It's ok for people with disabilities to want attention
A lot of things that people with disabilities do get pathologized as “attention seeking behaviors”, whether or not they have anything to do with wanting attention.
That’s not the only problem with the whole concept of “attention seeking behaviors”.
Another problem is that there’s actually absolutely nothing wrong with wanting attention. In fact, all communication involves seeking attention in some way.
Taken literally, here are behaviors that involve seeking attention:
Asking if someone is ok
Writing a blog post
Performing on stage
Teaching a class
Waving to someone
Asking a question
Reporting a problem
Commenting on something
Posting on Twitter
“Attention seeking” isn’t a neutral technical term. It’s professional jargon for saying “this person becomes unworthy of attention when they do this, and so we’re going to aggressively ignore them.”
That’s a value judgement, generally a very harsh value judgement. There’s nothing scientific, technical, or medical about that kind of judgement. And it’s a very cruel thing to do to people who don’t deserve it.
tl;dr Calling something an “attention seeking behavior” isn’t a technical term; it’s a (generally unwarranted) insult.
Dear Neurotypicals: Your child being diagnosed as Autistic isnt tragic.
If anythings tragic its the fact that neurotypicals see Autistic people in this way.
If anythings sad its the fact that so many neurotypical parents will put their autistic kids through abusive therapies after their kid has been diagnosed and consider their kid acting neurotypical to be well worth the trauma they put their kid through to achieve it.
Appearing to enjoy behavior modificiation is not meaningful
One common response to criticism of ABA is to claim that people subjected to it enjoy it:
“My child loves his therapist and asks to go to sessions!”
“All of my clients smile and have fun!”
“My ABA is play based!”
What people forget is that affect is a set of behaviors, and that behavior modification methods work as well on affective behaviors as they do on anything else:
You can reinforce people to look happy
You can reinforce people to praise therapy
It doesn’t have to be an explicit part of the behavior plan to happen
And it can keep happening even after you fade direct prompts or direct intentional reinforcers
ABA programs give the therapist massive power over the person. That power in itself can cause people to look happy, through a more subtle reinforcement mechanism than takes place on a behavior plan:
If you have power over someone in the way that behavior therapists do, they’re going to be highly motivated to please you
If they figure out that you want to believe that they are happy, they are very likely to act like they are
If you treat them better when they display the affect you want or praise you, they’re likely to act happy.
It doesn’t mean they’re actually happy
Or that what you’re doing is good for them
(Also, affect often is an explicit part of someone’s behavior plan. It is not at all uncommon for ABA programs to involve actively ignoring distress and withholding attention and rewards until someone looks happy. It is not at all uncommon for ABA programs to involve teaching people to smile, to hug, or to otherwise do things that would out-of-context indicate happiness, enjoyment, or affection. It doesn’t have the same meaning if it’s prompted or trained.)
Also, programs based on positive reinforcement involving controlling someone’s access to stuff they care about:
The first step in a program based on positive reinforcement is to find out what someone most enjoys or cares about
(This is called a preference assessment or a reinforcement inventory. Here’s an example.)
And then making sure they have no access (or limited access) to those things outside of sessions or other situations in which someone is actively reinforcing them to do something
Of course if someone’s only access to everything important to them happens in sessions they will ask for sessions
That doesn’t mean they like the fact that someone has that level of power over them
(No one likes being manipulated that way.)
That doesn’t mean they like the things that the therapist makes them do
That doesn’t mean the power dynamic is harmless
That doesn’t mean ABA is a good approach to teaching
People who can’t say no, can’t say yes meaningfully. Looking happy isn’t meaningful if you’re rewarded for affecting happiness and punished for looking visibly distressed. Making the best of a bad situation isn’t consent.
Therapist: “Where does grandma work?” Little boy: “Um… she works at the house.” “No. Where does grandma work? Say ‘library’.” “Library.” “Whee! Now you get a starburst.”
