Wednesday, October 15, 2014

A seven year inquiry into Applied Behavior Analysis (ABA) finds ethics problems of massive proportions.

[Edit note: I retain this post. It called ABA science. At this date, around October 2014, after having believed Skinner and his followers, naïvely for seven blind years that they could be ethical if only they followed Skinner's warnings against punishment. Eventually I came to see the hypocrite in each of them, especially Skinner, when in 2017 we see for certain that Skinner only opposed punitive coercion to whom he called "normal" people. The others were "beyond" the reach of reinforcers only. I retain this post for historical and developmental purposes over the development of my findings, from blinded by the misrepresentations, subtle and obvious, out from the cave of darkness where the light to #NoABA, other ways instead, shines big and bright.]

This web log is about the ethics of behavior modification, a topic which includes issues pertinent to the professional practice of the science of human behavior known as Applied Behavior Analysis (ABA). After seven years of investigation into the science and ethics of ABA, as of today, this blogger is prepared to present all his general conclusions to date. Most of them are contained within the body of this paper.

Some Science of ABA

First of all, in a nutshell, ABA is largely all about adding and removing various "schedules" of rewards and punishments contingent upon the emission of "target behaviors" in order to develop certain desirable behaviors in others or in one's self and in order to prevent or reduce certain "problem behaviors." Board Certified Behavior Analysts (BCBAs) know how to increase and decrease the frequency of occurrence of the specific behaviors they intend to modify. They also know how to extinguish behaviors, to make them disappear almost completely from the overall behavioral repertoires of human and non-human "organisms" alike. (See Pierce and Cheney, 2004.)

To their credit, they have discovered the alternatives to punishment. As though magicians cleverly twisting their positive techniques, they can make problem behaviors vanish into thin air while sparing the rod completely. BCBAs reinforce not-behaving ("badly"), they reward incompatible behaviors that cannot happen at the same time and place as unwanted behaviors, and they shape lower and lower rates of responding of the behaviors they are hired by parents and schools and paid by insurance companies to reduce. They establish positive instructional control by telling children to do something rewarding that they are already inclined to do and then later, when they teach them a skill that may tax them somewhat, they break it down into less taxing chunks, and rely on the pattern of instructional compliance previously habituated through positives to teach these kids some valuable skills, skills they otherwise may have escaped and avoided were they not broken down into smaller, reinforceable steps. Under all these positive conditions and contingencies, students may not try to avoid or escape some difficult demands, because the consent of the child or incapacitated adult can be automatic under total reinforcement, especially when deprivation of a basic need, such as a meal, is not manipulated in a preliminary manner in order to strengthen the reinforcement value of pieces of food given by the analysts to strengthen a desired target behavior, such as manipulating fractions, for example. So punishment and noncompliance are non-issues when punishment is not involved. (For a book on the alternatives to punishment, see Lavigna and Donnellan, 1986.)

Behaviorists may punish children or incapacitated adults when they don't have enough positive methods or know-how to its alternatives at their disposal. They have invented a device called The Self-Injurious Behavior Inhibiting System (SIBIS) which detects blows to the head and administers electric shock contingent upon a person's head-blowing behavior. (See Iwata, 1988.) They may also reinforce substitute behaviors while punishing challenging problem behaviors. If SIBIS was deemed necessary, it would be appropriate to reinforce standing hands-busy activities in the center of a room, with the head away from a wall or the floor, such as rolling a knee-high ball with a therapist or peer.

When their work is ethically scrutinized, however, one can say that if and when punishment and coercion is temporarily "effective" and absolutely unavoidable, if it does prevent, diminish, or eliminate rates of seriously harmful behavior, then the work of the analysts should never be considered finished until they find a positive alternative that works and fade the dependence upon any punitive techniques down to nothing. Until zero punishment has been achieved, they need to go back to the drawing board and try and try again until they do. These ideas are expanded in the ethics section below.

The Reputation and Promise of ABA

ABA has a bad public rap, however. Some of its reputation is warranted and most of it isn't. ABA is powerful. Power corrupts. The practice in the field can easily cross the line between helping and harming.

