About ABA

Most CASP member organizations provide applied behavior analysis (ABA) services. The effectiveness of ABA for the challenges faced by many autistic people has been well-documented in research that meets the rigorous standards of the American Medical Association.1 

ABA services are provided in various settings, including schools, communities, and homes. ABA services for the treatment of autism are covered in most fully insured health plans in all 50 states, Federal Employee Health Benefit plans, TRICARE, most self-funded health benefit plans, and under the EPSDT benefit of Medicaid.

As the prevalence of autism continues to rise2, the demand for ABA and other autism services continues to grow. As such, ABA has been subject to considerable scrutiny, particularly in social media, where misinformation can quickly spread. As the trade association for autism service providers who have demonstrated a commitment to promoting and providing evidence-based services for people with autism, CASP welcomes the opportunity to listen to stakeholders and engage in respectful dialogue. 

With input from CASP members and autistic adults who received ABA services as children, CASP has produced educational "Frequently Asked Questions about ABA" documents for both healthcare professionals and consumers. What follows is the FAQ for healthcare professionals. If you would like to share a copy of the FAQ for consumers with your families, it can be downloaded here

Questions and Answers about ABA

Facts for Professionals

Please Note: Although historically, person-first language has been preferred by the broader disability community, people diagnosed with autism spectrum disorder, their families, and providers have expressed dramatically different preferences. Because of this, we use both person-first and identity-first language in this Q&A.

A: Yes. ABA providers serving individuals with autism seek to develop or restore abilities that are important to autistic people. For example, a provider might teach a person with autism how to shop for their favorite foods or how to interview for a preferred job. ABA providers celebrate each autistic person’s individual identity and personality and incorporate personal preferences throughout treatment.

The Council of Autism Service Providers (2020). Applied behavior analysis treatment of autism spectrum disorder: Practice guidelines for healthcare funders and managers, 2nd edition.  

A: Yes. Credentialed ABA providers incorporate client choice throughout the treatment process. This begins at intake when clients and caregivers work with providers to set treatment goals that meet their needs (BACB, 2014, 4.02, 4.03, 4.04). It extends during treatment when clients are given the opportunity to choose the items and activities to be used during therapy.

Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Author.

A: Many social standards are not arbitrary. For example, people cannot walk down the street naked without consequence because our society does not accept public nudity. By teaching persons with autism to be aware of and make informed choices about existing social standards, ABA providers are helping autistic individuals to access new opportunities safely and as independently as possible. From early in ABA history, providers have recognized the importance of individualizing interventions to pursue results that are important to our consumers (e.g., Wolf, 1978). In doing so, providers work directly with recipients of their services to select meaningful, functional, and applied goals.

Wolf, M. M. (1978) Social validity: The case for subjective measurement or how behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11(2). https://doi.org/10.1901/jaba.1978.11-203

A: Not at all. The focus of ABA therapy is on empowering autistic persons to develop skills they need to be as independent as possible in all areas of their lives. ABA providers teach individuals with autism how to be self-sufficient so they can safely navigate their world and live long and healthy lives. To that end, credentialed ABA providers teach communication skills to persons with autism so they are able to express their wants and needs, strengthening their ability to advocate and participate in ongoing treatment decisions.

A: No. All recipients of ABA services have a right to receive effective treatment that is free from exploitation. The ethical code of conduct adopted by credentialed ABA providers explicitly addresses multiple relationships and forbids exploitative relationships, including sexual relationships (BACB, 2014). Any ABA providers who exploit or attempt to use their power to take advantage of autistic persons should be reported to the appropriate legal or regulatory authorities.

Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Author.

A: All science-based health care professions are constantly evolving. Rarely, if ever, would the type of health care services delivered decades ago be considered the standard of care today. For example, due to advances in breast cancer treatments, oncologists no longer recommend radical mastectomies for every breast cancer patient due to its significant impact on patients and superior alternative approaches. Lobotomies are rarely if ever performed today for patients with severe mental illness due to the development of effective antipsychotic and antidepressant medications. Society welcomes these advances in treatment and does not blame today’s medical professionals for treatment decisions made by their predecessors.

Similarly, the ABA practiced decades ago is not the same as the ABA practiced today. For example, conversion therapy would violate several of the current ethical codes in the profession of applied behavior analysis. These include, at minimum, ethical codes related to a client’s rights, integrity, consent, reliance on scientific knowledge, punishment, avoiding harmful reinforcers, affirming principles, and promoting an ethical culture (LeBlanc, 2020).

The last few decades have seen the practice of ABA advance with the establishment of quality controls in the field (e.g., ethical codes of conduct, established training curricula, supervised practice, certification, licensure, accreditation). In fact, many of these quality controls were established in response to incidents of abuse being carried out by some providers claiming to be practicing ABA.

Leblanc, L. A. (2020). Editor’s note: Societal changes and expression of concern about Rekers and Lovaas’ (1974) behavioral treatment of deviant sex-role behaviors in a male child. Journal of Applied Behavior Analysis, 53(4), 1830-1836. https://doi.org/10.1002/jaba.768

A: First, while Lovaas is credited with pioneering many important developments in the treatment of autism with ABA he is not considered the founder of ABA. The Journal of Applied Behavior Analysis was founded in 1968 and the first published application of ABA is often recognized as occurring in 1949 (Fuller, 1949). In other words, ABA had been around for almost four decades before Lovaas published his seminal study in 1987.

To the question, although Lovaas made some important contributions to ABA practice, some of the statements he made and methodologies he used almost half a century ago (Chance, 1974) would be roundly rejected today and are in direct conflict with the ethical codes of conduct adopted by the ABA provider community (BACB, 2014). For example, Lovaas and his colleagues initially employed electric shock on a very limited basis and eventually faded it out entirely.

Chance, Paul. (1974). O. Ivar Lovaas Interview with Paul Chance. Psychology Today.

Fuller, P. R. (1949). Operant conditioning of a vegetative human organism. The American Journal of Psychology, 62(4), 587-590.

A: No. “Punishment,” as that term is used in ABA, is not bad. Unfortunately, though, that term is exploited by those who are misinformed about our practice. “Punishment” never involves retribution or harm to the recipient of services. Credentialed ABA providers rarely use punishment and only after other attempts to treat a behavior have failed. When punishment strategies are used, they are expected to be used with other reward-based procedures and carefully watched. For example, a young child who runs across the parking lot may immediately be asked to practice walking across the same lot a few times while holding the hand of an adult. This action may decrease unsafe running in the future. Additionally, it serves as an opportunity for the child to practice a safe response that can be rewarded next time.

A: Yes. Credentialed ABA providers very deliberately take into account the reasons why recipients of their services perform certain activities. In fact, an entire methodology known as functional behavior assessment is designed around this basic idea. These reasons are expected to be incorporated into treatment to ensure needs, wants, and preferences are being met.

Last Updated July 16, 2021

Facts for Consumers

Download the ABA FAQ for Families