Questioning the growing use of an autism therapy that may be ineffective or harmful
Applied behavior analysis (ABA), a type of therapy for children with autism, is growing in popularity—often at kids’ expense, according to Harvard T.H. Chan School of Public Health’s Ari Ne’eman.
Ne’eman, assistant professor of health policy and management and an expert on autism and disability policy, was quoted in a Sept. 15 article in The74 about how ABA is crowding out more effective treatments for children with autism.
There is mounting evidence that ABA, a system of rewards and punishments aimed at eliminating certain behaviors, is frequently ineffective and often harmful. Private therapy centers often urge parents of children with autism to sign their kids up for as many hours as possible—up to 40 hours a week—regardless of their age or needs.
“I would argue that ABA is potentially harmful in any situation because we haven’t really addressed the ethical concerns of the potential mental health consequences,” Ne’eman told The74. “But even if we were to set that aside, the idea that there is an evidence base for applying ABA in all instances without regard to any consideration for age or the types of challenges that someone has, it’s just ludicrous.”
He added, “Forty hours a week of therapy is a full-time job for a 3-year-old. It’s harmful for kids and families first and foremost, but I also think it’s a poor use of public funds.”
The article noted that, amid lax federal and state regulation, a massive influx of private equity firms have capitalized on the autism therapy industry, acquiring 23 of the 50 largest ABA providers in the U.S.—and these providers have played a role in pushing the use of ABA. Over the course of six years, according to analysis by The74, Medicaid billing for ABA therapy was nearly $7 billion—$1 billion more than the U.S. has spent in 20 years on research and programs to improve autistic people’s lives.
“Private equity was attracted to ABA because the industry as a whole had set up a very tidy financial arrangement for itself,” Ne’eman said. “It’s not that private equity is corrupting a previously fine field. Private equity entered the field because of the flaws that were already there.”
Read article from The74:
Private Equity Is Cashing in on Autism Therapy. Children Are Paying the Price
Learn more
A research agenda to improve the lives of autistic people (Harvard Chan School news)
