The "chair", "table" and Applied Behavior Analysis

The past couple of weeks I have personally encountered several worrisome "ABA" situations. I put this in quotes because it is not therapy based on applied behavior analysis, although the people providing the services are claiming that it is.

These situations involve keeping a child in a chair under inappropriate circumstances. Here are the few examples that I have encountered either first-hand, or told to me by colleagues:

- Meeting a child for the first time, scooping them up by their elbows and sitting them in a chair.

- Placing a two year old child in a highchair, strapping them in, and let them cry for an hour while "therapy" is conducted.

- Having an 18-month-old child sit at a table and chair and begin identifying objects while crying.


These are troublesome because this is not how a child should ever be introduced to learning: by restraints, tears, and punishment. This will set a child up for building an aversion to teachers, therapists, and eventually people, not to mention that learning will not occur while a child is unhappy and screaming. It cannot be overstated how inappropriate these environments are.


Yes, in their therapy sessions, eventually a child will sit in chairs and work at the table, but this should not be done when a child is 2. The table and chair is not an appropriate environment for a two-year old child. The appropriate environment is the floor, their room, the playground, the backyard, etc., and sessions should be focused in these environments.


When a therapist first meets a child and family that they will work with, the most important thing to establish is a positive environment and rapport. This is usually done by bringing activities that might motivate and entice the child. The child will begin to associate the therapist with fun, play, and engaging activities. This will help the child associate the entire therapy environment, and learning in a positive manner.


Building and establishing rapport should take precedence over ANY structured programs. Much more will get accomplished if the child is in a positive environment that if filled with reinforcing people and activities. This might take several weeks, but it also might take longer and parents and therapists need to understand that this time is incredibly important and establishing this rapport is paramount.


Additionally, the focus of the first couple of weeks of session should be getting to know the child, performing assessments in the natural environment through observation of the child's interaction with family, people, and the environment. Language samples should be monitored. As the child becomes more comfortable and begins to get excited to see his therapists, more structured programs can be implemented. However, the majority of ANY session, with ANY age child, should not be at the table. This is a tool used in therapy, but not the only one, and certainly should not be the focus of an ABA program.


This is a challenge for many therapists and families. Many of us are married to the table, and find it challenging to pull away from the table and engage the entire environment that a child lives in. While challenging, it is necessary, and requires talented and creative therapists to be able to use all aspects of a child's environment.

Therapists will not leave the table on their own and may require training and coaxing to leave it. The table is easy. Sitting a child in a chair, once instructional control is established and running cards and programs, is easier than identifying learning opportunities in the natural environment. Training is necessary. Often natural environment instruction is perceived as playing in the natural environment and questioning a child on labels, colors and shapes in everyday objects. Natural environment teaching requires planning, programming, and data collection and monitoring.

The bottom line is that the child's instructional environment should from the beginning be positive and enjoyable. If the child is screaming when he sees a therapist, crying at the table, something has gone terribly wrong and must be changed. ABA therapy for children with autism does NOT equate discrete trial teaching in a chair at a table. The principles need to be applied to teach a child functional language and skills that will promote independence in his life. This should be done in any and all environments that a child will experience. Divorce the table.