Cara Santamaria

So the idea is

In applied behavior analysis, children with autism are taught to do things like stop stimming or to engage in specific behaviors in order to fit in within the classroom environment, in order to reduce what are seen as, quote, problematic behaviors in public.

And while sometimes it can be a godsend for families who are really struggling with certain difficult behaviors...

The compliance component of it, a lot of individuals who obviously are advocates for neurodiversity movements are like, what's wrong with my kids stimming?

The field itself, ABA, is actually evolving.

It more focuses on independence and, you know, happiness rather than complying with what is publicly deemed as, quote, appropriate behavior.

That's not really what we're talking about, but that's the foundation of what happens in these therapy clinics.

Yeah, I mean, I was about to, like, just rip it a new one, but then I looked and I was like, every major organization does say it's an evidence-based treatment.

And also, like, how do you define?

I mean, there's a lot of problems with something.

It's like, on the one hand, Steve, like, how do you define whether something like this works?

On the other hand, you can't blind something like... So there are certain things where the evidence may not be as strong as we would like, but there's also... I worry that ABA falls in the camp like a lot of what I do, which is existential psychotherapy, where it's just, it's not as easy to do it.

Yes.

And that's true.

The stakes are very, very high, especially because when I think about what I do in more existential orientations towards therapy, I'm often working with older adults.

I'm working in end of life settings and it's all about dignity and meaning and purpose.

And, you know, very often what we hear from patients is I this helps.

I feel better.

Whereas with children, especially children who are maybe more severe on an autism spectrum, they may not be able to communicate if they're in distress or if something is not helping.

Absolutely.