What Is ABA Therapy? A Parents’ Guide To Ethical Alternatives For Autism Support

Medically reviewed by Melissa Guarnaccia, LCSW

Updated March 5th, 2025 by BetterHelp Editorial Team

Applied behaviour analysis (ABA) therapy has been a widely recognized approach to supporting children with autism spectrum disorder (ASD). However, its use remains controversial due to ethical concerns and criticism from individuals and advocates within the neurodiversity movement.

As more compassionate evidence-based alternatives emerge, UK parents have a range of autism therapy options to consider. This guide explores ABA therapy, its research and controversy, and an overview of research-backed alternatives to help parents make informed decisions about autism support.

A woman teaches a girl with glasses how to roll dough in a kitchen, surrounded by baking tools. — Getty/Chanin Nont

What is applied behaviour analysis (ABA) therapy?

Applied behaviour analysis (ABA) therapy is a behavioral intervention grounded in learning theory principles. The modality focuses on modifying behaviors to improve communication, social skills, and daily functioning in children. Applied behaviour analysis therapy is commonly used as a treatment for those diagnosed with autism spectrum disorder (ASD), and practitioners use various ABA programmes, such as verbal behaviour therapy or functional communication training, as part of treating clients. In the UK, several ABA schools offer ABA-based support to children and teens. Key principles of ABA therapy include:

Reinforcement: Encouraging positive behaviors by providing rewards
Shaping: Gradually teaching new behaviors through small, incremental steps
Extinction: Reducing undesired behaviors by removing reinforcement
Functional analysis: Understanding why a behavior occurs to address its root causes

Why is applied behavior analysis controversial?

While some people may support the use of ABA therapy for Autistic children and adults, this treatment remains controversial due to the historical use of aversive techniques, including physical punishments, its perceived focus on adherence over individuality, and criticism from the neurodiversity movement, which argues that it can undermine autonomy and identity. Because autism cannot be cured and is a lifelong condition, and, for some, an identity, some argue that applied behaviour analysis aims to erase one’s Autistic identity and make them act neurotypical (non-neurodivergent).

Historical practices of ABA have been harmful due to their underlying philosophies and impact on those with autism. Critics argue that some aspects of applied behaviour analysis practice — both past and present — may be unethical. Below are some of these controversies and reasons they are generally frowned upon.

Aversive techniques

The earliest forms of applied behaviour analysis therapy included the use of aversive techniques such as verbal reprimands and physical punishments — including electric shocks — to discourage unwanted behaviors. While these methods may have produced the desired behavior, they raised significant ethical concerns and often caused emotional distress. These behaviour management techniques are no longer widely used, as today’s behavior analysts typically prioritize ethical practices that focus on positive reinforcement.

Intensity of counselling

ABA programs can involve many hours of weekly one-on-one therapy, including repeated drills, structured lessons, and constant behavioral reinforcement. Although research indicates that higher intensities of early ABA intervention correlate with skill improvement, critics argue that intensive schedules may be overwhelming for families, particularly if the program does not allow for sufficient breaks, play, or opportunities for self-directed learning. In addition, children with autism may be comfortable without these behavioral changes, and hours upon hours of learning to act neurotypical can lead to extreme stress, trauma, and confusion for Autistic children.

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Focus on normalization over individuality

Another central point of contention lies in the underlying goal of ABA therapy to remove or change behaviors caused by someone being Autistic. Applied behaviour analysis therapy often focuses on adherence with social norms and suppression of autism-related behaviors, such as avoiding eye contact or stimming (i.e. repetitive behaviors that help people with autism self-regulate). Neurodiversity advocates view this treatment as dismissive of Autistic identity, and many argue that this approach prioritizes societal expectations over the well-being and autonomy of the individual. In addition, studies show that behaviors like not making eye contact may actually be beneficial to Autistic people, helping them remain able to cognitively function.

What research says about this intervention method

ABA therapy is often regarded as an evidence-based intervention for children with autism. Some studies showcase effectiveness in helping children develop communication, social, and adaptive skills, and improve cognitive performance. These findings have contributed to its widespread adoption and recognition as a standard treatment for autism.

However, the evidence for specific forms of applied behaviour analysis therapy, such as early intensive behavioral intervention (EIBI) and pivotal response treatment (PRT), is weaker. Research suggests that while these interventions may be effective for some children with autism, the overall quality of evidence is low due to methodological limitations, small sample sizes, and a high risk of bias.

Although ABA therapy may benefit some people, there are more evidence-based therapeutic options available that are less divisive and raise fewer ethical concerns. These newer, person-centered approaches aim to support developmental growth in a more individualized and compassionate manner, focusing on each child's unique needs.

