Jonkman Kim M, den Hartog Charlotte, Sloot Bart, Begeer Sander, Back Elisa, Scheeren Anke M
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Academy Het Dorp, Arnhem, The Netherlands.
J Autism Dev Disord. 2025 Jul 18. doi: 10.1007/s10803-025-06958-x.
Applied Behavior Analysis (ABA) is a widely recommended intervention for autistic children, but it has recently been criticized because of its potential negative effects on mental health. This study aims to map experiences with ABA and related techniques in the Netherlands by investigating different types of ABA interventions, experiences and satisfaction levels, and explores variations across techniques and stakeholders. An exploratory sequential mixed methods design was employed, beginning with qualitative focus groups (n = 22) followed by a quantitative online survey (n = 219). Participants included autistic adults, parents/legal representatives, and healthcare professionals. Focus groups revealed six main themes: diverse interpretations of ABA, variations in its application, positive experiences, concerns about overburdening and psychological impacts, criticisms of the healthcare system, and quality control issues. Survey results indicated that satisfaction with ABA interventions varied, with autistic adults being less satisfied than parents and healthcare professionals. Positive outcomes included improved communication and independence, while negative experiences involved trauma and concerns about ethical application. Better quality interventions were associated with higher satisfaction levels. The study reveals diverse experiences and interpretations of ABA. Participants raised significant concerns that merit attention alongside the noted benefits of ABA. Improving training and ensuring ethical practices are crucial to maximize ABA's potential to positively impact the lives of autistic individuals. Future efforts should focus on enhancing regulation, standardization, and incorporating autistic perspectives to optimize outcomes.
应用行为分析（ABA）是一种被广泛推荐用于自闭症儿童的干预方法，但最近因其对心理健康的潜在负面影响而受到批评。本研究旨在通过调查不同类型的ABA干预、经历和满意度水平，描绘荷兰ABA及相关技术的使用情况，并探讨不同技术和利益相关者之间的差异。采用了探索性序列混合方法设计，首先进行定性焦点小组访谈（n = 22），随后进行定量在线调查（n = 219）。参与者包括成年自闭症患者、父母/法定代表人以及医疗保健专业人员。焦点小组访谈揭示了六个主要主题：对ABA的不同理解、其应用的差异、积极体验、对负担过重和心理影响的担忧、对医疗保健系统的批评以及质量控制问题。调查结果表明，对ABA干预的满意度各不相同，成年自闭症患者的满意度低于父母和医疗保健专业人员。积极结果包括沟通和独立性的改善，而负面体验则涉及创伤以及对道德应用的担忧。质量更高的干预与更高的满意度相关。该研究揭示了对ABA的不同体验和理解。参与者提出了重大担忧，这些担忧在ABA的显著益处之外值得关注。改进培训并确保道德实践对于最大限度发挥ABA对自闭症患者生活产生积极影响的潜力至关重要。未来的努力应集中在加强监管、标准化以及纳入自闭症患者的观点以优化结果。
