Academics and practitioners historically have pointed to extensive scientific literature that, they claim, justifies the use of ABA. But in 2020, Andrew Whitehouse, a respected autism researcher, published a comprehensive review of the evidence for childhood autism interventions that raised questions about the quality of the evidence for autism treatments. Whitehouse and his coauthors evaluated 58 systematic reviews of autism interventions, which together contained 1,787 unique studies. Using a quality-appraisal checklist to evaluate the risk of bias for each review, they deemed 47 percent of the studies “low quality,” 41 percent “moderate quality,” and just 12 percent “high quality.” While the reviews, on balance, found that those who received behavioral interventions benefitted, the evidence underlying such findings was of low and moderate quality. Startlingly, Whitehouse found that only one of eight reviews of behavioral interventions discussed their potential harms or negative effects, though the one that did raise the issue reported no actual occurrences of such harms.

Soon after Whitehouse released his report, numerous clinicians, therapy providers, and professional organizations went after him. They complained to his employer about his research, threatened to sue him, and harassed his family members. Their desire to attack a scientist who exposed the shabbiness of this literature—rather than the generations of scientists who compiled a low-quality body of work—speaks to how little the field today is focused on successfully understanding autism. A whole credentialing apparatus—professional organizations, certification bodies, and college-degree programs—revolves around ABA. As long as parents and the public believe the therapy is scientific, the ABA apparatus can keep profiting.

So, are ABA’s benefits greater than its costs? Short answer: nobody knows.

[And no one will find out in this environment, either. That seems to be the point behind this reaction to what should be normal scientific skepticism and testing. And that’s certainly not the only area in which challenges to the established norm in science has been met with reactions that emulate cult reactions to orthodoxy rather than the scientific method. — Ed]