Same Operant Technology, Updated Packaging

 I just got a question from a parent on "new" or "modern" ABA.  They were told is is not really the ABA they have heard about.  That somehow it is different.  On the ICDL website, we discuss ABA vs. DIR very briefly on one of the webpages.  On that page, we use an example of how DIR and ABA look at eye contact differently.  So, I just took that example and did a research review on ABA research in the last few years on training for eye contact.  Of course, the concept of training for eye contact remains very active in ABA.  Even though there are ethical concerns raised about training for eye contact in recent research, the operant conditioning process continues in full swing.  

Here is a summary with some of the references I found:

Is ABA Still Focusing on Training for Eye Contact?  

ABA and Eye Contact: Recent Evidence Shows It Remains a Targeted Behavior

Despite branding shifts to “modern” or “new” ABA, behavior-analytic interventions continue to explicitly target eye contact / social gaze as a teachable behavior using core ABA procedures (e.g., shaping, prompting, reinforcement, stimulus control). Recent peer-reviewed literature demonstrates this.

Examples of Recent Peer-Reviewed Evidence

Behavior-analytic scoping review on promoting social gaze (2023): Confirms behavioral interventions are effective for social gaze/eye contact and shows it remains a common behavioral target. URL: https://www.sciencedirect.com/science/article/pii/S1750946723000658

Using shaping to teach eye contact to children with autism (2018): Applied shaping and reinforcement to teach preschoolers sustained eye contact with maintenance and generalization. URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC6411557/

App with embedded video modeling to increase eye contact (2023): Mobile app using modeling and reinforcement increased eye contact with familiar and unfamiliar adults. URL: https://journals.sagepub.com/doi/abs/10.1177/10883576221124805

Shaping social eye contact via telehealth (parent-implemented) (2025): Parents, coached remotely, shaped eye contact successfully during naturalistic interaction. URL: https://www.researchgate.net/publication/395882572_Shaping_Social_Eye_Contact_in_Children_With_Autism_Via_Telehealth_A_Parent-Implemented_Intervention

Parent intervention via video modeling (eye contact and joint attention) (2024): Children with ASD/ID improved eye contact and joint attention using graded prompting and reinforcement strategies. URL: https://pubmed.ncbi.nlm.nih.gov/38391746/

What This Shows About 'New ABA'

1. Same operant technology, updated packaging. Across studies, the operative elements are classic ABA (modeling, prompting, shaping, differential reinforcement), now often delivered via apps, telehealth, or parent-implementation—but the behavioral target is still eye contact.

2. Ongoing ethical discussion, not abandonment of the goal. Contemporary behavior analysts debate whether and when to teach eye contact, underscoring that teaching eye contact remains an active ABA topic rather than an obsolete one.

Bottom Line

Recent literature (2018–2025) documents ABA interventions that directly train eye contact/social gaze using standard operant procedures. Claims that 'new ABA' no longer trains discrete social behaviors like eye contact are not supported by the current research record.

Furthermore, the Autistic Self Advocacy Network wrote a while paper centered on ethical practices in autism interventions entitled, For Whose Benefit? Evidence, Ethics, and Effectiveness of Autism Interventions.  On page 18 of the white paper they discuss new ABA.  Here is an excerpt from that section of the paper:

“New ABA” is Still ABA

At ASAN, we have heard from parents who say that ABA as practiced in their family is different from “traditional” ABA – describing interventions that are “holistic,” “play-based,” or “naturalistic,” that focus on communication or life skills rather than on “normalizing” a child’s behaviors, and that take a respectful approach to an autistic child’s existence and needs. This is sometimes termed “new ABA.” It can be hard to determine what is really going on in any given situation. If these practices are indeed ABA, we stress that they are still harmful. We also stress that many practices termed “new ABA” are not, in fact, ABA at all.

Sometimes, parents are describing something that still sounds like ABA, in that the intervention still uses reinforcements to modify . An intervention that, at its core, still uses ABA techniques, is still ABA and still unethical, no matter what other methods it may use. It still carries the same risks of harm, the same lack of acknowledgement of those risks, and the same lack of rigorous supporting evidence. Fundamental modifications of who an autistic person is – or attempts to do so – do not suddenly become acceptable just because the techniques used are less obviously cruel.

