Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis

“…the framework of this intervention, specifically, if this interven - tion was informed by Applied Behavior Analysis (ABA), due to self-reported harm and research linking ABA treat-ment to posttraumatic stress symptoms (Kupferstein, 2018), and the harm caused by ABA (Sanvodal-Norton & Shkedy, 2019).”

“However, this approach is increasingly being contested in practice and from the autistic community, on the basis of being control based and potentially abusive and harmful (e.g., resulting in post-traumatic stress difficulties; Kupferstein, 2018; McGill & Robinson, 2020).”

“…around such expectations have been argued to inadvertently create pressure for participants to appear socially ‘typical’, reinforcing camou-flaging behaviours and stigma (Evans et al., 2024; Kupferstein, 2018; Petrolini et al., 2023, cf also see Roisenberg, Boulton, Thomas, & Guastella, 2025).”

“These practices are described by many Autistic adults as deeply traumatic and damaging to their sense of self (Cumming et al., 2020; Kirkham, 2017; Kupferstein, 2018; McGill & Robinson, 2021).”

“This has sometimes led to the patholo-gizing of all autistic behaviours that are away from the neuro-typical ‘norm’ along with the promotion of paternalistic and potentially harmful treatments [42] that seek to minimise perceived deficits through behavioural conditioning and medications.”

“…from people with IDD who received ABA and researchers, as being ineffective and harmful (Autistic Self Advocacy Network, 2023; Gardiner, 2017; Kupferstein, 2018; Magiati et al., 2007; McGill & Robinson, 2020; Shkedy et al., 2021; United States Department of Defense, 2019; Wilkenfeld &…”

“…can deny autistic people the opportunity to develop their self-understanding and self-advocacy, creating a lasting negative impact on their mental and physiological health in the long run (Kupferstein 2018). yet, autistic people are clearly not the only ones displaying repetitive behaviours.”

“There is controversy around forms of ABA ‘interventions’ for autistic people (e.g., Armstrong 2021; Broderick 2011; Chapman and Bovell in press; Chown, Hughes, Leatherland and Davison 2019; Cumming et al. 2020; kupferstein 2018).”

“Further, it has recently been suggested that participation in EIBI or ABA intervention is associated with Post Traumatic Stress Disorder in adults with ASD (Kupferstein, 2018).”

“However, more and more researchers are finding ABA to have abusive qualities and so are advocating for its abolishment from autism best practices (Kupferstein, 2018).”

“Maria Deptuła, Alicja Potorska i Szymon Borisch (2018) zwracają uwagę, że specjaliści pracujący z dzieckiem powinni przede wszystkim skupić się na poszukaniu odpowiedzi na pytania: co ja jako terapeuta mogę zrobić, by jednostka z niepełnosprawnością mogła rozwinąć swój potencjał?”

“Autistic-led and community-attuned research supports the concerns about ABA potentially causing excessive levels of compliance that may endanger autistic people (Sandoval-Norton and Shkedy, 2019), as well as PTSD from the “therapy” itself (Kupferstein, 2018).”

“…with ASD and proponents of neurodiversity have raised ethical concerns about certain behaviorally intensive practices, particularly regarding their potential to prioritize compliance over the identity, well-being, and self-determination of individuals with ASD (Anderson, 2023; Kupferstein, 2018).”

“This is especially important when interventions are intensive, behavior-focused, or insufficiently adapted to the child’s sensory and emotional needs [12,15].”

“Studies such as [33,37] report points of tension regarding the intensity of behavioral training, the risk of masking behaviors, and the potential emotional burden.”

“Kupferstein (2018) also notes an association between participation in ABA interventions and higher rates of posttraumatic stress disorder (PTSD) in some adults with ASD.”

“In contrast, techniques targeting autistic behaviors, such as Applied Behavioral Analysis, have been demonstrated to encourage camouflaging of autistic traits and exacerbate mental health symptoms [81,82].”

“Dr. Dannell Roberts, a licensed behavior analyst specializing in ABA-based behavioral treatments, says, “Historically, some ABA therapies used methodologies that were more punishment-based and rightfully have gotten a bad rap.”

“[54] PBS actively seeks to make Autistic people behave in a non-Autistic way, and the acceptance of such approaches is allowed – we argue – by the construction of discourse such as we have found here that portrays Autism as an abnormality.”

“IPA may also provide a tool to understand and respond to criticisms of behavior analysis that suggest that it involves ableism (e.g., Arthur et al., 2023), dehumanization (e.g., DeVita-Raeburn, 2016), or abuse (e.g., Kupferstein, 2018; see also a reply from Leaf et al., 2018).”

“…candidly spoken about the potential harm and danger (i.e., suicidality, Anderson, 2023; symptoms of post-traumatic stress disorder, Gardiner, 2017; Kupferstein et al., 2018; clinical depression, McGill & Robinson, 2020) they experienced owing to interventions designed to make them…”

“One scholar created an online survey of 26 questions, which included questions about both autism-specific and intervention-related questions [2].”

“When worrying behaviors such as mood, sleep and attention deficit disorders are exacerbated, persist, and closely match the criteria for PTSD, it should be considered that the person has experienced a catastrophic event (Kupferstein, 2018).”