Thank you for the very thoughtful and articulate response. There are quite a few insights which I had no idea re: regulation and certification. I hope my blog didn’t come across as too hyperbolic, and I in no way would ever want to disparage the actual therapists I’ve worked with, many of whom have been fantastic.

I think where I may have misrepresented my point is in stating that ABA doesn’t seek to improve itself. I don’t have a lot of visibility into the conferences or journals that drive the profession, and so with that I thank you for those points. My concern is that from a strictly business perspective the industry doesn’t seem to be scaling, evolving, or adapting to the consumer, either in terms of the patient or the parent. You mentioned the exorbitant costs of ongoing training and national certification, as well as the lack of inclusiveness of individuals on the spectrum as being challenges. As the demand for ABA services increase what I don’t see is an attempt to “scale” the model to make it cheaper or more effective. There is still a very “mom and pop” feel to most practices, and many still utilize pen and paper notebooks without adapting to technology that would streamline and simplify the processes. Due to my frequent battles with providers to obtain services, I’ve often seen financials that indicate a lot of waste and unnecessary overhead. I often joke that if the insurance would pay me directly I could probably establish a business model for just my son that would be cheaper and more consistent.

With regard to “ parent prerogative”, this is an area that I agree and didn’t want to get too deep into for fear that it might stir some ill feelings from of the autistic followers I have with those kinds of triggered memories of ABA. In general my son’s program is based upon his direction, as he’s demonstrated his maturity and responsibility to pursue appropriate skills. However, there’s that other 20% which I consider “admin”, usually a mix of manners and safety. This is one of those areas that as you mentioned, bleeds into general parental responsibility that most children don’t like, NT or otherwise. However, there was a time when my son would stim by shoving as many marbles in his mouth as he could fit. That was a HUGE safety issue and had to be addressed. In addition, we’ve known friends with children who self-harm, and that is obviously a top priority to address.

Thank you once again for your feedback. I really appreciate the wisdom you’ve shared here :)