A core component of “new ABA” is contrasting its practices with the “old,” torturous practices of Lovaas and his ilk. Leaving aside that Lovaas’s practices are hardly consigned to the past (see the section “The Brutal Beginnings and the Horrific Present”), an intervention being less abusive than a different intervention does not mean that intervention is inherently ethical. Our ethical concerns with ABA go far beyond whether an intervention uses electrical shocks or withholds food to enforce compliance. To again use the metaphor of the rotting hotel, we would still advise others to avoid renting a room there, even if the owners assured us they had repainted and brought the electrical wiring up to code.

ABA that is play-based is still ABA. It is still harmful to try and modify autistic traits or the appearance of autistic behavior, even if it is couched in toys and the appearance of fun. Play-based ABA takes the activities an autistic person enjoys and turns them into ways to attempt to make the person less autistic. For example, if an autistic child collects shoelaces, the ABA therapist might hold a shoelace near the therapist’s eye in order to elicit eye contact. Or, the therapist might do a puzzle with a child, but require the child to look at the therapist and verbally request each piece of the puzzle. While this may seem “nicer” than a traditional discrete trial, the end goal is still to modify the child’s autistic trait. Using play to train a child to appear less autistic also warps the experience of play for the child. We want to stress that we do not believe that all play-based therapy is bad or harmful. We realize that play-based therapies can be incredibly useful, especially for nonspeaking autistic children. But play-based ABA, specifically, is harmful because it is still a form of ABA.

When ABA approaches are used to teach language or speech, we are concerned because the behaviorist approach to language development has been discredited (Chomsky, 1980). ABA approaches to language development, including Verbal Behavior, ignore decades of well-established research on how children, including autistic children and children with significant structural language impairments, learn language (Birner, 2021; Feldman, 2019; Kuhl, 2000). When children appear to gain language in these programs, it is important to understand that this progress is in spite of, not because of, ABA’s outdated and disproven methodology. Autistic children are best supported by a Speech-Language Therapist familiar with best practices for supporting their specific language challenges, including augmentative and alternative communication systems, or AAC.Teaching language via ABA is ineffective and not worth the harm it causes to those subjected to it.

Similarly, there are better ways to teach other core life skills, such as through non-ABA occupational and physical therapies. We once again reference that there are non-autism specific supports that can and do help autistic people build skills and lead more independent and self-directed lives. An autistic person with severe apraxia, for example, could benefit from some of the same occupational and physical therapies, along with the same assistive technology, as apraxic people with other developmental disabilities.. It is also important to remember that just because an autistic person needs a highly individualized or adapted intervention to help them, this does not mean they need ABA. ABA does not have sole claim to individualized or customized therapies and services.

We sometimes hear from parents that their child likes their ABA therapist or assents to an ABA intervention. We would still have concerns in these situations – liking one’s therapist does not make the intervention effective or ethical. Our ethical concerns with ABA (and all other autism therapies and services) do not center around the likeability of the practitioner or whether they can build a rapport with the autistic person.  (ASAN, 2021, p 18-19)

Recent Changes...Worrisome Changes

I just saw a post from John Elder Robison's from a couple months ago.  His genuine sadness touched me and sparked me to share this post.  John Elder Robison was a keynote presenter at an ICDL conference about 10 years ago.  His presentation was one of my favorites.  He is a genuine and caring person.  As I read his Facebook post (below) about the current US government's changes in how it is approaching autism, I felt his genuine sadness.  I share his sadness.  The government should work to do better and it can be good to challenge past ideas and policies.  But this could be done without tearing down years of work, without ignoring existing science, without ignoring the valuable input of autistic advocates, and it could be done without disrespecting autistic people and making them feel "on the outside" like John describes.  

On a related note, ICDL has formally endorsed the joint statement on Upholding Scientific Integrity and Supporting the Autism Community that was developed by organizations like the Autistic Self Advocacy Network, Autism Society, and Autism Speaks.  

 

Finally, ICDL's vision is "A world where individual differences are embraced and everyone achieves their fullest potential".  We very intentionally start this vision statement with the focus on embracing individual differences.  This has to be the starting place.  It would be great if our leaders would start with the same intent.

Understanding Builds Bridges, Reactions Burn Them

 

 I am at the American Mental Health Counseling Association conference this week and as I listen to the amazing and knowledgeable presenters present on important topics, I often find myself going back to some basic core concepts of good therapy which are essentially basic core concepts of DIR.  I keep finding myself in conversations with people here that the most important thing that a counselor needs to do during the counseling process is to seek to understand the person they are with.  Understanding is the key.  As Dr. Greenspan said, "There is no greater feeling than the feeling of being understood".

