How to Spot a Good– or Bad– Therapist for Your Autistic Child6 min read

Editor’s note: Heather is a non-autistic neurodivergent ally to autistic people who has been working as an autistic ally for many years.

The best advisors for your Autistic child are autistic adults.

One thing that may confuse you, however, is their intense dislike of ABA therapy, which stands for applied behavior analysis– something which may have been heavily recommended to you for your child.

Chances are after a diagnosis, your child will be recommended for some kind of therapy.  With all the confusion, which ones are safe and will help, and which ones are harmful?  Who should you listen to?

A few things I have discovered in my advocacy work: it’s not always as simple as just saying, “ABA is bad and speech therapy and occupational therapy are good.”  Here are the reasons:

  1. Some therapists who don’t bill as ABA use ABA
  2. Some ABA therapists are simply called “ABA” for insurance purposes

There are many other points we could consider, but lets get down to the main point:

What aspects of therapy are wrong?

Please watch this video with transcript.

Please print out that transcript and make sure you don’t witness these therapy methods, or make sure they aren’t included in your child’s therapy plan.  Printable transcript available for download or printing by clicking here.

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How do you know if your autistic child’s therapy is harmful?

Bad therapy can be abusive and has far reaching consequences like increased anxiety, depression, and PTSD in later life.

What does the therapist hope your child will achieve with them?  What are they aiming to do?

Cure them?
Heal them?
Reduce their autism symptoms or make them less autistic?

If so then please keep your child away from them.

If their goals are to help your child thrive as their autistic selves, to help them learn to successfully navigate a world they’re not built for, without betraying their nature-– they’re worth keeping.

What are the warning signs of a harmful therapist?  What can you see in your child’s plan that might signal danger?

___ How about forcing or encouraging increased eye contact?

Eye contact can be painful for autistic kids, can make it more difficult to listen and divert their attention.

___ Do they use the phrase “quiet hands” – stopping your child from stimming, which is vital for the regulation of their thoughts and feelings?

___ Is the term “extinction burst” used to describe your child’s emotional reaction to being forced to do something that feels wrong for them?

___ Do they listen to your child’s pleas to stop when it gets too much for them?

___ Do they treat meltdowns as if they were just tantrums?

___ Do they think sensory needs should be combated or overcome, rather than respected?

___ Is pushing your child to achieve results more important to them than preventing sensory overload?

___ Do they understand the need for sensory breaks?

___ Has your child’s behaviour ever been described as “attention-seeking”?

___ Do they use “planned ignoring” as a teaching tool despite the distress being ignored can cause anyone, especially a child?

___ Is the way your child chooses to play a problem to them?  Are words like “inappropriate” used about the way they play – as if playing wasn’t just playing?

___ Do they push your child repetitively to play “their way” without investigating their cognitive level or abilities?

___Do you see words like “dysfunctional” or “non-functional” in their reports or sales pitch?

___ Do they insist on speech as being the ONLY acceptable way to communicate?

___ Do they use sweets, treats, or privileges as tools to bribe your child into compliance?

___Is your child’s autonomy and right to self-determination respected the way you would?

Ask yourself these questions, and if you don’t like the answers, this therapist will not help your child to grow.  In fact they may lock them into a cycle of stress and self-loathing that never ends.

Beware of therapists that describe themselves as using “the gold standard” of service and techniques.  Steer clear of those who address lack of progress by pushing extra hours of therapy.

Always be ready to act if you see any of these signs.  Your child’s future is your responsibility and yours alone.  Don’t let false promises and slick sales techniques convince you that YOU aren’t in charge.

So what makes a GOOD therapist?

Some ABA proponents would say autistic adults advocate against any therapy, but this is completely untrue.  There are many excellent therapists who help Autistic kids every day.

Good therapists help children with finding ways to communicate, fostering independence without pushing too hard, understanding sensory issues, self-advocacy, learning to jump or ride a bike, understanding how to assess people and situations for danger, processing emotions in a way that is self-validating, and learning many new things the child desires to enhance their life.

These therapists can be amazing.

So how can we spot these people?

Please watch this video:

Please print out the transcript and use it to help you assess your child’s therapist or potential therapist.  There are many providers like thisfind one who is like this for your child.  You can find a printer-friendly version of this checklist for printing or downloading by clicking here.

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How to spot a good therapist for your autistic child

__ First things first, there is no “autism therapy”

__ Every autistic person has different needs.

__ Good therapy builds on a child’s intrinsic motivation to learn and connect with others.

__ Has no expectations or aims for eye contact.

__ Happily accepts your child’s harmless stimming

__ Respects your child’s choice of communication – sign language, AAC, other…

__ A good therapist respects bodily autonomy

__ Good therapy addresses root causes anxiety, sensory, cognitive)

__ The therapist talks about profiling and supporting sensory needs as these are so common.

__ Good therapy focuses on the child’s emotional well-being.

__ A good therapist respects a child’s limits and encourages self-advocacy, even when a child communicates, “No”.

__ A good therapist will not rely on motivating through extrinsic rewards and punishments.

__ Connection is made without rewards, treats, or conditional access to special interests.

__ When the child shows signs of distress, they are validated and unconditionally allowed to stop/avoid/access safe space – rather than pushing them through it or seeking compliance.

– A good therapist is kind, and trusts that a child is doing their best

– unconditionally reduces demands when the child shows any sign of distress, however communicated.

– The therapist is transitional, empowering parents and carers to support in the day to day.

– A good therapist shows warmth and kindness at all times.

– and is keen to learn from Autistic Adults.

– A therapist like this, your child will thrive.

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For more information on why ABA is harmful please read these links:

Invisible abuse : ABA and  the things only autistic people can see

Appearing to enjoy behavioral modification is not meaningful

Is ABA really dog training for children?  A professional dog trainer weighs in

If you have any questions, please join these Facebook groups:

Autistic Allies

The Aspergian has an article for that

And pages:

ABA controversy discussion page

Better Ways than ABA

Finally I would like to thank Autistamatic for volunteering to make the spectacular video and for all the parents, experts, and autistics who contributed at each stage of making this post.  Please take a moment to follow Autistamatic’s YouTube by clicking here and hitting the red “Subscribe” button.

2 Comments

  1. whether i’m autistic is debatable (fwiw, at least one ex-therapist thinks i am and i’m formally diagnosed as neurodivergent) but H*LL F*CkING YES to “therapists should not attempt to force eye contact”.  i hate trying, because if it’s more than briefly i feel like i’m violating that person’s boundaries, and that is an intensely revolting experience for me as a full-grown adult.

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