I recently learned about innatentive-type ADHD and it was like a lightbulb going off. I’m working on getting a formal diagnosis but my doc prescribed Concerta for me and it’s made a huge difference. Nice to know I wasn’t just a lazy smart kid, like I’ve been accused of (and believed myself) throughout my life. Basically every report card I ever got had the same sort of statement ‘Anna is very capable, but needs to pay attention’.
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I wish they’d known about this stuff when I was a kid in the 1970s. The only thing that saved me in elementary school was a couple of teachers who promised that if I could hold my shit together for the day I could have the last 15 minutes of class to get in front of class and tell jokes. They even wrote me into the daily schedule on the chalkboard, but with an asterisks.
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I just muddled through by waiting until the urgency of the upcoming deadlines made me do it. I hated being late and always managed something, sure would have been nice if my brain had let me get started before it became an emergency, I’m sure I would have produced much better results.
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I see you, and what you experienced, and we’re here for you.
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It’s coercive by design, coercion is baked into it from its inception up. It was designed by Ivar Lovaas, who was a student of B.F. Skinner, and inherent to the theory of ABA is that it doesn’t matter what the subject thinks, or their motivation for a particular behaviour, what matters is that the authority figure has decided that the behaviour must be eliminated, and that it is eliminated. Similarly, if a behaviour is required, it doesn’t matter a damn if the subject understands why that behaviour is mandated, just that they do it.
What this results in is the rigorous suppression of self-soothing behaviours: stimming is typically seen as contrary to the goal of “looking normal”, so not only is a stressful intensive regime imposed, but ways of coping with the stress of that regime are banned and punished. Which not only increases stress, but removes any outlet for managing it.
What this results in is children being taught to stare into people’s eyes, being taught to go up to strangers and say “Hello, my name is $name, how are you?”, without understanding why they’re doing it or when it’s appropriate or not.
What this results in is children being systematically trained that it’s not permissible to say “no” to an adult. With all that that implies.
When it’s backed off on, when the trainer (knowingly or not) gives the finger to Lovaas’s theoretical underpinning and applies human empathy to their task, then this form of “ABA” is basically an intensive training regime, and sometimes training in how to perform rituals and how to self-manage and that sort of thing is exactly what’s needed.
The trouble is, the instant you care about what’s going on inside the head of the subject, it’s not ABA any more. Many of the people who defend ABA (“That’s not how we do it!”) aren’t actually implementing ABA. And some of the success stories are 1) anecdotes, not data, 2) we’ve stopped this one severely autistic non-verbal kid from headbanging and self harm. Pay no attention to the dozens or hundreds of verbal, less severely affected kids who now have PTSD and lifelong trauma, and 3) was there another way to have achieved this result, without the trauma? No. No there was not. This study that we did where we asked ourselves whether our “treatments” work conclusively proves that our “treatments” work slightly better than actually we don’t have any examples of anything else we tried, including control groups, but just trust us OK?
The explicit goal of ABA is to approach “normal” behaviour. The trouble is, while the best practitioners say that they’re merely trying to erase maladaptive behaviour, when the point of the process is that the internal state of the subject is irrelevant, then it’s impossible to tell the difference between adaptive and maladaptive, and it wouldn’t be relevant if it were.
So ABA evangelists do goalpost shifting: they defend the process because of self-harm, but what they most often achieve is Quiet Hands.
Also, in a final aside because it’s veering into the genetic fallacy, Ivar Lovaas’s original method included yelling at and hitting autistic children, but that’s OK because as he once explicitly said in an interview: autistic children aren’t people, they’re just person-shaped:
“You see, you start pretty much from scratch when you work with an autistic child. You have a person in the physical sense – they have hair, a nose and a mouth – but they are not people in the psychological sense. One way to look at the job of helping autistic kids is to see it as a matter of constructing a person. You have the raw materials, but you have to build the person.”