This blogger, among other bloggers (See Dawson, 2006-2012.), hopes ABA professionals will become more ethical so the public will more readily accept their work, so that then we can move on to heal the world with more broad-scale applications of human science, which would hold merit, of course, only when they're ethical.

Since behavior analysts are good at changing the behaviors of people with less power, this blog challenges them to accept some modification of their own behaviors. Many of them appreciate ethical inquiry, but ethics is a loaded topic and nobody wants to be told their work is unethical, but what they dish out to others, behavior modification, to be precise, they should be able to take in stride whenever they're treated with a healthy dose of their own medicine. A bitter pill is hard to swallow, but medicine is meant to heal.

I firmly believe that the environmental movement would benefit immensely if environmental activists used ABA to teach people how to reduce their carbon footprints by stressing the immediate money savings quality of conservation and by lightening up on their constant bombardment in the public media of so may doom and gloom scenarios way off in a distant, yet imminent future. B.F. Skinner, the chief behaviorist in its early years, spoke about the need for immediacy for reinforcement to work.

Not only green groups, but nonprofits of all stripes and colors would better accomplish their aims if they stressed mass amounts of positive reinforcement of politicians who do the right thing, rather than making so many demands, by email, phone calls, faxes, petitions, picketing, and lying down on the ground so nobody can pick them up. Communicating their desires is not the problem, but the scarcity of praise when the desires have been met demonstrates a lack of psychological understanding on the part of the activists. The Koch brothers, on the other hand,  seem to know very well the behavioral strategy of rewarding friend in office, but with them it's not so much mobilizing the public to send thanks, it's about rewarding them with money. The activists, therefore, ignore behaviorism to their own peril. I have no doubt that an intense collaboration among nonprofits and behavior analysts would stem the tide of global warming, but this will not happen if the ABA profession-at-large does not improve its ethics.

Furthermore, the biggest promise of behaviorism is to stem the tide of punishment run amok in the world. Behaviorism, has offered the best solution, scientific analyses of human behavior without the noisy appeals for punishment and retaliation so common among all sides of a dispute. In a world without punishment, there would be no place in the USA or any other nation for a militarized police force.

More About Behavioral Ethics

Science tells BCBAs how to change human behavior, but only ethical analyses can prescribe which behaviors ought to change, so ABA need ethics if we should value it as worthwhile. BCBA training does include courses in ethics, but ABA in practice has a good share of ethical problems.

Since its inception in 1968, their flagship "Journal of Applied Behavior Analysis" (JABA) has been identifying "problems of social importance" as targets for change. So while gay pride marches in New York City first began to commemorate the 1969 Stonewall Riot that sparked the modern gay pride movement, some JABA articles were simultaneously labeling gay sexual activity as aberrant. Gay liberation struggled long and hard to eventually convince the social sciences to remove homosexuality from their lists of "disorders."

ABA today targets for reduction certain autistic behaviors. Indeed, ABA "treatment" of autism has spawned into an industry. Many autistic behaviors such as body-rocking and hand-flapping cause no physical harm to people or property, but parents will pay BCBA's to squelch these behaviors because they worry they won't "fit in" with their peers.

Meanwhile, communities of autistic adults are comparing ABA's history with gays to the current events involving the modification of autistic children's behaviors. The leaders are saying, "Don't try to change us. Changing us hurts us. We are not a disease. We are proud of our autistic identity. Just change society so they accept us and embrace us for the atypical people we happen to be." "Neurodiversity" advocates bear witness to the birth of a new movement.

What behavioralists call the "problem" of self-stimulating stereotypy (such as hand-flapping) and strive to eliminate ("quiet hands," they may say), the autistic leaders describe hand-flapping as much needed communication of less verbal people. Hand-flapping is a harmless atypical behavior unfairly targeted for modification by the dominant neurotypical population. It has been likened to a behavioral variety of eugenics, the attempted elimination of a disabled population.

