🚫 Escape Extinction

🔍 What It Is

Escape extinction is a behavioral intervention where a person is not allowed to leave, delay, or avoid a task or demand—even if they cry, protest, attempt to flee, or show distress. The goal is to reduce “escape-maintained behaviors” by removing the outcome (getting out of something unpleasant).

It’s most often used when someone refuses or avoids tasks like schoolwork, hygiene, or medical procedures.

📹 “Why Escape Extinction Can Be Harmful” – NeuroClastic (YouTube)
https://www.youtube.com/watch?v=jFbHhTmPj5c

🎯 Intended Use

Used for:

  • Task refusal

  • Work avoidance

  • Noncompliance with adult instructions

  • Avoidance of transitions, hygiene, meals, or medical care

📄 Autistic Self Advocacy Network – “What is Compliance?”
https://autisticadvocacy.org/2016/12/what-is-compliance/

📖 Ghaemmaghami et al., 2016 – “Promoting Consent Through Synthesized Reinforcers”
https://psycnet.apa.org/doi/10.1037/h0101321

⚙️ How It’s Implemented

  • Blocking the person from escaping

  • Repeating the demand until they comply

  • Physically guiding through tasks (often without consent)

  • Ignoring distress or escape attempts

📄 Hanley et al. – Practical Functional Assessment & Treatment
https://practicalfunctionalassessment.com/

📄 Behavior Babe – “Critical Reflections on Extinction”
https://www.behaviorbabe.com/extinction

📄 Learn From Autistics – “Rethinking Extinction”
https://www.learnfromautistics.com/rethinking-extinction-autistic-perspective/

🧪 Evidence Base

  • Pros: Reduces task refusal and avoidance in structured environments

  • Cons: Most studies do not measure emotional harm or long-term outcomes

  • “Success” is often defined as compliance, not well-being

📄 Jessel et al., 2016 – “Treatment Without Extinction”
https://psycnet.apa.org/doi/10.1037/h0101309

📄 Kupferstein, 2018 – “PTSD Symptoms in Autistic Adults Post-ABA”
https://link.springer.com/article/10.1007/s10803-018-3521-2

✅ Reported Benefits

  • Can suppress target behaviors quickly

  • Seen as effective in increasing compliance in structured settings

📹 “What ABA Looks Like When It Harms” – Autistic Adults Explain
https://www.youtube.com/watch?v=9Qg7zTxrfa4

📄 Neurodivergent Rebel – “Compliance Is Not the Goal”
https://neurodivergentrebel.com/2020/10/22/compliance-is-not-the-goal/

⚠️ Potential Side Effects / Harms

  • Escalation of distress (extinction bursts)

  • Physical restraint or forced compliance

  • Loss of autonomy and trust

  • Shutdown, trauma responses, or masking

  • PTSD symptoms and long-term relational harm

📹 Autistic Voices on Compliance Trauma (YouTube)
https://www.youtube.com/watch?v=U_nC9RKl9tE

📖 Devon Price – “The Trouble with Compliance (ABA)”
https://devonprice.medium.com/the-trouble-with-compliance-aba-5b7f3cfa8c48

📄 Kupferstein, 2018 – ABA and PTSD
https://link.springer.com/article/10.1007/s10803-018-3521-2

🧠 Ethical Considerations

  • Often implemented without informed consent or assent

  • Overlooks emotional regulation and underlying distress

  • Reinforces compliance over autonomy

  • Widely criticized by autistic adults and trauma experts

📄 Neurodivergent Insights – “Why I Left ABA”
https://neurodivergentinsights.com/blog/why-i-left-aba

📄 Lives in the Balance – CPS Model
https://www.livesinthebalance.org/

📄 ASAN – “What is Informed Consent?”
https://autisticadvocacy.org/2020/11/informed-consent/

🤝 Informed Consent Questions to Ask

  • Has the person consented to this procedure?

  • What happens if they resist or say “no”?

  • Are less intrusive options available?

  • Is emotional well-being being monitored?

  • What supports are offered instead of forced compliance?

📄 Assent-Based Consent Checklist (PDF)
https://selfdeterminationtheory.org/SDT/documents/2020_RethinkABA.pdf

📄 Trauma-Informed Alternatives to ABA – Ditch the ABA
https://www.ditchtheaba.com/trauma-informed-practices

🔄 Alternatives to Escape Extinction

  • Teaching communication (FCT)

  • Providing choices and negotiated demands

  • Gradual task shaping or systematic desensitization

  • Collaborative & Proactive Solutions (CPS)

  • Low-demand parenting and honoring refusals

📄 PFA Site – Assent-Based Practices
https://practicalfunctionalassessment.com/

📄 PDA Society – Low Demand Strategies
https://www.pdasociety.org.uk/what-is-pda/strategies/