Understanding builds bridges, reactions burn them.  

I can apply this to all sorts of situations.  

Parenting:  When a parent reacts to a child’s behavior, statements, thoughts, or way of being without seeking to understand them, it can create distance.  It can hurt the relationship.  It can result in the child feeling misunderstood and isolated.  We all do it sometimes.  It is hard not to react to something a child is doing or saying that feels disturbing and inappropriate.  But, by just reacting and not seeking to understand, we risk burning bridges instead of building them.  Our children need to know that we want to understand them.  Children, especially children with neurodevelopmental differences, often do not feel understood by others.  When people that love them react to their thoughts, the way their body is processing information, and their feelings in a negative way, they begin to encode an internal understanding that the way they are is bad.  I am not saying that some behaviors are not bad.  There are bad behaviors.  But, many of the behaviors our children exhibit are simply a way of coping and communicating.  They may be very poor attempts at coping and communicating, but nevertheless, that is often what they are.  Children desperately need to know that their parents understand them.  This understanding can help them weather the day-to-day challenges they face.  This understanding may not solve every daily problem or situation, but it will build the bridges necessary for your child to navigate their way over all the raging rivers they will face in life.  

Clinicians/Therapists:  It is easy to get caught up in our goals for a client.  It is easy to get focused on our therapeutic strategies and what is evidence-based.  It is easy to get lost in our agenda for the therapeutic process.  Remember, the best predictor of a positive outcome in therapy is the relationship between you and your client. Research has shown this to be true. It is not the technique you are using or how well you craft your written goals.  It is the relationship.  What is the most important part of that relationship?  It is that the client feels understood by you.  That they know you are willing to join with them to understand their existence.  To understand who they are and what struggles they are having.  Not to solve all their problems.  Not to fix them.  Not to teach them how to do something.  These all have a time and place, but these are not the key components to success.  The key is that your client feels totally and genuinely understood by you.

I could go on and on about this idea of how important understanding is.  I can apply this same quote to social justice issues.  I can apply it to suicide prevention (I will certainly write a blog on that soon).  I can apply it to world politics (I won’t dare write a blog on that anytime soon :)…but I should).  I can apply it to masking prevention (I did a presentation on this for PESI recently).  I can apply it to keeping marriages and long-term relationships together.   I can apply it to teaching in a classroom.  There are so many ways this simple idea can help us.  

Understanding builds bridges, reactions burn them.  

I'd love to hear your thoughts on this and if you have ways this can be applied.  

Meet Dr Emile Gouws & his lovely wife Sammi Gouws

 Recently I had the opportunity to speak at World Autism Awareness and Acceptance events in South Africa with ICDL's Board President, Dr. Emile Gouws.  We also were interviewed by a number of people, including for the below podcast.  I want to share this specific podcast with all of you so you can meet Emile and Sammi. I am excited by the impact ICDL is having internationally in advancing positive perspectives on development and learning.  When we do this well, we can support all people, including autistic people, to have meaningful experiences throughout the lifespan. 

Intensity Matters???

Historically, theorists, researchers, and practitioners alike have often presented that the intensity of therapy and therapeutic interactions for autistic children needed to be very high in order to get results.  While there is logic behind this guidance, we have been getting more information of late that the intensity may not need to be what we once thought. Nor may it need to be what therapy centers owned by equity firms may want it to be. 

What have we been learning?  Well, here is some information for consideration:

• Some DIRFloortime studies like the Solomon et al. (2014) and Pajareya et al. (2019) utilized around 12 hours a week and saw positive results.
• Rogers et al. (2021) compared 25 hours of ABA and ESDM to 15 hours and saw no significant difference in outcomes.  
• There isn't robust evidence that the benefits of early childhood interventions to young autistic children increase when those interventions are intensified (Sandbank et al., 2024).
• Autistic self-advocates are stressing that an autistic child needs time to be a child and everything the child is doing should not be therapy.  This can be seen in the Autistic Self-Advocacy Network’s For Whose Benefit?: Evidence, Ethics, and Effectiveness of Autism Interventions.
• Money may be a motivator for advocating for high intensity services.  You can read a telling article on the topic of equity firms that own therapy centers by clicking here. 
  

