Can ABA and Neurodiversity-Affirming Speech Therapy Actually Work Together?
That’s exactly what I wanted to dig into with my guest Linda, a bilingual SLP and BCBA and recipient of the SPABA Communicator Award. And her answer might surprise you.
What we talked about
Linda’s opening move was to separate two things that often get tangled: ABA as a science, and ABA as it’s been applied in the past. The science of how humans learn — reinforcement, behaviour function, motivation — is neutral. It doesn’t have an agenda. The problems people rightly criticise came from how that science was applied: with compliance as the goal, without respect for the child’s experience, without any concept of consent.
Neurodiversity-affirming practice, meanwhile, is an approach — a values framework that says we accept neurological difference as variation, not deficit. The key insight Linda shared: these two things don’t conflict. A good behaviour analyst and a good neurodiversity-affirming therapist are both asking the same question: “What does this child need to thrive — on their own terms?”
Three things that stuck with me
1. Intervention isn’t the opposite of acceptance.
One of the most important things Linda said: accepting neurodiversity doesn’t mean we do nothing when a child is hurting themselves. If a child is hitting hard surfaces because they need deep sensory input, the goal isn’t to stop the behaviour — it’s to understand its function and offer a safer alternative that meets the same need. That’s not compliance training. That’s care.
2. The 80/20 rule changes the feel of a session.
If you’ve spent any time in speech pathology spaces online, you’ve probably seen the debate. On one side: parents and advocates who’ve had harmful experiences with ABA and want it nowhere near their children. On the other: clinicians who swear by behavioural science as the most evidence-based tool they have. So where does that leave you — a parent, a therapist, someone trying to do right by the kids in front of you?
Linda described a session structure that I think a lot of parents would recognise as feeling different from traditional therapy. Eighty per cent of the time, the therapist follows the child’s lead — joining their play, modelling language, building momentum. Twenty per cent introduces a targeted, slightly higher-demand task. The ratio shifts as the child progresses. What this means in practice: sessions that feel less like drills, and more like play with a clear purpose.
3. Assent is non-negotiable — and it’s not just about words.
Assent-based practice means continuously checking whether the child is actually okay with what’s happening. For non-speaking children, that means reading the body: eye contact, proximity, reaching out — those signal comfort. Turning away, pushing hands, crying — those signal dissent. The moment you see dissent, you stop. Full stop. Linda was clear: a therapist’s flexibility in that moment is what builds the trust that makes learning possible later.
What you can do with this
If you’re a parent: when you’re evaluating therapy for your child, these questions are worth asking. Does the therapist follow your child’s lead for most of the session? Do they talk about what your child is communicating through their behaviour — not just trying to stop it? Do they notice and respond when your child seems uncomfortable?
If you’re a therapist: Linda’s framework is a useful pressure-test. Ask yourself — is compliance the goal, or is quality of life the goal? Those aren’t always the same thing.
If ABA feels like a dirty word in your circles, this episode is worth a listen. The science isn’t the problem. How we use it — and who we centre in the process — that’s what matters.
Listen to the full episode at blackburnslp.com.au/resources | Follow Chloe: @phd.speechie.mum
ABA同神經多元友善做法，可唔可以共存？
如果你係言語治療師，或者你係一個自閉症孩子嘅家長，你一定喺網上見過呢個爭論。一邊係有過不愉快ABA經歷嘅家長，覺得ABA傷害過自己嘅孩子。另一邊係臨床工作者，覺得行為科學係最有實證基礎嘅工具。咁你，究竟應該點睇？
今集我請咗Linda——一位雙語言語治療師同BCBA，亦係SPABA Communicator Award得主——一齊研究呢個問題。佢嘅答案，可能會令你出奇。
今集我哋傾咗啲乜
Linda首先劃分咗兩樣嘢：ABA作為一門科學，同ABA過去嘅應用方式。人類學習嘅科學原理——強化、行為功能、動機——本身係中性嘅。問題唔係科學本身，係舊式ABA嘅應用方式：以服從為目標，唔尊重孩子嘅感受，完全冇同意（consent）嘅概念。
而神經多元友善做法，係一套價值觀框架——接受神經差異係多樣性嘅一部分，而唔係缺陷。Linda嘅核心見解：呢兩樣嘢唔係對立嘅。一個好嘅行為分析師同一個好嘅神經多元友善治療師，問緊同一個問題：「呢個孩子需要乜嘢，先可以喺自己嘅條件下好好發展？」
三個令我印象深刻嘅重點
1. 介入唔係接納嘅對立面
Linda說得好清楚：接受神經多元，唔係話我哋喺孩子傷害自己嘅時候袖手旁觀。如果一個孩子因為需要深層感覺輸入而撞頭，目標唔係停止個行為——係理解個行為嘅功能，然後提供一個安全嘅替代方案，滿足到同樣嘅需求。呢個唔係服從訓練，係真正嘅關顧。
2. 80/20法則改變咗治療嘅質感
Linda描述咗一個session結構：80%時間跟住孩子行——加入佢哋嘅遊戲、示範語言、建立動力。20%時間引入針對性、稍微有挑戰性嘅任務。隨著孩子進步，比例會調整。呢個結構嘅意思係：session感覺唔係操練，而係有目的嘅遊戲。
3. Assent係不可妥協嘅——而且唔只係靠講話
Assent-based practice係指持續確認孩子係咪真係OK。對於唔講話嘅孩子，就要讀身體：眼神接觸、靠近、伸手——呢啲係舒適嘅信號。轉身、推開你隻手、喊——呢啲係拒絕嘅信號。一見到拒絕嘅信號，就要停。Linda說得好直接：治療師喺嗰一刻嘅靈活性，係日後建立信任、令學習成為可能嘅基礎。
你可以點做
如果你係家長：評估治療師嘅時候，問呢幾個問題。治療師大部分時間係跟住孩子行嗎？佢哋有冇討論孩子嘅行為係在「表達乜嘢」，而唔只係想停止個行為？佢哋有冇留意到孩子唔舒服嘅時候作出回應？
如果你係治療師：Linda嘅框架係一個好嘅自我檢查工具。問自己——我嘅目標係服從，定係生活質素？呢兩樣唔一定係同一回事。
完整節目收聽：blackburnslp.com.au/resources｜追蹤Chloe：@phd.speechie.mum