Furthermore, young autistic children are virtually powerless on their own to stop behavior change plans once they're set into motion. Theoretically, the Behavior Analyst Certification Board (BACB) does recommend that their BCBAs seek the dual consent of both the parent or guardian and the child or incapacitated adult when they implement steps toward behavioral "control," as B. F. Skinner called it. During practice, however, as their published studies of experiments taking place in applied settings seem to indicate, they have not been commonly known to grant the recipients of their treatments, when they are children or incapacitated adults, the power to dissent from punishment when their surrogate decision makers had already signed legally-written informed consent documents. In practice, child study teams may give these behavioral mod recipients a seat at the table during behavior plan meetings and they may "cooperate" there out of fear of reprisals, not knowing what they're getting themselves into, but under the terms of informed consent, it looks like young children and incapacitated adults have no authority to object to legally approved behavior change plans, especially when their parent advocates are not watching the actual interventions unfold.

BCBAs may say they are looking out for the "welfare" of the children when they punish them or reward them and they may emphasize a predominance of skills training under positively reinforcing contingencies, but the denial of a person's dissent when punishment does occur obstructs her or his free exercise of the right to self-determination, the natural, equitable right to autonomy that everybody shares, regardless of age or cognitive ability. Even when they do consider the best-interest of the child, well-meaning parents and analysts can and do make harmful mistakes. They may assess their preferences to see what the children like to do or receive as rewards, but if they listened more to their objections during punishment procedures, some serious problems could be prevented.

So taking us beyond the ABA-profession's notion that they are protecting the welfare of the child when they punish some "problem" behaviors, it can be argued that the autonomy of the child is vital to the best-interest of the child and the exercise of one right should not block the other, so then the dual consent of the parent and child, therefore, would be necessary, a balance of the right to autonomy with the right to have one's interest protected. Children should have an enforceable power to say, "Leave me alone!" But it looks as though they don't.

To illustrate the ABA paucity of a parent and child partnership of consent, consider the most egregious case known in the press, where the staff at the Judge Rotenberg Center (JRC), near Boston, MA, presents painful electric skin shock to autistic children and others soon after they "emit" behaviors as mild and harmless as not doing as they're told. When it was presented in a lawsuit against JRC, Fox News recorded the videotape evidence of JRC employees restraining a disabled boy face down upon a board and shocking him while he was "screaming for help." Warning: the footage is graphic. JRC shocked him 31 times that day. Fox News said they shocked him for "refusing to take off his coat." JRC called it "treatment." The boy's mother called it terror and abuse. She said to Fox News that when she signed him into the school, she "had no idea, no idea, that they tortured the children in the school." Fox News said she had testified to the jury about watching the video and hearing staff members laughing while her son was on the floor. "She got him to the hospital that day where he was diagnosed with acute stress response caused by the shocks." She told Fox news she tried to turn his head that day but it only stayed straight. When she waived her hand in front of his face, his eyes didn't blink.

The United Nations said the JRC violated the rights of these children under their Convention Against Torture. The Food and Drug Administration is currently deliberating on its upcoming decision on whether or not to ban JRC's patented Contingent Skin Shock (CSS) devices. The issue is still reoccurring in the mainstream media.

JRC promoters and ABA dissemination experts have claims in the media that JRC protects the children from harming themselves and others by shocking some severe internally and externally directed forms of aggression. They are misleading the public with incomplete information when they do. It is less well known that the school will also shock their children for creating a classroom disturbance or for refusing to obey orders.

Have Dr. Matthew Israel, the founder of JRC, their governing board, and their staff ever subjected themselves to the identical shock they are using on their children. This would include being tied to a board by people with more power who are laughing at you when they let you stand and you fall down to the ground while they're shocking your skin with the same intensity they have already used on their children, after they told you to take off your coat, but you refused to do it knowing your coat-less body would make it easier for them to shock you again and again, so they shocked you for disobeying this command, as one more shock out of a total of 31 shocks in one day, rendering you into a completely stress-induced zombie.

The Golden Rule of Ethics (empathy) requires us to do unto others as we'd have them do unto us. Therefore, any of the JRC members or supporters as listed above who do not voluntarily submit themselves precisely to this specific contingency cannot legitimately describe their job as highly ethical. Without experiencing the shock they administer, they cannot empathize directly with their students, so they are less capable of following the Golden Rule if they don't know how if feels to get the treatment.