Also, he proposed that ABA would be useful for Gay Conversion “Therapy”, tried it out, and wrote a paper on the experience. Also, in his experiments with aversives, he tried electric shocks and strapping devices to children to apply shocks. He gave up the process (not because it was inherently cruel and wrong, but because “they got used to it” and it stopped working — or as Deadpool said, “Here’s the problem with round-the-clock torture, is that you can’t really step it up from there.”), but Matthew Israel took that idea and ran with it at the Judge Rotenberg Center (for torturing disabled children). Which is still, I should point out, strapping tasers to disabled children today.
TL;DR: ABA done “correctly” has nothing to do with therapy, but is a means to train compliance through an intensive regime of operant conditioning. ABA done sensitively with concern for the inner well-being and understanding of the subject isn’t ABA any more.
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I was just a weird kid (hi, @AnnaTheWeird and the others at the weird kids table!) because in the 60s and 70s there were no words for what I was. When I was in kindergarten, before going to Catholic school, my mother took me to the doctor to find out why I couldn’t sit still. His diagnosis? “She’s just hyper. She’ll have to learn to sit still.” (That statement stays with me to this day; I can hear Dr. Lerch’s voice in my head.) To this day, thanks to the training (conditioning?) of rigorous Catholic nuns, I can sit Perfectly Still if I fold my hands and keep my knees and ankles together.
When I was an adult and kids were getting diagnosed with ADD, ADHD, autism, and all the neurodivirgent things, I went to the Internet, which told me that duh, of course, I’m not neurotypical, that’s been obvious since toddler days. I haven’t been officially diagnosed with anything, although I have been managing my ADHD with caffeine for decades (we’ll ignore the few years I “managed” it with speed or cocaine), knowing since teen years that drinking a Coke or coffee calmed me down and let me focus better.
Knowing about the autism spectrum disorders (I’m unsure of the currently correct terminology) explained So Much. Apparently masking was what they called how I got thru life. Good to know there’s a name for it, huh? And a reason? So I really am a Weird Kid.
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Ha, yeah, I thought it was weird that Red Bull calms me down, and can put me to sleep, and that a coke or a cup of coffee made me calmer.
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Books books books.
Here are a few more, that may be relevant / helpful. We like 'em.
[edited: tyop]
“Autism in Heels - The Untold Story of a Female Life on the Spectrum” by Jennifer Cook O’Toole
“The Asperkid’s Secret Book of Social Rules” by Jennifer Cook O’Toole (again)
“The Asperkid’s Launch Pad” by Jennifer Cook O’Toole (yes! She’s driven!)
“A Different Sort of Normal” by Abigail Balfe
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So, on Friday the Australian Senate Inquiry into Autism tabled its report.
(Full disclosure, I wrote Submission 143, and am name-checked in another.)
This has received exactly no media attention whatsoever.
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Just for the record: as with all spectrum conditions, there is a great variability and variety of reactions to stimulants. So if anyone does not react “paradoxically” to stimulants, this doesn’t mean that they aren’t on an AD(H)S spectrum. Likewise, if someone does react “paradoxically”, this is just a possible indication to look at other traits and circumstances (refraining from the word symptoms here on purpose, and also refraining from writing looking for).
I guess I just want to say: be careful with self-diagnosis, and challenge the beliefs of yourself and beliefs of others on psychological states, conditions, syndromes and whatnot.
What helps me the most is searching for exchanges with people who are, in a way, kindred spirits - but also to be sceptical about everyone and everything, including myself. It’s not the most convenient thing, but it helps me to define myself newly every now and then.
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Definitely agree. Being married to a therapist helped me to frame all of it.
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I couldn’t recommend her two TV specials on Netflix more highly!
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As someone who can speak a couple…
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Damn, paywalled.
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Damn.
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Wow. Thanks. I really wonder what would happen to him if he would go to West Africa.
Could we get him a scholarship just for learning dying languages?
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Fairly small RR (1.01-1.05) makes me wonder about the “why” on this. Behavioral or SES differences, perhaps? I suspect something more along these lines than biological causes, but certainly clinically applicable data.
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Framing is a thing.
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