Behaviorism 101: Identifying Autistic, NeuroDivergent, and Other forms of Conversion "Therapy"
ANY behavioral modification program that uses negative & positive reinforcements to manipulate someone into emulating behaviors that are forced and unnatural to them so they can be more palatable.
CONTENT WARNING: This piece discusses themes that may upset some readers (such as Autistic and other NeuroDivergent Conversion "Therapies," manipulation, coercion, and abuse). Reader discretion is advised.
Some people automatically assume when I mention Autistic or NeuroDivergent Conversion Therapies that I'm ALWAYS talking about ABA (or Applied Behavioral Analysis). However, this is inaccurate.
Though ABA is the most common form of NeuroDivergent Conversion Therapy, these "normalization treatments" go by many names. They can even be worked into reputable services (like speech and OT) if providers are ill-informed.
Additionally, because ABA is often one of the only services many insurance providers in the US will pay for, many providers will admit to committing insurance fraud by billing things on insurance as ABA (that are NOT ABA) to get those services covered by insurance.
I understand that these practitioners are doing what they think is best to help people gain access to services they wouldn't be able to access otherwise, but I am frustrated at the harm and confusion their "mis-billing" causes in the process.
While the kids may be befitting from accessing services that are not ABA (but billed as such to get around the rules and limitations on hours for speech, OT, and other services), their parents see the growth and think the young person is benefitting from ABA.
When providers do this and fail to tell clients they are NOT REALLY getting ABA, they create new "followers" of ABA (who will excitedly go into the world and sing the praises of ABA to everyone they know), even if their kid isn't in "real ABA."
The confusion and validity they give to ABA when doing this directly contribute to the harm and spread of ABA and other Autistic Conversion Therapies.
Additionally, tough long-term exposure to ABA has been tied to increased rates of PTSD in Autistics who were exposed to it and studies have shown that that it doest NOT to do what ABA providers claim it will. For example, the Department of Defense reported to Congress on Oct 25, 2019, that “after one year of ABA treatment, 76% of those with Autism had no change in symptoms AND 9% WORSENED by more than one standard deviation.”
Despite the evidence of its inefficacy and the potential for harm and trauma, these Conversion “Therapies” are big business and are still widely recommended (sometimes forced) upon NeuroDivergent People and their families.
What IS Conversion Therapy?
I consider "Conversion Therapy" to be ANY behavioral modification program that uses negative and positive reinforcements to coerce and manipulate someone into emulating behaviors that are forced and unnatural to them to make the person blend in and appear more "socially acceptable" (whether for Queer, NeuroDivergent, or any other type of behavior that is not considered the "social norm").
In Trans People, this could be the use of punishments and rewards to shape "desired behaviors" that enforce the gender norms that align gender we were assigned at birth.
In Gay People, Conversion "Therapy" may include forced engagement in heterosexual relationships and punishments for displaying "Queer behavior" or attraction to people of the same gender.
NeuroDivergent Conversion "Therapies" pressure NeuroDivergent People into emulating NeuroTypicals through positive reinforcement (rewards) for the display of "NeuroTypical" behaviors and punishments or aversives for expressing themselves in a NeuroDivergent way, putting the needs of NeuroTypicals before the needs of the NeuroDivergent Person (often at the expense of the ND person's needs and health).
All of these Conversion "Therapies" pressure People (Queer/NeuroDivergent or both) into emulating people who are unlike them through positive reinforcement (rewards) for the display of "socially acceptable" behaviors and punishments (or aversives) for showing behaviors that are NOT "socially acceptable."
Conversion "Therapy" has become less favorable for Queer and Trans People since being Queer is no longer considered a medical condition and is even illegal in many parts of the world today.
Because these therapies can go by many names, it is crucial to learn how to recognize them (regardless of what they are called).
How do I know if "therapy" is based on or using behaviorism?
Behaviorists evaluate human and other animal behaviors, separating them into two categories:
"Desirable" behaviors
"Undesirable" behaviors.
In a faulty black-and-white way of thinking, Behaviorists divide all behaviors into the categories of "good" or "bad," so "desired behaviors" can be encouraged and "undesired behaviors" can be discouraged (through an individually tailored program of reinforcements and punishments).
Reinforcements and Punishments Used in Modern Human Behaviorism (and OLD World Animal Behaviorism)
Positive Reinforcement is Desired behavior followed by a Treat/Reward = MORE of the desired Behavior.
Negative reinforcement occurs when something unpleasant or uncomfortable is removed to increase a desired behavior (to avoid feelings of discomfort). With Negative Reinforcement, a person or aminal is exposed to an unpleasant situation or stimulus that is ONLY terminated when "undesired behavior" stops or "desired behavior" starts.
Positive Punishment would be when an Undesired Behavior is followed by a consequence or Punishment in hopes of discouraging the undesired behavior from occurring in the future.
Negative Punishment is when one removes a pleasant stimulus to decrease an undesired behavior. In animals and children, this can be taking away, withdrawing, or withholding toys, activities, love, and affection when the animal or child misbehaves (this can create a stress response greater than that of someone who's being Negatively Reinforced).
Animal Behavoirsm is Kinder than Human Behavior
These techniques were first developed and tested on animals, then later adapted for humans. Still, in many ways, today's Animal Behaviorism has become kinder and gentler than the behavior modification methods used with humans today.
In addition to being an undiagnosed NeuroDivergent Person who experienced the trauma of having my NeuroDivergence treated "behaviorally" thanks to being put on a "behavioral plan" for my undiscovered Autism and ADHD at school, I am ALSO a former Animal Behaviorist. I’ve worked with dogs, cats, horses, lizards, frogs, and even birds and a few wild animals.
For years, the Animal Behaviorism Movement has been a movement toward Positive ONLY Training or Positive Reinforcement Training (R+) (that avoids using punishments and aversives altogether).
Behaviorism in humans typically utilizes ALL of the four types of reinforcements and punishments listed above. However, many dog and animal trainers no longer use Negative Reinforcements, Postive Punishments, or Negative Punishments in working with animals, only addressing and supporting Positive Behavior.
While I DO think this is a move in the right direction, these methods are still imperfect in that they are dependent on labeling behaviors as "desirable" or "undesirable," "good," and "bad."
It pains me to see that the treatment of humans is so far behind the treatment of other animals, but it doesn't surprise me.
For example, using shock and prong collars on animals has become less favorable in recent years (and shock collars are even illegal in some countries). However, while using electric shock collars on dogs has become more controversial, disabled youth in America are STILL being zapped with shock collars (worn across their entire bodies) as part of human behavioral modification programs.
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