This is not how you teach three year olds to communicate in language. Communicating is not about saying what you think other people want you to say. Communicating is about connecting thoughts to words the best you can and saying them (or typing them, or pick your pleasure). This is not how you teach a kid “the woman who gives me many cookies works in a big building full of stories, which is awesome” this is how you teach a kid “when people tell me “blah blah blah” I should say “blah blah BLEE blah”.” And this shows how, even “playful nice aversive-free” ABA is about having the kid be right, and not having the kid be a kid who mixes up “house” and “library”, or calls a library a “bookhouse”, or thinks Grandma’s “work” is baking him cookies. Don’t you want to say, “What does she do at the house?” and hear him say “Gives me cookies” and see him light up, and smile with him, or maybe he’ll tell you she stacks the books at the house and you can say “I think she does that at the library.” in a nice way, and also a way that actually teaches him something, because the way you’re doing it he just knows he’s wrong, and he doesn’t know why. Being a little kid shouldn’t be about wrong and right. If a kid tells you he’s found a portal to fairyland, you aren’t supposed to say “No”, you’re supposed to say “Take me with you”.
content note/trigger warning: ABA therapy, restraint, medical abuse, psychological abuse, infantilizing of an autistic adult
I forgot to do writeups of ABA….sorry….so here’s a write up of it, past tense. I’m gonna do this in sections, categories, if you like, simply because that’s going to be easier than doing it session by session. If you want an account of what a session looked like, I did a full write up of session 1 here. I’ve tried to do this in a logical order, so the information makes sense in light of the earlier sections, let me know if this seems to not make sense.
Fact: Ivar Lovaas, pioneer of applied behavior analysis (ABA) compliance training for autistic people, was first known for using the same techniques and methodologies in the NIH-funded feminine boys study. In that project, Lovaas used ABA to force boys with stereotypically feminine speech, movement, and dress to comply with more stereotypically masculine behavior in hopes this would prevent them from becoming homosexual.
I just had to handle one too many messages from ABA practitioners this April, and my last last ounce of chill just evaporated in the heat of my rage.
So naturally I took to Twitter, to send my righteous anger out across the internet in 140 characters. I’m using the hashtag #ABAapologists, which hasn’t really been a thing, but maybe it is now. Anyone who wants to join in, please do.
Content note: This post is written with parents and professionals in mind. It’s about a common way that rewards-based behavior modification hurts people, and the importance of being aware of that effect in work with people who might be ABA survivors.
I’ve seen a lot of well-meaning people who are trying to fix special education and adult disability services say things like “you have to find out what they’re interested in and incorporate it.”
This can be good advice. It’s also important to realize that this is loaded, and that not all disabled people are going to be willing or able to show you what they’re interested in.
For people with disabilities, “what do you like?” can be a deeply intimate personal question. It can be very dangerous to let people know what you are interested in.
Autistic people (and others with intellectual and developmental disabilities) are often subjected to intense behavior modification. This is often aimed at silencing them, getting them to pretend to be non-autistic, or otherwise change in ways that deny fundamental things about who they are.
In practice, what that often means is that anything a disabled person expresses interest in will be taken away and used as a reinforcer for a behavior plan. The more they care about something, the more their access to it will be contingent with compliance with what powerful people in their life want.
Even if the thing they care about is something like math. Or books. Or access to fresh air. Or their teddy bear.
People subjected to this kind of thing learn quickly that when they express interest in something, it will probably be taken away.
And beyond that, they learn that when people know what you care about, they will use it to manipulate you into doing awful things to yourself. In many cases, this includes being manipulated into maintaining a grateful affect and praising the therapist.
When people have experienced this type of violation, sharing their interests with anyone is a big risk. Particularly if that person has power over them. Particularly if that person is a member of a professional culture that largely approves of what was done to them. (And if you’re a teacher, therapist, direct support professional, or similar, you have power over them and your professional culture approves of misusing it.)
It’s important to keep in mind that people you work with have every reason to believe that it is dangerous to tell you what they care about. They don’t know what you will do with that information, and have every reason to believe that you will use it against them. (Or that information they give you will get back to people who will do so.) It might take a long time before some people are willing to share their interests. Some people may never trust you. The way you teach and offer support needs to take this into account.
tl;dr It’s important to be aware of the loaded nature of asking disabled people to express interest in things. It’s important to make space to incorporate interests; it’s also important to allow people to keep their interests private.