Most unfortunately for the children, but also for the reputation of the professional community of behavior analysts, the Ass. for Behavior Analysis International (ABAI) gives JRC leaders an audience of their peers when they present and defend their "aversive therapy" at ABAI convention "symposiums." Critics of ABA hit them hard with legitimate arguments, especially regarding their ties with JRC. Obviously, their reputation suffers, yet they continue to support JRC or try to ignore the JRC controversy. Their journals don't report it. It is quite unfathomable to this blogger why all the ABA professional membership organizations don't issue public statements about the harmful nature of painful electric skin shock contingent upon "noncompliance," as the JRC leaders proudly described to their ABAI audience at the 2009 Phoenix Convention.

Here's a clue to a possible answer. CQ Weekly reported that in March alone of 2010, JRC paid "the lobbyist, Edward D. Krenik of Bracewell and Giuliani, an EPA liaison to Congress in the Bush administration," $20,000 to "persuade senators to provide an exemption — in legislation that would deny federal funding to schools that physically restrain students — for the court-approved electric shocks that the Judge Rotenberg Center uses with some of its students." (Zeller, 2010) When there's a problem, it pays to follow the money. So to what extend does JRC lobby the ABAI?

The Future of ABA

To conclude the conclusions of this long-term investigation, ABA is ethical, in general, to a degree, but it has much need for improvement. It is vulnerable to other solid criticisms not mentioned above, such as the threat of its enormous potential falling into the wrong hands of authoritarian rulers. If the profession would publicly tackle its lingering deficiencies and build further upon its strengths, its reputation would no doubt improve. Then the world can move on and heal itself through the scientific design of culture, as the founder of their science, B.F. Skinner, had envisioned. This can only happen in a good way, however, when it's extremely well restrained.

If the ABA profession does not want to improve its ethical status, if they would rather fix the autistics than fix society, then society needs to proceed without them and apply the principles of Skinnerian science without the aid of those expert behaviorists whose salaries mainly depend upon the control of autistic behavior.

As my psychologist said to me last week, Joseph Stalin had amassed nearly absolute power over the Soviet Union. Among his many atrocities, his followers executed about 250,000 people of foreign ethnicities. (From Wikipedia, Joseph Stalin, Purges and Deportations referencing Montefiore (2004).) While Stalin was corrupting the theories of Marx, French intellectuals on the left, supporters of communism such as the existentialist philosopher Jean Paul Sartre, did not break away from Soviet ideology. So what will become of B.F. Skinner's teachings on behaviorism, my doctor wondered, if most of its own leading intellectuals refuse to denounce the JRC?*

The public is well aware of the JRC reports in the mainstream media. In the name of their science, for the sake of the children, and for goodness sake, the public would like to know: why don't the behavior analyst organizations stop the activities of the governing board member of the Judge Rotenberg Center? Is it because of their leadership roles in the community? Is it because of the Rotenberg money? Or is it a profession-wide malady of the community-at-large? How are they supposed to help fix the world with this kind of reputation?

Post Script

As a post script here, the most viewed essay in this blog describes at length how parents, teachers, and BCBAs can obtain the dual consent of the recipients of their behavior change programs along with their parents or legal guardians, if they are not already free and independent as adults.


* October 16, 2014 Google Scholar searches of the exact phrase: "Judge Rotenberg Center" in leading ABA journals returned no articles. Searches included the Behavior Analysts, published by ABAI, JABA, published by Society for the Experimental Analysis of Behavior, and Behavior and Philosophy, by the Cambridge Center for Behavioral Studies, Behavior Analysis Digest, Behavior Analyst Online, etc.

Reference List 

Zeller, Shawn. "Client of the Month: The Judge Rotenberg Center." CQ Weekly (July 12, 2010): 1675.

Montefiore, Simon Sebag (2004). Stalin: The Court of the Red Tsar. ISBN 0-7538-1766-7

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I am an advocate for people with disabilities certified to teach special education with a Master of Arts in Teaching. I am not a Licensed Psychologist or a Board Certified Behavior Analyst. When in doubt, seek the advice of an MD, a PhD, or a BCBA. My ability to analyze the ethics of ABA stems from the fact that I am disabled and ABA interventions are often done to people like me, which I voluntarily accept, but only when I alone am the person granting consent, and not a parent, sibling, guardian, or institution.