Alternative UK options for autism interventions

For families seeking alternatives to ABA therapy, there are numerous compassionate and evidence-based approaches available in the UK. Many neurodiversity advocates suggest alternatives to applied behaviour analysis that focus on supporting children with autism in ways that respect their needs and autonomy while encouraging natural development. Research each modality and the therapists you consult before starting services, as the information below may not cover all aspects of a treatment’s efficacy or ethicality.

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DIR/Floortime

Developmental, individual-differences, relationship-based therapy (DIR or floortime therapy) focuses on building emotional connections, communication, and social skills through playful, interactive activities. Research shows that DIR Floortime often leads to significant improvements in emotional functioning, communication, daily living skills, and parent-child interactions.

Speech and language counselling

Speech and language therapy (SLT) may help Autistic children improve communication, social interactions, and daily functioning. One recent study, for example, found that SLT produced significant improvements in language skills such as articulation and comprehension and enhanced social abilities like initiating conversations and interpreting social cues. This type of therapy might also help with self-confidence, reduce behavioral challenges, and support adaptive skill development.

Occupational counselling

Occupational therapy (OT) for children with autism focuses on improving social participation, play, and daily routines. Research shows strong evidence for specific OT interventions in enhancing social engagement. These interventions might include the following:

Social skills groups: Structured group activities designed to teach Autistic children how to interact with others, interpret social cues, and build relationships in a supportive environment
Communication systems (e.g., picture exchange communication system): Tools that help children with autism communicate their needs and thoughts, often using pictures or symbols to support or replace verbal communication
Sensory integration therapy: Helping children with autism manage and respond to sensory input, such as sights, sounds, textures, or movement, that might be overwhelming or confusing to them

Play counselling

Play-based approaches use enjoyable, engaging activities to help children with autism develop social, emotional, and adaptive skills. In play therapy, Autistic children learn to interact and express themselves through toys, games, and activities. Although evidence is still limited, play therapy shows promise in supporting unique developmental needs and improving psychosocial well-being.

Parent-mediated counselling

Parent-mediated therapy trains parents and caregivers to use therapeutic techniques at home to support their child’s development. Parents play an active role in this approach, naturally integrating various therapeutic methods into everyday life. Research shows strong evidence for parent-mediated therapy in improving speech, social skills, play, daily life skills, and managing autism-related challenges.

Cognitive-behavioural therapy

Cognitive-behavioural therapy (CBT) may help children with autism address social-emotional challenges through structured, goal-oriented techniques. Research shows that CBT can improve some autism-related challenges, with noticeable progress reported by parents, teachers, and clinicians. However, children and teens themselves may not always recognize these changes. While more definitive trials are needed, CBT shows promise for enhancing emotional regulation and reducing autism-related difficulties.

Building a support network for families of children with autism

Families navigating the challenges of autism often benefit from building a support network that offers emotional and practical support, as well as professional help and community-based services. If you are caring for a child or young person with autism, consider the following resources:

Local parent support groups: Connect with other families who understand your experiences
Online forums and communities: Share advice and gain insights from a broader network
Autism charities: Seek resources, events, and training from groups like Child Autism UK and the National Autistic Society
Professionals and experts: Build relationships with therapists, educators, and healthcare providers
Community events: Attend autism-friendly activities to meet other families and professionals
Advocacy efforts: Participate in autism awareness events and programs

A man and a woman seated at a table with coffee and a laptop appear to be in a video call. — Getty/bernardbodo

Online mental health support for parents

For some parents, supporting a child with autism can be overwhelming, and research suggests that parents of Autistic children often experience higher levels of stress, depression, anxiety, and adverse health outcomes. Mental health support, including cognitive behavioral therapy, mindfulness and relaxation techniques, and acceptance-based therapies, has proven effective in reducing stress and improving mental well-being for caregivers of autistic children.

If you’re busy at home and struggle to make an in-person appointment, online therapy with a platform like BetterHelp may be more accessible. With an online platform, you can connect with professional therapists specializing in these therapeutic approaches and attend weekly virtual therapy sessions via phone, video, or live chat. Online therapy is known to be as effective as in-person therapy and may be preferable for caregivers with busy schedules. Online therapy may also be helpful for Autistic adults who prefer an at-home method of support.

Takeaway

While modern ABA therapy practices might work for some people, parents concerned about the ethical implications of its methods may want to explore alternatives that prioritize compassion, individuality, and the unique needs of their child. Families may also consider building a support network of professionals and other families navigating similar challenges. For mental health guidance, consider reaching out to a therapist online or in your area.

