The most important considerations in this effort to contain costs while assuring access to appropriate services are the appropriateness of this service, the concerns expressed by adults who received this service, and what is lost when hours and hours are spent in therapy that is based on rewards and consequences without sufficient attention to what is happening in the nervous system. While ABA continues to be promoted as evidence-based, the original research does not meet today’s criteria. Most of the research is generated by the industry itself. However, other research paints a different picture.

• Regarding effectiveness:  the TRICARE study regarding ABA: https://therapistndc.org/aba-is-not-effective-so-says-the-latest-report-from-the-department-of-defense/  Here is a follow-up to concerns expressed by the ABA industry to that report:  https://therapistndc.org/rebuttal-to-critique-of-dod-aba-report/
• Evidence of Increased PTSD Symptoms in Autistics Exposed to Applied Behavior Analysis: https://www.emerald.com/aia/article-abstract/4/1/19/39360/Evidence-of-increased-PTSD-symptoms-in-autistics?redirectedFrom=fulltext
• Mental health outcomes associated with applied behavior analysis in a US national sample of privately insured autistic youth: https://journals.sagepub.com/doi/10.1177/13623613251390604

• In a 2022 survey of 11, 212 (7491 who were autistic), nearly 90% of autistic people (and almost 60% of non-autistic professionals) disagreed with the use of ABA on autistic children, (almost 80% and over 40% respectively disagreeing strongly). https://autisticnotweird.com/autismsurvey/#aba

• A Preliminary Investigation into the Presence of Woozles in Applied Behavior-Analytic Publications  https://repository.stcloudstate.edu/items/b6006788-0072-41af-a3f5-eee13b08ecd8
• The Gold Standard Fallacy of ABA: A Reference Guide for Therapists, Educators, & Parents, by Julie Roberts (Available on Amazon and elsewhere)
• The Autism Industrial Complex: How Branding, Marketing, and Capital Investment Turned Autism into Big Business, by Alicia A. Broderick

ABA ignores the extensive body of research and experience about behaviors that are not chosen, that is, behaviors in response to unconscious stimuli that trigger automatic protective responses (fight, flight, freeze, for example), as well as the impact of nervous system state.

Hours spent in “therapy” (often provided by individuals with only forty clock hours of training) are hours that are not available for everyday learning activities, for neuro-affirming therapies including Occupational Therapy, Speech and Language Therapy, and Augmentative and Assistive Communication Services.