What do we get when we add up this emerging information?  We get an understanding that the high level of intensity that we once thought was needed, may not be needed.  In addition, when you consider the feedback from self-advocates, being in therapy all the time may also have negative consequences for the well-being of the child.  

In DIRFloortime practice, and in most of the studies that have been conducted on DIRFloortime, the hours of professional therapy is actually quite low.  Often it is about 2 hours a week or less.  The additional 12 to 20 hours that has been studied are therapeutic interactions provided by the caregivers.  

20 hours a week can be a lot for both the child(ren) and the caregiver(s).  Based on the emerging research and perspectives from autistic self-advocates, it seems we need to modify the old recommendation and adjust our recommendations to be about 12 hours a week instead of 20 or more.  It may be that we don't even need to get to 12, but there is no clear research to show how beneficial less than 12 is for autistic children.  Nevertheless, I have talked to many families that cannot get to 12 hours a week and they still have seen wonderful positive progression for there child when they utilize DIRFloortime.  

Part of it may not just be the implementation of DIRFloortime.  It may also be the embedding of DIR into the family culture.  For example, embedding a respectful and joyful focus on helping the children in the family grow and development in the context of their own authentic selves instead of fixing them or trying to make them look neuortypical may be as valuable as the actual therapeutic techniques that are used. 

Bottom line: What I always tell families is to go for 12 hours if you can.  See if you can get there. But remember, it all starts with one, and one is better than none!  

What makes us humans?

 

I just asked ChatGPT, “What makes us humans?”  Here was the response that was generated:

What makes us human is a mix of biological, cognitive, emotional, and social factors that set us apart from other species. Here are some key aspects:

1. Consciousness & Self-Awareness

We have a deep understanding of ourselves, our emotions, and our existence. We can reflect on our past, anticipate the future, and question our own purpose.

2. Complex Thinking & Problem-Solving

Humans can think abstractly, create complex ideas, and solve problems beyond immediate survival needs. We use logic, reasoning, and creativity to innovate.

3. Emotion & Empathy

We experience deep emotions like love, joy, sadness, and guilt. Our ability to empathize and connect with others emotionally is a core part of our humanity.

4. Language & Communication

Our ability to create and use language (both spoken and written) allows us to share complex ideas, preserve knowledge, and build civilizations.

5. Morality & Ethics

Humans develop moral values, a sense of right and wrong, and societal rules. We can act selflessly, consider the well-being of others, and make ethical decisions.

6. Creativity & Art

We create art, music, literature, and culture—not just for survival, but to express emotions, tell stories, and leave a legacy.

7. Relationships & Social Structures

Unlike many animals, humans form deep social bonds that go beyond survival. We build families, communities, and societies based on shared values and cooperation.

8. Curiosity & Innovation

Humans constantly seek knowledge, explore the unknown, and push boundaries. Our curiosity has led to scientific discoveries, space exploration, and technological advancements.

9. Imperfection & Growth

We make mistakes, learn, adapt, and grow. Our ability to recognize flaws and strive for improvement is a defining part of being human.

In short, being human is about thinking, feeling, creating, and connecting—with ourselves, each other, and the world around us.

I then searched the results for the word “behavior”.  Interestingly, but not surprisingly, behavior did not come up a single time in generating a definition of what makes us humans.  Rather, it was words like social, connection, communication, curiosity, thinking, emotion, empathy, imperfection and growth. 

In many ways, this is why DIR works so well.  It helps us, as imperfect humans, grow.  It is focused on human connections and how those connections actually help us expand our capacity for engagement, communication, problem solving, thinking, curiosity, and reasoning, to name a few.

While those that use ABA can measure outcomes easily, behaviors are not what makes us humans and changing behaviors is not the key to helping us grow and develop as humans.  Feeling and thinking are much more the areas we need to focus.  Feelings come first and as we feel the world around us and connect with others, we then develop and deepen our capacity for thinking in innovative, creative, unique, and meaningful ways.  All of these words, and each of the items ChatGPT highlighted relate to the developmental capacities that are described in DIR and are the core focus of all goals of DIRFloortime.  If you are a Floortimer, I am certain you will see particular Functional Emotional Developmental Capacities (FEDCs) clearly associated with each of the nine points ChatGPT gave for what makes us humans.  And if you are an ABAer, I am sorry to say that you won’t see behavior modification, extinction, or reinforcement in this definition of what makes us humans.  

DIR helps us grow and develop in the ways that make us humans.  ABA helps humans behave…but, that is not what makes us humans!