By Emma Ryan | The Learning Garden
Let’s talk cultural considerations in ABA.
One day, I was supervising a session with a young boy who did not earn his reward (Google Maps). As he scored his own behaviors, he became increasingly upset. By the end, tears were streaming down his face. “I didn’t earn,” he said. “I didn’t earn Google Maps. I really need my Google Maps!”
To her credit, his BT very calmly acknowledged his feelings saying, “I know you really wanted Google Maps. I understand that you’re feeling sad.” The child sobbed, looked straight back at her, and said, “I’m not sad, I’m happy.”
This went right into my little notebook as a priority for this child’s program going forward.
I took a clinical approach, initially. I assumed that this deficit was a manifestation of the child’s Autism — a mismatch between affect and verbal output, or an inaccurate understanding of sadness as an emotion.
But my BT had a different, and very important, observation.
“His dad doesn’t think it’s okay for him to be sad,” she said. She explained that during a session she was running independently, the client became upset, and the client’s father repeatedly told him that he was okay, that he needed to be a big boy and not cry over something so little.
In other words, it wasn’t my clinical knowledge I needed to draw on first. It was cultural considerations.
This child is from a family whose culture values a machismo attitude. Any emotional vulnerability — especially crying, especially saying “I feel sad” — does not fit with how men and boys are expected to behave. This seven-year-old had learned that expressing sadness was not acceptable. So he did the only thing he could do: unable to control his bodily response, he denied that he was upset at all. He went even further, stating that he felt “happy.”
So here is my struggle: was the behavior I was observing a deficit to target? Or was it a cultural adaptation that I, as an outsider, didn’t have the understanding to effectively evaluate?
What Behavior Tells Us Depends on Who’s Watching
Here is a really tricky thing: behavior can be cultural. If you’ve ever visited a foreign country, you’ll probably have several examples of this. In Japan, you remove your shoes in many public spaces to show respect. If you tried this in the United States, you’d probably be asked to leave.
If I moved to Japan to practice as a BCBA, I could not teach my clients to leave their shoes on. It would be totally inconsistent with the variables at play: the antecedents presented suggest that everyone removes their shoes, the instruction given is to “please remove your shoes,” and the client would be met with punishing consequences — glared at, or asked to leave.
It’s all about the cultural context.
Our job, as BCBAs and special educators, is not to impose a single cultural standard of appropriate behavior. It is to examine cultural considerations carefully before developing a behavior plan — to be sure that the programs we implement will help the individual participate fully in their lives: with their families, their communities, and their culture.
For some behaviors, making these cultural considerations is simple and fairly self-explanatory. For others, it is very challenging.
Culturally Relevant Reinforcers
Anyone who has worked with individuals with ASD knows that praise does not always immediately serve as a reinforcer. However, in the United States, verbal praise is very common — and this is the reason we often teach it as a reinforcer, because most individuals will come into contact with it in the natural environment.
This is not true of all cultures. In some cultures, public praise can be extremely embarrassing and cause its recipient to feel ashamed. It is simply expected that the individual achieve their goals — any praise given is viewed as unnecessary.
Furthermore, if praise is not valued by the environment in which the individual spends the most time, they will likely not come into contact with it outside of sessions, and skills risk going unreinforced in the natural environment.
The most important implication: a practitioner must observe, ask, or — most preferably — both: “What does success look like in the context of this family and culture, and how is it typically acknowledged?” We must then communicate openly with families and work together on a reinforcement plan that is most likely to be maintained across environments.
Culturally Relevant Target Behaviors
This might be the most challenging part. Best practice is to involve families — and the client — in the skills chosen to be targeted. We, as practitioners, make choices based on clinical understanding and our sense of what skills an individual needs to be a productive member of society. But every time we choose a behavior for acquisition or reduction, we are making a value judgment about what is and isn’t appropriate. That value judgment needs to be informed by the family’s cultural values — not imposed on them.
Some questions that may help in creating more culturally considerate goals:
- Who decided this was a problem behavior — and through what cultural lens?
- Does the behavior the school or agency wants to target conflict with something the family values?
- Is the replacement behavior we’re planning to teach congruent with the family’s cultural norms?
- What is the best way to ensure that the family’s cultural expectations are met while guaranteeing that the individual’s safety, wellbeing, and progress are being prioritized?
Asking these questions before writing a single goal changes the entire process — and the next section describes what that looked like in practice.
What Culturally Responsive ABA Practice Actually Looks Like
Include families as genuine collaborators. Involve the family from the very beginning. Let them know that their input is valued and essential. As you develop the behavior plan, and throughout the process, consider asking:
- Are there behaviors we’ve identified as concerns that are not concerns at home?
- Are there behaviors we’re planning to teach that might feel uncomfortable or inappropriate within your family’s values?
- How do you typically express and respond to emotions in your home?
- How is praise given in your family?
- What does success look like for your child, in your family’s view?
Conduct culturally informed preference assessments. Find out what is motivating for the child in their family environment. These are the reinforcers that will likely be present for this child throughout their entire life — they are worth identifying carefully.
Consult and refer when needed. If you are unfamiliar with a family’s values and are unsure how to proceed, consult with others in the field. Do your research. Cultural humility includes knowing the limits of your own understanding.
“Sitting With It”
Culturally considerate practice sounds right until you are faced with a value that really contradicts your own. It’s important to sit with it.
When I learned that the father of this sweet, sensitive, tiny boy was telling him to “be a man,” I was heartbroken and angry. My personal values include emotional vulnerability and equal emotional expression for all genders. I was genuinely upset by this mismatch — and that’s okay.
But upon further reflection, I was grateful for a deeper understanding: my job is to help individuals find success in their families and communities. I just had to do more work to figure out what that meant for this child.
In my ideal world, the client would learn to say “I feel sad” or “I feel upset.” I hypothesized that this would lead to fewer explosive meltdowns, greater empathy, and increased confidence.
But I had to recognize that teaching a boy to say “I feel sad” — especially publicly, especially to an adult — may be directly in conflict with what his family is teaching him about what it means to be a man. Doing so would be confusing and harmful to the child.
So here’s what I did instead:
1. I consulted the family before selecting emotional expression as a target behavior. I spoke with the family and described the benefits of emotional identification in the context of emotional regulation. I described what I had observed during sessions.
2. I found out what emotional expression looks like within their cultural framework. This was very interesting — they reported that several family members have a tendency to “hold things in” and eventually having a larger, more explosive reaction later on.
3. I worked with the family to consider whether the goal was for the school, or for the family. In this case, the family ultimately agreed that having the student calmly label his emotions was preferable to a more drawn-out reaction.
4. I determined whether the goal was clinically necessary and worked with the family on how to make it as culturally responsive as possible. The family opted for the child to state his emotion quietly, then ask to find a private place where he could cry, if needed.
A Note on Other Cultural Considerations
Culture shapes many other aspects of behavior programming that deserve their own careful thought — physical affection and proximity, communication styles, volume and assertiveness norms, gender roles and expectations. I’ll be exploring eye contact specifically in an upcoming post, as it sits at the intersection of ABA practice, neurodiversity, and cultural context in ways that are worth a full conversation.
The Tearful Child
The child I mentioned at the beginning of this post? It was an ongoing process to determine the best course of action for him. But this is what matters most: that cultural considerations were taken, and that the best interests of the child were always at the center of the intervention.
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