strengths, interests and passions, rather than their deficits and challenges. You can use what someone is already good at and the things they love to improve their current skills and develop new ones.
When trying out strength-based therapy, it’s helpful to reframe the language you use when talking about autistic individuals. Jessie Ginsburg, M.S., CCC-SLP, offers a few examples of how to reframe language around autism on her blog:
“Instead of: He has severe meltdowns.
Try: He feels emotions intensely.
Instead of: He is obsessed with cars.
Try: He is very passionate and enthusiastic about cars.
Instead of: He is perseverating on the fan spinning.
Try: He is fascinated by the fan spinning.
Instead of: He displays restricted and repetitive behaviors.
Try: He enjoys moving his body in the same way over and over again.
Instead of: He is rigid with his routines.
Try: He prefers consistency and sameness.
Instead of: He is an extreme picky eater with severe food aversions.
Try: He has a sensitive palate and specific food preferences.
Instead of: He is nonverbal.
Try: He is nonspeaking. Here’s how he communicates…
Instead of: He is low-functioning.
Try: He needs a higher level of support.”
2. Remember That Speech Doesn’t Necessarily Equal Communication
ABA uses reinforcement to get nonverbal individuals to speak, but because they are just often repeating what was said to them, and usually only to receive a reward or avoid a punishment, they’re not really learning how to communicate. They might know that a certain phrase will get a certain result, but they may not know why.
While speech is a very helpful skill to have, it’s not the be-all and end-all of communication. It’s better for someone to be nonverbal and truly communicate with others through other methods, rather than being able to speak, but not able to participate in reciprocal communication.
3. Augmentative and Alternative Communication
Instead of focusing only on speech, offer augmentative and alternative communication (AAC) options. AAC refers to all the ways someone can communicate other than speech.
- Gestures and facial expressions
- Writing or drawing
- Pointing to images or written words
- Spelling out words by pointing to letters
- Using a speech-generating device
- Using an app on a phone, tablet or other device to communicate
While it’s nice to have access to high-tech options like tablets or speech generators, you can just as effectively use a physical communication board to facilitate communication. Providing access to different types of communication allows the client to choose which one works best for them.
4. Accommodate Sensory Sensitivities
For many autistic people, sensory sensitivities impact their lives every single day. The physical and emotional reactions caused by sensory sensitivities can be extreme for some, causing intense psychological distress. Yet sensory tools that can comfort and reduce distress and overwhelm are typically not allowed in ABA-based therapy sessions.
Accommodating sensory sensitivities gives your clients the feelings of wellbeing and safety they’ll need to be fully open to learning new things.
A few ways you can accommodate sensory sensitivities include:
- Lowering the lights for clients who are sensitive to bright light
- Lowering your voice or other sounds in the room for clients who are sensitive to noise
- Providing sensory tools that can comfort and reduce stress, like fidget spinners, weight blankets, headphones or sunglasses
- Allowing clients to stim, which can help them to self-regulate
5. Help Autistic Clients To Develop Skills in a Way That Works for Them
A client might be nonverbal, but could excel at using gestures to communicate. In that case, you could encourage their use of nonverbal communication. The important thing is that they’re communicating. Being able to communicate is crucial – otherwise, it will be very difficult to get their needs and wants met throughout their life. So, whichever way someone best communicates is the best communication technique for them.
Most importantly, don’t train autistic people to mimic neurotypical social skills. While social skills are important, many autistic people find it difficult to perform expected neurotypical social behaviors, like making small talk or eye contact during a conversation.
Constantly having to pretend to be someone they’re not can cause psychological stress and, in some cases, lead to mental health problems like depression, anxiety, PTSD and suicidality. The energy that autistic individuals put into masking also takes away their resources for managing emotions and interactions, making speech therapy more difficult for them.
Why ABA Doesn’t Work
American psychologist B.F. Skinner is considered to be the father of operant conditioning – a theory based on behaviorism. According to operant conditioning, behavior that leads to pleasant consequences will be repeated and behavior that leads to unpleasant consequences will not be repeated. Operant conditioning is the foundation of ABA.
The problem with operant conditioning is that the results aren’t real. An autistic child who fears punishment will eventually learn to do what their therapist or parent wants them to do, but it doesn’t mean they’ve actually learned anything useful. They’re only doing it because, on the most basic level, they’ve learned that they will be punished if they perform an undesired behavior and that they will be rewarded if they perform a desired behavior. But they don’t know why they should do the things that they’re told to do. And this means that they aren’t able to apply it to their everyday life.
Why ABA Is So Harmful To Autistic Individuals
Oxford Languages defines behaviorism as the “theory that human and animal behavior can be explained in terms of conditioning, without appeal to thoughts or feelings.”
You’re probably familiar with Russian physiologist Ivan Pavlov’s most famous experiment, in which he conditioned dogs to salivate at the sound of a bell. Modern behavior therapies are based on the same concept. They hold the belief that behavior isn’t explained by internal thoughts and motivations, but by external and observable causes – that an autistic person’s thoughts, feelings and desires don’t matter when it comes to their therapy.
Behavior therapies like ABA:
- Encourage masking, which can lead to lifelong mental health consequences
- Often don’t allow sensory supports (like headphones, sunglasses, etc.) to be used during a session or, if they do, they’re used as a reward, not as a true sensory support
- Encourage therapists to ignore a child who’s having a meltdown, experiencing sensory sensitivities or is otherwise in distress
For autistic people who undergo ABA, these experiences often lead to lifelong mental health problems, such as PTSD and a higher risk of suicide.
RDI® Builds Real, Reciprocal Communication
Reciprocal communication is essential for the development and expression of basic wants and needs. Speech therapy helps children to communicate clearly, with an emphasis on verbal communication. But for autistic children, speech therapy must also be designed to enable them to communicate functionally and spontaneously and must include nonverbal language.
Every aspect of the Relationship Development Intervention (RDI®) program is focused on the relationship between the child and the guide. Speech therapy is no different.
Some ways you can use RDI® principles in speech therapy include:
- Sharing experiences
- Limiting verbal language directives
- Slowing the rate of communication
- Increasing the use of gestures
- Increasing the emphasis on vocal tone, pacing, timing, and volume
- Limiting questions, commands, and prompts
- Practicing patience (children sense impatience and become discouraged)
- Increasing opportunity without demanding response (declarative language)
RDI® Is a More Effective, More Compassionate Way To Do Speech Language Pathology
In the Relationship Development Intervention program, we focus on real communication, not just spoken language. RDI® is based on years of research around autism and is an effective and empathetic approach to autism remediation.
If you’re interested in how you can use RDI® in your speech therapy sessions, find out more information about the RDI® Professional Training Program and apply today to become a Certified RDI®Consultant.