Frequently asked questions

Below are some questions frequently asked about this topic.

Is applied behaviour analysis (ABA) therapy effective for children with autism?

ABA counselling is often regarded as an effective method for helping Autistic children develop skills, including communication, social interaction, and daily living tasks. However, applied behaviour analysis remains controversial due to ethical concerns and its historical and current practices. For this reason, more evidence-based modalities may be beneficial alternatives.

How much does ABA therapy cost in UK areas?

Costs for services like ABA therapy can depend on which therapist and program you select. For example, attending an applied behaviour analysis school might cost more than meeting one-on-one with a board-certified behaviour analyst. Because applied behaviour analysis often involves long hours, it is generally considered more expensive than traditional therapy and other autism support options. In some cases, families might meet with a registered behaviour technician, who is not a therapist but has been trained in programs like early intensive behavioural intervention, which has also been considered a controversial treatment option by organizations like the National Autistic Society.

How do you become an ABA therapist in the UK?

Behaviour analysts and therapists typically achieve a bachelor’s degree in a human sciences field before getting postgraduate certification in ABA through an external program, such as Child Autism UK. However, although ABA therapy practices may be somewhat changed from historical practices, applied behaviour analysis is still considered a potentially harmful option. Instead, individuals might consider getting certified in a modality with more evidence-based and person-centred practices to benefit a child’s progress.

Is ABA or CBT better for autism?

ABA and CBT have both been used to teach self-help skills, help a child evolve positively, and target challenging behaviours. However, applied behaviour analysis has been associated with more controversy due to potential harm it can cause in children and young adults with autism. CBT is an evidence-based modality with years of social proof in supporting children with learning disability-related challenges, autism, and other developmental disabilities.

Many modalities exist that parents can explore when looking for a treatment for an Autistic child. For advice on ethical treatments that support a child’s strengths, look to external groups and organizations like the independent expert advisory group of the National Autistic Society for their valuable input and lived experiences. As UK society continually strives to look for improved autism support options, amplify Autistic voices in conversations about ensuring practices of counselling are ethical and meet specific needs of those they claim to serve.

Can you do ABA instead of school?

Families cannot replace a child’s required schooling with ABA due to laws and values led by the UK government to ensure all children get schooling. However, some families choose schools that focus on applied behaviour analysis counselling and follow the UK SBA’s Public Protection Act, a review resulting proposed actions to ensure all applied behaviour analysis practitioners follow strict ethical guidelines within the UK. Alternatives to ABA-focused schools include special education schools, occupational therapy, and other support services not focused on behavioral intervention.

At what age is ABA therapy most effective?

Some providers may recommend ABA before age four. However, because of the intensity of counselling programs and their goals, some Autistic advocates recommend other options, especially those that do not require over 40 hours weekly of “training.” Autistic children may become overwhelmed by extensive efforts before age four, which might contribute to distress and trauma for that child. Strengths-focused and person-centered therapy is often considered more ethical.

Why is ABA therapy controversial?

ABA therapy is controversial because of its history of causing trauma for Autistic individuals through long hours of behavioral intervention, often aimed toward changing an Autistic person to behave in more neurotypical ways. Some symptoms of autism, such as lack of eye contact, difficulty verbalizing, and positive stimming, do not harm an Autistic child but are often focused on as “problem behaviors” in applied behaviour analysis, leading to unnecessary distress in children to make them act more neurotypical for those around them.

Is ABA therapy covered by insurance?

ABA counselling is not often covered by UK insurance. In some cases, this option is covered by educational grants. However, insurance may more frequently cover evidence-based alternatives to applied behaviour analysis that provide counselling and a person-centered approach to support. In addition, psychotherapy can be accessed through the NHS.

What is the success rate of ABA therapy?

ABA therapy studies are still in infancy, so no single success rate has been reported. In addition, smaller studies often contain more bias. For this reason, more evidence-based modalities, such as CBT and occupational therapy, may be helpful when seeking treatments for a child with autism.

What is the difference between IEP and ABA?

An individual education plan (IEP) is a plan put in place in a child’s school to offer a child support from behavioral specialists, teachers, mentors, and case managers as needed for their unique needs. Some children with an IEP may get extra support with organization skills, whereas others may take specialized classes instead of working with standard classes and teachers. IEPs are individualized and depend on a child’s needs. IEPs are not a form of therapy, though a child may receive counseling or mental health support through a plan. Applied behaviour analysis is a form of behavioral intervention and is not always offered in a school setting.

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