Experiences of autistic individuals, caregivers and healthcare providers with ABA-derived therapies: a sequential exploratory mixed methods study

Purpose: Applied Behavior Analysis (ABA) is a widely recommended intervention for autistic children, but it has recently been criticized because of its potential negative effects on mental health. This study aims to map experiences with ABA and related techniques in the Netherlands by investigating different types of ABA interventions, experiences and satisfaction levels, and explores variations across techniques and stakeholders.

Methods: An exploratory sequential mixed methods design was employed, beginning with qualitative focus groups (n=22) followed by a quantitative online survey (n=219). Participants included autistic adults, parents/legal representatives, and healthcare professionals.

Results: Focus groups revealed six main themes: diverse interpretations of ABA, variations in its application, positive experiences, concerns about overburdening and psychological impacts, criticisms of the healthcare system, and quality control issues. Survey results indicated that satisfaction with ABA interventions varied, with autistic adults being less satisfied than parents and healthcare professionals. Positive outcomes included improved communication and independence, while negative experiences involved trauma and concerns about ethical application. Better quality interventions were associated with higher satisfaction levels.

Conclusion: The study reveals diverse experiences and interpretations of ABA. Participants raised significant concerns that merit attention alongside the noted benefits of ABA. Improving training and ensuring ethical practices are crucial to maximize ABA’s potential to positively impact the lives of autistic individuals. Future efforts should focus on enhancing regulation, standardization, and incorporating autistic perspectives to optimize outcomes.